Bantis, Athanasios; Sountoulides, Petros; Kalaitzis, Christos; Giannakopoulos, Stelios; Agelonidou, Eleni; Foutzitzi, Soultana; Touloupidis, Stavros
2010-01-01
The urethra is a usual site of introduction of foreign bodies for autoerotic stimulation. We present an unusual case of bladder perforation caused by foreign body that was self-inserted in the urethra and consequently slipped inside the bladder in a 29-year-old female patient with psychiatric disease. The patient was referred to our department for macroscopic hematuria and abdominal pain. Imaging studies revealed the presence of a foreign body in the pelvic area which had perforated the left lateral wall of the bladder. The foreign body was removed via open cystotomy. In psychiatric patients hematuria and pelvic pain may result from insertion of a foreign body in the bladder usually during masturbation.
Bantis, Athanasios; Sountoulides, Petros; Kalaitzis, Christos; Giannakopoulos, Stelios; Agelonidou, Eleni; Foutzitzi, Soultana; Touloupidis, Stavros
2010-01-01
The urethra is a usual site of introduction of foreign bodies for autoerotic stimulation. We present an unusual case of bladder perforation caused by foreign body that was self-inserted in the urethra and consequently slipped inside the bladder in a 29-year-old female patient with psychiatric disease. The patient was referred to our department for macroscopic hematuria and abdominal pain. Imaging studies revealed the presence of a foreign body in the pelvic area which had perforated the left lateral wall of the bladder. The foreign body was removed via open cystotomy. In psychiatric patients hematuria and pelvic pain may result from insertion of a foreign body in the bladder usually during masturbation. PMID:20862362
Urethral Foreign Bodies: Clinical Presentation and Management.
Palmer, Cristina J; Houlihan, Matthew; Psutka, Sarah P; Ellis, K Alexandria; Vidal, Patricia; Hollowell, Courtney M P
2016-11-01
To review a single institution's 15-year experience with urethral foreign bodies, including evaluation, clinical findings, and treatment. In total, 27 patients comprising 35 episodes of inserted urethral foreign bodies were reviewed at Cook County Hospital between 2000 and 2015. Retrospective chart review was performed to describe the clinical presentation, rationale for insertion, management, recidivism, and sequelae. Median patient age was 26 (range 12-60). Twenty-six patients (97 %) were male, 1 was female (3%). Items inserted included pieces of plastic forks, spoons, metal screws and aluminum, pieces of cardboard or paper, staples, writing utensils such as pens and pencils, as well as coaxial cable and spray foam sealant. Reported reasons for insertion were self-stimulation, erectile enhancement, and attention seeking. Presenting symptoms included dysuria, gross hematuria, urinary retention, urinary tract infection, and penile discharge. The most common technique for removal was manual extraction with extrinsic pressure (n = 19, 54%). Other methods include endoscopic retrieval (n = 8, 23%), open cystotomy (n = 1, 3%), and voiding to expel the foreign body (n = 7, 20%). Postremoval complications included urinary tract infection (n = 7), sepsis (n = 4), urethral false passage (n = 5), laceration (n = 5), and stricture (n = 1). We present the largest single-institutional series of urethral foreign bodies to date. Urethral foreign body insertion is a relatively rare occurrence and, commonly, is a recurrent behavior. Urethral trauma related to foreign body insertion is associated with significant risk of infection and urethral injury with long-term sequelae. Copyright © 2016 Elsevier Inc. All rights reserved.
Foreign bodies in the urinary bladder and their management: a Pakistani experience.
