Effect of Topical Instillation of Pegaptanib Sodium Upon Inflammatory Corneal Neovascularization in Rabbits.

Purpose: To evaluate the effect of topical instillation of pegaptanib sodium upon inflammatory angiogenesis induced in the rabbit cornea by alkaline cauterization. Methods: Inflammatory angiogenesis was induced by alkaline (sodium hydroxide) cauterization in the corneas of 29 male New Zealand rabbits. The animals were divided into 4 groups: a control group treated with 0.5% carboxymethylcellulose sodium eye drops, a group treated with 1.0% prednisolone acetate eye drops, a group treated with 0.5% pegaptanib sodium diluted in 15 mL 0.5% carboxymethylcellulose sodium, and a group treated with 1.0% pegaptanib sodium diluted in 15 mL 0.5% carboxymethylcellulose sodium. After cauterization, eye drops were administered every 12 hours for 21 days. The animals were evaluated every 3 days after cauterization, and the newly formed vessels were quantified from photographs. The treatment effectiveness was analyzed with 3 parameters of antiangiogenic response: neovascularization area (NA), total vascular length (TVL), and number of blood vessels (BVN). Results: Average NA, TVL, and BVN values were significantly higher in both pegaptanib groups than in the prednisolone group. A nonstatistically significant reduction in parameters on days 18 and 21 was the minimum achieved in both pegaptanib groups. The efficacy of the treatments in relation to the control was significantly greater in the prednisolone group than in the 0.5% pegaptanib group or the 1.0% pegaptanib group (P < 0.001). Conclusion: Topical instillation of 0.5% and 1.0% pegaptanib sodium diluted in 15 mL 0.5% carboxymethylcellulose sodium had no inhibitory effect on corneal neovascularization in this rabbit model.

Destoxificação e perfil nutricional da torta de mamona destoxificada por diferentes soluções alcalinas / [Detoxification and nutritional profile of the detoxified castor by different alkaline solutions]

Objetivou-se avaliar a destoxificação da torta de mamona bruta (TMB), por meio de dois produtos alcalinos em diferentes concentrações, e seus efeitos sobre a composição química, a degradabilidade in situ da MS e o fracionamento de proteínas. Utilizou-se o hidróxido de cálcio [Ca(OH)2] e o hidróxido de sódio (NaOH) em duas concentrações (60 e 90 gramas), diluídos em quatro quantidades de água (1.000; 1.500; 2.000 e 2.500mL de água por quilo de TMB). Observou-se que, das diferentes concentrações utilizadas, somente a utilização de 90 e 60 gramas de Ca(OH)2 e NaOH, respectivamente, conseguiu destoxificar 100% da TMB, ambas diluídas em 2.000mL de água. Por outro lado, ao avaliar o tempo mínimo de contato dos reagentes com a TMB para uma máxima destoxificação, observou-se que três horas de contato é o tempo necessário para os reagentes diminuírem em 100% as proteínas citotóxicas, além de não deixar atividade hemaglutinante nesse material. A destoxificação com o NaOH proporcionou maior degradação das proteínas solúveis e da matéria seca, favorecendo a disponibilização do nitrogênio não proteico, estando sua aplicação em escala industrial na dependência de estudos sobre viabilidade operacional e econômica.(AU)

This study aimed to evaluate the detoxification of crude castor (DCC) through two alkaline products in different concentrations and their effects on the chemical composition, in situ degradability of DM and the fractionation of proteins. We used the calcium hydroxide [Ca(OH)2] and sodium hydroxide (NaOH) in two concentrations (60 and 90 grams) diluted in 4 quantities of water (1,000; 1,500; 2,000 and 2,500ml of water per kilo of DCC). It was observed that in the different concentrations used, only the use of 90 and 60 grams of Ca(OH)2 and NaOH, respectively managed to detoxify 100% of the DCC, both diluted in 2,000ml of water. On the other hand, when assessing the minimum time of contact of the reagents with the DCC for maximum detoxification, it was observed that with three hours of contact is the time required for the reagents decrease in 100% of the cytotoxic proteins, in addition to not leave haemagglutinating activity in this material. The detoxification with NaOH provided greater degradation of soluble proteins and degradation of dry matter, favoring the provision of non-protein nitrogen, while its application on an industrial scale is in the dependence of studies on operational feasibility and cost.(AU)

Efficacy of management for obstruction caused by precipitated medication or lipids in central venous access devices: A systematic review and meta-analysis.

