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Nihon Eiseigaku Zasshi 2018 ;73(3):258-264

Department of Environmental Health Sciences, Akita University Graduate School of Medicine.

Mercury and its compounds are classified into three main groups: metallic mercury (Hg), inorganic mercury (Hg), and organic mercury (methyl mercury: CHHg, etc.). Metallic mercury is the only metal that is liquid at ambient temperature and normal pressure, which readily forms an amalgam with other metals. Read More

BMJ Case Rep 2018 Jun 21;2018. Epub 2018 Jun 21.

Department of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland.

Sodium hydroxide is a corrosive, highly alkaline (PKa=14.8) household product. Ingestion of sodium hydroxide liquid is common, showing toxicity on the oesophagus and stomach. Read More

Ann Surg 2019 07;270(1):109-114

Department of Digestive and Endocrine Surgery, Saint-Louis Hospital AP-HP, University Paris Diderot Sorbonne Paris Cite, Paris, France.

Background: Endoscopy is the best predictor of stricture formation after caustic ingestion.

Objective: Our aim was to compare the accuracy of emergency computed tomography (CT) and endoscopy in predicting risks of esophageal stricture.

Methods: We describe a CT classification of esophageal caustic injuries: Grade I show normal esophagus; Grade IIa display internal enhancement of the esophageal mucosa and enhancement of the outer wall conferring a "target" aspect; Grade IIb present as a fine rim of external esophageal wall enhancement. Read More

World J Surg 2018 07;42(7):2028-2035

Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan.

Background: Corrosive ingestion results in necrosis of the digestive tract, spillage of intraluminal fluid, and spread of bacteria that threatens the lives of patients. Some authors advise extensive surgery, although others recommend conservative operation. This study presents the outcomes of the patients of corrosive injury who undergo emergent surgery. Read More

Int J Pediatr Otorhinolaryngol 2017 Dec 14;103:20-28. Epub 2017 Sep 14.

Lady Cilento Children's Hospital, 501 Stanley St, South Brisbane, QLD 4101 Australia.

Purpose: To explore the experiences of children with dysphagia and/or feeding difficulties post-chemical or button battery ingestion injury from the perspective of the primary caregiver.

Method: Five primary caregivers of children with a history of dysphagia and/or feeding difficulties post-ingestion injury (4 chemical, 1 button battery) completed the Children's Picky Eating Questionnaire (CPEQ), and participated in a semi-structured interview. Interviews explored experiences of caring for a child with dysphagia and/or feeding difficulties, impressions of services and supports, and additional impacts to the child and family. Read More

J Pediatr Gastroenterol Nutr 2018 Jun;66(6):898-902

Weill Cornell Medicine-Qatar, Doha, Qatar.

Objectives: Caustic ingestion can have a complicated clinical course. Corticosteroids are widely used but there is uncertainty about its role in preventing esophageal stricture formation following caustic ingestion. This systematic review and meta-analysis assessed the available clinical evidence regarding the efficacy and safety of corticosteroids for preventing esophageal strictures following caustic injury. Read More

Pediatr Clin North Am 2017 06;64(3):507-524

Department of Pediatric Gastroenterology, Hepatology and Nutrition, Cleveland Clinic Foundation, 9500 Euclid Avenue, Dept A111, Cleveland, OH 44195-0001, USA.

Children inevitably swallow foreign material accidentally or intentionally. Each type of ingestion carries their own set of risks and complications, short and long term, some requiring immediate attention while others close monitoring. Alkalotic household cleaning products and lithium button batteries are increasingly common and damage the esophagus quickly. Read More

Rev Gastroenterol Peru 2017 Jan-Mar;37(1):22-25

Gastroenterohepatology Research Center, Nemazee Teaching Hospital,, Shiraz University of Medical Sciences. Shiraz, Iran.

Caustic ingestion is a major health concern in both developed and developing countries, that may lead to serious esophageal injury. The clinical presentation of caustic ingestion in children vary from asymptomatic to serious and fatal sequelae, such as perforation and stricture formation.

