tannins and aluminum-sulfate

Industrial wastewater causes several environmental and health issues due to its composition, and hydrogen sulfide is one of the main contaminants from various industrial activities, including tannery wastewater treatment plants. This study aimed to evaluate the application of a modified tannin to remove hydrogen sulfide, chemical oxygen demand, total nitrogen, color, and turbidity from tannery wastewater and to reduce the atmospheric emission of sulfides. The wastewater was treated using modified tannin, aluminum sulfate, and a combination of both. Gaseous sulfide emissions were analyzed qualitatively using paper soaked in lead acetate. The qualitative methodology of hydrogen sulfide in the atmosphere was efficient to identify the most critical areas in the tannery. The wastewater treatment tests showed that the best option was the combination of both coagulants, in a 50:50 ratio, resulting in a total coagulant dosage of 3,000 mg/L. The removal efficiencies achieved were 13.8% sulfides, 23.3% chemical oxygen demand, 9.1% total nitrogen, 97.3% turbidity, and 96.4% color. This treatment technique promotes the replacement of 50% of the aluminum sulfate currently used in the tannery by a non-toxic coagulant and does not require chemicals to adjust the pH of the wastewater.

Topics: Hydrogen Sulfide; Industrial Waste; Sulfides; Tannins; Waste Disposal, Fluid; Wastewater; Water Pollutants, Chemical

Aluminum potassium sulfate and tannic acid (ALTA) is an effective sclerosing agent for the treatment of internal hemorrhoids. ALTA therapy with rectal mucopexy (AM) is a new approach for treating hemorrhoidal prolapse. This study investigated the midterm outcomes of AM surgery in patients with hemorrhoids.. Patients with grade III hemorrhoids who underwent AM surgery were enrolled in this retrospective analysis of prospectively collected data from a single institution. Cumulative success rates, postoperative symptoms, including pain scores, analgesic requirements, and postoperative complications, and patient satisfaction were assessed.. The median number of ALTA injection procedures was 3 (range 1-4), and the median total injection dose was 19 mL (range 7-32 mL). The median number of mucopexy procedures was 2 (range 1-4). The median postoperative pain score (0 = no pain at all, 10 = worst pain imaginable) at rest or during defecation were ≤2. The total dose of analgesics administered during the first two weeks after surgery was 1 (range 0-25). Six patients (5.3%) showed postoperative complications: five showed Clavien-Dindo (C-D) grade I and one showed C-D grade IIIa complications. Cumulative success rates at one, three, and five years were 96.5%, 85.3%, and 85.3%, respectively. Patient satisfaction scores, which were assessed using a 10-point scale, were ≥9 at each postoperative year.. AM surgery is an effective non-excisional surgery with satisfactory mid-term results for grade III hemorrhoids, and is associated with lower complication rates, postoperative analgesic requirements, and higher patient satisfaction.

Topics: Analgesics; Hemorrhoids; Humans; Ligation; Pain, Postoperative; Retrospective Studies; Sclerotherapy; Tannins; Treatment Outcome