At present, central venous access devices (CVADs) are widely used in clinical practice. The reasons for CVAD obstruction caused by precipitated medication or lipids are increasingly complex. However, there is no clear treatment program for CVAD obstruction caused by precipitated medication or lipids. The target of this study was to analyze data regarding obstruction caused by precipitated medication or lipids in CVADs and to calculate the efficacy of different treatment methods. A systematic review with meta-analysis was conducted in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The PubMed, Web of Science, EMBASE, Cochrane Library, CINAHL, and China National Knowledge Internet databases were searched for original research published before 2018. There were 1356 publications initially screened, with one additional study identified through snowballing. Seven studies met the inclusion criteria. The reasons for obstruction, except for clot formation, primarily included the following: mechanical complications; lipid deposition; mineral deposition; or drug precipitation. Meta-analysis showed that sodium hydroxide resulted in the highest recanalization rate in lipid deposition, followed by ethanol, and the difference was significant. The efficacy analysis revealed that hydrochloric acid and l-cysteine have similar effects on mineral deposition and drug precipitation. According to this review, the most effective methodology was shown to be the intravenous perfusion of sodium hydroxide in several treatments when the obstruction is caused by lipid deposition. In contrast, mineral deposition and drug deposition are best treated with l-cysteine to recover the patency of central venous access devices.

Sodium hydroxide as a sclerosing agent in patients with neoplastic pleural effusion non-candidates for VATS: results of a minimally invasive protocol.

Symptomatic neoplastic pleural effusion (SNPE) is a significant cause of morbidity in patients with advanced neoplastic disease. These patients often present a deteriorated general condition which prevents them from undergoing pleurodesis with video-assisted thoracic surgery (VATS). We developed a minimally invasive therapeutic protocol specially designed for this population, achieved by combining chemical pleurodesis with placement of small-bore pleural catheters (PC), which resulted in early hospital discharge, low morbimortality and good therapeutic results. This study reports the safety and efficacy of administration of sodium hydroxide (NaOH) through PC in 60 patients diagnosed with SNPE who were admitted to Hospital Italiano de Buenos Aires between January 2012 and December 2015. Successful pleurodesis was achieved in 96% of procedures. Recurrence occurred in 25% of patients during follow-up, with recurrence occurring earlier than 30 days after pleurodesis in 8% of patients. There were no reports of major morbidity or associated mortality. In total, 44% of patients were discharged within 48 h of pleurodesis. Administration of NaOH through a small-bore PC represents an effective and safe method of pleurodesis in patients who are not candidates for talc pleurodesis by VATS.

The Influence of pH and Sodium Hydroxide Exposure Time on Glucosamine and Acrylamide Levels in California-Style Black Ripe Olives.

Acrylic acid, N-acetyl-glucosamine and glucosamine were investigated for their role in the formation of acrylamide in California-style black ripe olives [CBROs]. Levels of acrylic acid and glucosamine are reported for the first time in fresh (333.50 ± 21.88 and 243.59 ± 10.06 nmol/g, respectively) and in brine-stored olives (184.50 ± 6.02 and 165.88 ± 11.51 nmol/g, respectively). Acrylamide levels significantly increased when acrylic acid (35.2%), N-acetyl-glucosamine (29.9%), and glucosamine (124.0%) were added to olives prior to sterilization. However, isotope studies indicate these compounds do not contribute carbon and/or nitrogen atoms to acrylamide. The base-catalyzed degradation of glucosamine is demonstrated in olive pulp and a strong correlation (r2 = 0.9513) between glucosamine in olives before sterilization and acrylamide formed in processed CBROs is observed. Treatment with sodium hydroxide (pH > 12) significantly reduces acrylamide levels over 1 to 5 d without impacting olive fruit texture.

Economic and Environmental Considerations During Low Fresh Gas Flow Volatile Agent Administration After Change to a Nonreactive Carbon Dioxide Absorbent.

