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At least 19 recordsLinked to original sources
PubMedDate not supplied

Caustics mapping: an image-space technique for real-time caustics.

In this paper, we present a simple and practical technique for real-time rendering of caustics from reflective and refractive objects. Our algorithm, conceptually similar to shadow mapping, consists of two main parts: creation of a caustic map texture, and utilization of the map to render caustics onto nonshiny surfaces. Our approach avoids performing any expensive geometric tests, such as ray-object intersection, and involves no precomputation; both of which are common features in previous work. The algorithm is well suited for the standard rasterization pipeline and runs entirely on the graphics hardware.

Algorithms↗
PubMed1997

Esophageal perforation and caustic injury: emergency management of caustic ingestion.

Diagnosis and treatment of caustic ingestion injuries remain controversial. Based on experience with a wide spectrum of upper gastrointestinal tract injuries from caustic ingestion, prospectively observed in 58 adult patients treated in a teaching hospital in Milan, the authors suggest an early staging of the lesions by endoscopy, followed by resective surgery for high-degree esophagogastric lesions. Ingestion of a large amount of corrosive agent results in a life-threatening condition that requires a much more aggressive diagnostic and therapeutic approach than was formerly recommended. Early surgery plays a fundamental role in the prevention of acute hemorrhagic and perforative complications as well as of development of scar tissue and neoplastic stricture over time. The multidisciplinary approach to the management of these patients is underlined, stressing the need of close cooperation between a number of different specialists.

Adolescent↗
PubMed2006

Ingestion of caustic substances: a 15-year experience.

OBJECTIVE: The objective of this study was to analyze the circumstance, demographic features, clinical findings, and complications of caustic ingestion in relation to the type and amount of caustic substance. STUDY DESIGN: The authors conducted a retrospective cohort study in a tertiary medical center. METHODS: The authors reviewed medical records from 1988 to 2003 of patients with a history of caustic ingestion and clinical signs of injury to the aerodigestive tract. Parameters examined included age at presentation, gender, demographic status, nature of the caustic substance ingested, amount of substance, circumstance of the event, diagnostic tools, degree of injury, and anatomic distribution of the injury, early and late complications, and requirement for ventilatory support. RESULTS: A total of 50 cases of caustic ingestion were identified (age range, 5 months-71 years). A biphasic distribution of the patients was noted; half were children under 5 years old and the remainder was adults. The most common caustic agent ingested was alkaline (42%) followed by acidic (32%) and chlorine bleach (26%). The most frequent cause for ingestion was accidental (67%) as opposed to attempt suicide (33%). All cases of attempted suicide occurred in adults. Most of them reported ingestion of large amounts of caustic substance. In the pediatric group, an association between the caustic agent and ethnicity was observed. Among Jewish children, alkaline cleaning agents were the most common cause (82%). Acetic acid was the most common substance ingested by the Arab children (100%). The findings of rigid esophagoscopy in 36 patients were as follows: first-degree esophageal injury in 16 (44%), second-degree in 6 (17%), third-degree in 7 (19%), fourth-degree in 6 (17%), and one (3%) was normal. Mucosal injury to the esophagus was worse in the acidic ingestion group as compared with the alkaline substance ingestion group with marginally statistically significant difference in the median degree of injury between the three types of ingested substances (P = .054). Mucosal injury to the esophagus was worse among patients who attempted suicide as compared with accidental ingestion with a statistically significant difference in the median degree of injury between the two reasons for ingestion (P = .002). CONCLUSION: Severity of injury from caustic ingestion damages depend on the type of ingested substance, which varies depending on ethnicity. Ingestion of caustic agents by children involves specific substances according to the season, cultural and religious festivals, and ethnicity. The majority of adult cases are intentional with more serious injuries and a higher rate of complications. In our series, ingestion of acidic substances and ingestion associated with suicide attempt had the most severe consequences.

