Surgical aspects of esophageal disease: perforation and caustic injury.
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Treatment of corrosive injuries of the esophagus remains largely unsatisfactory, and severe esophageal burns still frequently result in stricture with accompanying morbidity or death. The nine patients presented here with 3-year follow-up accidentally drank a concentrated alkaline solution. All were teenagers or young adults who drank from the same bottle while at a party. The problems encountered in these patients led us to conclude that all patients with moderate to severe corrosive injury of the esophagus should have assessment of the entire esophagus and stomach at the time of initial assessment. Six patients underwent diagnostic laparotomy and one underwent thoracotomy as well for assessment of his esophageal injuries. Had we followed the traditional approach of esophagoscopy only to the level of the first circumferential burn, more severe and potentially life-threatening injuries would have been missed. Early endoscopic evaluation of the esophagus and stomach remains the standard for diagnosis; however, complete assessment may require laparotomy or thoracotomy. Early resection of necrotic tissue in the esophagus or stomach can lead to increased survival.
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The role of polyoxyethylene lauryl ether (POELE), a nonionic surfactant, in removing bovine serum albumin (BSA) and catechin from polyethylene terephthalate (PET) particles was quantitatively studied. Relatively large fractions of adsorbed BSA and catechin were removed from PET particles under weak alkaline conditions below pH 9, whereas cleaning with high concentrations of NaOH was not so effective, especially on the removal of BSA. This was attributed to the lower susceptibility of PET particles to water-based alkali (OH-) cleaning because of the lower degree of the polarity of PET surfaces. The combined use of NaOH solutions of moderate pHs and POELE could successfully improve the efficiency of cleaning of PET particles without a significant dissolution of PET materials. There was a good correlation between the lowered surface tension (7) of the NaOH solution with POELE and the removal efficiency of BSA or catechin. No effect of POELE was observed on the NaOH cleaning of hydrophilic alumina (A12O3) particles fouled with BSA. It could be concluded that the role of POELE in NaOH cleaning of PET particles was to lower the gamma of the NaOH solution and hence to facilitate penetration of OH- ions into the PET-BSA and PET-catechin interfaces.
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It is the purpose of the study to assay the effect of intrabiliary injection of scolicide agents most frequently used in clinical practice. Fifty-five albino rats are divided up into 4 groups according to type of solution injected, as follows: control group A--with physiological saline, B--20 per cent natrium chloratum, C--10 per cent povidone iodine, and D--3 per cent hydrogenium hyperoxidatum. Histological assessment of extrahepatic bile ducts and liver parenchyma are conducted at 10 and 90 days of treatment. Lesions along with cholestatic and reparative changes are documented, most markedly expressed after injecting 20 per cent NaCl, rather weakly--after 10 per cent povidone iodine, and least pronpunced after injecting 3 per cent hydrogen peroxide. Periductal sclerosis is noted in three rats only injected with hypertonic saline. The experimental results are analyzed, and clinically relevant inferences reached.
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