BACKGROUND: Reducing fresh gas flow (FGF) during general anesthesia reduces costs by decreasing the consumption of volatile anesthetics and attenuates their contribution to greenhouse gas pollution of the environment. The sevoflurane FGF recommendations in the Food and Drug Administration package insert relate to concern over potential toxicity from accumulation in the breathing circuit of compound A, a by-product of the reaction of the volatile agent with legacy carbon dioxide absorbents containing strong alkali such as sodium or potassium hydroxide. Newer, nonreactive absorbents do not produce compound A, making such restrictions moot. We evaluated 4 hypotheses for sevoflurane comparing intervals before and after converting from a legacy absorbent (soda lime) to a nonreactive absorbent (Litholyme): (1) intraoperative FGF would be reduced; (2) sevoflurane consumption per minute of volatile agent administration would be reduced; (3) cost savings due to reduced sevoflurane consumption would (modestly) exceed the incremental cost of the premium absorbent; and (4) residual wastage in discarded sevoflurane bottles would be <1%. METHODS: Inspired carbon dioxide (PICO2), expired carbon dioxide, oxygen, air, and nitrous oxide FGF, inspired volatile agent concentrations (FiAgent), and liquid volatile agent consumption were extracted from our anesthesia information management system for 8 4 week intervals before and after the absorbent conversion. Anesthesia providers were notified by e-mail and announcements at Grand Rounds about the impending change and were encouraged to reduce their average intraoperative sevoflurane FGF to 1.25 L/min. Personalized e-mail reports were sent every 4 weeks throughout the study period regarding the average intraoperative FGF (i.e., from surgery begin to surgery end) for each agent. Batch means methods were used to compare FGF, volatile agent consumption, net cost savings, and residual sevoflurane left in bottles to be discarded in the trash after filling vaporizers. The time from reaching a PICO2 = 3 mm Hg for 3 minutes until agent exhaustion (PICO2 = 5 mm Hg for 5 minutes) was evaluated. RESULTS: A total of N = 20,235 cases were analyzed (80.2% sevoflurane, 15.1% desflurane, and 4.7% isoflurane). Intraoperative FGF was reduced for cases in which sevoflurane was administered by 435 mL/min (95% confidence interval [CI], 391 to 479 mL/min; P < 10). Hypothesis 1 was accepted. Sevoflurane consumption per minute of administration decreased by 0.039 mL/min (95% CI, 0.029 to 0.049 mL/min; P < 10) after the change to the nonreactive absorbent. Hypothesis 2 was accepted. The difference in mean cost for the sum of the sevoflurane and absorbent purchases for each of the 10 4-week intervals before and after the absorbent switch was -$293 per 4-week interval (95% CI, -$2853 to $2266; P = 0.81). Hypothesis 3 was rejected. The average amount of residual sevoflurane per bottle was 0.67 ± 0.06 mL (95% CI, 0.54 to 0.81 mL per bottle; P < 10 vs 2.5 mL). Hypothesis 4 was accepted. Once the PICO2 reached 3 mm Hg for at least 3 consecutive minutes, the absorbent became exhausted within 95 minutes in most (i.e., >50%) canisters. CONCLUSIONS: We showed that an anesthesia department can transition to a premium, nonreactive carbon dioxide absorbent in a manner that is at least cost neutral by reducing FGF below the lower flow limits recommended in the sevoflurane package insert. This was achieved, in part, by electronically monitoring PICO2, automatically notifying the anesthesia technicians when to change the absorbent, and by providing personalized feedback via e-mail to the anesthesia providers.

The effects of different environmental pH on healing of tympanic membrane: an experimental study.

In this study, we investigated the effect of environmental pH on healing of acute rat tympanic membrane perforations. Twenty Wistar albino rats were divided into four groups and used in the study. A large myringotomy was performed in the posteroinferior quadrants of both tympanic membranes. In left ears, topical pH 4 standard calibration solution was used in groups 1 and 3, and pH 7 standard calibration solution was used in groups 2 and 4. Right ears served as controls, and allowed for spontaneous healing. The solutions were applied for 2 days in groups 1 and 2, and for 7 days in groups 3 and 4. Healing was assessed by macroscopic closure of the tympanic membrane perforation, and histopathological analysis of lamina propria edema, neovascularization, inflammatory cells, and fibroblastic reaction in the temporal bones. pH 7 and pH 4 groups were similar for macroscopic closure of perforation on day 2; however difference was significant on day 7. The fibroblastic activity was significantly less on days 2 and 7 in pH 4 group. On day 7, there were significant differences between pH 4 and pH 7, and pH 7 and control groups for inflammatory cell infiltration. In conclusion, clinical and histopathological results of this study indicated that acidic environmental pH speeded up and shortened wound-healing process. By building up optimum environmental pH, a healthy healing may be achieved in acute tympanic membrane perforations.

