4.Evaluation and Management of Caustic Injuries from Ingestion of Acid or Alkaline Substances.
Clinical Endoscopy 2014;47(4):301-307
Although the numbers have decreased compared with in the past, cases of patients who ingest caustic substances and visit the emergency room are not rare. However, well-summarized data about caustic injuries are insufficient. Therefore, in this article, I will discuss the etiologic causative agents, injury mechanism, and clinical characteristics, as well as the endoscopic evaluation of the degree of injury and proper management of the patient, in gastrointestinal caustic injury.
Alkalies
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Eating*
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Emergency Service, Hospital
;
Humans
5.Evaluation of Mycobacterial Recovery by Specimen Preparation and Inoculating Media.
Joseph JEONG ; Chulhun L CHANG
Korean Journal of Clinical Pathology 2000;20(2):188-193
BACKGROUND: During the specimen preparation, neutralization after alkali processing is not necessary when inoculate into agar or broth media, but into 3% Ogawa media, the mostly used egg-based media in Korea. To simplify the specimen processing, the recovery of mycobacteria from 3% Ogawa media inoculating differently processed sputa, was evaluated. Futhermore, the recovery from the three different media was evaluated, too. METHODS: 209 sputa were included. Each specimen was divided into 3 bottles.(A) One was only decontaminated by 4% NaOH before inoculation.(B) Another was decontaminated, and concentrated without neutralization. These two specimens were inoculated into 3% Ogawa media.(C) The other was decontaminated, neutralized and concentrated, and innoculated into 3% Ogawa, Middlebrook 7H9 selective broth and 7H10 selective agar media. The isolates were identified by AccuProbe method. RESULTS: M. tuberculosis were isolated from 43(20.5%) specimens. The recovery number and time from Ogawa media, inoculating specimens processed by A, B, and C method, were 29(13.9%), 35(16.7%), and 36(17.2%), and 23, 23, and 19 days, respectively. The recovery number and time from Ogawa, 7H10 agar and 7H9 broth media, inoculating specimens processed by C method, were 36(17.2%), 42(20.1%), and 41(19.6%), and 26, 24, and 22 days, respectively. CONCLUSIONS: Neutralization of alkali-decontaminated specimens could be used to inoculate into 3% Ogawa media. Inoculation into homemade 7H10 agar and 7H9 broth media in addition to 3% Ogawa media improved the recovery rate and time of mycobacteria.
Agar
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Alkalies
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Korea
;
Mycobacterium tuberculosis
;
Sputum
;
Tuberculosis
6.Possibility of Dilution and Neutralization Therapy with Cold Solution in Cases of Strong Acid or Strong Alkali Ingestion.
Joong Eui RHEE ; Hyoung Gon SONG ; Dong Hoon KIM ; Woon Yong KWEON ; Young Ho KWAK ; Gil Joon SUH ; Yeo Kyu YOUNE
Journal of the Korean Society of Emergency Medicine 2001;12(3):207-213
BACKGROUND: There is no effective treatment modality for caustic agent ingestion. Dilution and neutralization are prohibited because of the risk of secondary thermal injury. This experiment is designed to evaluate the amount of dilution and neutralization heat and to gauge the applicability of dilution and neutralization therapy using cold solutions to suppress the peak temperature. METHODS: This is an in-vitro chemical experiment. HCl, CH3COOH, NaOH, and NH4OH are selected as representatives of strong and weak acids and strong and weak alkali, respectively. 20degrees C, 11.6M, 5.8M, and 2.9M solutions of each acid and alkali are made and mixed using a magnetic stirrer at a room air temperature of 28degrees C. The peak temperature, the duration above 40degrees C, and the heat amount are measured or calculated. RESULTS: When a 11.6M HCl or NaOH solution is diluted with same amount of water, 32 or 18cal. per mL of HCl or NaOH is produced, respectively. HCl produces a significant peak temperature, but NaOH does not. The lower the concentration, the lower the amount of heat production. 11.6M CH3COOH and NH4OH solutions don't produce dilution heat. 11.6M and 5.8M solutions of all acids and alkali produce destructive neutralization heat. However, 2.9M solutions produce neutralization heat which might be controllable. When a 11.6M HCl or NaOH solution is neutralized with a -10degrees C 2.9 M NaOH or HCl solution, respectively, the peak temperature produced is below 40degrees C and seems to add little thermal damage to viable tissue. CONCLUSION: Dilution and neutralization with a cold solution in cases of strong acid or alkali ingestion is a promising method to avoid thermal injury.
Alkalies*
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Eating*
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Hot Temperature
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Thermogenesis
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Water
7.Effects of Topically Applied Na-Hya luronan on Stromal and Endothelial Healing in Experimental Corneal Alkali Wounds.
