[Corrosive injury of the esophagus. Causes and treatment of accidental corrosive injuries of esophagus, with suggestions for preventive measures].
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Microbiologically influenced corrosion (MIC) threatens global infrastructure, causing billions of dollars in annual losses. Its persistence stems from unresolved mechanisms─particularly the metabolites produced by microorganisms that drive or inhibit corrosion─and the microbial community structures. Progress has been hindered by the absence of systematic workflows to rapidly and accurately identify MIC-relevant microorganisms and their functions. Here, we present DURABLE (Detection of Unique Corrosion Resistant or Accelerating Biologics in a Laboratory Environment), a pipeline that couples high-throughput microbial screening with genomic and metabolic workflows. We applied the DURABLE workflow to six diesel tank samples and revealed fuel-dependent microbial community structures, which showed greater diversity and evenness in bacterial communities than their fungal counterparts. The workflow used carbon steel beads to rapidly screen over 80 bacterial isolates for corrosive activity, reducing assay time to approximately 2 days compared with the conventional 30-day metal coupon test. More than 40 isolates were identified as corrosive. Further testing using mass spectrometry analysis revealed corrosion-associated metabolites, which were further validated using electrochemical assays. Thus, DURABLE achieved a ∼15-fold increase in screening speed and provided a scalable and mechanistic framework for dissecting MIC dynamics. We expect this advance will enable the development of precision mitigation strategies in hydrocarbon fuel infrastructure.
An ideal combination of mechanical and corrosion properties of long-term implants such as joint endoprostheses has yet to be found. Besides being resistant to pitting and crevice attack, which can lead to corrosion fatigue and stress corrosion cracking failures, the implant material must be highly resistant to wear and abrasion. Two cobalt-based alloys, wrought CoNiMoTi and air-cast CoCrMo, were subjected to a number of selected in vitro electrochemically and chemically accelerated corrosion tests in chloride-containing solutions with wrought AISI-316L used as a reference alloy. A limited number of immersion tests in FeCl3 and acidified FeCl3 solutions were also conducted. It is found that the mechanical properties of wrought CoNiCrMoTi alloy qualify it as a substitute for cast CoCrMo alloy and wrought AISI-316L in anchorage shaft production for all types of joint endoprostheses. Wrought CoNiCrMoTi has a higher resistance to fatigue cracking compared with cast CoCrMo and is as resistant to selective corrosion phenomena such as stress corrosion cracking.
In vitro corrosion experiments were conducted employing potentiostatic polarization techniques, a saline environment and candidate biomaterial alloy/carbon combinations. Corrosion currents and potentials of carbon/metal couples were predicted by mixed-potential theory utilizing the polarization curves generated. The alloys examined were annealed ELI grade Ti-6A1-4V and cold-worked 316L stainless steel while the types of carbon examined were LTI pyrolytic carbon and vapor-deposited carbon. It was determined that galvanic couples of carbon to cold-worked 316L stainless steel with carbon/metal area ratios of 10:1 to 100:1 produced coupled corrosion potentials in the range of the observed breakdown potential of the stainless steel. It was therefore predicted that localized corrosion in the form of pitting could occur on the cold-worked stainless steel when coupled to carbon with area ratios of 10:1 or greater. The titanium alloy did not exhibit a breakdown potential up to a potential of 1.2 V. Therefore, accelerated corrosion was not predicted for the titanium alloy to carbon galvanic couples under these experimental conditions. Direct carbon/alloy coupling experiments were conducted to verify the corrosion currents and potentials predicted from mixed-potential theory and polarization curve analysis. The experimental and theoretical values showed good agreement.
When measuring sweating rates, close correspondence was found with the clinical estimation of hyperhidrosis. Corrosion was seen to increase with increasing sweat rates, reaching its maximum after an assumed rise in the actual sodium chloride concentration on the skin surface due to evaporation of water. The findings confirm that hyperhidrosis is of primary importance in the constitution of a 'ruster', and are also in good agreement with experimental reports. The small variations in palmar skin pH had no influence on the degree of corrosion; nor had the character of the metal surface. Of the two types of metal studied. corrosion was much more severe on the type having the lowest concentration of copper, thus confirming that increasing copper concentrations have a positive effect in reducing corrosion rates. At 50--60% relative humidity (RH) corrosion increased as time elapsed, whereas at 40% RH no corrosion developed on a sweat-contaminated plate. When exposed to 75% RH, metal samples became severely corroded in the course of a few days. Protective methods for the avoidance of rust are mentioned, with special emphasis on frequent handwashing.
