Sympathetic hyperactivity, respiratory failure, pruritus, and anesthesia after unintentional epidural injection of potassium chloride: Case report

Background and Objectives. A combination of epidural and general anesthesia has been widely used to attenuate the surgical stress response and to provide postoperative analgesia. This case report illustrates the use of this anesthetic technique. Analgesia was induced with local anesthetic in the immediate postoperative period using unintentional 19.1% potassium chloride (KCI) as diluent. Methods. An ASA I male patient was scheduled for surgical correction of idiopathic megaesophagus under continuous epidural anesthesia combined with general anesthesia. In the postoperative period, while preparing 10 mt 0.125% bupivacaine to be administered through the epidural catheter for pain control, 5 mt 19.1% KCI was unintentionally used as diluent, resulting in a 9.55% potassium solution concentration. Results. The patient developed warmness of the lower limbs, tachycardia, hypertension, intense pruritus on the chest, agitation, exacerbation of sensory and motor blocks, and respiratory failure secondary to pulmonary edema, requiring ventilatory support. Total recovery was observed after 24 hours. Conclusions. Epidurally injected potassium leads to severe clinical manifestations caused by autonomic dysfunction, spinal cord irritation, and possible release of histamine. Despite continuous recommendations, ampule misidentification still happens in hospitals, frequently leading to serious accidents.

Evaluation of an electroless nickel interlayer on the fatigue & corrosion strength of chromium-plated AISI 4340 steel

Despite the fact that chromium electrodeposition results in protection against wear and corrosion, combined with chemical resistance and good lubricity, the reduction in fatigue strength of base metal and environmental requirements causes one to search for possible alternatives. To improve the fatigue and corrosion resistance of AISI 4340 steel, an experimental study has been made for an intermediate electroless nickel layer deposited on base metal. The objective of this study was to analyze the effect of nickel underplate on the fatigue and corrosion strength of hard-chromium-plated AISI 4340 steel. Deposition of the conventional wear-resistant hard chromium plating leads to a decrease in mechanical properties of the base metal, especially the fatigue strength. Rotating bending fatigue tests results indicate better performance for conventional hard chromium plating. Good corrosion resistance in salt fog exposure was obtained for the accelerated hard chromium plating. Experimental data showed higher fatigue and corrosion resistance for samples prepared with accelerated hard chromium plate over electroless nickel plate, when compared with samples without electroless nickel underplate.

XPS study of the corrosion protection of fluorozirconate glasses dip-coated with SnO2 transparent thin films

Tin oxide nanoparticles prepared by an aqueous sol-gel method were deposited by dip-coating on fluorozirconate glass, ZBLAN (53%ZrF4-20%BaF2-4%LaF3-3%AlF3-20%NaF) to improve its resistance against wet corrosion. The aqueous leaching of uncoated and SnO2-coated fluorozirconate glass was studied by X-ray photoemission spectroscopy (XPS) and it was shown that even an ultra thin tin dioxide film provides good protection of the glass surface against the bulk propagation of the hydrolytic attack.

Study on the initial stages of water corrosion of fluorozirconate glasses

The surface corrosion process associated with the hydrolysis of fluorozirconate glass, ZBLAN (53ZrF(4), 20BaF(2), 20NaF, 4LaF(2), 3AlF(3)) was investigated using X-ray photoelectron spectroscopy (XPS), grazing-incidence small angle X-ray scattering (GISAXS), X-ray reflectivity (XRR) and scanning electron microscopy (SEM). After a short exposure period (25 min) of the glass surface to deionized water the XPS data indicate an increase of the oxygen content accompanied by a decrease of fluorine concentration. The analysis of the chemical bonding structure identified the predominant surface reaction products as zirconium hydroxyfluoride and oxyfluoride species. The second most abundant glass component, bariumfluoride, remains almost unaffected by oxygen, while sodium fluoride is completely removed from the attacked surface region. The detected structural and compositional changes are related to the selective dissolution of the glass components leading to the formation of a new surface phase. This process is accompanied by a visible surface roughening caused by reprecipitated species, observed by SEM. The modification of the glass surface is responsible for an increase of the GISAXS intensity. The scattering was attributed to nanovoids formed at the surface region of the glass with an average size of 2.4 +/- 0.05 nm. (C) 2004 Elsevier B.V. All rights reserved.