Mannan, A; Anwar, S; Qayyum, A; Tasneem, R A
2011-01-01
This was a retrospective study conducted to assess the nature, presentation, mode of insertion, diagnosis and management of foreign bodies in the urinary bladder. Between January 1998 and December 2007, 20 patients with foreign bodies in their urinary bladder were treated at our centre. The records of these patients were reviewed and analysed for their symptoms, mode of insertion, diagnosis, management and complications. A total of 20 foreign bodies were recovered from the urinary bladders during the study period. These included JJ stents with calculi, intrauterine contraceptive devices with stones, a rubber stick, ribbon gauze, encrusted pieces of Foley catheter, proline thread with calculus, a suture needle, broken cold knives, the ceramic beak of a paediatric resectoscope, a knotted suprapubic tube, a hair clip, a nail, an electrical wire and a hairpin. The common presenting features were dysuria and haematuria. The diagnosis was established radiologically in most of the cases. The circumstances of insertion were variable; iatrogenic in 16 (80.0 percent) cases, sexual stimulation in two (10.0 percent), accidental insertion by a child in one (5.0 percent) and physical torture in one (5.0 percent). 17 (85.0 percent) foreign bodies were recovered endoscopically, and cystolithotomy was required in three (15.0 percent) patients. The instances of foreign bodies in the urinary bladder are uncommon. A diagnosis is usually made radiologically. Iatrogenic foreign bodies were found to be the most frequent type of insertion encountered. Endoscopic retrieval is usually successful, with minimal morbidity.
Intravesical foreign body–induced bladder calculi resulting in obstructive renal failure
Kamal, Fadi; Clark, Aaron T.D.; Lavallée, Luke Thomas; Roberts, Matthew; Watterson, James
2008-01-01
We report the case of a 30-year-old man who presented with obstructive renal failure and urosepsis due to bladder outlet–obstructing bladder calculi that formed around 3 copper wires that were self-inserted into his urinary bladder 15 years previously. We present the evaluation, imaging and management of the unique complications resulting from the self-insertion of an intra-vesical foreign body. Our patient’s case was unique for 2 reasons. First, the length of time (15 yr) from foreign body insertion to presentation is the longest interval reported in the literature. Second, this is the first report of bladder calculi induced by the insertion of a foreign body that resulted in obstructive renal failure. PMID:18953457
Mahadevappa, Nagabhushana; Kochhar, Gaurav; Vilvapathy, Karthikeyan Senguttuvan; Dharwadkar, Sachin; Kumar, Sumit
2016-01-01
Objectives: To study retrospectively the frequency, demographic, phenomenological, and psychiatric profile in patients presented with self-insertion of foreign bodies in the lower genitourinary tract in our institute. Materials and Methods: From January 2009 to 2015, the records of patients admitted with self-insertion of foreign bodies into the lower urinary tract were analyzed retrospectively regarding demographic and phenomenological profile, the mode of presentation, diagnosis, management, complications, and possible contributing factors leading to the event. Results: Out of 17,978 inpatients, ten patients (0.055%) presented with foreign body insertion in the lower genitourinary tract in last 6 years. Mean age was 28.1 ± 13.9 (7–50) years. Objects used for insertion were varied from seeds, twigs to the electric wire. The contributing factors were lack of partner, misconception about masturbation, and underlying psychiatric illness. The presenting symptoms were pain and swelling of the penis, difficulty in voiding, and skin ulceration. The diagnosis was possible by simple observation in four patients, X-ray kidney, ureter, and bladder, and sonography of the pelvis in six patients. Five patients had endoscopic retrieval of foreign body, 2 had an open, suprapubic cystotomy, urethrotomy was needed in one patient, and forceps removal in two patients. There were no postoperative complications. Psychiatric profile was evaluated in nine patients. Conclusions: Foreign body insertion to lower urinary tract was rare. A main cause for insertion of foreign bodies was autoerotism, misconceptions regarding masturbation, and underlying psychiatric illness. In addition to suitable method of surgical removal, counseling and psychiatric evaluation are necessary to prevent recurrences or for early detection of psychiatric problems. PMID:27453657
A penal problem: the increasing incidence of implantation of penile foreign bodies.