The influence of corrosion on the copper wire in the Copper T-200 intrauterine device (IUD) was studied in devices which had been in utero for 3 to 52 months. This was done mainly by examining cross-sections of the wires under a light microscope. Corrosion was normally localized to narrow areas and led to breakage and fragmentation of the copper wire. Neither deposits on the wire nor corrosion products prevented the dissolution of the copper. The progress of the corrosion over a given time was determined by comparing the depth of corrosion with the original dimension of the wire. The lifetime of the IUD was evaluated on the basis of the progress of corrosion, the calculated copper release, and the number of cases of wire breakage. It was found that the Copper T-200 could be left in place for up to 45 months.
The linear polarization technique has been used to measure polarization resistances and corrosion currents directly in the mouths of baboons and in vitro for a wide range of dental and implant alloys. Good correlations were found to exist between these two conditions, indicating that this test is accurate and valid as well as being simple to perform. Intraoral corrosion proceeded faster, probably due to abrasion by foodstuffs. Tarnish has also been measured using an intraoral tristimulus colorimeter and results were compared with the corrosion determinations. The tarnish of pure metals (Au, Ag, and Cu) was inversely proportional to corrosion. Gold alloys tarnished little but varied in corrosion current. Dental amalgams corroded the most but the tarnish experience depended more on their chemistry than their precious metal composition.
Corrosion of amalgam is a natural phenomenon of the behaviour of a metallic substance in the oral environment. Corrosion is a process in which we have a anodic reaction resulting in a loss of electrons and a cathodic reaction resulting in a captation of electrons. One single amalgam restoration in a electrolitic environment as the saliva shows areas acting as anode and others acting as cathode. Certain factors may influence the corrosion: they are the composition of the alloy, the particle size and form, the mercury content, the presence of more or less important quantity of gamma-2 phase, the degree of surface finishing, etc. It is likely that the dispersion phase alloy are more resistant to corrosion than the conventional alloys and that fluoridates amalgams are also more prone to corrosion.
Early diagnosis of acute corrosive lesions of the oesophagus enables adequate treatment to be given to the patient and prevents unnecessary treatment of uninjured individuals. In an analysis of 64 patients of varying ages subjected to oesophagoscopy during a 10-year period for suspected corrosive lesions of the oesophagus caused by alkali, acids and other corrosive substances, it was found that neither clinical signs, laboratory investigations nor X-ray examination gives sufficient information about whether the patient has a corrosive lesion of the oesophagus or not. Oesophagoscopy establishes the diagnosis. Patients suspected of having corrosive lesions of the oesphagus should therefore be subjected to oesophagoscopy as soon as their condition permits.
The effects of crevice corrosion on the major structural phases of a high copper dental amalgam were studied in vitro. Three kinds of samples were used: (1) amalgam prepared from a high copper, single composition alloy, (2) annealed ingots of the Ag3Sn and Cu3Sn phases, and (3) high copper, single composition alloy tablets electroplated with mercury. Specimens were examined in a scanning electron microscope before and after the exposure to a corrosion environment. The Ag3Sn and Cu3Sn phases were least affected by corrosion. The Ag-Hg-Sn phase (gamma1) slowly deteriorated, but the attack was nonuniform. The Cu6Sn5 phase exhibited good corrosion resistance, better than that of gamma1 phase. Particles of a tin rich phase of uncertain origin were observed on some of the samples after long exposures.
BACKGROUND: Corrosive esophageal injury frequently results in esophageal stricture requiring repeated endoscopic dilatation and substantial healthcare expenditure. This study evaluated the cost-effectiveness of omeprazole plus standard treatment compared with standard treatment alone for preventing esophageal stricture in adult patients with Zargar grade 2b and 3a corrosive esophageal injuries. METHODS: A trial-based economic evaluation was conducted alongside a randomized controlled trial from the healthcare provider and patient perspectives. Twenty patients were randomized to receive either standard treatment alone (n = 10) or standard treatment plus omeprazole (n = 10). Direct medical costs were analyzed using the incremental cost-effectiveness ratio. Deterministic one-way sensitivity analysis and probabilistic sensitivity analysis using Monte Carlo simulation were performed. RESULTS: The incidence of corrosive esophageal stricture was 20% (2/10) in the omeprazole group and 70% (7/10) in the standard treatment group (relative risk, 0.29; 95% confidence interval, 0.08-1.05; Fisher's exact test, P = .070). Omeprazole plus standard treatment reduced healthcare costs by THB 4642.30 per patient from the provider perspective and THB 5476.60 per patient from the patient perspective. The intervention remained the dominant strategy across all deterministic sensitivity analyses. Probabilistic sensitivity analysis demonstrated that 68.3% and 78.8% of simulations favored omeprazole from the provider and patient perspectives, respectively. CONCLUSION: Omeprazole plus standard treatment may represent a cost-effective strategy for adult patients with Zargar grade 2b and 3a corrosive esophageal injuries. However, these findings should be considered preliminary and require confirmation in larger multicenter randomized controlled trials.