Accidents↗
PubMedDate not supplied

[Clinical-epidemiological characteristics in caustics ingestion patients in the Hipólito Unanue National Hospital].

UNLABELLED: The ingestion of caustic substances represents a serious problem, often with devastating consequences on the esophagus and the stomach. OBJECTIVES: 1) Determine the main caustic substance ingested and the lesions on the esophageal-gastric mucose. 2) Find out the clinical-epidemiological characteristics of these patients in our hospital. RESULTS: 45 inpatients at the Hipólito Unanue National Hospital were evaluated between 1996 and 2001, 29 female patients (64.4%) and 16 male patients (35.6%) with an average age of 28 years in a range between 15 and 60 years. The caustic substances ingested were: bleach, 30 patients (66.7%), muriatic acid (hydrochloric acid) 13 patients (28.9%), nitric acid and caustic soda, one patient each (2.2%). Among the women: 24 patients ingested bleach (82.7%) 4 patients, muriatic acid (13.7%) and one patient, caustic soda (3.4%). Among the men: 9 patients took muriatic acid (56.3%) 6 patients, bleach (37.5%) 1 patient, nitric acid (6.25%); 29 patients ingested the caustic substances in pure form (64.4%) and 16 patients diluted with other substances: water, soft or alcoholic drinks, oatmeal (35.5%). The time passed between the ingestion and medical attention was of 104 minutes, with a range of 15 to 360 minutes. The average of total ingested solution was 73 ml., ranging between 10 ml and 170 ml. The reason for the ingestion was a conflict with their spouse, 24 patients (53.4%) family conflict, 13 patients (28.9%) accident, 4 patients (8.9%) psychiatric problems, 3 patients (6.7%) and a monetary factor, 1 patient (2.2%). The signs and symptoms when admitted into the hospital were: abdominal pain, 31 patients (68.9%) nausea, 22 patients (48.9%) vomit, 21 patients (46.7%) mouth cavity pain, 19 patients (42.2%) dysphagia, 14 patients (31.1%) sialorrhea, 14 patients (31.1%) odynophagia, 13 patients (15.6%) sensory disorder, 7 patients (15.6%) dysphonia, 3 patients (6.7%) and cephalea, 1 patient (2.2%). Oral compromise was: normal in 11 patients (24.4%) congestion in 23 patients (51.1%) and erosions in 11 patients (24.1%). Endoscopic lesions found were: grade 0 in 6 patients (13.3%) grade 1 in 21 patients (46.7%) Grade 2A in 7 patients (15.6%) Grade 3B in 2 patients (4.4%). CONCLUSIONS: Adolescents and young adults are the age groups which most suffer of this pathology. Bleach is the most ingested caustic substance (66.7%). Women have a higher risk of ingesting a caustic substance (64.4%). Caustic substances are mostly ingested pure (64.4%). Conjugal conflicts are the main reason for caustic ingestion. Clinical symptoms vary, with abdominal pain being the main discomfort among these patients. Oropharyngeal congestion is the most frequent finding. Esophageal-gastric mucose edema and hyperemia (Zargar 1) are the endoscopic lesions mostly found.

Adolescent↗
PubMed1999

The preventive effect of heparin on stricture formation after caustic esophageal burns.