Yoo Kyung PARK ; Jang Hyun CHUNG
Journal of the Korean Ophthalmological Society 2000;41(8):1631-1637
The effects of topical sodium-hyaluronan on the stromal and endothelial healing were examined in the repair process of experimental corneal alkali wounds. Corneal alkali wounds were produced in one eye of each rabbit by applying a 5.5 mm round filter paper soaked in 1N NaOH onto the central cornea for 60 seconds. Then the eyes were treated topically with either 1% Na-HA(the treatment group)or a phosphate buffered saline(PBS)(the con-trol group)4 times per day for 3 weeks. Endothelial wound morphometry was performed after alizarin red and trypan blue staining. The stromal healing was assessed by counting polymorphonuclear leukocytes(PMNs)and keratocytes in the central and marginal wounds areas. The stroma treated with Na-HA had less PMNs than that of the control group during the early healing period. The defect area of the endothelium was significantly smaller in the Na-HA treated group than in the control corneas. The present findings indicate that topically applied 1%Na-HA affects stromal and endothelial healing during the early repair process after corneal alkali wounds.
Alkalies*
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Cornea
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Endothelium
;
Trypan Blue
;
Wounds and Injuries*
8.Effects of Topically Applied Na-Hyaluronan on Epithelial Healing and Aqueous Composition in Experimental Corneal Alkali Wounds.
Yoo Kyung PARK ; Jang Hyun CHUNG
Journal of the Korean Ophthalmological Society 2000;41(6):1265-1271
The effects of topical sodium-hyaluronan (Na-HA)on the epithelial healing and aqueous compositions were examined in the repair process of experimen-tal corneal alkali wounds.Corneal alkali wounds were produced in one eye of each rabbit by applying a 5.5 mmround filter paper soaked in 1N NaOH onto the central cornea for 60 seconds.Then the eyes were treated topically with either 1%Na-HA (the treatment group)or a phosphate buffered saline (PBS) (the control group)4 times per day.The epithelial healing was assessed using a quantitative method and the changes of the concentration of ascorbic acid and glucose in aqueous were evaluated.The initial epithelial healing rate was similar between 1%Na-HA treated and control groups and the later healing was enhanced in the treated group but statistically insignificant.The concentrations of ascorbic acid and glucose in aqueous humor are not statistically different in the early phase, but ascorbic acid concentration in later healing phase was higher in the treated group when compared with the control group.The present findings in dicate that topical-ly applied 1%Na-HA affects late epithelial healing and ascorbic acid concentration in aqueous humor during the repair process after corneal alkali wounds.
Alkalies*
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Aqueous Humor
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Ascorbic Acid
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Cornea
;
Epithelium
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Glucose
;
Wounds and Injuries*
9.Effects of 0.1% Dexamethasone on Experimental corneal Epithelial Healing Following Alkali Wounds.
Yang Keum KANG ; Jang Hyun CHUNG
Journal of the Korean Ophthalmological Society 1997;38(5):750-755
The effect of topical steroid on corneal alkali wound has been controversial due to a complexity of its mechanism and a risk of ulceration and perforation. In this study, the effect of topical 0,1% dexamethasone on corneal epithelial wound healing following alkali burn was evaluated quantitatively. 22 eyes wounded by alkali burn out of 22 white rabbits were divided into 3 groups ; A group treated with topical 0.1% dexamethasone for eight weeks, B grouptreated with topical 0.1% dexamethasone for the first one week followed by another seven weeks without treatment, C group with no treatment served as a control. The area of corneal epithelial defect was examined at 6, 18, 30, 42 hours following corneal alkali wound for initial wound healing and examined every other day from 4 days to 48 days following corneal alkali wound for late wound healing. In this study, it was found that topical 0.1% dexamethasone delayed corneal epithelial healing following corneal alkali burn in both stage of initial and late wound healing.
Alkalies*
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Burns
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Dexamethasone*
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Rabbits
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Ulcer
;
Wound Healing
;
Wounds and Injuries*
10.The Effect of Cartilage on Corneal Neovascularization.
Journal of the Korean Ophthalmological Society 1977;18(4):279-283
Corneal neovascularization is a major complication of several corneal diseases and many investigations have been performed to inhibit the ingrowth of vessels in the corneal tissue. In this experiment, the author investigate the clinical effect of cartilage to corned neovascularization. Using 12 albino rabbits, corneal neovascularization was induced by alkali burns, and cartilage was implanted subconjunctivally at the limbus before or after the alkali burns. Except 2 eyes which showed inhibition of neovascularization after implantation of cartilage, there was no demonstrable difference between control and cartilage-implanted eyes.
Alkalies
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Burns
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Cartilage*
;
Corneal Diseases
;
Corneal Neovascularization*
;
Rabbits
;
Zea mays