Aluminum potassium sulfate and tannic acid sclerotherapy for hemorrhoids produced almost the same effects as excisional hemorrhoidectomy. However, its long-term effectiveness remains unknown.. The purpose of this study was to investigate the long-term results of sclerotherapy using aluminum potassium sulfate and tannic acid for treating prolapsed hemorrhoids.. This was a retrospective review of a single-institution experience.. This study was conducted within a coloproctology unit at a community-based hospital.. In total, 1180 patients with grade II to IV hemorrhoids treated with injection sclerotherapy were enrolled.. Efficacy measures included cumulative recurrence rates and postoperative complications.. Recurrence rates at 3, 6, and 9 years were 7.4%, 27.2%, and 47.5%. Postoperative complications included fever ≥38°C in 16 (1.4%) patients, rectal ulcer in 10 (0.9%) patients, rectal stricture in 5 (0.4%) patients, and perianal abscess in 4 (0.3%) patients.. This was a retrospective, nonrandomized, single-center study. In addition, office visits after 3 years were optional and the number of follow-ups steadily decreased.. Sclerotherapy using aluminum potassium sulfate and tannic acid offers reasonable long-term results and is associated with low complication rates. Therefore, it seems to be an attractive alternative for patients with prolapsed hemorrhoids. See Video Abstract at http://links.lww.com/DCR/B733.RESULTADOS A LARGO PLAZO DE LA ESCLEROTERAPIA CON SULFATO DE ALUMINIO Y POTASIO, Y ÁCIDO TÁNICO PARA LAS HEMORROIDES PROLAPSADAS: ESTUDIO OBSERVACIONAL DE UN SOLO CENTRO.. La escleroterapia con sulfato de aluminio y potasio, y ácido tánico para las hemorroides produjo casi los mismos efectos que la hemorroidectomía por escisión. Sin embargo, se desconoce su eficacia a largo plazo.. El propósito de este estudio fue investigar los resultados a largo plazo de la escleroterapia con sulfato de aluminio y potasio, y ácido tánico para tratar las hemorroides prolapsadas.. Revisión retrospectiva de la experiencia de una sola institución.. Este estudio se realizó dentro de una unidad de coloproctología en un hospital comunitario.. En total, 1.180 pacientes fueron inscritos con hemorroides grado II a IV tratados con inyecciones esclerosantes.. Las medidas de eficacia incluyeron tasas acumulativas de recurrencia y complicaciones posoperatorias.. La tasa de recurrencia a los 3, 6 y 9 años fue del 7,4%, 27,2% y 47,5%, respectivamente. Las complicaciones posoperatorias incluyeron fiebre ≥ 38 grados Celsius en 16 pacientes (1,4%), úlcera rectal en 10 (0,9%), estenosis rectal en 5 (0,4%) y absceso perianal en 4 (0,3%) pacientes.. Este fue un estudio retrospectivo, no aleatorio, de un solo centro. Adicionalmente, las visitas al consultorio después de 3 años eran opcionales y el número de seguimientos disminuyó constantemente.. La escleroterapia con sulfato de aluminio y potasio, y ácido tánico ofrece resultados razonables a largo plazo y está asociada con bajas tasas de complicaciones. Por tanto, parece ser una alternativa atractiva para pacientes con hemorroides prolapsadas. Consulte Video Resumen en http://links.lww.com/DCR/B733. (Traducción- Dr. Francisco M. Abarca-Rendon).

Topics: Adjuvants, Immunologic; Adolescent; Adult; Aged; Aged, 80 and over; Alum Compounds; Female; Hemorrhoids; Humans; Male; Middle Aged; Retrospective Studies; Sclerotherapy; Tannins; Time Factors; Treatment Outcome; Young Adult

This study aimed to evaluate an alternative to reduce trihalomethane (THM) formation in brewing water. THM affects the organoleptic properties of water and, consequently, the produced beer. Water treatment based on common chemicals such as alum and free chlorine could potentially form THM. Therefore, we studied the replacement of chemicals used in water treatment: aluminum sulfate by a tannin-based coagulant and sodium hypochlorite by chlorine dioxide. Experimentally, jar tests were conducted, and the role of coagulants and oxidizing agents was evaluated for: the removal of apparent color, turbidity, natural organic matter (NOM) and microorganisms; the formation of trihalomethanes (THM); and the sensory quality of the water. Using tannin-based coagulant with chlorine dioxide was associated with the lowest THM in treated water (1.7 µg/L) and higher satisfaction in the sensory analysis. However, using these chemicals make the water treatment more expensive than the current strategy. Overall, using the tannin-based coagulant and chlorine dioxide treatment is an alternative to produce water with a lower THM concentration, better physical-chemical, and sensory quality. These findings motivate further brewing experiments and a deeper economics evaluation considering the process's sustainability.

Topics: Chlorine; Disinfection; Oxidants; Sodium Hypochlorite; Tannins; Trihalomethanes; Water Pollutants, Chemical; Water Purification

Topics: Alum Compounds; Anti-Bacterial Agents; Drug Resistance, Bacterial; Drug Resistance, Microbial; Genes, Bacterial; RNA, Ribosomal, 16S; Tannins; Wastewater

Aluminum potassium sulfate and tannic acid (ALTA) injection is a new sclerosing therapy for internal hemorrhoids that has been gaining widespread use. However, there have been few reports about rectal cancer after ALTA injection. We performed laparoscopic surgery for three patients who had underwent ALTA therapy 6 months or 1 year earlier: (i) a 51-year-old man with neuroendocrine tumor; (ii) a 44-year-old woman with rectal cancer; and (iii) 77-year-old man with rectal cancer. All three patients had sclerosis of the resected rectal wall stump, making transection of the rectum difficult. Histological examination of the specimens also showed an inflammatory reaction and/or fibrosis of the resection stump. Although laparoscopic low anterior resection was planned for all three patients, we had to construct a diverting stoma for two patients and could not perform sphincter-preserving surgery for the other. We must be well prepared for laparoscopic rectal surgeries after ALTA therapy, and these cases suggest sigmoidoscopy before ALTA therapy should be recommended.

