Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CAUSTICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 991 records · Page 55Linked to original sources
PubMed2001

Esophageal reconstruction for hypopharyngoesophageal strictures after corrosive injury.

OBJECTIVE: To evaluate the surgical outcome of patients with caustic stricture of the hypopharyngoesophagus. MATERIALS AND METHODS: During a 25-year period, we performed esophageal reconstruction in 152 patients with diffuse or multiple caustic esophageal stricture. Of them, esophageal substitute was pulled up and anastomosed to the hypopharynx in 50 (33%) patients, and anastomosed to the cervical esophagus in the other 102 (67%) patients. Patients whose esophageal substitute anastomosed to the hypopharynx were enrolled to the present study. Among these 50 study patients, 13 underwent ablation of damaged organs and feeding jejunostomy in acute stage of corrosive injury, and the remaining 37 patients were initially organ preserved with or without feeding gastrostomy or jejunostomy. Six patients had respiratory distress caused by laryngotracheal stricture. The ileocolon (28/50) was commonly used as an esophageal substitute in reconstruction and most substitutes (43/50) went through the substernal route. RESULTS: There was one operative death. Eight (16%) patients had major early postoperative complications. Six patients underwent revision for late stenosis of hypopharyngeal anastomosis, and one redoing reconstruction using the jejunum because of failure of the transplanted ileocolon. Postoperatively, swallow function and maintaining body weight were considered good in 42 patients (84%) after an average of 8 months follow-up. Five of six patients who underwent concomitant tracheostomy or laryngosurgery for laryngotracheal stricture got unsatisfactory result. The surgical outcome of the study patients was worse than that in patients with esophageal substitute anastomosed to a healthy cervical esophagus. In the later group of patients, 95/102 (93%) had good swallow function and only 7/102 (6.8%) had major early complications. CONCLUSION: Caustic stricture of the hypopharyngoesophagus is a challenging reconstructive problem. A successful reconstruction requires a correct hypopharyngeal opening and anastomosis, a good esophageal substitute, and a patent esophageal route and airway.

Adolescent↗
PubMed2002

Balloon catheter dilatation in children with congenital and acquired esophageal anomalies.

BACKGROUND/PURPOSE: Esophageal stricture requiring dilatation often is the sequelae in children with a history of congenital or acquired esophageal anomalies. Balloon catheter dilatation (BCD) for esophageal stricture is well established in adults, yet its role in children is less well described. The authors report their initial experience using BCD in children with esophageal stricture, assessing outcome. METHODS: Between January 1994, and December 1998, 20 children (age range, 17 days to 12 years) underwent BCD for esophageal strictures and were divided into 2 etiology groups (A and B). (A, n = 10) included congenital anomalies (esophageal atresia, 10), and (B, n = 10) included acquired anomalies (caustic ingestion, 7; tight fundoplication, 2; peptic stricture, 1). BCD was performed in all cases under conscious sedation with a balloon catheter (6 to 25 mm) with fluoroscopy. Outcome parameters included number of dilatations; complications, ie, perforation; and success or failure of procedure. Success was defined as increasing intervals of age-appropriate food tolerance between dilatations, and failure was defined as abandonment of dilatation in favor of surgical intervention. Follow-up for A and B ranged from 6 to 42 months. RESULTS: Seventeen of 20 (85.0%) underwent successful BCD. In A, 10 of 10 (100%) had complete resolution of symptoms with follow-up ranging from 6 to 42 months versus 7 of 10 (70.0%) in B with follow-up of 6.5 to 36 months. In A, number of dilatations ranged from 1 to 4 over an average period of 2 months. In B, number of dilatations ranged from 3 to 40 over periods ranging from 2 to 30 months. All 3 failures occurred in children with caustic ingestion, with 1 child suffering perforation requiring urgent surgical intervention. CONCLUSIONS: Balloon catheter dilatation can be applied safely and effectively to children in whom esophageal strictures develop after repair of esophageal atresia. However, its use in children with acquired esophageal anomalies, notably caustic injury, is associated with higher complication and failure rates, necessitating greater caution and lower expectations.

Catheterization↗
PubMed2003

Management of esophagogastric corrosive injuries in children.

