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At least 1,207 records · Page 67Linked to original sources
PubMed1992

A comparative analysis of two models of colitis in rats.

Two models of colitis produced in rats that have received significant attention over the past few years are the acetic acid and trinitrobenzene sulfonic acid (TNBS) models. The objective of this study was to quantify and compare the temporal relationship among mucosal permeability, epithelial injury, and inflammation induced by acetic acid, ethanol (vehicle), ethanol plus TNBS (unbuffered, pH 1.0), and ethanol plus TNBS (pH 7.4). Data obtained show that the inflammation induced by these four irritants results from caustic injury to the colonic epithelium and interstitium as measured by the rapid and dramatic increases in mucosal permeability and tissue water content as well as by histological analysis. The injurious nature of TNBS was confirmed in a separate series of studies showing that buffered TNBS (pH 7.4), in the absence of ethanol, is toxic to cultured rat intestinal epithelial cell monolayers. Only after 1-2 days of the initial insult, were signs of classical inflammation observed, including increases in colonic myeloperoxidase activity (neutrophil infiltration) and colon weight as well as hyperemia and mucosal ulcerations. Although ethanol plus TNBS (pH 1.0 or 7.4) tended to produce higher mucosal permeabilities (epithelial cell injury) at 1-2 weeks after the enemas than acetic acid or ethanol groups, only the ethanol plus TNBS (pH 7.4) permeabilities were found to be significantly enhanced. In addition, all four groups showed significant elevations in colonic myeloperoxidase activity and colon weight at 1-2 weeks after enema. It is suggested that these models of colitis are useful to study events that occur at the time of inflammation and repair. However, these models may have significant limitations in understanding events that initiate inflammation of the intestine in human inflammatory bowel disease.

Acetates↗
PubMed1993

Wet cement: a poorly recognized cause of full-thickness skin burns.

Cement is a rare cause of full-thickness burns. We have examined the aetiology, frequency and severity of these burns, and assessed public awareness of the potential of cement as a caustic agent. Of patients, 95 per cent were unaware of the potential of cement to cause burns, and none had seen precautionary warnings on cement bags or delivery dockets. Factors important in burn production appear to be alkalinity, duration of contact and the abrasive nature of the cement particles. It is concluded that doctors, especially casualty officers, should know of the potential of progressive full-thickness burns from wet cement. General public awareness should be increased. The cement manufacturers were asked to comment on the content of this paper.

Adult↗
PubMed1984

The challenges of vaginal atresia and stenosis: Nigerian experience.

From July 1973 to December 1980, 6942 patients were admitted to the Gynaecology unit of the University of Benin Teaching Hospital, Benin City, Nigeria. Fifty-nine patients presented with gynatresia (vaginal atresia and stenosis), an incidence of 8.5 1000. The most common causes of this condition were caustic vaginitis, secondary to local herb pessary insertion, and circumcision. The resulting vaginal adhesions were effectively treated surgically by simple adhesiolysis . There was a low incidence of congenital gynatresia . As the large proportion of cases of acquired gynatresia were preventable, improvement in health education should further reduce incidence of this condition in our community.

Adult↗
PubMed1991

Ileocolic replacement of esophagus in children with esophageal stricture.

Between 1970 and 1988, 12 restrosternal esophageal substitutions using an ileocolic interposition were performed. The ages of the 12 children ranged from 2 to 6 years. In 11 children the esophageal strictures were secondary to ingestion of caustic liquid. All patients had failed esophageal dilation therapy. One death occurred on the 7th postoperative day following an episode of cardiac arrest at surgery. Early postoperative complications included three cervical ileoesophageal anastomotic leaks, which healed spontaneously. One patient had gastrointestinal bleeding 10 years postoperatively. This was controlled by antacid therapy without recurrence. Redundancy of the interpositioned ileocolic segment was observed in three children. All 11 surviving patients can eat a normal diet and have normal growth and development.

Anastomosis, Surgical↗
PubMed1992

Gastric transposition for esophageal substitution in children.