Topics: Adult; Aged; Alum Compounds; Female; Hemorrhoids; Humans; Laparoscopy; Male; Middle Aged; Rectal Neoplasms; Sclerosing Solutions; Tannins

Following injection sclerotherapy using ALTA (aluminum potassium sulfate and tannic acid) (ALTAS) and transanal rectocele repair (TAR), changes in anorectal physiology were analyzed to compare the significance of the two treatments.. ALTAS was administered to 23 patients and 18 patients were treated using TAR. Efficacy measures included changes in defecography, anorectal manometry and constipation scoring system value.. This was a retrospective cohort analysis conducted on prospectively collected data. Comparing anorectal physiology pre- and post- ALTAS, a statistically significant difference in push was observed with pre-ALTAS treatment (pre-A) at 104.33 ± 4.91° compared with post-ALTAS treatment (post-A) at 113.95 ± 4.74° (p < 0.001). With a pre-A value of 1.55 ± 0.18 cm and a post-A value of 2.46 ± 0.34 cm, perineal descent also showed an increase as well (p < 0.001). The rectocele size decreased post-A from a pre-A value of 7.74 ± 0.86 cm compared with a post-A value of 2.91 ± 0.52 cm (p < 0.001). The rectal sensation improved post-A compared with pre-A. Comparing anorectal physiology results of ALTAS and TAR treatments, no differences in defecography and rectal sensation were detected pre- and post-treatment. However, in terms of anorectal manometry, the mean resting pressure and maximal squeezing pressure showed statistical difference with two treatments.. ALTAS treatment is a feasible option resulting in rapid and effortless long-term outcome, with low rates of complications. Therefore, this treatment may be an effective alternative for patients with symptomatic rectocele.

Topics: Adult; Alum Compounds; Anal Canal; Constipation; Defecation; Defecography; Female; Humans; Injections; Middle Aged; Perineum; Rectocele; Rectum; Retrospective Studies; Sclerotherapy; Tannins; Treatment Outcome

The bio-flocculants used in this study were synthesised by the Mannich reaction, which includes three reagents: a substrate (tannin extracts of Acacia, Quebracho, and Castanea), formaldehyde, and an amine derivative (ethanolamine, diethanolamine, ammonium chloride). Nine natural flocculants were prepared by combining extracts and amines; these products were evaluated in three different wastewater samples in two experimental phases. In phase I, five physicochemical parameters were analysed. From the data obtained, a multivariate, completely randomised design (CRD-Manava) was used, with a factorial arrangement and mean plots. In phase II, the three bio-flocculants with the most statistically significant responses and their mixtures were examined, evaluating 14 biological and physicochemical parameters. Statistical analysis was guided in this phase by CRD blocks, finding a significant removal in the physicochemical parameters analysed in the different types of wastewater and obtaining removal rates between 50 and 90%, depending on the parameter. At the end of both phases, the bio-flocculants acacia-ammonium chloride and quebracho-diethanolamine were the most efficient in the removal of turbidity (34-99%), true colour (93-100%) and total solids (12-99%). In addition, the natural flocculants showed low mutagenicity index (MI: 0.33-0.93) compared to aluminium sulphate (MI: 4.87-8.81).

Topics: Acacia; Alum Compounds; Flocculation; Tannins; Waste Disposal, Fluid; Wastewater; Water Pollutants, Chemical; Water Purification

Topics: Adult; Alum Compounds; Hemorrhoids; Humans; Male; Polyglycolic Acid; Rectal Diseases; Sclerotherapy; Tannins; Ulcer

We are reporting a rare case of acute liver injury that developed after an internal hemorrhoid treatment with the aluminum potassium sulfate and tannic acid (ALTA) regimen. A 41-year-old man developed a fever and liver injury after undergoing internal hemorrhoid treatment with a submucosal injection of ALTA with lidocaine. The acute liver injury was classified clinically as hepatocellular and pathologically as cholestastic. We could not classify the mechanism of injury. High eosinophil and immunoglobulin E levels characterized the injury, and a drug lymphocyte stimulation test was negative on postoperative day 25. Fluid replacement for two weeks after hospitalization improved the liver injury. ALTA therapy involves injecting chemicals into the submucosa, from the rectum to the anus, and this is the first description of a case that developed a severe liver disorder after this treatment; hence, an analysis of future cases as they accumulate is desirable.