There has been an increase in the number of patients admitted to our hospital with caustic esophageal injuries during the last five years. The aim of this study was to analyze the complications and results of the treatment of corrosive esophagogastric injury. Between 1990 and 2000, 120 caustic ingestion accidents were admitted to our unit. The mean age was 4 years, with a 2 : 1 male to female ratio. The average time between the caustic ingestion and admission to hospital was 14.9 days. The ingested substances were alkali in 80.9 % and acid in 19.1 % of the cases. Stenosis of the esophagus developed in 31 (25.8 %) and gastric outlet obstruction (GOO) in 6 (5 %) patients. Management of the esophageal stricture consisted of dilatation in 28 patients. Three children underwent colonic interposition without a dilatation attempt. Six children were lost to follow-up; 4 patients were successfully treated; 13 patients were still in the dilatation program at the time of writing with 6 improving and 2 patients waiting for interposition surgery; 4 patients underwent colonic interposition and 1 patient underwent resection of the stenotic part of the esophagus. Among the patients in the dilation program, we observed 4 esophageal perforations. Three of them were treated medically and further dilatations were carried out, while one was managed by colonic interposition. The treatment modalities for GOO cases consisted of pyloroplasty in 3, Billroth I in 2 and balloon dilation of the pylorus in 1 child. Although balloon dilatation of the esophagus carries the risk of perforation, it should be the first line of treatment in suitable cases. GOO cases may require surgical therapy following a detailed endoscopic evaluation.

Acids↗
PubMed1998

Evaluation of recycled HDPE milk bottles for food applications.

The possibilities of recycling milk-contaminated HDPE were investigated. Bottles were blown of respectively untreated, caustic-washed and caustic-washed/steam-stripped/air-dried recycled material. The migration characteristics of the different bottles were compared using various food simulants, as well as their sensorial and mechanical properties. From the analytical and sensorial experiments, it was shown that the untreated and caustic-washed recycled material could not be considered as a food packaging material. A high number of compounds able to migrate were detected, causing an off-flavour which could easily be recognized. The steam-stripped recycled material however, seemed to perform almost as well as its corresponding virgin material. Only low amounts of compounds able to migrate could be detected, resulting in a packaging material characterized by excellent sensorial properties which could not be distinguished from its virgin material. Furthermore it was proved that the mechanical properties of the recycled material did not change during the recycling process.

Air↗
PubMed2002

Wavefronts and waveforms in deep-water sound propagation.

A new method of calculating waveforms in underwater sound propagation is presented. The method is based on a Hankel transform-generalized Wentzel-Kramers-Brillouin (WKB) solution of the wave equation. The resulting integral leads to a new form of ray theory which is valid at relatively low frequencies and allows evaluation of the acoustic field on both the illuminated and shadow sides of caustics and at cusps where two caustics meet to form a focus. The integral is evaluated by stationary phase methods for the appropriate number of stationary points. Rays of nearby launch angle which have a travel time difference less than a quarter period must be considered together. The description of all other ray arrivals corresponds to simple ray theory. The phase, amplitude, and travel time of broadband acoustic pulses are obtainable directly from a simple graph of ray travel time as a function of depth at a given range. The method can handle range dependence but is illustrated here in long-distance propagation in deep water where the ray paths do not pass close to surface or bottom. The method is fast and gives close agreement with normal-mode calculations. The field on the shadow side of a caustic is properly given in terms of rays with complex launch angles, but good approximations can be obtained without the need to find complex rays.

Journal Article↗
PubMed2003

Role of the tunneling ray in near-critical-angle scattering by a dielectric sphere.

The scattering far zone for light transmitted through a sphere following p - 1 internal reflections by a family of near-grazing incident rays is subdivided into a lit region and a shadow region. The sharpness of the ray theory transition between the lit and the shadow regions is smoothed in wave theory by radiation shed by electromagnetic surface waves. It is shown that when higher-order terms in the physical optics approximation to the phase of the partial-wave scattering amplitudes are included, the transition between the lit and the shadow regions becomes a two-ray-to-zero-ray transition, called a superweak caustic in analogy to the more familiar scattering caustics and weak scattering caustics. One of the merged rays is a tunneling ray.

Journal Article↗
PubMed2003

Analysis of specular resonance in dielectric bispheres using rigorous and geometrical-optics theories.