Controlled trial comparing the efficacy of 88% phenol versus 10% sodium hydroxide for chemical matricectomy in the management of ingrown toenail.

BACKGROUND: Partial nail avulsion with lateral chemical matricectomy is the treatment of choice for ingrown toenails. Phenol (88%) is the most widely used chemical agent but prolonged postoperative drainage and collateral damage are common. Sodium hydroxide (NaOH) 10% has fewer side-effects. METHODS: Adult, consenting patients with ingrown toenails were alternately allocated into two treatment groups in the order of their joining the study, to receive either 88% phenol (Group 1, n = 26) or 10% NaOH (Group 0, n = 23) chemical matricectomy. The patients as well as the statistician were blinded to the agent being used. Post-procedure follow-up evaluated median duration of pain, discharge, and healing along with recurrence, if any, in both the groups. The group wise data was statistically analyzed. RESULTS: Both the groups responded well to treatment with the median duration of postoperative pain being 7.92 days in Group 0 and 16.25 days in Group 1 (P < 0.202). Postoperative discharge continued for a median period of 15.42 days (Group 0) and 18.13 days (Group 1) (P < 0.203). The tissue condition normalized in 7.50 days (Group 0) and 15.63 days (Group 1) (P < 0.007). LIMITATIONS: Limited postsurgical follow up of 6 months is a limitation of the study. CONCLUSION: Chemical matricectomy using NaOH is as efficacious as phenolisation, with the advantage of faster tissue normalization.

Chemical matricectomy with sodium hydroxide: long-term follow-up results.

BACKGROUND: Chemical matricectomy with sodium hydroxide is a method being used successfully in the treatment of ingrown toenail. OBJECTIVE: In this study, it was aimed to evaluate long-term recurrence rates after chemical matricectomy using sodium hydroxide application of different durations. MATERIALS AND METHODS: Two hundred two patients with ingrown nail edges were treated with either 1-minute (Group 1) or 2-minute (Group 2) applications of sodium hydroxide matricectomy. All patients were followed for at least 2 years. RESULTS: Chemical matricectomy with sodium hydroxide was applied to a total of 585 nail edges of 202 cases. The overall recurrence rates in Group 1 and Group 2 were 6.4% and 7.1%, respectively, during the average 7.5-year follow-up period. No statistically significant differences were detected in terms of recurrence between the 2 groups (p = .73). CONCLUSION: Chemical matricectomy with sodium hydroxide is an easy method in the treatment of ingrown nails, with low morbidity and high success rates. There was no difference between 1-minute and 2-minute applications in terms of recurrence during the long-term follow-up. Chemical matricectomy with 1-minute application of sodium hydroxide showed high success in terms of long-term follow-up results.

Skin barrier integrity and natural moisturising factor levels after cumulative dermal exposure to alkaline agents in atopic dermatitis.

Dermal exposure to alkaline agents may lead to skin barrier damage and irritant contact dermatitis. The objective of this study was to investigate the effects of cumulative exposure to 0.5% sodium lauryl sulphate (SLS) and 0.15% NaOH on the barrier function and natural moisturising factor (NMF) levels in atopic dermatitis and healthy volunteers with known filaggrin genotype. The skin response was monitored by measurement of erythema and transepidermal water loss. The stratum corneum NMF levels were determined by high-performance liquid chromatography. Repeated exposure to 0.5% SLS and/or 0.15% NaOH in atopic dermatitis resulted in more severe impairment of the skin barrier function. Cumulative exposure to the irritants reduced significantly NMF in both the atopic and healthy controls group. The pronounced decrease of NMF after repeated single and sequential irritant exposure may be a pathogenetically relevant factor for development of chronic irritant contact dermatitis in both healthy and atopic individuals.

Preventing irritant contact dermatitis with protective creams: influence of the application dose.

