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At least 1,153 records · Page 64Linked to original sources
PubMed1996

Early operation for severe corrosive injury of the upper gastrointestinal tract.

OBJECTIVE: To describe our experience of treating severe corrosive burns of the upper gastrointestinal (GI) tract. DESIGN: Open study. SETTING: Teaching hospital, France. SUBJECTS: 18 patients who had swallowed an alkaline substance (caustic soda in 10 cases) and 4 who had swallowed either hydrochloric or sulphuric acid. INTERVENTIONS: Endoscopy was done a mean of 4 hours after the substance had been swallowed. 10 patients underwent oesophagogastrectomy without thoracotomy. MAIN OUTCOME MEASURES: Morbidity and mortality. RESULTS: 4 of the 10 patients died and 3 developed postoperative complications. Of the 12 patients treated by feeding jejunostomy 7 developed stenosis that required operation and 3 developed stenosis that responded to dilatation. None of the 12 died. CONCLUSIONS: Early oesophagoscopy allowed optimal management. Patients died if they swallowed more than 60 ml of a strong alkaline substance. When patients are treated conservatively about half will develop stenoses that require operation.

Acids↗
PubMed1997

Acute poisoning due to alkalis used during industrial cleaning of soft drinks' glass containers: a case report.

Corrosive alkalis are used in the soft drink and beer industries for the cleaning of the non-disposable glass containers using several different methods. It is well understood that complete cleaning of these vessels by multiple and well-organized rinsing is an absolute necessity. In cases of disturbance of this process, some residuals of alkaline agents may be retained in the glass containers, causing severe health risks to consumers. This case of acute poisoning due to caustic alkalis concerns a young woman who consumed carbonated lemonade from a non-disposable glass container. Clinical signs and symptoms and the treatment of the affected woman are described. Toxicological analysis of the soft drink consumed led to the detection, identification and quantitative determination of the presence of the alkalis.

Adult↗
PubMed1997

Indications, new surgical technique and results of colon interposition or bypass in esophageal surgery.

Over a 5-year period, 29 patients with esophageal disease underwent colon interposition or bypass. The indication was cure of cancer in 11 patients, who underwent earlier a gastric resection. Other indications was benign stricture in 7 patients, bypass for unrespectable cancer in 6, having a caustic injury in 3 and after an esophageal perforation in 2. In 14 patients the left colon, in 15 the right colon was used. The colon was transected without dividing the mesentery other than just along its mesenteric border. This preserves additional blood supply from the marginal artery, also improves the function of the graft in transporting food. Anastomosis leakage occurred in 4 cases (13.7%). Graft necrosis occurred in 2 of 29 patients, one of whom alter underwent a successful second reconstruction. The 30 day operative mortality rate was 13.7%. A colon interposition provides good quality of deglution, and is the organ of choice for patients who require an esophageal substitute and are potential candidates for long survival, or when the stomach is unsuited for replacement or bypass.

Anastomosis, Surgical↗
PubMed2002

Consequences of using escharotic agents as primary treatment for nonmelanoma skin cancer.

BACKGROUND: The use of escharotic or caustic pastes to treat skin cancer is based on the centuries-old observation that selected minerals and plant extracts may be used to destroy certain skin lesions. Zinc chloride and Sanguinaria canadensis (bloodroot) are 2 agents that are used as part of the Mohs chemosurgery fixed-tissue technique. The use of escharotics without surgery has been discredited by allopathic medicine but persists and is promoted among alternative practitioners. Patients may now purchase "herbal supplements" for the primary self-treatment of skin cancer, and physicians will see patients who elect this therapy for their skin cancers. OBSERVATIONS: We reviewed the history of escharotic use for skin disease and performed an Internet search for the availability and current use of escharotics. Our search located numerous agents for purchase via the Internet that are advertised as highly successful treatments for skin cancer. We report 4 cases from our practice in which escharotic agents were used by patients to treat basal cell carcinomas in lieu of the recommended conventional treatment. One patient had a complete clinical response, but had a residual tumor on follow-up biopsy. A second patient successfully eradicated all tumors, but severe scarring ensued. A third patient disagreed with us regarding his care and was lost to follow-up. One patient presented with a nasal basal cell carcinoma that "healed" for several years following treatment elsewhere with an escharotic agent but recurred deeply and required an extensive resection. The lesion has since metastasized. CONCLUSIONS: Escharotic agents are available as herbal supplements and are being used by patients for the treatment of skin cancer. The efficacy of these agents is unproven and their content is unregulated. Serious consequences may result from their use. Conventional medicine has an excellent track record in treating skin cancer. Physicians should recommend against the use of escharotic agents for skin cancer, and the Food and Drug Administration should be given the authority to regulate their production and distribution.