We have recently identified the resonant scattering from dielectric bispheres in the specular direction, which has long been known as the specular resonance, to be a type of rainbow (a caustic) and a general phenomenon for bispheres. We discuss the details of the specular resonance on the basis of systematic calculations. In addition to the rigorous theory, which precisely describes the scattering even in the resonance regime, the ray-tracing method, which gives the scattering in the geometrical-optics limit, is used. Specular resonance is explicitly defined as strong scattering in the direction of the specular reflection from the symmetrical axis of the bisphere whose intensity exceeds that of the scattering from noninteracting bispheres. Then the range of parameters for computing a particular specular resonance is specified. This resonance becomes prominent in a wide range of refractive indices (from 1.2 to 2.2) in a wide range of size parameters (from five to infinity) and for an arbitrarily polarized light incident within an angle of 40 degrees to the symmetrical axis. This particular scattering can stay evident even when the spheres are not in contact or the sizes of the spheres are different. Thus specular resonance is a common and robust phenomenon in dielectric bispheres. Furthermore, we demonstrate that various characteristic features in the scattering from bispheres can be explained successfully by using intuitive and simple representations. Most of the significant scatterings other than the specular resonance are also understandable as caustics in geometrical-optics theory. The specular resonance becomes striking at the smallest size parameter among these caustics because its optical trajectory is composed of only the refractions at the surfaces and has an exceptionally large intensity. However, some characteristics are not accounted for by geometrical optics. In particular, the oscillatory behaviors of their scattering intensity are well described by simple two-wave interference models.

Journal Article↗
PubMed2005

Enhanced radionuclide immobilization and flow path modifications by dissolution and secondary precipitates.

Caustic radioactive wastes that have leaked at Hanford Site (Richland, WA) induce mineral dissolution and subsequent secondary precipitation that influence the fate and transport of contaminants present in the waste solutions. The effects of secondary mineral precipitates, formed after contacting solids with simulated caustic wastes, on the flow path changes and radionuclide immobilization were investigated by reacting quartz, a mixture of quartz and biotite, and a Hanford sediment (Warden soil: coarse-silty, mixed, superactive, mesic Xeric Haplocambids) with simulated caustic tank waste solution. Continuous Si dissolution and concomitant secondary mineral precipitation were the principal reactions observed in both batch and flow-through tests. Nitrate-cancrinite was the dominant secondary precipitate on mineral surfaces after 3- to 10-d reaction times in batch experiments. X-ray microtomography images of a reacted quartz column revealed that secondary precipitates cemented quartz grains together and modified pore geometry in the center of the column. Along the circumference of the packed column, however, quartz dissolution continuously occurred, suggesting that wastes that leaked from buried tanks in the past likely did not migrate vertically as modeled in risk assessments but rather the pathways likely changed to be dominantly horizontal on precipitation of secondary precipitate phases in the Hanford vadose zone. Based on batch equilibrium sorption results on the reacted sediments, the dominant secondary precipitates (cancrinites) on the mineral surfaces enhanced the sorption capacity of typical Hanford sediment for radionuclides 129I(-I), 79Se(VI), 99Tc(VII), and 90Sr(II), all of which are of major concern at the Hanford Site.

Adsorption↗
PubMed1999

[Esophageal reconstruction using the stomach in children].

The authors present an account of their experience with oesophageal replacement by gastric transposition in 10 children during the period between November 1992 and January 1999. Indications for oesophageal replacement was in seven children atresia of the oesophagus at the age of 9-36 months and in three children (2.5, 3 and 14 years) a long stricture of the oesophagus after caustic injury which did not respond to balloon dilatation. Replacement after caustic injury was made in children aged 2.5, 3 and 14 years. In eight patients the replacement was made without thoracotomy, by blunt resection of the mediastinum, in two patients after caustic injury thoracotomy had to be performed. In three patients after surgery a temporary fistula developed at the site of anastomosis which healed spontaneously. Eight patients are in a satisfactory condition after surgery, one patient five months after operation swallows with difficulty, his birth weight was 1500 g. One female patient died one year after oesophageal replacement, apparently due to aspiration and respiratory arrest. Gastric transposition is a considerate and relatively simple method in child age. The functional results are favourable.

Adolescent↗
PubMed2003

Phosphate recovery from sewage sludge in combination with supercritical water oxidation.

Supercritical Water Oxidation (SCWO) is an innovative and effective destruction method for organics in sewage sludge. The SCWO process leaves a slurry of inorganic ash in a pure water phase free from organic contaminants, which opens possibilities for a simple process to recover components like phosphates from the sewage sludge. In a continuous pilot plant for the SCWO process digested sludge has been treated. The ash has been extracted in lab scale with both caustic and acids in order to recover phosphates. By leaching the ash with caustic, 90% of the phosphorus could be separated as a sodium phosphate solution. By treating the sodium phosphate solution with lime, calcium phosphate was precipitated and caustic recovered and circulated back to the leaching process.

Agriculture↗
PubMedDate not supplied

[Indications for esophageal replacement in children].