BACKGROUND: Skin protection creams (PC)s are used in the occupational setting to help prevent irritant hand dermatitis. The actual amounts of PC applied and the resulting dose per unit area on hands at work are lower than recommended. OBJECTIVES: To assess the influence of the applied dose on the efficacy of PCs in the prevention of irritant contact dermatitis. METHODS: Experimental cumulative irritant contact dermatitis was induced by twice daily application of 0.5% NaOH or sodium lauryl sulfate (SLS) for 4 days on the backs of 20 healthy volunteers. Test areas were left unprotected or were pretreated with three different PCs applied at a low dose (2 mg/cm(2) ) or a high dose (20 mg/cm(2) ) before irritation. Irritant responses were assessed by visual scoring and measurement of transepidermal water loss, chromametry, and corneometry. RESULTS: Although cumulative irritant dermatitis developed in all unprotected test sites, irritation was significantly reduced in a dose-dependent manner on PC-protected sites. The higher doses of all PCs provided significant protection against irritation. However, the lower dose of one product did not significantly protect against SLS-induced irritation. CONCLUSIONS: The protective efficacy of PCs depends on the amount of product applied per unit skin surface area. Some products may show no protective efficacy when used at doses close to those practically applied at workplaces. Future efficacy studies of PCs should be performed with doses not higher than 2 mg/cm(2) , to avoid overestimation of their protective efficacy.

Effects of sulfur and acidity on performance and digestibility in feedlot lambs fed dried distillers grains with solubles.

Negative interactions of the acidity and S content of dried distillers grains with solubles (DDGS) have not been quantified. The objectives of this study were to determine the effects of dietary S, dietary acidity, and their interactions on growth, feed efficiency, ruminal H2S concentration, and apparent nutrient digestibility in lambs fed DDGS-based diets. To neutralize acidity, the DDGS was untreated or treated with 2% NaOH. Dietary S content was adjusted with Na2SO4 to achieve a 0.2 percentage unit difference in dietary S. Experiment 1 included 72 ewe and wether lambs (BW = 24.9 ± 0.4 kg) penned by sex in 24 pens, blocked by BW, and allotted in a 2 × 2 factorial arrangement of treatments for a 60 d feeding trial. On a DM basis, diets were: i) 60% DDGS + 0% Na2SO4, ii) 60% DDGS + 0.88% Na2SO4, iii) 62% NaOH-treated DDGS + 0% Na2SO4, and iv) 62% NaOH-treated DDGS + 0.83% Na2SO4. There were no interactions (P ≥ 0.19) of dietary S concentration and NaOH treatment. Lambs fed DDGS treated with 2% NaOH had 4% greater (P = 0.05) final BW and tended (P ≤ 0.07) to have greater DMI and ADG than lambs fed untreated DDGS; however, NaOH treatment did not affect (P = 0.42) G:F. Increasing dietary S with Na2SO4 tended (P = 0.07) to reduce DMI; however, dietary S did not affect (P > 0.17) ADG, G:F, or final BW. Rumen H2S concentration in gas samples collected on d 32 and 60 were not (P > 0.17) affected by dietary S or NaOH treatment. Experiment 2 included 24 lambs (initial BW = 43.0 ± 4.4 kg) used to determine the effects of NaOH treatment of DDGS and sulfur (Na2SO4) supplementation on N retention and the apparent digestibility of NDF, ADF, and OM. Treatments were similar to those used in Exp. 1, except that dietary DDGS was reduced to 45% of DM. Intake of DM, NDF, ADF, and N was not affected (P > 0.16) by NaOH treatment of DDGS or dietary S (Na2SO4) content. Treating DDGS with 2% NaOH reduced (P = 0.05) NDF digestibility by 10% compared with lambs fed untreated DDGS. Urine pH for lambs consuming DDGS treated with 2% NaOH was increased (P = 0.01) 1.74 pH units compared with urine from lambs fed untreated DDGS. Nitrogen intake and retention were not affected (P > 0.35) by dietary S concentration or NaOH treatment of DDGS. For feedlot lambs, treating DDGS with 2% NaOH did not lower ruminal H2S concentrations, but tended to increase ADG and DMI. Although treating DDGS with 2% NaOH was an effective way to neutralize the acidity in DDGS, this treatment reduced NDF digestibility.