Administration, Topical↗
PubMed1980

Sterile hypopyon following intraocular lens surgery.

Energy-dispersive x-ray analysis (EDXA) was used to study nine intraocular lenses from one manufacturer. Residual polishing compound was found on two of three dry-sterilized lenses from a "hot lot" associated with a high incidence of sterile hypopyon. Similar material was not present on normal lenses. This polishing compound was apparently fused to the lens surface, preventing its removal by ultrasonic cleaning. In addition, three wet-sterilized lenses were found to be covered with small crystals containing barium. These crystals apparently resulted from leaching of the glass storage vial by the caustic storage fluid. It is suggested that some cases of sterile hypopyon following intraocular lens surgery may be caused by residual polishing compound present on the lens surface.

Anterior Chamber↗
PubMed1977

Treatment of corrosive burns of the esophagus.

Forty patients with caustic ingestion have been treated between 1955 and 1975. Strong alkali was the corrosive in 95%, and 80% were under 10 years old. Early esophageal stricture developed in 18 patients four weeks after lye ingestion. Among these, esophageal bougienge restored an adequate lumen in two patients with short, soft annular strictures, and right colon interposition was used for esophageal subsitution in ten who had long, dense strictures. We recommend early diagnostic esophagoscopy, to the uppermost level of burn injury only, to determine the presence and severity of the esophageal injury. If esophagoscopy reveals esophageal burn injury, corticosteroid and antibiotic therapy are continued. If no burn injury is visualized, the patient is spared unnecessary treatment. Long, dense strictures unresponsive to bougienage place the patient at risk from instrumental perforation, and these patients should undergo colon interposition through a substernal extrapleural tunnel.

Adolescent↗
PubMed2001

Endothelial cell apoptosis is inhibited by a soluble factor secreted by human colon cancer cells.

In contrast to normal tissues, tumors are exposed to adverse environmental conditions, such as hypoxia and acidity. Despite this caustic environment, tumor cells and supporting vascular structures survive the latter, providing nutrients and oxygen to facilitate tumor growth. Therefore, we hypothesized that cancer cells express factors that protect endothelial cells from apoptosis. Human umbilical vein endothelial cells were grown in serum-free medium or in medium conditioned by either human colon cancer cells or non-malignant cells. Endothelial cells grown in medium conditioned by colon cancer cells demonstrated a decrease in apoptosis, whereas endothelial cells grown in medium conditioned by non-malignant cells did not. Erk-1/2 phosphorylation increased when endothelial cells were incubated in medium conditioned by colon cancer cells but not when cells were incubated in medium conditioned by non-malignant cells. Protein fractions from medium conditioned by colon cancer cells that were < 3 kDa protected endothelial cells from apoptosis and activated Erk-1/2. Heat-inactivated conditioned media did not protect endothelial cells from apoptosis and did not activate Erk-1/2. Human colon cancer cells secrete a soluble factor or factors that inhibit endothelial cell apoptosis. This factor is likely to be a protein or protein fragment because it loses its activity after heat inactivation. These studies support the hypothesis that tumor cells can alter the phenotype of endothelial cells.

Antibodies↗
PubMed2002

An improved formulation of SYPRO Ruby protein gel stain: comparison with the original formulation and with a ruthenium II tris (bathophenanthroline disulfonate) formulation.

SYPRO Ruby protein gel stain is compatible with a variety of imaging platforms since it absorbs maximally in the ultraviolet (280 nm) and visible (470 nm) regions of the spectrum. Dye localization is achieved by noncovalent, electrostatic and hydrophobic binding to proteins, with signal being detected at 610 nm. Since proteins are not covalently modified by the dye, compatibility with downstream proteomics techniques such as matrix-assisted laser desorption/ionisation-time of flight mass spectrometry is assured. The principal limitation of the original formulation of SYPRO Ruby protein gel stain, is that it was only compatible with a limited number of gel fixation procedures. Too aggressive a fixation protocol led to diminished signal intensity and poor detection sensitivity. This is particularly apparent when post-staining gels subjected to labeling with other fluorophores such as Schiff's base staining of glycoproteins with fluorescent hydrazides. Consequently, we have developed an improved formulation of SYPRO Ruby protein gel stain that is fully compatible with commonly implemented protein fixation procedures and is suitable for post-staining gels after detection of glycoproteins using the green fluorescent Pro-Q Emerald 300 glycoprotein stain or detection of beta-glucuronidase using the green fluorescent ELF 97 beta-D-glucuronide. The new stain formulation is brighter, making it easier to manually excise spots for peptide mass profiling. An additional benefit of the improved formulation is that it permits staining of proteins in isoelectric focusing gels, without the requirement for caustic acids.