Objective: Due to the lack of a comprehensive study in our area, this study has evaluated clinical and endoscopic manifestations and complications of caustic ingestion in children in south of Iran. Read More

Ann Ital Chir 2017 ;88:82-86

Accidental caustic ingestions are serious medical problems especially in childhood. Various treatment modalities are being used for the complications of caustic injuries such as stricture formation. The aim of this study is to establish whether ursodeoxycholic acid (UDCA) has protective effects on experimental corrosive esophagitis in rats. Read More

Clin Toxicol (Phila) 2017 Aug 26;55(7):645-651. Epub 2017 Apr 26.

a NPIS (Birmingham Unit) , City Hospital , Birmingham , UK.

Introduction: Oven cleaning products contain corrosive substances, typically sodium or potassium hydroxide.

Objective: To determine the reported toxicity from exposure to oven cleaning products.

Methods: Telephone enquiries to the UK National Poisons Information Service regarding oven cleaning products were analysed retrospectively for the period January 2009 to December 2015. Read More

Arch Argent Pediatr 2017 04;115(2):e85-e88

Ankara University, School of Medicine, Department of Pediatric Surgery, Ankara, Turkey.

Esophageal or gastric injuries secondary to caustic substance ingestion is still an important issue in developing countries. Its clinical spectrum can vary from absence of mucosal injury to complications such as severe burns, strictures and perforation. Physical examination and first endoscopic evaluation are very important in the diagnosis. Read More

Lancet 2017 May 26;389(10083):2041-2052. Epub 2016 Oct 26.

Department of Digestive and Endocrine Surgery, Saint-Louis Hospital AP-HP, Université Paris Diderot Sorbonne Paris Cité, Paris, France.

Corrosive ingestion is a rare but potentially devastating event and, despite the availability of effective preventive public health strategies, injuries continue to occur. Most clinicians have limited personal experience and rely on guidelines; however, uncertainty persists about best clinical practice. Ingestions range from mild cases with no injury to severe cases with full thickness necrosis of the oesophagus and stomach. Read More

Am J Emerg Med 2017 Mar 6;35(3):488-492. Epub 2016 Dec 6.

Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, NSW, Australia; Clinical Toxicology Research Group, University of Newcastle, NSW, Australia. Electronic address:

Purpose: We aimed to determine the incidence of esophageal strictures in corrosive ingestions and potential predictors of severe injury.

Basic Procedures: This was a retrospective cohort study of corrosive ingestions from a toxicology unit (1987-2013) with telephone follow-up at least 1 y post-ingestion. Clinical data and investigations were obtained from a toxicology admission database. Read More

Dis Esophagus 2017 Feb;30(3):1-7

Department of Pediatric Surgery, Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Türkiye.

The aim of this study was to determine the necessity of endoscopy in cases in which a corrosive substance was ingested and to find a practical way to avoid unnecessary endoscopies for similar cases in the future. The clinical records of 458 hospitalized cases with clinical histories of corrosive substance ingestion between January 2007 and December 2013 were retrospectively reviewed. The demographics of the cases, the ingested substances, and the rigid endoscopy findings were evaluated. Read More

Langenbecks Arch Surg 2016 Feb 21;401(1):81-7. Epub 2015 Dec 21.

Department of General Surgery and Transplantation, Université Nord de France, 59000, Lille, France.

Purpose: Best clinical management of severe caustic injury is still a subject of debate. Most surgical teams consider severe caustic injury as an indication for emergency surgery. But, under certain circumstances, conservative management is feasible, avoids the need for gastrectomy, and has a low mortality rate. Read More

Rev Chil Pediatr 2015 May-Jun;86(3):189-93. Epub 2015 Jul 8.

Unidad de Gestión Clínica de Pediatría, Hospital Universitario Puerta del Mar, Cádiz, España.

Introduction: There is no clear consensus on the management of accidental ingestion of caustic substances in paediatrics. The aim of this study was to determine the profile of the paediatric population treated due to caustic ingestion in a Healthcare Centre.

Patients And Method: A descriptive study was conducted on patients treated for the ingestion of caustic substances in our hospital during the period 2008-2011. Read More

J Pediatr Surg 2015 Aug 28;50(8):1264-8. Epub 2014 Nov 28.