Topics: Adult; Alum Compounds; Chemical and Drug Induced Liver Injury; Fever; Hemorrhoids; Humans; Injections, Intralesional; Lidocaine; Liver; Liver Function Tests; Male; Postoperative Complications; Sclerosing Solutions; Sclerotherapy; Tannins

Salivary protein difference value (SP D-value) is a quantitative measure of salivary protein replenishment, which reportedly relates to individual differences in perceived astringency. This in vitro measure is calculated as the difference in total salivary protein before (S1) and after (S2) stimulation with tannic acid, with a greater absolute value (S2-S1) indicating less protein replenishment. Others report that this measure predicts perceived astringency and liking of liquid model systems and beverages containing added polyphenols. Whether this relationship generalizes to astringent compounds other than polyphenols, or to solid foods is unknown. Here, the associations between SP D-values and perceived astringency and overall liking/disliking for alum and tannic acid (experiment 1) as well as solid chocolate-flavored compound coating with added tannic acid or grape seed extract (GSE) (experiment 2) were examined. In both experiments, participants (n=84 and 81, respectively) indicated perceived intensity of astringency, bitterness, sweetness, and sourness, and degree of liking of either aqueous solutions, or solid chocolate-flavored compound coating with added astringents. Data were analyzed via linear regression, and as discrete groups for comparison to prior work. Three discrete groups were formed based on first and third quartile splits of the SP D-value distribution: low (LR), medium (MR), and high responding (HR) individuals. In experiment 1, significantly higher mean astringency ratings were observed for the HR as compared to the LR/MR groups for alum and tannic acid, confirming and extending prior work. In experiment 2, significantly higher mean astringency ratings were also observed for HR as compared to LR groups in solid chocolate-flavored compound containing added tannic acid or GSE. Significant differences in liking were found between HR and LR groups for alum and tannic acid in water, but no significant differences in liking were observed for chocolate-flavored compound samples. A significant linear relationship between SP D-values and perceived astringency was observed for both alum and tannic acid (p's<0.001), although the variance explained was relatively low (R(2)=0.33 and 0.29, respectively). In the solid chocolate-flavored compound spiked with either tannic acid or GSE, the relationship was not significant (p=0.17 and 0.30; R(2)=0.03 and 0.02, respectively). Due to the weak associations overall, and the lack of significant differences

Topics: Adolescent; Adult; Alum Compounds; Astringents; Dose-Response Relationship, Drug; Female; Healthy Volunteers; Humans; Male; Middle Aged; Models, Biological; Regression Analysis; Saliva; Salivary Proteins and Peptides; Tannins; Taste; Taste Perception; Touch Perception; Young Adult

Although various surgical techniques have been described for the treatment of rectocele, there is currently no method exhibiting overall superiority because of the different types of complications and varying rate of recurrence. The aim of this study was to evaluate the outcomes of injection sclerotherapy using aluminum potassium sulfate and tannic acid in the management of symptomatic rectocele.. Twelve patients were recruited and treated using injection sclerotherapy. Efficacy measures included changes in the Constipation Scoring System value and rectocele size.. The median operative duration was 7.5 min (range, 3-16 min). Three months after treatment, the mean Constipation Scoring System value decreased significantly in comparison with the baseline value (8.9 ± 4.1 vs. 4.9 ± 2.8, P = 0.0014) and the mean rectocele size reduced significantly in comparison with the baseline size (3.8 ± 0.5 vs. 1.7 ± 0.9, P < 0.001). Regarding complications, a patient showed temporary fecal impaction after treatment. The recurrence rate at 4 years was 29% (95% confidence interval, 10%-66%).. Injection sclerotherapy is quick, easy to perform, and offers reasonable mid-term outcomes; furthermore, it is associated with a low rate of complications. Therefore, it appears to be a reasonable alternative for patients with symptomatic rectocele.

Topics: Aged; Aged, 80 and over; Alum Compounds; Female; Humans; Injections; Middle Aged; Rectocele; Retrospective Studies; Sclerosing Solutions; Sclerotherapy; Tannins; Treatment Outcome