BACKGROUND/PURPOSE: Preventing thrombus formation after caustic esophageal ingestion has been proposed to have beneficial effects. Therefore, an experimental study was carried out to investigate the effects of heparin on the esophagus after caustic burns. METHODS: Caustic esophageal burns were produced in rats by irrigation with 50% NaOH as described by Liu. Rats were divided into four groups as follows: group A, animals with esophageal burns, received placebo and underwent autopsy 48 hours after caustic injury; group B, animals with esophageal burns, received subcutaneous heparin treatment and underwent autopsy 48 hours after caustic injury; group C, animals with esophageal burns, received placebo and underwent autopsy 28 days after caustic injury; group D, animals with esophageal burns, received subcutaneous heparin treatment for 7 days and underwent autopsy 28 days after caustic injury. Histopathologic evaluation was performed in all groups, and collagen content of esophageal sections was analyzed by determination of hydroxyproline levels. RESULTS: Submucosal vascular thrombosis was encountered in all group A animals but the submucosal venules and arterioles were patent in most of group B animals. Esophageal strictures did not develop in any of group D animals, although varying degree of esophageal stenoses were encountered in all animals of group C. The circumferences of the burned segment have been narrowed to 3+/-1 mm in group C rats. There was obvious collagen deposition in submucosa, and epithelial regeneration was not complete in group C rats. Submucosa and epithelial integrity seemed normal in group D animals. Hydroxyproline contents in group D were significantly lower compared with group C (P < .05). CONCLUSIONS: Heparin has ameliorating effects on stricture formation after caustic esophageal burn. Those effects may occur through possible anticoagulant, antithrombotic, and endothelial protective effects, and modifying effects of heparin on wound healing.

Animals↗
PubMed2005

Calf response to caustic paste and hot-iron dehorning using sedation with and without local anesthetic.

Dairy producers require effective methods of reducing the pain associated with dehorning. Previous work has shown that analgesics can reduce pain associated with hot-iron dehorning, but these interventions may not be practical for some producers. Some producers favor the use of caustic paste (to cause a chemical burn as opposed to thermal burn), but little is known about how to treat pain caused by caustic burns. In 2 experiments, head shaking and head rubbing behaviors were used to evaluate pain following dehorning using caustic paste. In experiment 1, sedated calves were dehorned using a caustic paste, with or without a lidocaine local block. Calves treated with lidocaine showed no evidence of reduced pain response in the hours after the caustic paste was applied. In experiment 2, response to caustic paste dehorning with a sedative only was compared with hot-iron dehorning using a sedative and local anesthetic. In the first 4 h after dehorning, calves dehorned with a hot iron showed more head shaking than calves dehorned with caustic paste. These results indicate that dehorning with caustic paste combined with a sedative results in less pain to calves than dehorning with a hot iron combined with a sedative and a local anesthetic.

Adrenergic alpha-Agonists↗
PubMed2005

Inhibition of iNOS with S-methylisothiourea was impaired in wound healing in caustic esophageal burn.

OBJECTIVE: Stricture formation is a late complication of caustic esophageal burn, which is a common problem in childhood. For this reason, this experimental study was designed to observe the possible effect of nitric oxide on healing and fibrosis formation in caustic esophageal burns. MATERIALS AND METHODS: The rats were divided into five groups. Group A (n=12) received sham burn and treatment with saline injection. Group B (n=34) received caustic burn. Rats in group C (n=31), were given water supplement with 10 g/L L-arginine that was started 24 h preoperatively and continued until postoperative day 4. In group D (n=21), S-methylisothiourea (SMT, specific inducible nitric oxide synthase (iNOS) inhibitor), was injected at a dose of 3 mg/kg i.p. at 30 min before caustic burn, and similar dose was reinjected immediately after caustic burn. SMT 6 mg/kg/day injections continued for 4 days long. In group E (n=22), Nomega-nitro-L-arginine (L-NNA, nonspecific nitric oxide synthase (NOS) inhibitor) was injected at a dose of 15 mg/kg i.p. at 30 min before caustic burn, and similar dose was reinjected immediately after caustic burn. L-NNA 30 mg/kg/day continues for 4 days. RESULTS: Dead rates were significantly higher in group E than in groups A-D. The mean hydroxyproline levels in esophageal tissue were significantly lower in groups A and B than in group D. Histopathologically, tissue damage scores in the esophageal tissue were higher in group D than in groups A-C. CONCLUSIONS: Inhibition of iNOS with SMT was impaired in wound healing due to caustic esophageal burn and provoked collagen accumulation at a later period. Those effects may due to inhibition of antioxidant, immunomodulatory and antifibrotic effects of NO.