Modelo experimental de estenose traqueal mediante ressecção cirúrgica submucosa de anéis traqueais combinada com instilações de hidróxido de sódio / Experimental model of tracheal stenosis with submucosal resection of cartilaginous rings combined with sodium hydroxide instillations

OBJETIVO: Desenvolver, experimentalmente, malácia e estenose traqueal para testar novos modelos de órteses traqueais. MÉTODOS: Ressecamos três anéis cartilaginosos da traqueia cervical de cães no grupo A (n=5) e seis anéis no grupo B (n=4) para produzir malácia. Logo após, a mucosa da região com malácia recebeu aplicações de uma solução de hidróxido de sódio (NaOH) a 23 por cento, e os animais eram acompanhados com exames broncoscópicos para observar o desenvolvimento de estreitamento da luz da via aérea. Quando a estenose era de mais de 50 por cento da luz, ou havia sinais mínimos de insuficiência ventilatória, os animais eram sacrificados. O segmento de via aérea estreitada foi então coletado para análise histológica e era calculada a área de luz residual do segmento traqueal com estenose e malácia. RESULTADOS: Na análise histológica, foi constatada fibrose na submucosa e adventícia, associada a granulomas na mucosa. A luz residual média dos segmentos com estenose foi de 9 por cento e 12 por cento nos grupos A e B, respectivamente, (p>0,05). CONCLUSÃO: A combinação da ressecção de anéis cartilaginosos e da aplicação de NaOH 23 por cento na mucosa respiratória promoveu uma estenose traqueal intensa, porém esteve associada à perda de animais. Novos estudos são necessários para verificar se o emprego isolado de uma das técnicas seria mais seguro e eficaz para desenvolver estenose traqueal.

OBJECTIVE: To experimentally develop tracheal stenosis and malacia to test new models of tracheal stents. METHODS: We resected three cartilaginous rings from the cervical trachea of dogs in group A (n = 5) and six rings in group B (n = 4) to produce malacia. The mucosa of the region with malacia then received applications of a solution of sodium hydroxide (NaOH) at 23 percent, and the animals were accompanied with bronchoscopic examinations to observe the development of luminal narrowing of the airway. When the stenosis was of more than 50 percent or there were minimal signs of ventilatory failure, the animals were sacrificed. The segment of narrowed airway was then collected for histological analysis and calculation of the area of residual lumen in the tracheal segment with stenosis and malacia. RESULTS: In histological analysis, fibrosis was found in the submucosa and adventitia, associated with granulomas in the mucosa. The average residual lumen of the segments with stenosis was 9 percent and 12 percent in groups A and B, respectively (p> 0.05). CONCLUSION: The combination of resection of the cartilaginous rings and the application of 23 percent NaOH in the respiratory mucosa promoted severe tracheal stenosis, but was associated with loss of animals. Further studies are needed to verify that the isolated use of one of the techniques would be safer and more effective to develop tracheal stenosis.

Experimental model of tracheal stenosis with submucosal resection of cartilaginous rings combined with sodium hydroxide instillations.

OBJECTIVE: To experimentally develop tracheal stenosis and malacia to test new models of tracheal stents. METHODS: We resected three cartilaginous rings from the cervical trachea of dogs in group A (n = 5) and six rings in group B (n = 4) to produce malacia. The mucosa of the region with malacia then received applications of a solution of sodium hydroxide (NaOH) at 23%, and the animals were accompanied with bronchoscopic examinations to observe the development of luminal narrowing of the airway. When the stenosis was of more than 50% or there were minimal signs of ventilatory failure, the animals were sacrificed. The segment of narrowed airway was then collected for histological analysis and calculation of the area of residual lumen in the tracheal segment with stenosis and malacia. RESULTS: In histological analysis, fibrosis was found in the submucosa and adventitia, associated with granulomas in the mucosa. The average residual lumen of the segments with stenosis was 9% and 12% in groups A and B, respectively (p> 0.05). CONCLUSION: The combination of resection of the cartilaginous rings and the application of 23% NaOH in the respiratory mucosa promoted severe tracheal stenosis, but was associated with loss of animals. Further studies are needed to verify that the isolated use of one of the techniques would be safer and more effective to develop tracheal stenosis.

Thermochemical ablation in an ex-vivo porcine liver model using acetic acid and sodium hydroxide: proof of concept.