Astringents (alum, malic acid, tannic acid) representing 3 broad classes (multivalent salts, organic acids, and polyphenols) were characterized alone, and as 2- and 3-component mixtures using isoboles. In experiment 1, participants rated 7 attributes ("astringency," the sub-qualities "drying," "roughing," and "puckering," and the side tastes "bitterness," "sourness," and "sweetness") using direct scaling. Quality specific power functions were calculated for each stimulus. In experiment 2, the same participants characterized 2- and 3-component mixtures. Multiple factor analysis (MFA) and hierarchical clustering on attribute ratings across stimuli indicate "astringency" is highly related to "bitterness" as well as "puckering," and the subqualities "drying" and "roughing" are somewhat redundant. Moreover, power functions were used to calculate indices of interaction (I) for each attribute/mixture combination. For "astringency," there was evidence of antagonism, regardless of the type of mixture. Conversely, for subqualities, the pattern of interaction depended on the mixture type. Alum/tannic acid and tannic acid/malic acid mixtures showed evidence of synergy for "drying" and "roughing"; alum/malic acid mixtures showed evidence of antagonism for "drying," "roughing," and "puckering." Collectively, these data clarify some semantic ambiguity regarding astringency and its subqualities, as well as the nature of interactions of among different types of astringents. Present data are not inconsistent with the idea that astringency arises from multiple mechanisms, although it remains to be determined whether the synergy observed here might reflect simultaneous activation of these multiple mechanisms.

Topics: Adolescent; Adult; Alum Compounds; Astringents; Dose-Response Relationship, Drug; Female; Humans; Malates; Male; Middle Aged; Tannins; Taste; Taste Perception; Xerostomia

Despite recent interest in transforming biomass into bio-oil and syngas, there is inadequate information on the compatibility of byproducts (e.g., biochar) with agriculture and water purification infrastructures. A pyrolysis at 300°C yields efficient production of biochar, and its physicochemical properties can be improved by chemical activation, resulting in a suitable adsorbent for the removal of natural organic matter (NOM), including hydrophobic and hydrophilic substances, such as humic acids (HA) and tannic acids (TA), respectively. In this study, the adsorption affinities of different HA and TA combinations in NOM solutions were evaluated, and higher adsorption affinity of TA onto activated biochar (AB) produced in the laboratory was observed due to its superior chemisorption tendencies and size-exclusion effects compared with that of HA, whereas hydrophobic interactions between adsorbent and adsorbate were deficient. Assessment of the AB role in an adsorption-coagulation hybrid system as nuclei for coagulation in the presence of aluminum sulfate (alum) showed a synergistic effect in a HA-dominated NOM solution. An AB-alum hybrid system with a high proportion of HA in the NOM solution may be applicable as an end-of-pipe solution.

Topics: Adsorption; Alum Compounds; Biomass; Charcoal; Humic Substances; Hydrophobic and Hydrophilic Interactions; Spectrophotometry, Ultraviolet; Tannins; Thermodynamics; Water; Water Purification

Perineal approaches are widely applied for the treatment of rectal prolapse. Recently, less-invasive treatments such as sclerotherapy using aluminum potassium sulfate/tannic acid (ALTA) have been introduced for internal hemorrhoids. Herein, we report the results of ALTA injection for the treatment of rectal prolapse in high-risk patients.. Between January 2009 and March 2011, we performed ALTA injection sclerosing therapy in 12 female patients with high risk for preoperative complications. Using the perineal approach, 0.5 to 1 mL of ALTA was injected into the submucosa at 30 to 60 different sites.. All patients were successfully treated without any operative or postoperative morbidity. Average operation time took 35±7 (mean±SD) minutes, and average volume of ALTA injected was 39±6 mL per patient. Neither complaints of bleeding nor findings of anal stenosis were noted. A slight degree of recurrence of prolapse developed in a patient after 8 months. The patient required an additional injection to be cured.. ALTA injection could be administered for the treatment of rectal prolapse without any pain or complication and would be useful even for patients with risks due to preoperative complications and/or medical history.

Topics: Aged; Aged, 80 and over; Alum Compounds; Drug Combinations; Female; Humans; Injections; Rectal Prolapse; Recurrence; Retrospective Studies; Sclerosing Solutions; Sclerotherapy; Tannins; Treatment Outcome

Topics: Alum Compounds; Endoscopy, Gastrointestinal; Hemorrhoids; Humans; Sclerosing Solutions; Sclerotherapy; Tannins

Aluminum potassium sulfate and tannic acid (ALTA) is an effective sclerosing agent for internal hemorrhoids. However, it is contraindicated for patients with chronic renal failure on dialysis, because the aluminum in ALTA can cause aluminum encephalopathy when it is not excreted effectively. We conducted this study to measure the serum aluminum concentrations and observe for symptoms relating to aluminum encephalopathy in dialysis patients after ALTA therapy.. Ten dialysis patients underwent ALTA therapy for hemorrhoids. We measured their serum aluminum concentrations and observed them for possible symptoms of aluminum encephalopathy.. The total injection volume of ALTA solution was 31 mL (24-37). The median serum aluminum concentration before ALTA therapy was 9 μg/L, which increased to 741, 377, and 103 μg/L, respectively, 1 h, 1 day, and 1 week after ALTA therapy. These levels decreased rapidly, to 33 μg/L by 1 month and 11 μg/L by 3 months after ALTA therapy. No patient suffered symptoms related to aluminum encephalopathy.. Although the aluminum concentrations increased temporarily after ALTA therapy, dialysis patients with levels below 150 μg/L by 1 week and thereafter are considered to be at low risk of the development of aluminum encephalopathy.

