ABSTRACT
OBJECTIVE: To examine associations between local and systemic symptoms and the wear of the tin weld of Essure implants. DESIGN: study of a series of cases. SETTINGS: Two French hospitals. PARTICIPANTS: Eighteen patients explanted by hysterectomy and salpingectomy for removal of their Essure implants between September 2019 and July 2020, have had a common anatomopathological process. MAIN OUTCOME MEASURES: anatomopathological examination by optical microscopy and mineralogical analysis of the fallopian tube or uterine horn with scanning electron microscopy coupled with energy dispersive X-ray (SEM-EDX). Evaluation of local and systemic symptoms with a questionnaire. Examination of blood metal assays (nickel, chromium, and tin). RESULTS: anatomopathological examination highlights foreign body granulomas, fibrosis, adenomyosis, nonspecific inflammation, cysts and myomas in the Fallopian tubes, uterine horns, or both and mentions the presence of foreign bodies in seven cases. SEM-EDX analyses showed, systematically, the presence of tin particles integrated in the wall near the weld, generally in clusters, and with a size ranging from about one micron to several dozen microns. The questionnaire shows that the most frequent local symptoms were pelvic pain, urinary disorders, bleeding, and pains during intercourse. The most common systemic symptoms were: asthenia, visual disturbances, amnesia, giddiness, dorsal pains, headaches, and joint pains. The majority of local and systemic symptoms decreased after explantation, but sometimes incompletely. Before explantation, high levels of nickel, tin and chromium were observed in 11/17, 1/7 and 2/17 patients. After explantation, tin levels were high in 3/11 patients. CONCLUSIONS: our new anatomopathological process systematically demonstrates the presence of tin particles in tissue near the weld. These particles could be responsible for granulomatous inflammations as well as local symptoms. Many of the systemic symptoms are consistent with chronic organotin poisoning but further studies are needed to find out whether tin from the solder can be converted to organotin in the patients' bodies.
Subject(s)
Fallopian Tubes , Sterilization, Tubal , Chromium , Female , Humans , Nickel , TinABSTRACT
The influence of the oxide support (i.e., Al2O3, Nb2O5, SiO2, and TiO2,) on the surface properties, reduction and oxidation properties, acid-base properties, and catalytic activity of supported indium oxide catalysts has been investigated by temperature-programmed reduction/oxidation, thermogravimetry coupled to differential scanning calorimetry, ammonia and sulfur dioxide adsorption calorimetry, and reduction of NOx by ethene in highly oxygen-rich atmosphere. Two series of In2O3-containing catalysts at low (approximately 3 wt %) and at theoretical geometric monolayer (from 20 to 40 wt %) In2O3 content were prepared and their properties were compared with unsupported In2O3 material. Supports able to disperse the In2O3 aggregates with high In stabilization gave rise to active catalytic systems. Among the studied oxide supports, Al2O3 and, to a lower extent, TiO2 were found to be the best supports for obtaining active de-NOx catalysts.
ABSTRACT
A new synthesis procedure is reported for the preparation of mixed Al,Ga-offretites over the entire solid solution range 0 < or = Ga/(Ga + Al) < or = 1. The resulting materials are characterized by X-ray powder diffraction, adsorption microcalorimetry and multinuclear solid state NMR. The 29Si MAS-NMR data are consistent with statistical occupancy of the T1 and T2 sites by aluminum and gallium, and also show no positive evidence for preferential siting effects between both framework metals. Isotropic chemical shifts and nuclear electric quadrupolar coupling constants for 27Al and 71Ga have been obtained from a field-dependent analysis of the center of gravity in the MAS-NMR spectra. H-Al,Ga-offretites produced by ammonium exchange and subsequent calcination reveal evidence of partial demetallation of the framework with formation of extra-lattice metal species.