PURPOSE: To establish proof of concept in tissue, using the exothermic neutralization reaction of acetic acid and sodium hydroxide in ex vivo porcine liver and to conduct an initial probe into the relationships of volume and concentration of reagents to temperatures and the areas affected. MATERIALS AND METHODS: A total of 0.5 mL or 2 mL of either 5 mole/L or 10 mole/L acid and base solutions was injected simultaneously into the periphery of ex vivo porcine liver using a prototype injection device. Tissue temperature was recorded at the injection site for 5 minutes using a type T thermocouple temperature probe inserted parallel to and near the tip of the injection device. The injections were repeated for infrared thermography, and ablated tissues were sectioned quickly and imaged. A gross photograph was captured in each case to provide correlation. RESULTS: Maximum temperatures (17°C baseline) ranged from 42.1° ± α3.34°C to 61.7° ± α10°C (P<.05) when injecting 0.5 mL of 5 mole/L reactants and 2 mL of 10 mole/L reactants, respectively. The maximum temperature measured by infrared imaging ranged from 31°-47°C. Using an infrared viewing scale from 19°-40°C, the cross-sectional area of tissue heating above baseline measured from 1.07 cm(2)± 0.45 to 4.95 cm(2)± 0.28 (P <05). CONCLUSIONS: The reaction of acetic acid and sodium hydroxide releases significant heat energy at the site of injection, and histologic changes are consistent with coagulation necrosis. Increased reagent concentration and volume were associated with larger temperature changes and larger areas of hyperthermia at gross pathology and infrared imaging.

Chemical matricectomy with 10% sodium hydroxide for the treatment of ingrown toenails in people with diabetes.

BACKGROUND: Treatment of ingrown toenails using chemical matricectomy in patients with diabetes has been difficult, because delayed wound healing, wound infections, and digital ischemia can interfere with the procedure. Chemical matricectomy with 10% sodium hydroxide is an effective treatment for ingrown toenails in a normal population. OBJECTIVES: Investigation of the effectiveness and safety of chemical matricectomy with 10% sodium hydroxide solution for ingrown toenails in patients with diabetes. MATERIAL AND METHODS: Thirty patients with diabetes with 40 ingrown toenails and 30 patients without diabetes with 41 ingrown toenails were enrolled in the study. After partial avulsion of the affected edge, germinal matrix was treated for 1 minute with 10% sodium hydroxide. Patients were observed on alternate days until complete healing was achieved and followed for up to 24 months for recurrence. RESULTS: Assessment of the treatment in both groups for complete healing, postoperative pain, tissue damage, drainage, infections, and rate of recurrences revealed no statistically significant difference. CONCLUSIONS: The partial avulsion of the affected edge and the treatment of the germinal matrix for 1 minute with 10% sodium hydroxide preceded by matrix curettage is an effective and safe treatment modality for ingrown toenails in people with diabetes.

Electrocautery versus 23% NaOH infiltration to induce subglottic stenosis in a canine experimental model.

Subglottic stenosis (SGS) is defined as the narrowing of the lower larynx. Difficulties in the management of subglottic stenosis, especially in the pediatric population, justify the development of experimental models. The objective of this study was to compare the two methods of experimental subglottic stenosis induction. Twenty-three dogs were randomly selected and assigned by lottery to either one of the two groups: Gp I (n = 10) of electrocoagulation; and Gp II (n = 13) of 23% NaOH injection. In Gp I, self-interruption electrocoagulation was applied to one point in each of the four quadrants of the cricoid cartilage. In Gp II, 0.2 ml of 23% NaOH was injected in the submucosal layer in the anterior and posterior portions of the cricoid cartilage. Once a week, endoscopy was performed and the caliber of the subglottic region was measured using endotracheal tubes, and the injection was repeated if there were no signs of subglottic stenosis. The animals were killed on day 21; animals that developed respiratory distress were killed before day 21. One animal in Gp I died on day 14 after the injection and during transportation; two animals in Gp II died, one on day 7 due to a tracheoesophageal fistula, and the other of unknown causes on day 5. Significant subglottic stenosis (over 51% obstruction) was found in 67% of the animals in Gp I and in 64% of those in Gp II (P = 0.99). Median time to development of significant stenosis was 21 days in both groups, and required either two or three injections. Mean time for the performance of the procedures was significantly shorter (P < 0.01) in Gp I (mean: 6.36 min) than in Gp II (mean: 14.88 min). Electrocoagulation and 23% NaOH injection in the subglottic region were effective in the development of significant subglottic stenosis in dogs, both methods leading to stenosis in the same period of time and after the same number of procedures. However, electrocoagulation was the fastest method.