Topics: Aged; Aged, 80 and over; Alum Compounds; Aluminum; Biomarkers; Contraindications; Dialysis; Female; Hemorrhoids; Humans; Kidney Failure, Chronic; Male; Middle Aged; Neurotoxicity Syndromes; Risk; Sclerosing Solutions; Sclerotherapy; Tannins

We report a case of laparoscopic surgery for a rectal carcinoid after aluminum potassium and tannic acid (ALTA) therapy for an internal hemorrhoid. A 66-year-old man was admitted to our hospital because of bleeding during defecation. He was diagnosed via anoscopy with Goligher grade II internal hemorrhoids. Examination via colonoscopy revealed 2 yellowish submucosal tumors in the lower rectum that were 5mm and 10mm in diameter. A rectal carcinoid tumor was diagnosed based on histopathology. Abdominal computed tomography demonstrated no metastases to the liver or lymph nodes. First, we performed ALTA therapy for the internal hemorrhoids. Two weeks later, we performed laparoscopic-assisted low anterior resection (D2) for the rectal carcinoid. The patient was discharged without complications and has not experienced recurrence during the 2 years of follow-up care.

Topics: Aged; Alum Compounds; Carcinoid Tumor; Combined Modality Therapy; Hemorrhoids; Humans; Intestinal Neoplasms; Male; Rectal Neoplasms; Tannins; Treatment Outcome

In Japan, a new type of sclerotherapy termed ALTA (aluminum potassium sulfate and tannic acid) injection therapy has recently been introduced. The objectives of this study were to determine whether the presence or absence of antithrombotic treatment (AT) affected the efficacy rate or the occurrence of complications associated with ALTA injection sclerotherapy.. This study was a case-matched study of 37 patients who underwent ALTA therapy to treat hemorrhoids between 2007 and 2009. Each AT patient was matched for age and degree of hemorrhoids with a control non-AT patient. In each of the subgroups, the therapeutic efficacy of ALTA therapy was evaluated by comparing an assessment completed before therapy with an assessment completed 6 months after therapy.. The efficacy in patients with bleeding did not differ between the two groups (P = 0.074). The efficacy in patients with prolapse was significantly lower in the AT group than in the non-AT group (P = 0.013). The two groups did not differ significantly in the occurrence of complications (P = 0.450).. Among patients with hemorrhoids receiving AT, ALTA injection sclerotherapy is recommended for those in whom it is difficult to discontinue AT.

Topics: Adult; Aged; Aged, 80 and over; Alum Compounds; Case-Control Studies; Female; Fibrinolytic Agents; Hemorrhoids; Humans; Male; Middle Aged; Sclerotherapy; Tannins; Treatment Outcome; Warfarin

Sclerotherapy with aluminum potassium tannic acid (ALTA), which was approved in Japan for the treatment of internal hemorrhoids in July 2004 (Takano et al., Int J Colorectal Dis 21:44-51, 2006), has been widely accepted because of its effectiveness and low invasiveness. More than 200,000 patients have received ALTA injection therapy. ALTA is injected directly into 4 points of an internal hemorrhoid (4-step injection) to induce sclerosis and remission of the hemorrhoids, and consequently, resolution of symptoms such as prolapse and bleeding. The precision of the 4-step injection is considered to be a crucial determinant of the success of this therapy and the risk of complications. However, sufficient evidence has not yet been obtained concerning the diffusion and distribution of the injected drug. A pilot study visualized the real-time diffusion/distribution of the drug solution following the 4-step injection, using the ICG (indocyanine green) fluorescence technique, and an infrared camera (Photodynamic EYE; PDE, Hamamatsu Photonics K.K.).