Esophageal substitution in children is required in several types of esophageal atresia, as well as following strictures caused by caustic ingestion or peptic esophagitis. Nowadays, two main types of procedures are used for esophageal replacement: colon segment esophagoplasty (that seems to be preferred by most pediatric surgeons) and gastric tube esophagoplasty. The paper presents the personal experience in the management of a series of 56 children with esophageal replacement, during the last 10 years. In 46 patients, the stricture cause was caustic ingestion, while peptic esophagitis accounted for 3 cases. The remaining 7 cases were long-gap esophageal atresias that could not be managed by primary neonatal anastomosis. The results are rated as good in 42 cases. Complications occurred in 13 cases, while fatal outcome occurred in 5 patients. The most remarkable feature of the series is the high number of procedures required after caustic ingestion.

Adolescent↗
PubMed1992

Deaths from poisoning in Barcelona (Spain), 1986-1989.

Between 1986 and 1989, 3226 violent deaths were recorded in Barcelona, 489 of which were due to poisoning. The yearly distribution of these 489 deaths was: 1986, 74; 1987, 98; 1988, 134; and 1989, 183. Of all poisoning deaths, 316 were due to narcotic opiates use, 54 to the inhalation of toxic gases, 49 to the use of psychoactive agents, 37 to caustic products and the others 33 cases to various toxic agents (insecticides, methanol, solvents, mushrooms, etc.). Opioid use is currently the leading cause of death by poisoning in Barcelona, and affects a young population with a mean age between 25 and 27 years. In the groups corresponding to toxic gases and psychoactive drugs, the mean ages are 48 and 45.7 years, respectively. The oldest population was found in the group where death was caused by caustic agents, where the mean age is 56.5 years. The male sex was predominant in all groups except that of caustic agents, where 56.8% of the victims were women. This study confirms the notable increase in opiate- related deaths in the city of Barcelona (up from 27 cases in 1987 to 158 in 1989) and shows stability in the numbers for the other groups. Among the different hypotheses concerning of this remarkable increase in deaths related to opiate use, the aging of consumers and changes in the purity or composition of the product seem to be the most probable.

Adolescent↗
PubMed1995

[Hydrogen peroxide-induced lesions in the digestive tract. Apropos 4 cases].

Gastrointestinal injury caused by caustic products a are relatively infrequent, occurring mainly in the upper gastrointestinal tract. Accidental ingestion accounts for most of the cases, and the severity and extent of damage produced, depends on the composition and volume of the caustic agent ingested; endoscopy is a safe and effective diagnostic procedure. We report four unusual cases of caustic injury of the gastrointestinal tract due to hydrogen peroxide, two cases due to oral ingestion and another two due to the accidental administration of enemas, there was a good clinic and endoscopic recovery with conservative treatment.

Accidents, Occupational↗
PubMedDate not supplied

[Treatment with Savary-Gilliard bougies in esophageal stenosis in children].

30 patients (less than 15 years old) were admitted for esophageal strictures, 16 of them secondary to corrosive injury. All the patients were treated with endoscopic dilatation with Savary-Gilliard bougie. The dilations were done with general anesthesia using an Olympus GIF-XP10 endoscope and with fluoroscopic control. In the esophageal stenosis secondary to caustic ingestion endoscopic injection with Betamethasone was also used. The most frequent site of the stenosis was the upper third of the esophagus, and the main type of stenosis was tubular in the secondary to caustic burns and annular in the other group. In the post-caustic group 385 dilations were performed in 115 sessions. In the other group 159 dilations were done in 51 sessions. Two perforations and one sepsis were reported in patients with corrosive stenosis. There was no mortality. 43.7% of the patients with corrosive stenosis and 85.7% with stenosis secondary to other causes obtained complete healing. Esophageal dilation with Savary-Gilliard bougies represents a safe and reliable method for the treatment of esophageal strictures.

Adolescent↗
PubMed1985

A case-control study of renal cancer mortality at a Texas chemical plant.

An in-plant case-control study of 26 renal cancer deaths was conducted to determine whether an occupational exposure may be related to an apparent increase in mortality from this disease observed among a sample of employees at a multiple process chemical production facility. None was found that explained the excess. Elevated odds ratios were identified for employment in the cell maintenance area of chlorine production and with those presumptive exposures considered to occur in this job, asbestos and caustic, but not chlorine. While an association between renal cancer and asbestos has been previously reported, an association with caustic, per se, is not consistent with prior observations made by others. Diminished risk estimates were observed for employment in magnesium production and for exposures in this process to sulfur dioxide and heat. Both the increased and decreased risks, while statistically significant, are based on small numbers of exposed subjects and may be spurious owing to the problem of multiple comparisons.