Fifty-four gastric transposition procedures have been carried out for esophageal substitution in the 10-year period 1981 through 1990. The indication for esophageal replacement was esophageal atresia in 36 (19 long-gap atresia with distal fistula and 17 isolated atresia), caustic stricture in 9, intractable peptic reflux stricture in 3, 2 achalasia and 1 each of prolonged foreign body impaction, diffuse leiomyoma, congenital esophageal stenosis, and congenital short esophagus. Eight patients had previously undergone an unsuccessful colonic replacement procedure. The age at gastric transposition ranged from 4 months to 16 years. The procedure of choice was posterior mediastinal transposition without thoracotomy in 37 cases. The esophagogastric anastomosis leaked in 7 patients (12.9%), all of which closed spontaneously, whereas 5 patients developed an anastomotic stricture that responded to bouginage. There were 5 deaths (9.2%). Major complications developed postoperatively in 12 patients: 4 required additional gastric drainage procedures, 2 required temporary tracheostomy, 2 developed adhesion obstruction, and 1 each developed paraesophageal hernia, leakage of the jejunal feeding tube, tracheomalacia, and major hemorrhage following resection of a colonic graft. Major but temporary feeding problems were encountered in 12 children. Medium-term results were assessed as excellent in 67%, good in 20%, fair in 6%, and poor in 6% of the 34 patients surviving longer than 1 year postoperatively (ie, excluding 7 patients lost to follow-up).

Adolescent↗
PubMed1991

Evidence for and possible mechanisms of non-genotoxic carcinogenesis in mouse skin.

Most chemicals that produce skin cancer are genotoxic by in vitro and in vivo short-term assays and produce a high incidence of skin cancer within a year if optimal doses are applied. If in long-term skin painting studies one or two tumours in 50 mice are observed there is a general consensus that no carcinogenic activity can be claimed and it has been suggested that if up to 10% tumours are induced by irritant substances this could be due to an enhancement of spontaneous tumour incidence. Observations of skin tumour incidences higher than 10% with non-genotoxic substances, usually after a long latent period, is considered to represent evidence for a non-genotoxic mechanism. Examples of such substances include croton oil, 12-O-tetradecanoyl-phorbol-13-acetate (TPA), sodium hydroxide, potassium hydroxide, phenol, dodecylbenzene and petroleum-derived middle distillates. Two distinct mechanisms appear to be involved in the production of tumours by a non-genotoxic substance. The first of these is that seen with the strong promoting agents. These, by binding to and activating protein kinase C, appear to directly stimulate sustained epidermal hyperplasia without severe skin damage. The other appears to involve substances producing severe skin damage either by a direct caustic effect or by cumulative irritancy. These changes give rise to marked epidermal hyperplasia with repeated episodes of regeneration and damage. The tumour induction by both mechanisms probably results from oncogene activation and it is possible that oxidative enzymes from inflammatory cells may be involved in the activation process. Various reasons are given why non-genotoxic carcinogenesis in the skin is considered not to be relevant to man and ways of recognising and avoiding its occurrence in animals studies are recommended.

Animals↗
PubMed1983

Cervical resorption in bleached teeth.

A case of cervical resorption in a bleached, pulpless tooth is reported. The tooth has not been traumatized, and no other reason for the resorption could be found except the possible effects of a caustic bleaching agent. This case further supports the evidence in the literature that a cause-and-effect relationship exists between Superoxol bleaching and cervical resorption.

Female↗
PubMed1986

A new sensitive fluorometric method for measurement of plasma exudation in the inflammatory skin reaction.

A new fluorometric method using fluorescein isothiocyanate-conjugated bovine serum albumin (F-BSA) as a tracer has been developed for measurement of vascular permeability in the skin tissues of rats. This simple and rapid assay has the advantage of high sensitivity, good recovery, and low cost. The tracer extravasated in the skin was recovered as fragments of F-BSA by digestion of the tissue in caustic alkali. The recovery rate of the fluorescence intensity of the tracer from the skin was about 98%. The time required for the extraction of the fluorescent tracer from the skin sample was only 2 hr.

Animals↗
PubMed1986

Screening complex hazardous wastes for mutagenic activity using a modified version of the TLC/Salmonella assay.

10 complex hazardous wastes were tested for mutagenic activity using a modified version of the TLC/Salmonella assay developed by Bjørseth et al. (1982). This fractionation/bioassay scheme couples thin-layer chromatography (TLC) with the Salmonella/mammalian-microsome (Ames) assay for the detection of mutagenic constituents in complex mixtures. Crude (unadulterated) hazardous wastes and selected hazardous waste extracts were fractionated on commercially available cellulose TLC plates. Mutagenicity testing was performed in situ by applying a single overlay of minimal growth agar, tester strain TA98 or TA100, and the optional metabolic activation system directly onto the developed chromatogram. A mutagenic effect was indicated either by the appearance of localized clusters of revertant colonies or by an increase in total revertant growth vis-à-vis control plates. 7 of 10 hazardous wastes (including tars, emulsions, sludges, and spent acids and caustics) demonstrated mutagenic activity when tested by this method. To assess the sensitivity of the modified TLC/Salmonella assay, 14 Salmonella mutagens from a wide range of chemical classes and polarities were tested. Selected compounds included heterocyclics, aromatic amines, alkylating agents, antitumor agents, a nitrosamine and a nitroaromatic. 11 of the 14 mutagens were positive in this test system. The 3 compounds refractory to analysis included a polycyclic aromatic hydrocarbon and two volatiles.