Topics: Alum Compounds; Diffusion; Hemorrhoids; Humans; Indocyanine Green; Injections; Molecular Imaging; Optical Imaging; Pilot Projects; Sclerosing Solutions; Sclerotherapy; Tannins

Understanding astringency has focused on the interaction of tannins with the salivary proline-rich proteins (PRPs), although it remains unclear if other astringents precipitate the PRPs or how this interaction relates to sensory perceptions of astringency. We used 2 approaches to compare how distinct classes of astringent compounds interacted with the salivary PRPs and mucins. Using sodium dodecyl sulfate polyacrylamide gel electrophoresis, we evaluated protein patterns and characterized the salivary proteins present in the supernatants and pellets of pooled saliva assayed with tannin, alum, and hydrochloric acid solutions. Tannins and alum precipitated many of the PRPs, but acid did not. Mucins were precipitated by both the acid and alum, but not by the tannins. From our research, it appears that the precipitation of salivary proteins may be involved in the mechanism of astringency, but the precipitation of PRPs is not requisite for the development of astringency. We also measured mucin and deoxyribonucleic acid content of expectorated solutions of astringents that panelists swished in their mouths to determine if astringency was associated with a loss of oral lubricating films.

Topics: Alum Compounds; Astringents; Chemical Precipitation; Electrophoresis, Polyacrylamide Gel; Humans; Hydrochloric Acid; Molecular Weight; Mouth Mucosa; Mucin-1; Mucin-2; Mucus; Protein Denaturation; Saliva; Salivary Proline-Rich Proteins; Sensation; Tannins

Aluminum potassium sulfate and tannic acid (ALTA) induce noninvasive sclerosis and the involution of hemorrhoids by initiating an inflammatory reaction. We assessed the mid-term outcome after ALTA sclerotherapy for symptomatic hemorrhoids.. Between May 2006 and July 2009, 1210 patients with grade III or IV hemorrhoids underwent surgery at Kunimoto Hospital. Our treatment strategy for internal hemorrhoids is first establishing whether ALTA therapy is possible for the type of hemorrhoid, and then performing either ALTA therapy or alternatively, ligation and excision (LE) for those types unsuitable for ALTA therapy.. A total of 448 patients were treated with ALTA therapy alone (Group A), 706 patients were treated with a combination of ALTA and LE therapy (Group B), and 56 patients were treated with LE alone (Group C). The overall recurrence rates were 3.6% (16/448) and 0.3% (2/706) in Groups A and B, respectively. There was no recurrence in Group C. Rectal ulcers developed at the injection site in four (0.9%) patients from Group A, but they healed within a few months with conservative therapy.. ALTA sclerotherapy is a simple and safe treatment for symptomatic hemorrhoids, with few complications.

Topics: Alum Compounds; Female; Hemorrhoids; Humans; Injections, Intralesional; Ligation; Male; Middle Aged; Sclerosing Solutions; Tannins

We retrospectively compared the results of sclerotherapy with a new sclerosing agent (aluminum potassium sulphate/tannic acid) and hemorrhoidopexy using an improved type of circular stapler with hemorrhoidectomy.. Between January 2006 and September 2008, we performed hemorrhoidectomy in 416 patients, sclerotherapy in 784 patients and hemorrhoidopexy in 118 patients with prolapsing internal hemorrhoids.. The median volume of the agent injected into a hemorrhoid was 7 ml (interquartile range = 4). The operation duration was significantly shorter (p < 0.01) in sclerotherapy, 13 min (interquartile range = 7), than in hemorrhoidectomy, 43 min (interquartile range = 15), and hemorrhoidopexy, 31 min (interquartile range = 16). Postoperative pain, needing pain killer injection, occurred in 59 patients (14%) in hemorrhoidectomy, 14 patients (1.8%) in sclerotherapy and 1 patient (0.8%) in hemorrhoidopexy (p < 0.01). The disappearance rates of prolapse were 100% (416/416 patients) in hemorrhoidectomy, 96% (753/784 patients) in sclerotherapy and 98.3% (116/118 patients) in hemorrhoidopexy.. Hemorrhoidectomy, widely applied for hemorrhoids, needs hospitalization, being accompanied by pain. Sclerotherapy could be performed on outpatient bases without any severe pain or complication. Hemorrhoidopexy is a useful alternative treatment with less pain. Less invasive treatments would be useful when performed paying attention to avoid complications.