Comparisons were made of several dip-applied corrosion inhibitors for protection of carbon steel dental instruments during autoclaving. Although none were totally effective, several provided significant corrosion inhibition. Sodium nitrite and one proprietary inhibitor were about equally effective and notably superior to the other inhibitors investigated. Because sodium nitrite is a food preservative that is relatively harmless when ingested in small quantities, whereas commercial inhibitors are of proprietary composition and unspecified toxicity, we prefer to use sodium nitrite for corrosion inhibition during autoclaving. Sodium nitritie is readily available from chemical suppliers and is generally much less expensive than most commercial inhibitors. Although the autoclave used in this investigation is typical of many used in clinical situations, minor variations in design, steam impurities, and other unknown factors might effect the results. Further research is needed to determine the corrosive effects of impurities in the steam supply, residual detergents, method of postautoclave drying, steam supply deoxygenation, pH, and possibly the use of oxygen scavengers within the autoclave.
Commercial total hip prostheses often show certain metallurgical faults (porosities, coarse grains, growth dendrites, carbide networks). In order to investigate more accurately the role played by these different parameters in prostheses failure we performed a large number of systematic corrosion, fatigue and fatigue - corrosion tests on these materials and on commercial total hip prostheses. Ultimate strengthes seem to be reached for cast cobalt alloys, whereas titanium alloys, such as Ta 6 V, present very high fatigue limit under corrosion. Thus, rotative bending fatigue - corrosion tests in biological environment provide values about 50 DaN/mm2. This value, is nevertheless appreciably higher than those obtained with stellites and stainless steel. Titanium alloys, because of their mechanical performances, their weak Young's modulus (11000 DaN/mm2) and their relative lightness (4.5. g/cm3), which are associated with a good biocompatibility, seem very promising for permanent implants realisation.
An 8-year experience of the surgical treatment of 28 patients with corrosive oesophageal stricture is reviewed. Eight patients underwent oesophageal bypass using colonic or jejunal graft with one death (12.5 per cent mortality). The single death (5 per cent mortality) among 20 patients undergoing oesophageal resection was not related to the technical difficulty of the operation. In 17 of these patients reconstruction was by cervical oesophagogastrostomy and in 2 by pharyngogastrostomy. One case of oesophageal carcinoma occurred among 5 cases of corrosive stricture exceeding 20 years in duration. Oesophageal resection for severe corrosive stricture is not a hazardous procedure as generally believed and is desirable in view of the pre-malignant nature of corrosive stricture. Reconstruction by cervical oesophagogastrostomy after oesophageal resection is advantageous because of its relative simplicity and safety.
Case reports of 3 patients are given with severe corrosive lesions of the esophagus and stomach due to acid ingestion. All of them survived the initial phase and seemed to be expecting a favourable clinical course. In all of these cases however massive upper gastrointestinal bleeding, perforation, and death occurred in a later phase after an interval free of symptoms. Treatment of severe corrosions of the upper gastrointestinal tract differs significantly from treatment of less serious cases. In less severe cases care has to be taken to avoid later complications in the first place. If there are serious corrosions however vital indications are predominant in determining the course of treatment during the initial phase. An interval with no or rather few clinical symptoms of 3 weeks duration after severe corrosive lesions should not be considered to exclude the danger of later lethal complications, especially bleeding and perforation. In order to avoid such complications endoscopic and eventually surgical exploration after the acute initial phase is recommended.
Alloys of cast Co-Cr-Mo, wrought Co-Cr-W, wrought, Co-Ni-Cr-Mo(MP35N), Ti-60% Al-4% V, and graphite were incorporated in specimens which simulated both a couple and a crevice corrosion condition. These specimens were implanted in a dog for 30 months. Post-sacrifice examination showed no substantial evidence of corrosion activity on the surfaces of the metals except for a tarnish film on the titanium alloy specimens. The presence of the tarnish film is taken as more evidence of corrosion activity and this correlated with a thicker average fibrous membrane, cellular activity in and near the fibrous membrane, and some increased vascularity. These must be regarded as preliminary observations.
Corrosion of base metal alloys was studied by placing the alloys in artificial saliva for 2 months and then determining the concentration of metal ions in the saliva. The distribution of the attack on the surface was examined. The results indicated that the amount of metal ions in the artificial saliva could be related to the Cr content of the alloy. When the Cr content exceeded 16% very little corrosion was observed. The corrosive attack was located at Cr depleted areas, grain boundaries. The Cr depletion probably resulted from coring during solidification.