Animals↗
PubMed2005

Colour remediation of pulp mill effluent using purified fungal cellobiose dehydrogenase: reaction optimisation and mechanism of degradation.

Cellobiose dehydrogenase purified from two different fungal sources was assessed for its ability to remove and/or reduce colour from pulp mill bleach plant effluent. Cellobiose dehydrogenase purified from Phanerochaete chrysosporium was shown to prefer acidic conditions and was consequently used to treat the acid effluent stream discharged from a pulp mill bleach plant, while an analogous enzyme originating from Humicola insolens preferred alkaline conditions, and was applied to the effluent discharged from the caustic sewer of the bleach plant. Both enzyme preparations were able to remove colour from their respective effluent sources to a comparable extent. Up to 50% of the effluent colour was removed within 4 days when treated under optimised conditions. Furthermore, it was also shown that this enzymatic approach was effective at removing colour generated by both softwood and hardwood resources. Mechanistically, it was shown that colour was removed from all molecular weight fractions, and the higher molecular weight material (>300 kDa) was concurrently preferentially degraded. Cellobiose dehydrogenase treatment of effluent did not target phenolic, stilbene, or alpha-carbonyl structures, but did affect the quinone content. Further investigations using model compounds confirmed these results, and subsequently showed that only the para-quinones with low substitution were reduced with cellobiose dehydrogenase.

Ascomycota↗
PubMed1987

Effective management of extremity cancers using cisplatin and etoposide in isolated limb perfusions.

Four cases of extremity cancers received effective management with cisplatin and etoposide via isolated limb perfusion. They demonstrated minimal, if any, soft tissue damage. This result counters the theory that a caustic response is a prerequisite for successful therapy. This characteristic allows for simultaneous surgical resection with regional, isolated limb perfusion of potent cytotoxic agents without increased morbidity from tissue necrosis, a common consequence of previously used drugs. There is no apparent affect on wound healing, even in cases involving extensive, radical operative procedures.

Aged↗
PubMed2003

Late-onset respiratory distress after inhalation of laundry detergent.

Accidental poisoning with household cleaning products can pose significant risks to children. Exposure to granular laundry detergents accounts for a number of calls each year to poison control centers, though few of these exposures result in hospitalization. While caustic gastrointestinal injury resulting from ingestion of these highly alkaline cleaning agents is well-recognized, few reports address the potential damage to the respiratory tract that can occur following ingestion or inhalation of granular laundry detergent. We present a previously healthy 1-year-old who presented to the emergency department with Late-onset stridor and increased work of breathing following presumed inhalation of granular laundry detergent. Parents, primary care providers, and emergency department physicians need to be aware of the potential toxicity of these widely used household products.

Administration, Inhalation↗
PubMed2005

Developing a game plan for good sportsmanship.

It is widely believed in the United States that competition is beneficial for youngsters. However, the media are full of examples of players, fans, and coaches whose behavior veers out of control. There have been well-documented examples of youth in livestock competitions illegally medicating show animals to make them appear calmer, officials biasing their rulings toward a team that will take the most fans to a playoff game, and team rivalries that have become so caustic as to be dangerous for competitors and fans. A university extension and its partners created a program called "Great Fans. Great Sports." in order to teach the kinds of behaviors we wish to instill among all who are involved in competitions. It requires entire communities to develop and implement plans for enhancing sportsmanship in music, debate, drama, 4-H, and other arenas, as well as sports. The goal is to make good sportsmanship not the exception but the norm. The authors provide anecdotal evidence that "Great Fans. Great Sports." is having a positive impact on the attitudes and behaviors of competitors, fans, and communities.

Adolescent↗
PubMed1986

The outcome of colonic replacement of the esophagus in children.

An analysis of 112 children undergoing colonic replacement of the esophagus over a 30-year period is presented. The indication for esophageal replacement was atresia in 92 children and intractable stricture (peptic, caustic, or congenital) in 20. The procedure consisted of a transthoracic replacement of the entire esophagus in 82 cases and a partial replacement in 18, while a retrosternal replacement was used in ten cases. Two colon loops had to be abandoned prior to reconstruction due to irreversible ischemic damage. There were 15 deaths (13.4%)--all in the atresia group. Failure of the colonic graft was encountered in 16 patients (14.3%) and accounted for six of the deaths. Leakage of the proximal esophago-colonic anastomosis occurred in 54 cases (48.2%). Strictures of this anastomosis developed in 34 cases (30.3%). A total of 20 patients required operative revision of the anastomosis. The final outcome was excellent in 43 of 77 cases followed up for up to 24 years postoperatively (55.9%), good in 27 cases (35%), and only fair in seven cases (9.1%).