Animals↗
PubMed2004

[Study of predictive factors of severe digestive lesions due to caustics ingestion].

OBJECTIVE: Our purpose was to analyze the predictive factors of severe upper gastrointestinal injury by caustic substances in adult patients. PATIENTS AND METHOD: Retrospective study between February 1995 and February 2001 of adult patients who underwent an urgent upper endoscopy due to caustic ingestion. Endoscopic caustic ingestion criteria by Zargar et al were used to determine the degree of injury. We performed a univariate study of factors associated with sever digestive injury and, lately, a logistic regression analysis of predictive factors. Sensitivity, specificity, positive and negative predictive values of these factors were calculated. RESULTS: One hundred and fifty nine patients were included in the study, whose mean age was 48.9 (20.1) years and 49.7% were men. The more frequent caustic ingested was lye (47.8%). A severe caustic injury was found in urgent upper endoscopy in 18.4% of patients, which was located in esophagus in 14.6%, stomach in 8.2% and duodenum in 0.6% of cases. Male sex, voluntary ingestion, oropharingeal lesions, significant clinical symptoms and dishwasher and detergents ingestion were associated with severe upper gastrointestinal tract (GIT) injury. Voluntary ingestion, oropharingeal lesions and significant clinical symptoms at admission were independent predictive factors of severe GIT injury. The existence of one of these factors had an 89.7% of sensitivity while two or more displayed a specificity of 91%. CONCLUSIONS: Clinical and exploratory data may determine, before upper endoscopic procedure, the probability of severe GIT injury by caustic ingestion. Therefore, these data could play a significant role in the diagnostic, prognostic and therapeutic management of caustic ingestion.

Adult↗
PubMed2001

[Upper gastrointestinal tract injury caused by ingestion of caustic substances].

BACKGROUND: To determine the distribution, extension and severity of injuries produced by the ingestion of caustic substances in the upper gastrointestinal tract, and to assess the relationship of these factors with the type of caustic substance ingested, whether intake was accidental or deliberate and the appearance of strictures or death. PATIENTS AND METHOD: Between 1993 and 1999, 138 patients (74 males and 84 females) who underwent upper gastrointestinal endoscopy in our unit within the first 24 hours after ingestion of caustic substances were included in the study. Mean age was 47 years (14-97 years). The severity of caustic injury was evaluated using the classification of Showkat et al. RESULTS: The type of caustic substance ingested was as follows: lye in 84 patients (53%), nitric acid in 21 (13%), different caustic mixtures in 43 (27%) and unknown in 10 patients (6%). Lesions were grade I in 51 patients(32%), grade II in 33 (21%) and grade III in 20 (13%). No lesions were seen in 54 patients (34%). Of the 158 patients, gastric injury was found in 91 (57.5%), esophageal burn in 72 (45.5%) and duodenal injury in 28 (18%). Ingestion was accidental in 80 patients (51%) and voluntary in 62 (39%); the reasons for ingestion were unclear in 16 patients (10%). Voluntary ingestion and acid use were associated with greater severity of lesions (p < 0.0005). Eight patients (5.0%) died, 10 patients (6.3%) required emergency surgery, and 7 (4.4%) developed esophageal-gastric strictures that required surgery or endoscopic treatment. CONCLUSIONS: The most common type of caustic substance ingested was lye. In 66% of the patients, lesions were absent or superficial. The more severe injuries, producing strictures and higher mortality, were related to voluntary and nitric acid ingestion. The part of the digestive tract most frequently affected after lye and acid ingestion was the stomach.

Adolescent↗
PubMed1994

Consequences of caustic ingestions in children.