Chromatography, Thin Layer↗
PubMedDate not supplied

Free flap reconstruction of recalcitrant hypopharyngeal stricture.

A case report is presented of the use of a jejunal microvascular free flap for the reconstruction of a hypopharyngeal stricture caused by caustic ingestion. Although the airway was reestablished, there was aspiration and diplophonia. This case is discussed as an example of an effective treatment of a difficult problem, but one posing secondary problems arising from the use of jejunum.

Adolescent↗
PubMed1983

Formic acid burn--local and systemic effects. Report of a case.

Formic acid is an organic acid which has mainly been used in industry, but in recent years its use in agriculture has greatly increased in the Scandinavian countries. Formic acid is more caustic to the skin than acetic acid. However, reports on formic acid burns are scarce in the medical literature, and no serious burn has previously been described. A few reports on formic acid ingestion have been published. It is of great interest that formic acid has been shown to play the major role in the methanol poisoning syndrome. A case of severe burn with undiluted formic acid is reported. In the beginning, the dermal injury seemed to be of minor degree, but then the patient, a 15-year-old girl, developed signs of systemic formic acid intoxication, including metabolic acidosis, intravascular hemolysis and hemoglobinuria. These signs were similar to those described as a result of formic acid ingestion. The systemic effects were successfully treated without late sequelae, but the burn turned out mainly to be full-thickness, resulting in major scarring, as commonly seen after various chemical burns.

Acidosis↗
PubMed1989

Chemical burns.

This study reports the incidence and nature of chemical burns admitted to a large regional burns unit between 1 January 1981 and 31 December 1987. Of the 3251 patients admitted, 100 had sustained chemical burns; although they only comprised 3.1 per cent of the workload they accounted for 16.5 per cent of all industrial burning accidents. The victims were mainly male adults of working age. Alkaline materials caused 37 per cent of the accidents, 26 per cent attributable to caustic soda; acids caused a further 27 per cent, hydrofluoric acid accounting for half of these. The nature of the chemical was unknown in 13 per cent of the cases; this, together with the fact that workers were often unaware that they were using hazardous substances gives cause for concern. The methods for managing a diverse range of chemical burns are described.

Accidents, Home↗
PubMed1993

Prehospital care of burns: an analysis of 3 years use of the emergency physician system (EPS) Cologne.

Little information is available about the vital parameters of burns victims shortly after the accident. Therefore cases of burns, electrical and caustic injuries presenting to the Cologne Emergency Physician System over 3 years (n = 262) were prospectively studied and analysed. The average incidence in Cologne, Germany (population 1 million), of burns victims attended by the Emergency Medical System and emergency physicians at the scene was 74 adults and 14 children per year. Children are mainly injured by scalds (41.4 per cent); adults by fire accidents (43 per cent). A classification of the victims at the site of the accident according to their vital signs (Trauma Score (TS) after Champion H. R., Sacco W. J. and Carnazzo A. J. et al. (1981) Trauma Score. Crit. Care Med. 9, 672) showed, that in spite of a major burn injury, the vital signs were usually not or only slightly impaired. Subsequent measurements instituted by the emergency physician at the scene increased with decreasing initial TS. With TS = 14, 50 per cent of the patients were intubated; below 14 points nearly 100 per cent. The fluid administered also increased with a decreasing TS.

Adolescent↗
PubMed1996

Treatment of a severe alkali burn.

The case history of a 20-year-old male patient who sustained an 85 per cent total body surface area alkali burn to his skin, after falling into a caustic lime pit, is reported. Considerable problems regarding the correct estimate of burn wound depth, predominant location of the deepest burn on the posterior half of the body, appropriate wound coverage, and lack of sufficient skin graft donor sites required a complex treatment plan. Excisions to fascia and intradermal debridement were required to achieve an appropriate bed for wound closure. Five per cent mafenide acetate solution (Sulfamylon) was applied to prevent burn wound sepsis. Human allografts and Biobrane were used extensively to achieve temporary wound closure, to provide mechanical protection of freshly autografted wounds, and to prevent desiccation following application of cultured epidermal autografts on to debrided wounds and split thickness skin grafted donor sites. The case illustrates a number of problems associated with the evaluation and treatment of patients suffering severe alkali burns, and demonstrates the implementation of both established and evolving technologies in the management of these injuries.