Topics: Alum Compounds; Ambulatory Care; Female; Hemorrhoids; Hospitalization; Humans; Male; Middle Aged; Pain, Postoperative; Prolapse; Retrospective Studies; Sclerosing Solutions; Sclerotherapy; Surgical Staplers; Surgical Stapling; Tannins; Treatment Outcome

No surgical method for repair of total rectal prolapse has been established as optimal. We describe a new technique that uses ALTA (aluminum potassium sulfate and tannic acid) injection as a simple perianal procedure for total rectal prolapse.. Fourteen patients with total rectal prolapse were treated with sclerosing therapy by using ALTA injection. Via a perianal approach, 0.5 to 1 ml of ALTA solution was injected along a linear track into the submucosa at 30 to 80 different sites, totaling 20 to 60 ml.. All 14 patients treated with injection sclerotherapy were cured, with no intraoperative or postoperative complications. One patient required a repeat injection after two months to be cured. No exacerbation of constipation has resulted, and no stenosis has been evident on rectal examination. In seven of ten patients presenting with fecal incontinence, this complaint resolved after therapy.. ALTA sclerotherapy yielded satisfactory results in total rectal prolapse, causing no alteration in neurophysiology of bowel function. Injection sclerotherapy should be recommended as the first procedure for treatment of total rectal prolapse.

Topics: Adjuvants, Immunologic; Adult; Aged; Aged, 80 and over; Alum Compounds; Defecography; Drug Combinations; Humans; Injections; Middle Aged; Rectal Prolapse; Sclerosing Solutions; Tannins

The objective of this research work was to evaluate the performance of enhanced coagulation by alum and polymer. Synthetic source waters containing high molecular weight humic acids, medium molecular weight tannic acids and low molecular weight p-hydroxybenzoic acid were formulated by adjusting the concentration of turbidity and pH; and jar tests were used to study the effect of various types and dosages of polymer on reducing the above model compounds. At a specific pH condition, the applied alum dosage would efficiently decrease the turbidity to 2 NTU follows the order: humic>tannic>p-hydroxybenzoic acid. Adjustment of pH influenced the performance of alum obviously but not of p-DADMAC. High p-DADMAC dosage overwhelming the effects of alum is less affected by pH adjustment. The results of this investigation reveal that enhanced coagulation with p-DADMAC was founded to be very effective for removing high-molecular-weight THM precursors, i.e., humic acid and tannic acid, and markedly reduced the alum dosages required for turbidity removal. The other two polymers, i.e., cationic PAM and non-ionic PAM, which had higher molecular weight but lower charge density than p-DADMAC, were not capable of removing organic precursors. It was thus concluded that enhanced coagulation with polymer, p-DADMAC, could be considered as a promising technique for removal of NOMs with hydrophobic and higher-molar-mass (>1K) in water treatment plants.

Topics: Air Pollutants; Alum Compounds; Butter; Humic Substances; Hydrogen-Ion Concentration; Models, Theoretical; Parabens; Polyethylenes; Quaternary Ammonium Compounds; Tannins; Waste Disposal, Fluid; Water Pollutants; Water Purification

Astringency of aqueous solutions of phenolic compounds (grape seed tannins, tannic acid, catechin and gallic acid) increased upon addition of citric acid, whereas the astringency of alum was reduced. Astringency of alum was decreased equivalently by addition of equi-sour levels of lactic acid, citric acid or hydrochloric acid. The difference between alum and the phenolic compounds is speculated to result from chemical modifications affecting binding of the astringents with oral proteins rather than cognitive differences. Chelation of the aluminum ion in alum by acids reduces its availability for interacting with salivary proteins or epithelial proteins. In contrast, the increased astringency produced upon acidification of phenolic compounds is speculated to result from the pH driven increase in the affinity of the phenols for binding with proteins. These results suggest that alum cannot be used interchangeably with phenolic astringents in psychophysical studies.

Topics: Adult; Alum Compounds; Catechin; Citric Acid; Female; Gallic Acid; Humans; Hydrogen-Ion Concentration; Hydrolyzable Tannins; Male; Phenols; Solutions; Tannins; Taste

Two-component mixtures of astringent materials were rated for perceived intensity of astringent and taste attributes over time. Components included alum (a complex salt), gallic acid (the monomeric component of hydrolyzable tannins), catechin (the monomeric component of condensed tannins) and citric acid. Mixtures of alum and gallic acid showed mixture suppression, in that the 50/50 mixture was less intense than either component in astringency, drying, roughing and puckery/drawing sensations. Suppression was seen at concentration levels producing moderate to strong astringency but was absent or less pronounced at lower concentration levels. A similar pattern held for citric acid, although the suppressive effects were less pronounced. Catechin and gallic acid mixtures were additive. Sensory interactions between astringent materials appears to depend on the substances involved and their concentrations (or intensity levels).

Topics: Adult; Alum Compounds; Astringents; Catechin; Citrates; Citric Acid; Drug Interactions; Female; Gallic Acid; Humans; Male; Tannins; Taste