Adolescent↗
PubMed1993

Etiology of intoxication: a study of 557 cases.

Our results were obtained from the emergency service at Elche General Hospital, which covers an adult population of 275,076 inhabitants. We studied intoxicated patients aged 15 years and above, during 1988. Our aim was to investigate the etiological and epidemiological circumstances of intoxications. We obtained a prevalence of voluntary cases (61.6%) over accidental cases (38.3%), with self-poisoning being more frequent than drug addiction, in the first group and animal stings being more frequent than domestic or occupational intoxication in the second. Mortality resulted in 1.6% of cases; the etiology of the highest mortality was self-poisoning and the most common toxic substances were caustic substances.

Accidents↗
PubMed1995

Can the morbidity of esophagectomy be reduced by the thoracoscopic approach?

Esophagectomies have a high morbidity rate, mainly related to pulmonary complications. The aim of this work was to assess whether the thoracoscopic approach could reduce this morbidity. We have made a prospective study of the results of 29 attempts of esophagectomy using a right thoracoscopic approach. There were 20 males and 9 females having an average age of 47. The indication was a squamous cell carcinoma in 22 patients, an adenocarcinoma in 1 patient, a melanoma in 1 patient, and a caustic stenosis in 5. The whole esophagus was mobilized thoracoscopically and the esophagectomy was completed through the abdomen. The reconstruction was achieved using a gastric pull-through and a cervical anastomosis. There were five failures for the following reasons: unresectable carcinoma (one case), large tumor making a thoracoscopic dissection unsafe (two cases), and incomplete lung collapse making the exposure of the posterior mediastinum difficult (two cases). The average time of the thoracoscopic procedure was 135 min. The postoperative course was uneventful in all but five patients who had a pulmonary complication: atelectasis (three cases), right purulent pleural effusion (one case), acute respiratory disease syndrome (one case). The latter complication was lethal. Four out of five respiratory complications occurred in patients for whom the dissection was considered difficult. Among the other complications, there were five anastomotic leakages and three cases of laryngeal nerve palsy. The mortality rate was 3.8%. These initial results do not show a real benefit of the thoracoscopic approach for esophageal dissection, especially with respect to difficult esophagectomies. Further evaluation of the technique is needed.

Adenocarcinoma↗
PubMed1986

Acute fatal selenium poisoning. Toxicological and occupational medical aspects.

Neutralizing selenic acid with caustic soda caused a hyperintensive exothermic reaction, with about 450 1 of the reaction mixture erupting in a factory hall. A 44-year-old industrial worker was fatally intoxicated, suffering from second-degree skin burns, necrosis of oral mucous membranes and hemorrhagic lung edema. He died 90 min later. Analysis of body fluids and tissue samples showed high selenium concentrations in blood serum, urine, stomach content and lungs. The analytical results are discussed in comparison with normal selenium levels of non-exposed groups.

Adult↗
PubMedDate not supplied

Video-assisted endoscopic esophagectomy with stapled intrathoracic esophagogastric anastomosis.

Thoracic esophagus was usually removed through the transhiatal approach or via an open thoracotomy. The long incision and spreading of the ribs usually resulted in much pain and interference with chest wall mechanics. Today, with the development of a video-assisted endoscopic procedure, many intrathoracic lesions can be removed through small incision. Since March 1992 we have attempted 20 esophagectomies and reconstruction using a right thoracoscopic approach in 16 males and 4 females whose average age was 56 years. Indications for its use were esophageal cancer in 17 patients (squamous cell carcinoma in 12 patients, adenocarcinoma in 5) and caustic stenosis in 3. It is our impression that video-assisted endoscopic esophagectomy and reconstruction potentially causes less trauma, less postoperative discomfort, and a rapid functional recuperation. Our initial experiences showed that it is a feasible, effective procedure.

Adenocarcinoma↗
PubMed1995

Multiple brain abscesses following esophageal dilation.

A 6-year-old boy esophageal stricture due to the ingestion of caustic 7 months prior to admission. Eight esophageal dilations and a feeding gastrostomy were performed. He presented with seizure, right-sided weakness, fever, and somnolence. Computed tomographic scans revealed multiple brain abscesses. The abscesses were treated by burr-hole drainage. The patient improved and was discharged from the hospital without neurological deficit. Brain abscesses are not very common following esophageal dilation. It should be kept in mind that brain abscess is a potential complication of esophageal dilation.

Brain Abscess↗