A retrospective analysis of 98 patients, less than 15 years of age, treated for caustic ingestion during 1976-1990 was performed to evaluate the modern consequences of caustic ingestion in children and to set indications for esophagoscopies and radiographic and laboratory examinations. Dishwasher detergents were ingested by 56 children. There were no lye ingestions, since lye has not been freely available in Finland since 1969. Household acetic acid (vinegar) was the most commonly (12/23) ingested acid. Primary esophagoscopy was performed in 79 of the 98 cases (80.6%). Esophageal burns were found in 20 patients. Acids caused burns more often than alkalies (9/23 (39.1%) versus 11/75 (14.7%); p = 0.011; 95% confidence intervals (CI) for the difference 5.6-43.3%) and acid burns more often developed into scars (7.4% versus 4%; p = 0.029; 95% CI for the difference 1.4-25.4%). The only esophageal stricture developed after ingestion of a Clinitest tablet. The mean time for hospitalization as a result of acid ingestion was significantly longer than after alkaline ingestion (3.2 (SD 3.5) days, n = 23 versus 1.5 (1.6) days, n = 75; p < 0.05; 95% CI for the difference 0.7-2.8 days). Prolonged drooling and dysphagia (12-24 h) predicted esophageal scar formation with 100% sensitivity and 90.1% specificity, but signs and symptoms did not predict esophageal burns after primary esophagoscopy. Radiographic examinations and leukocyte counts were of no value in predicting esophageal burns and scars. The panorama of caustic ingestion appears to have changed, probably due in part to the law banning sale of lye products since 1969. This type of law should be encouraged elsewhere. Acids cause even more caustic burns than alkalies. Vinegar should be regarded as a potent caustic substance and distributed in baby-safe bottles with appropriate information on its caustic nature. As severe esophageal lesions after accidental ingestion of caustic substances are now rare in children, primary esophagoscopies and hospitalization of patients are not indicated routinely. The decision on esophagoscopy can be made on the basis of drooling and dysphagia during follow-up.

Adolescent↗
PubMed2001

Ingestion of caustic substances and its complications.

CONTEXT: Caustic substances cause tissue destruction through liquefaction or coagulation reactions and the intensity of destruction depends on the type, concentration, time of contact and amount of the substance ingested. OBJECTIVES: To analyze the complications in patients who ingested caustic substances and correlate them with the amount of caustic soda ingested. DESIGN: Retrospective study. SETTING: University hospital, a referral center. PARTICIPANTS: A total of 239 patients who ingested caustic soda. MAIN MEASUREMENTS: The amount of granulated caustic substance ingested was measured as tablespoonfuls and the following complications were analyzed: esophagitis, esophageal stenosis and progression to cancer, fistulas, perforations, stomach lesions, brain abscesses, and death. Stenosis was classified as mild, moderate or severe according to the radiological findings. RESULTS: We observed an 89.3 % incidence of esophagitis; 72.6 % of the cases involved progression to stenosis and 1 per cent died during the acute phase. Stenosis was mild in 17.6 % of cases, moderate in 59.3 % and severe in 23 %. The incidence of stenosis was 80.8 per cent in women and 62.5 % in men. The incidence of stenosis was 46.9 % in the group that ingested "fragments" and 93.6 % in the group that ingested one or more tablespoonfuls of caustic substances. Among subjects who ingested one or more tablespoonfuls, 32.2 % developed lesions of the stomach-duodenum, whereas the ingestion of "fragments" was not sufficient to induce these lesions. There was no correlation between the intensity of lesions of the esophagus and of the stomach. Progression to cancer of the esophagus occurred in 1.8 % of cases, death during the chronic phase in 1.4 %, perforations in 4.6 %, fistulas in 0.9 %, and brain abscesses in 1.4 %. CONCLUSIONS: The complications were related to the amount of caustic soda ingested. Small amounts caused esophagitis or stenosis and large amounts increased the risk of fistulas, perforations and death.

Adolescent↗
PubMedDate not supplied

Risk factors for stricture development after caustic ingestion.