Health Sciences Research Institute-National University of Cordoba-National Scientific and Technical Research Council (INICSA-UNC-CONICET), Cordoba, Argentina. Electronic address:

Background: The ingestion of caustic substances remains an important public health issue worldwide. Children represent 80% of the ingestion injury population globally. Accidental alkaline material accounts for most caustic ingestions. Read More

Korean J Gastroenterol 2015 Jan;65(1):12-20

Department of Health Promotion Medicine, Ewha Womans University Medical Center Mokdong Hospital, Seoul, Korea.

Background/aims: Caustic ingestion can cause severe injury to upper gastrointestinal tract. There were few studies about clinical characteristics and treatments of caustic injury in Korea. We investigated the changes in clinical features of caustic injury over the past 20 years including pattern of endoscopic mucosal injury and treatment modality. Read More

Pediatrics 2015 Feb 12;135(2):e547-50. Epub 2015 Jan 12.

Allergy/Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

Anaphylaxis presents in children with rapid involvement of typically 2 or more organ systems including cutaneous, gastrointestinal, and respiratory. Caustic ingestions (CI) may also present with acute involvement of cutaneous, gastrointestinal, and respiratory systems. We present 2 cases of "missed diagnosis" that illustrate how CI presenting with respiratory symptoms can be mistaken for anaphylaxis owing to these similarities. Read More

Clin Toxicol (Phila) 2014 Nov 16;52(9):911-25. Epub 2014 Sep 16.

Department of Acute Medicine, Chelsea & Westminster Hospital NHS Trust , London , UK.

Introduction: Corrosive ingestions are common, although most ingestions do not result in clinically significant effects. Limited guidance is available on the role of endoscopy and/or computerised tomography (CT) in the investigation of individuals with corrosive ingestion, and the present data regarding predictors of poor outcome are confusing. Furthermore, whilst there are many case series describing the use of endoscopy in corrosive ingestions, no clear ideal time frame has been established as to when it should be undertaken. Read More

Surg Endosc 2015 Jun 27;29(6):1452-61. Epub 2014 Aug 27.

Department of General, Endocrine and Digestive Surgery, Saint-Louis Hospital, APHP, Université Paris 7 Diderot, Paris, France,

Background: Esophagectomy is the standard of care for high-grade corrosive esophageal necrosis as assessed endoscopically. However, the inaccuracy of endoscopy in determining the depth of intramural necrosis may lead to unnecessary esophageal resection, with devastating consequences. Our aim was to evaluate the use of computed tomography (CT) for the emergency diagnostic workup of endoscopic high-grade corrosive esophageal necrosis. Read More

Dis Esophagus 2015 Apr 18;28(3):258-61. Epub 2014 Mar 18.

Department of Pediatrics, Çanakkale Onsekiz Mart University Medical Faculty, Çanakkale, Turkey.

Corrosive esophageal injuries are one of the life-threatening morbidities leading to esophageal stricture and perforation affecting all age groups but especially children due to accidental ingestions in this age group. Glucagon-like peptide-2 (GLP-2) is an intestinal polypeptide with potent anti-inflammatory effects. Its effects are studied in various studies but not in corrosive esophagitis. Read More

World J Surg 2014 May;38(5):1233-7

Department of Gastrointestinal Surgery and Transplantation, CHU Lille, Université Nord de France, 59000, Lille, France,

Background: For selected cases of severe caustic injuries, evidence favors conservative management, consisting of radiographic and clinical observation without emergency surgery. However, this approach can lead to the development of gastric distension caused by combined esophageal and antral strictures, called gastrocele. This study assessed the safety of a two-stage surgical treatment for gastrocele. Read More

Best Pract Res Clin Gastroenterol 2013 Oct 5;27(5):679-89. Epub 2013 Sep 5.

Sorbonne Paris Cité Paris 7, University, Paris, France; APHP, Lariboisière Hospital, Department of Gastroenterology, Paris, France. Electronic address:

Foreign body ingestions, food bolus impactions, and caustic agent injuries are frequent but specific situations. Although most foreign bodies will naturally pass through the digestive tract, practitioners should recognize specific situations were endoscopic management is required. In such cases, timing and adequate equipment are critical. Read More

Clin Toxicol (Phila) 2013 Nov 13;51(9):834-7. Epub 2013 Sep 13.