Adult↗
PubMed1991

Aphthous stomatitis (canker sores): a consequence of high oral submucosal viscosity (the role of extracellular matrix and the possible role of lectins).

Recurrent aphthous stomatitis (RAS) or canker sores occur in 20-60% of all persons. The lesion occurs because of increased viscosity of oral submucosal extracellular matrix (ECM). The lesions begin in the second decade and peak in the third decade. Sex hormones are an important influence on fibroblasts, especially in the early phase of exposure. Sex hormones are known to concentrate, to a degree, in the bucal mucosa in animals. Lesions of RAS localize clinically and experimentally at sites of trauma. In the skin, edema is known to trigger early cellular inflammation. Increased viscosity of ECM heightens the response. The histopathology of the ulcerated lesions is similar to that which occurs under sites of acute inflammation in the skin. Systemic corticosteroids completely supress the lesions. Caustics, such as silver nitrate and phenol, stop the growth and pain of lesions. Irritants are known to break ECM viscosity. The oral mucosa exerts some control on underlying ECM. Substances such as lectins influencing the mucosa could influence ECM. Soluble substances in food or organisms could also penetrate to influence ECM. A number of different foods have been incriminated as trigger agents in individual cases. This includes gluten in patients with gluten sensitive enteropathy. Gluten is known to alter the mucosa of the small intestine in persons with celiac disease.

Extracellular Matrix↗
PubMed1995

Fatal alkali burns.

A case is reported of a worker in an aluminium plant who was found lying in a shallow pool of concentrated caustic solution, which had been heated to approximately 95 degrees C. He had been employed to operate a pump draining a sump. A pressurised ruptured airline lay nearby, this being the likely precipitating cause of an alkaline spray. The spray led to the deceased running towards the nearest safety shower, at the base of which he was subsequently found. This is a relatively uncommon form of death, resulting from contact with a hot concentrated alkali solution. Subsequent experimentation indicated that the deceased had been in contact with the fluid for a period of approximately 13 min.

Accidents, Occupational↗
PubMed1986

Gastric lavage.

Gastric lavage has been used to manage toxic ingestions since the early 1800s. The entire realm of gastrointestinal decontamination has been extensively studied for the past 30 years. Recommendations are still evolving and remain controversial. The current indications for lavage are obtundation, unprotected airway, seizures, the need for urgent removal, and the tendency to form concretions. Hydrocarbon management depends on specific toxicity and viscosity. Contraindications for this procedure are insignificant ingestions, prolonged time since ingestion, and caustic poisoning. Proper technique minimizes complications and maximizes toxin removal. Activated charcoal and a cathartic are given after lavage. Complications include nasal trauma, esophageal perforation, tracheal intubation, aspiration, electrolyte imbalance, and hypothermia.

Cathartics↗
PubMed1995

[Esophageal dilatation in pediatrics: study of 33 patients].

BACKGROUND: Esophageal dilatation is usually regarded as an effective therapy in a majority of esophageal stenosis in childhood. However, the limited number of pediatric data does not allow definite conclusions on indications and complications of such a procedure. PATIENTS AND METHODS: The files of 33 children whose esophageal stenosis had been treated by dilatation by the same operator between 1983 and 1992 were retrospectively reviewed. The structure mechanisms were: group 1: repair of esophageal atresia (n = 9), group 2: caustic esophagitis (n = 6), group 3: peptic esophagitis (n = 12), group 4: unclassified structures (congenital esophageal stenosis, achalasia) (n = 6). The dilatations were performed under general anesthesia, and the dilatator guide was introduced under endoscopic control. Two methods were used: Savary esophageal bougies and balloon dilatation. A thoracic X-ray was systematically performed after each dilatation. RESULTS: One hundred and fourteen dilatations (3.5 dilatations/child) were performed (range: 1-32 dilatations). Twenty-five of the 33 children (76%) were dramatically improved after mechanical dilatation. Esophageal dilatation was unsuccessful in the eight other patients, seven of them requiring a surgical repair. Complications occurred in 3.4% of the dilatations: one esophageal perforation, one pneumomediastinum and two cardiac arrests (one of vagal origin and 1 after accidental extubation). All patients survived. Efficacy, duration of dilatation and complication rates were not similar in the four groups. CONCLUSIONS: Esophageal dilatation should be considered as a simple and effective procedure when strict security rules are respected by a trained operator.

Adolescent↗