BACKGROUND/AIMS: Stricture of the upper digestive tract is the most feared sequelae of caustic ingestion. Determinant risk factors for its development are not entirely known. The aim of this study was to investigate the risk factors associated with the development of fibrotic strictures induced by caustic ingestion. METHODOLOGY: Clinical, laboratory, radiological and endoscopic data from 48 patients admitted to our department for caustic ingestion were reviewed. All cases were submitted to emergency endoscopy and caustic lesions were graded according to Zargar's classification. Twenty-three patients with severe endoscopic lesions (grade IIb/grade III) and/or acute severe complications (gastrointestinal bleeding, respiratory failure) were admitted to an intensive care unit. After hospital discharge, all patients were followed-up (mean follow-up time: 4.1 +/- 1.8 years). RESULTS: Twelve patients (25%) developed caustic strictures. Four patients (8%) were submitted to surgery for stricture resolution. Factors significantly associated with development of caustic stricture were hematemesis (p = 0.002), serum lactic dehydrogenase > 600 U/L (p = 0.008), grade III lesions (p = 0.0002) and involvement of the entire esophagus (p = 0.0003). CONCLUSIONS: Severe endoscopic lesions, involvement of the entire length of the esophagus, hematemesis and increased serum lactic dehydrogenase represent risk factors for the development of fibrotic strictures induced by caustic ingestion. Assessment of these parameters may contribute to prevent this complication.

Adolescent↗
PubMed2003

[Posioning by caustic substances].

There are discordant guides and protocols when it comes to treating a patient who has ingested a caustic substance. Different ideas or tendencies speak in favour of dilution, neutralization, provoking vomiting, carrying out stomach washes, etc., depending on the milieu where the problem arises: at home, at the health centre, emergency service or hospital. The same occurs with the type of diluent or neutralizing agent to be used, how and when to start the treatment pattern with corticoids and/or antibiotics and antisecretory, if indeed this is necessary. We have carried out an exhaustive bibliographical study, an experimental work and a study of the different diagnosis and treatment guides and protocols used in different Spanish hospitals. At the experimental level it was found that there are histopathological markers that advise against the use of diluent substances following the ingestion of caustic alkali. Except in the cases of ingestion of solid caustic substances -crystalline or granulated- categorical contraindications are given against dilution. Corticoids are not efficient when a caustic acid is ingested; their use is more than questionable following the ingestion of caustic alkali. Diagnosis and quality of treatment are based on endoscopy. There is no single criterion that defines which moment (the time following ingestion) is the most convenient for carrying this out, although the period between the first 6-12 hours is the most suitable. We present an independent protocol of diagnosis and treatment -in the form of algorithms- that must be followed after the ingestion of caustic acids or caustic alkali.

Acute Disease↗
PubMed1993

Ingestion of caustic alkali farm products.

Since the Poison Prevention Packaging Act took effect, the number of ingestions of caustic alkali from household products has been significantly reduced. Commercial caustic alkalis used on farms, however, were not included in this legislation. Fourteen children over a 5 year period were seen after ingestion of commercial caustic alkalis used on farms. Seven of the children had ingested liquid pipeline cleaners and seven had ingested solid agents used for a variety of reasons. Six of seven children ingesting liquid agents did so from nonoriginal containers into which the caustic had been transferred for convenience. All seven children ingesting solid agents did so from the original container. Eight of the 14 children were found to have second-degree or worse esophageal involvement. Both solid and liquid caustic agents used commercially on farms can cause significant morbidity. Development of a child-resistant container for daily transfer of liquid pipeline agents could be helpful in preventing injuries from liquid pipeline cleaners. Pediatric gastroenterologists as well as primary care physicians in rural areas should be familiar with this type of injury and should take an active role in instructing parents of children living on farms to prevent such injuries. Extension of the Poison Prevention Packaging Act to caustic alkalis used on farms needs to be considered.

Adolescent↗
PubMed2004

Surgical management of esophageal strictures after caustic burns: a 30 years of experience.