Israel Poison Information Center, Rambam Health Care Campus, The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology , Haifa , Israel.

Context: Corrosive substance ingestion is a toxicological emergency with relatively high mortality requiring rational surgical decisions.

Objective: Evaluate the role of chest and abdominal computed tomography (CT) in assessing the severity of acute corrosive ingestion.

Methods: A retrospective study of adults admitted due to corrosive ingestion, who underwent gastrointestinal endoscopy and CT within 48 h of admission. Read More

Indian J Pediatr 2014 Jul 7;81(7):675-9. Epub 2013 Aug 7.

Division of Pediatric Gastroenterology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.

Objectives: To evaluate children who ingested corrosive substances, in terms of demographic features, nature of ingested substances, clinical findings, management and complications.

Methods: A total of 1709 cases aged between 0 and 16 y who ingested corrosive substance were analyzed retrospectively by evaluating the medical records of the patients.

Results: The mean age of the cases was 35. Read More

Pan Afr Med J 2013 6;15:11. Epub 2013 May 6.

Department of Ear Nose and Throat, LAUTECH Teaching Hospital, Osogbo, Osun state, Nigeria.

Introduction: Potentially catastrophic presentations and lifelong complications resulting from corrosive ingestions in humans is one of the most challenging situations encountered in clinical medical practice. This study reviewed pattern, mechanisms and associated socio-medical challenges with ingestion of corrosive agents as seen in a tertiary health institution in South-western Nigeria.

Methods: A retrospective review of all patients that were managed for corrosive ingestion at Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Osun State, Nigeria, over a seven year period. Read More

Pediatr Emerg Care 2013 Jun;29(6):743-7

Carolinas Poison Center, Carolinas Medical Center, Charlotte, NC, USA.

Objectives: The objectives of this study were to present and explore the clinical presentation of the increasingly common pediatric exposure to the widely available single-use laundry packets or "laundry pods."

Methods: This is a case report of 4 pediatric patients with significant toxicity due to laundry pod detergent exposure and a review of the available literature including abstract-only publications.

Results: An unexpectedly severe clinical pattern was noted; 3 of the 4 children required intubation for management, airway injury was noted in 1 of them, and 2 of them had hospital courses of at least 1 week. Read More

Arch Pediatr 2012 Dec 7;19(12):1362-8. Epub 2012 Nov 7.

Unité de gastroentérologie, hépatologie, nutrition et diabétologie, hôpital des Enfants, 330, avenue de Grande-Bretagne, TSA 70034, 31300 Toulouse cedex 9, France.

In children, caustic ingestion is due to accidents at home and inadequate storage of caustic agents. In emergency, it is useful to remove the soiled clothes, rinse the affected area, and prevent vomiting and feeding. Caustic ingestion (pH<2 or>12) induces burns of the upper gastrointestinal tract requiring esophagogastro-duodenoscopy between H12 and H24. Read More

J Pediatr Surg 2011 Oct;46(10):1893-7

Department of Pediatric Surgery, Süleyman Demirel University Medical School, 32260, Isparta, Turkey.

Introduction: Accidental ingestion of caustic substances may cause serious problems in children. Approximately 20% of caustic ingestions result in esophageal stricture formation, resulting from excessive collagen synthesis to the extracellular matrix by fibroblasts. Recent studies showed that a single application of 5-fluorouracil (5-FU) is a very effective inhibitor of fibroblast proliferation and differentiation for prolonged periods. Read More

J Pediatr Surg 2011 Sep;46(9):1739-45

Department of Surgical Sciences, University of Parma, Parma 43100, Italy.

Purpose: This study aims to highlight the peculiar presentation and management of children's corrosive ingestions in developing countries associated with malnutrition, delay in management, lack of technology, and sporadic follow-up.

Methods: An observational study was carried out since 2005 on all children (<15 years old) admitted for caustic soda ingestion to the "Emergency" Surgical Center in Sierra Leone, either in the acute postinjury phase or for dilatation of esophageal strictures. Complications, mortality, stricture recurrence, and ability to swallow were the main outcome measures. Read More

Toxicology 2011 Jul 28;285(3):114-25. Epub 2011 Apr 28.