Comparison of phenol and sodium hydroxide chemical matricectomies for the treatment of ingrowing toenails.

OBJECTIVE: Chemical matricectomy is performed mainly by two agents: phenol and sodium hydroxide. Both agents have excellent cure rates, but there are no data about the comparison of postoperative healing periods. This study was designed to compare the postoperative morbidity rates of sodium hydroxide and phenol matricectomies. MATERIALS AND METHODS: Forty-six patients with 154 ingrowing nail sides were treated with either sodium hydroxide or phenol matricectomy. In the postoperative period, the patients were evaluated for the duration and severity of pain, drainage, and peripheral tissue destruction; complete healing periods; and overall success rates. RESULTS: The incidence of pain was higher in the sodium hydroxide group on the first visit, on the second day, but all patients became pain-free after that. The incidence and duration of drainage and peripheral tissue destruction was significantly higher in the phenol group. The mean period for complete recovery was 10.8 days in the sodium hydroxide group, whereas it was 18.02 days in the phenol group. The overall success rates in the sodium hydroxide and phenol groups were found to be 95.1 and 95.8%, respectively. CONCLUSION: Both sodium hydroxide and phenol are effective agents giving high success rates, but sodium hydroxide causes less postoperative morbidity and provides faster recovery.

[Effect of different cooking treatments of Mucuna beans on its L-Dopa content]. / Efecto de diversos tratamientos en la cocción del frijol Mucuna sobre el contenido de L-Dopa.

The main limiting factor in the consumption by humans of the velvet bean (Mucuna) is its relatively high content of L-Dihydroxyphenylalanine (L-Dopa), with levels as high as 9%. Conventional cooking methods used to transform raw velvet bean into an edible product are not sufficiently effective in reducing the levels of L-Dopa in adequate processing time. In this report, Mucuna beans were cooked by microwave, utilizing vapor and in water solutions at pH 3, 6, 7, 9 and 11. Cooking alkaline solutions were achieved using sodium hydroxide, potassium hydroxide, and calcium hydroxide. The acid pH was achieved through the use of HCl. The initial cooking time was fixed at 6 hrs. The processed bean samples were dried, ground and analyzed for L-Dopa and protein. The ground samples were further washed with boiling water for 0, 3 and 6 minutes, them dried and analyzed. None of the procedures evaluated was capable of eliminating L-Dopa from Mucuna beans. The Ca(OH)2 treatment at pH 9 which was washed with hot water produce a reduction of L-Dopa of 80.4%. There was not effect attributed to the alkaline ions. Reducing particle size appears to be most effective as it has been shown by other workers.

Dissolution of porcine incisor pulps in sodium hypochlorite solutions of varying compositions and concentrations.

BACKGROUND: The solubility of dental pulp tissue in sodium hypochlorite has been extensively investigated but results have been inconsistent; due most likely to variations in experimental design, the volume and/or rate of replenishment of the solutions used and the nature of the tissues assessed. Traditionally, the sodium hypochlorite solutions used for endodontic irrigation in Australia have been either Milton or commercial bleach, with Milton being the most common. Recently, a range of Therapeutic Goods Administration (TGA) approved proprietary sodium hypochlorite solutions, which contain surfactant, has become available. Some domestic chlorine bleaches now also contain surfactants. The purpose of this study was to perform new solubility assessments, comparing Milton with new TGA approved products, Hypochlor 1% and Hypochlor 4% forte, and with a domestic bleach containing surfactant (White King). METHODS: Ten randomly assigned pulp samples of porcine dental pulp of approximately equal dimensions were immersed in the above solutions, as well as representative concentrations of sodium hydroxide. Time to complete dissolution was measured and assessed statistically. RESULTS: White King 4% showed the shortest dissolution time, closely followed by Hypochlor 4% forte. White King 1% and Hypochlor 1% each took around three times as long to completely dissolve the samples of pulp as their respective 4% concentrations, while Milton took nearly 10 times as long. The sodium hydroxide solutions showed no noticeable dissolution of the pulp samples. CONCLUSIONS: The composition and content of sodium hypochlorite solutions had a profound effect on the ability of these solutions to dissolve pulp tissue in vitro. Greater concentrations provided more rapid dissolution of tissue. One per cent solutions with added surfactant and which contained higher concentrations of sodium hydroxide were significantly more effective in dissolution of pulp tissue than Milton.