AIM: To analyze a 30-year historical series of patients treated in our hospital, who ingested corrosive substances, and to assess the effectiveness of surgical therapy administered in patients with strictures after caustic injury in esophagus during this period. METHODS: A total of 79 cases of caustic burns in esophagus were treated in Tangdu Hospital from 1971 to 2001. Their clinical and pathological data were reviewed, and collected from the medical records of patients and interviews with them. RESULTS: More men (n = 61) than women (n = 18) ingested caustic substances with a sex ratio of 3.4:1 during the 30-year period. The caustic materials were liquid lye and acids (54 cases and 25 cases, respectively). Sixty-eight patients were given esophageal replacement in more than three months after caustic injury with no postoperative death, of which 17 cases developed postoperative complications making a complication rate of 25%. The most common one was cervical anastomotic leakage. All patients had improvement in swallowing afterwards. CONCLUSION: The presence and severity of injuries are correlated with the amount of caustic substances ingested. Surgical treatment is a good option in patients with severe strictures, and colonic interposition might be the best surgical process. The most important factors to guarantee a successful outcome for surgery are good vascular supply and absence of tension in the anastomosis.

Adolescent↗
PubMed1997

A retrospective analysis of ingestion of caustic substances by children. Ten-year statistics in Galicia.

UNLABELLED: We reviewed the case histories of 743 children seen at our hospital from 1981 to 1990 for suspected ingestion of caustic substances. Mean patient age was 27 months; 85% of patients were less than 3 years old. The male-to-female ratio was about 2:1. About 53% of patients were from urban environments. All ingestions appear to have been accidental. Of the 743 children, 20% presented oesophageal burns (11.8% first-degree, 3.1% second-degree and 2.7% third-degree). Alkaline products were ingested about 11 times more frequently than acid products. The substance ingested was bleach in 73% of cases. The most dangerous substances were dishwasher liquids/powders (59% of ingestions led to oesophageal burn), caustic soda (55%) and drain cleaners (55%). The caustic product was not in its original container in 75% of cases. Most accidents (58%) took place in the home. We did not detect any reliable predictive relationship between the presence of symptoms and signs and of oesophageal burns. Of the 743 patients, 5% developed oesophageal stricture and 3% required oesophageal dilatation. CONCLUSION: The incidence of accidents caused by the ingestion of caustic substances can only be reduced by broad-based preventive strategies, including enforcement of safe manufacturing practices and public education programmes. Most importantly, the containers for caustic household products should be cheap, small and childproof.

Accidents↗
PubMed2004

The roles of free oxygen radicals, nitric oxide, and endothelin in caustic injury of rat esophagus.

PURPOSE: The authors aimed to find out the roles of free oxygen radicals, nitric oxide (NO), and endothelin (ET) in caustic injury of rat esophagus. METHODS: Forty-five Wistar albino rats were used to form 6 groups. The study groups are summarized as 1, sham (S; n = 7); 2, sham + L-arginine (SA; n = 7); 3, sham + L-NAME (SN; n = 7); 4, injury (I; n = 8); 5, injury + L-arginine (IA; n = 8); 6, injury + L-NAME (IN; n = 8). Normal saline in the sham groups and 50% NaOH in the caustic injury groups were administered to the distal esophagus. Free oxygen radicals and NO were detected by chemiluminescence from tissue samples, and they were correlated with histologic examinations. Tissue ET was measured also with immunohistochemistry. RESULTS: The injury was verified histologically. Free oxygen radical levels were found to be increased as well as NO and ET with the caustic injury (P <.05). L-arginine caused a histologic increase in the injury that was close to statistical significance (P =.08). L-NAME showed no significant effect. CONCLUSIONS: Free radicals, NO, and ET increase in the early phase of caustic esophageal injury. Understanding their early interactions during the caustic injury may help in future therapeutic strategies.

Animals↗