National Center for Environmental Assessment, U.S. Environmental Protection Agency, Washington, DC 20460, USA.

Trichloroacetic acid (TCA) is a common drinking water disinfection byproduct that produces a spectrum of liver effects, including hepatomegaly and liver tumors, in mice. It is also an oxidative metabolite of trichloroethylene (TCE), a solvent used in degreasing with widespread environmental exposure, which also produces hepatomegaly and liver tumors in mice. Physiologically based pharmacokinetic (PBPK) modeling of TCE and TCA can be used to quantitatively compare the dose-responses for hepatomegaly for these two chemicals on the basis of internal TCA dose, and thereby test the hypothesis that TCA could fully explain TCE-induced hepatomegaly. Read More

Medicina (Kaunas) 2009 ;45(10):830-7

Department of Intensive Care, Kaunas University of Medicine, Eiveniu 2, 50009 Kaunas, Lithuania.

Caustic ingestions (alkalis, acids) may cause severe chemical burns and lifelong complications, which worsen life quality. Approximately 80% of caustic ingestions occur in children. They mostly intoxicate because of chemical substances kept insecurely or in inappropriate containers. Read More

Acta Gastroenterol Belg 2006 Oct-Dec;69(4):372-6

Departments of Internal Medicine, Gulhane Medical School, Etlik, Ankara, Turkey.

Background And Study Aims: Caustic ingestion caused by swallowing a detergent can produce a progressive and devastating injury in the esophagus and stomach. One of the most important outcomes of the corrosive oesophagitis is the stricture formation, which is resistant to treatment. The aim of this study was firstly to determine the relation between agent, inflammation and stricture, and secondly investigate the efficiency of dilation in patients having esophageal stricture due to corrosive oesophagitis. Read More

Pediatr Rev 2006 Apr;27(4):154-5; discussion 155

The Brody School of Medicine East Carolina University, Greenville, NC, USA.

Toxicol Rev 2005 ;24(2):125-9

Department of Occupational Medicine and Poisons Information Centre, First Medical Faculty and General Teaching Hospital, Charles University, Prague, Czech Republic.

The most serious complication of corrosive damage to the oesophagus besides perforation is stricture formation. The role of corticosteroids in preventing corrosive-induced strictures is controversial. This review evaluates the usefulness of corticosteroid treatment by critically assessing clinical reports published between 1991 and 2004 in the English, German, French and Spanish literature. Read More

Am J Emerg Med 2005 Mar;23(2):171-6

Department of Emergency Medicine, University of Virginia Medical Center, Charlottesville, 22908, USA.

The clinician can approach the poisoned patient using the toxidrome system of toxin identification; this approach makes use of findings noted on the physical examination, highlighting the importance of abnormalities in blood pressure, heart rate, respiratory effort, body temperature, mental status, pupillary size, skin color, diaphoresis, and gastrointestinal sounds. Such a method provides structure and guidance to the clinical evaluation, providing the clinician with rapid diagnostic information and suggesting urgent management issues. A case of hydrofluoric acid poisoning is used as an example of this diagnostic approach. Read More

Hepatogastroenterology 2004 Sep-Oct;51(59):1397-400

Department of Trauma and Emergency Surgery, Istanbul Medical Faculty, Istanbul, Turkey.

Background/aims: The ingestion of caustic substances is a common condition, which may result in serious injuries of the upper gastrointestinal system. The purpose of this study is to assess the outcomes of patients who had a history of the ingestion of caustic substances.

Methodology: Between January 1995 and May 2002, 53 patients with clinical and/or endoscopic signs of caustic agents injury admitted to the Emergency Surgery Service of University of Istanbul, Istanbul Medical School, were retrospectively evaluated. Read More

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2004 Jan;47(1):2-6

Beratungsstelle für Vergiftungserscheinungen Berlin, Berlin.

In children unintentional ingestions of metasilicate- containing machine dishwashing agents have caused corrosive injuries of the mouth and esophagus in up to 50% of all cases. Whether substituting the corrosive ingredient by disilicates and carbonates reduces the number of corrosive injuries was studied in a 2-year prospective follow-up of 396 unintentional childhood ingestions. Symptoms of possible mucous membrane injury by machine dishwashing agents containing disilicates and carbonates (group DC) were compared to ingestions of irritating but definitely non-corrosive surfactants (group S). Read More

Toxicology 2004 Jul;199(2-3):169-83

Molecular Biosciences, Pacific Northwest National Laboratory, Richland, WA 99352, USA.