Adult↗
PubMed1978

Local injuries by accidental ingestion of corrosive substances by children.

Own data and analysis of previous publications show that situations where accidental ingestion of corrosive substances by children may have happened are frequent, but severe corrosive esophagitis leading to perforation or stricture formation is very rare. In case of suspected esophageal injury, esophagoscopy and glucocorticoid treatment become necessary. The evaluation of the initial symptoms in patients from our own material and from the literature indicates that all children with serious esophageal burns had one or more of the following symptoms: visible burns in the oral cavity, hypersalivation, retching, vomiting, retrosternal or epigastric pain, cardiovascular collaps, airway stenosis. Hence, children with an uncertain history of ingestion and without any of these symptoms need not be treated. After ingestion of liquid substances, but never of dry or granular products, lesions in the esophagus without accompanying burns in the oral cavity were observed. The evaluation of 1158 cases of accidental ingestions of several types of household products and a collection of data from the literature on the causticity of these substances shows that cleaners containing mainly detergents and phosphates (with pH values generally between 9 and 11), and household bleaches on sodium hypochlorite basis, are relatively harmless. Drain cleaners (NaOH), decalcifiers (formic acid) and detergents for automatic dish washing machines (metasilicates) are very caustic and are responsible for the majority of serious accidents in children.

Accidents, Home↗
PubMed2006

Oesophageal substitution with free and pedicled jejunum: short- and long-term outcomes.

In children, the indications for oesophageal substitution are principally, long gap oesophageal atresia (OA), severe anastomotic disruption following primary repair of OA and severe caustic or peptic strictures. We present an outcome review of eight cases who underwent oesophageal substitution with jejunum at our institution between 1986 and 2001. The purpose of this study was to evaluate our experience with free/pedicled jejunal grafts and its long-term outcome as an oesophageal substitute. Operative and postoperative outcome with free and pedicled jejunal grafts in four cases of pure OA, two cases of OA and distal tracheo-oesophageal fistula (TOF), one patient with a high retrolaryngeal oesophageal web and one case of severe caustic oesophageal stricture. Six patients had an oesophagostomy and a gastrostomy fashioned previously. Eleven free jejunal grafts were performed in six patients (three intraoperative redo interpositions for immediate graft loss, three separate grafts in one patient and two free grafts in two patients). One patient's pedicled jejunal graft proximally required microvascular anastomosis while the other had a pedicled graft without microvascular anastomosis. Early postoperative complications included four upper anastomotic leaks (three free grafts, one pedicled with microvascular support), pneumothorax requiring prolonged ventilation and Horner's syndrome. Recurrent laryngeal nerve injury occurred in the patient who had a high retrolaryngeal oesophageal web. During follow up (5-18 years) late complications of upper anastomotic stricture in four patients and graft redundancy with subsequent kinking of the lower anastomosis were observed in one patient. Three patients established a complete oral diet; a further three patients relied on supplemental gastrostomy feeds and one patient is entirely gastrostomy fed. There were two late deaths, one from aspiration and the other from a severe asthmatic attack (5 and 7 months postoperatively, respectively). Our results indicate that there are significant complications related to the use of free jejunal grafts. Early recognition and treatment are of paramount importance in the ultimate achievement of a successful technical outcome.

Adolescent↗
PubMed1995

Experimental models of tracheobronchial stenoses: a useful tool for evaluating airway stents.

BACKGROUND: Stent implantation is a conservative alternative to open operation for treating benign tracheobronchial strictures. Most of the presently available stents were primarily designed for endovascular use. Their respiratory use entails a risk of iatrogenic complications. From a scientific and from an ethical point of view these risks justify preclinical evaluation of new respiratory stents in experimental models of central airway stenoses. Therefore, an attempt was made to develop such models in piglets and adult minipigs. METHODS: Tracheal stenoses were obtained by creating first a segmental tracheomalacia through extramucosal resection of cartilaginous arches. The fibrous component of the stenoses was then obtained through bronchoscopic application of a caustic agent causing progressive deep mucosal and submucosal injury. Stenoses of the main bronchi were created by topical application of the caustic agent only. RESULTS: These models demonstrated the typical features of benign fibromalacic tracheobronchial stenoses with constant recurrence after mechanical dilation. Preliminary experiments showed that short-term problems of tolerance of stent prototypes are easily demonstrable in these models. CONCLUSIONS: These experimental models, which simulate quite realistically human diseases, offer the opportunity to perfect new tracheobronchial stents specifically designed for respiratory use and to evaluate their long-term tolerance before their use in humans.

Animals↗