Aggregation behaviour of hydrophobically modified poly(allylammonium) chloride

The behaviour of hydrophobically modified poly(allylammonium) chloride having octyl, decyl, dodecyl and hexadecyl side chains has been studied in aqueous solution using fluorescence emission techniques. Micropolarity studies using the I-1/I-3 ratio of the vibronic bands of pyrene show that the formation of hydrophobic microdomains depends on both the length of the side chain and the polymer concentration. The I-1/I-3 ratio of the polymers with low hydrophobe content (less than 5% mel) changes substantially when reaching a certain concentration. These changes are assigned to aggregation originating from interchain interactions. This behaviour is also confirmed by the behaviour of the monomer/excimer emission intensities of pyrene- dodecanoic acid used as a probe. For polymers having dodecyl side chains and hydrophobe contents higher than 10%, aggregates are formed independently of the polymer concentration. Anisotropy measurements show that microdomains resulting from the inter- and/or intramolecular interactions are similar to those observed for cationic surfactants. Viscosity measurements show that the coil dimensions are substantially decreased for the polymers having high hydrophobe contents, indicating intramolecular associations.

Laser weld: microstructure and corrosion study of Ag-Pd-Au-Cu alloy of the dental application

The laser Welding process was introduced into dentistry by the end of the 1980s, resulting on a great impulse to that area with the development of cheaper and smaller equipment, using simpler technique. This allowed greater use of that process on the confection of prostheses compared to the brazing process since the heat source for that process is a concentrated light beam of high power, which minimizes distortion problems on the prosthetic pieces. Ag-Pd-Au-Cu alloy used on the confection of dental implant prostheses was observed before and after subjection to the laser welding process. The microstructure was analyzed with the. use of optic microscopy and the corrosion resistance was studied by the traditional electrochemical techniques and by electrochemical impedance, under environmental conditions simulating the aggressiveness found in the mouth cavity. A structural change was detected on the weld area, which presented a refined microstructure deriving from the high-speed cooling. The base metal out of the weld area presented a fusion coarse microstructure. The electrochemical essays showed differences on the potentiodynamic polarization behavior in both weld and metal base areas, indicating superior corrosion resistance in the weld area. The impedance spectra were characterized by capacitive distorted components, presenting linear impedance in the low frequencies area. (C) 2002 Elsevier B.V. B.V. All rights reserved.

Solid-state and solution structural study of acetylacetone-modified tin(IV) chloride used as a precursor of SnO2 nanoparticles prepared by a sol-gel route

The effect of addition of different amounts of acetylacetone (acacH) on the species formed at room temperature and after thermohydrolysis at 70 degreesC for 30 and 120 min of ethanolic SnCl4.5H(2)O solutions is followed by EXAFS spectroscopy at the Sn K-edge. We show that thermohydrolyzed solutions are a mixture of SnO2 nanoparticles and soluble tin polynuclear species. The complexation of the tin molecular precursors by acetylacetonate ligands is evidenced by H-1, C-13, and Sn-119 NMR spectroscopy and EXAFS for a acacH/Sn ratio higher than 2. Single crystals are isolated from solution and the structure, determined by X-ray diffraction, is built up from monomeric Cl-3(H2O)Sn(acac)-H2O units bridged together by hydrogen bonding. The acacH/Sn ratio in solution controls the polycondensation of the hydrolyzed species but not the crystallite size of the SnO2 nanoparticles (similar to2 nm). Because of the major presence of chelated tin mono- and dimeric complexes in solution for acacH/Sn > 2, the condensation is almost inhibited, meanwhile the decrease of amount of chelated complexes for the acacH/Sn < 2 gives rise to an increase of the number of nanoparticles.

Microstructure and corrosion resistance of inorganic-organic (ZrO2-PMMA) hybrid coating on stainless steel

Zirconia-polymethylmetacrylate hybrids prepared by a sol-gel method were deposited by dip-coating on stainless steel to improve the resistance against wet corrosion. The effect of the concentration of polymethylmetacrylate and the number of coating applications on the microstructure and corrosion performance of coated samples was investigated. The microstructural properties of samples was analyzed by scanning electron and atomic force microscopy, adhesion tests and profilemeter measurements. The electrochemical corrosion was evaluated through potentiodynamic polarization curves at room temperature. Results show that the sample prepared with 17 vol.% of polymethylmethacrylate has a maximum corrosion resistance, smaller roughness, are hermetic and adherent to the substrate. This film increases the life time of the stainless steel by a factor 30. (C) 1999 Elsevier B.V. B.V. All rights reserved.