Interactions between carcinogens in mixtures found in the environment have been a concern for several decades. In the present study, male B6C3F1 mice were used to study the responses to mixtures of dichloroacetate (DCA), trichloroacetate (TCA), and carbon tetrachloride (CT). TCA produces liver tumors in mice with the phenotypic characteristics common to peroxisome proliferators. Read More

Vet Hum Toxicol 2002 Feb;44(1):45-7

Department of Emergency Medicine, Scott & White Clinic and Memorial Hospital, Texas A&M University Health Science Center, College of Medicine, Temple 76508, USA.

The purpose of this study was to develop an animal model that would grade in-vivo therapeutic modality testing for caustic ingestion. Caustic substances are found in many household items (eg detergents, bleaches, pipe cleaners) and pose a serious threat to health if ingested accidentally or intentionally with resulting injuries including immediate death or chronic debilitating morbidity. This study used 5, 3. Read More

Exp Toxicol Pathol 1997 Dec;49(5):369-73

St. Xavier's College, Dept. of Zoology, Bombay, India.

Tertiary butyl alcohol and trichloroacetic acid are known to be contaminants in drinking water. In order to evaluate the interactive toxicity of t-butyl alcohol with trichloroacetic acid, young male Wistar rats were dosed through water at a dose level of t-butyl alcohol (TBA)-0.5% (v/v), trichloroacetic acid (TCA)-25 ppm and a combined dose of TBA + TCA (0. Read More

Toxicol Appl Pharmacol 1997 Jun;144(2):235-46

Pharmacology/Toxicology Graduate Program, Washington State University, Pullman, USA.

Dichloroacetate (DCA) and trichloroacetate (TCA) are two hepatocarcinogenic by-products of water chlorination. To compare the effects of DCA and TCA on cell replication in the nodules and tumors they induce, male B6C3F1 mice were administered 2.0 g/L DCA or TCA in their drinking water for 38 or 50 weeks, respectively. Read More

J Toxicol Environ Health 1992 Sep;37(1):139-48

Department of Pharmacology and Toxicology, West Virginia University Health Sciences Center, Morgantown 26506.

Dichloro- and trichloroacetic acids (DCA and TCA) and chloroform are formed during chlorination disinfection of drinking water. The effects of DCA and TCA treatment on CHCl3 toxicity were assessed in these studies. Male and female rats were gavaged with DCA or TCA (0. Read More

Toxicology 1990 Oct;64(1):71-80

University of Idaho, WOI School of Veterinary Medicine and Pharmacology/Toxicology Graduate Program, Moscow 83843.

Male Sprague-Dawley rats were treated with either dichloroacetic acid (DCA) or trichloroacetic acid (TCA) in the drinking water at levels of 0, 50, 500 and 5000 ppm for a period of 90 days to determine the toxicities associated with subchronic exposure. All animals were sacrificed and examined for gross and histopathologic lesions, serochemical changes, immune dysfunction, hepatic peroxisomal and mixed function oxidase enzyme induction and organ-body weight changes. Animals treated with DCA had decreased body weight gains (500 and 5000 ppm) and decreased total serum protein (all doses). Read More

Toxicology 1990 Jul;63(1):63-72

Department of Pharmacology and Toxicology, West Virginia University, Morgantown 26506.

Trichloroacetic acid, TCA, is a water chlorination by-product similar to dichloroacetic acid, DCA. Because DCA has been shown to have effects on intermediary metabolism, TCA was tested to determine if it possesses similar capabilities. The effects were more pronounced in females. Read More

Gig Sanit 1989 Nov(11):7-9

Through taking into account frequency of sister chromatid metabolisms and chromosome aberrations in bone marrow cells of animals it is demonstrated that under long-term body intake chromium in a wide range of doses can produce mutagenic effect. When assessing chromium mutagenic effect in vivo it is also shown that the test on sister chromatid metabolism is more sensitive than the test on chromosome aberrations in bone marrow cells. Read More