Flynn, Ryan M; Mostafa, Hesham I; Khan, Omar A; Haselhuhn, Gregory D; Jain, Samay
2014-12-01
Our objective is to describe a novel presentation of subcutaneous penile insertion of foreign bodies. This is a practice performed globally and mostly has been reported outside of the United States. We present three cases of incarcerated males that implanted sculpted dominos into the penile subcutaneous tissue. The patients presented with erosion of the foreign bodies through the skin without evidence of infection. We believe that insertion of foreign bodies into penile subcutaneous tissue by incarcerated American males for sexual enhancement is more widespread than previously reported. Erosion is a novel presentation.
Kuzaka, Bolesław; Kobryń, Andrzej; Niemierko, Maciej; Czaplicki, Maciej
2009-01-01
Authors have reported a case report of life threatening complications due to insertion of foreign bodies into the vagina, because of masturbation purpose. In this case subsequently came to perforation of the urinary bladder by the huge calculus that developed over the foreign body, and next to the peritoneum with development peritonitis and acute renal insufficiency with the need of dialysotherapy. After a number of surgical operations, the patient with a definitive percutaneous nephrostomy was discharged.
Risk factors for otolaryngological foreign bodies in Eastern Poland.
Rybojad, Beata; Niedzielski, Artur; Niedzielska, Grazyna; Rybojad, Pawel
2012-11-01
To identify the sociodemographic characteristics and risk factors associated with suspected foreign bodies in the ear, nose, throat, airway, and esophagus among Polish children. Case series with chart review. Setting Tertiary care medical center. A retrospective analysis of the medical records of patients hospitalized for a suspected foreign body (FB) between 1998 and 2008 was conducted. Data regarding place of residence, presence of siblings, parents' educational status, seasonality, psychomotor development, age, and sex were collected and statistically analyzed. Of the 1011 patients with suspected foreign body insertion, 849 (84%) had a positive diagnosis. Of the confirmed foreign bodies, 96 were found in the tracheobronchial tree, 142 were found in the esophagus, and 611 were located in the external auditory canals, nasopharyngeal passage, tonsils, auricles, or lips. Sociodemographically, 596 of the children came from urban areas, with a preponderance of males (55%). Objects were removed more frequently in summer and autumn (60%). Children with siblings (53%) predominated. The majority of patients (52%) had parents with an elementary education. Food was the most frequent foreign body in children under 3 years of age. Patients with delayed psychomotor development constituted 1.6% of the analyzed population. Being male, 1 to 3 years of age, belonging to an urban family with siblings, and having parents with an elementary education increased the risk of foreign body insertion. Training caregivers about proper nutrition and safety rules when playing with children can reduce the risk of accidents related to foreign body insertion.
Olaoye, Iyiade Olatunde; Adensina, Micheal Dapo
2013-10-01
Retained rectal foreign bodies are most commonly seen in homosexuals and after assault. A few have been reported after self-treatment of anorectal conditions and prostatic massage. Harmful traditional medical practices have been reported in many communities in Africa but therapeutic anal insertion of foreign bodies for the management of haemorrhoids is rare. We present a patient with features of peritonitis following insertion of a wine bottle into his rectum in an attempt to manage his prolapsed haemorrhoids.
A Very Long Foreign Body in the Bladder
Imai, Atsushi; Suzuki, Yuichiro; Hashimoto, Yasuhiro; Sasaki, Atsushi; Saitoh, Hisao; Ohyama, Chikara
2011-01-01
In the urinary tract, foreign body is most commonly found in the urinary bladder. But it is anatomically very difficult for a man to self-insert a long object into the urinary bladder. Here we report a case of a 49-year-old Japanese man who has inserted a 140-cm vinyl tube in the bladder for masturbation. He could not retrieve it, and the bladder foreign body remained in this position for about two years. He was referred to our hospital and open surgery was performed. PMID:21687624
Stricker, T; Navratil, F; Sennhauser, F H
2004-04-01
To evaluate the clinical features and outcome in girls with a vaginal foreign body. Retrospective review of medical records of 35 girls with a vaginal foreign body seen in an outpatient clinic for paediatric and adolescent gynaecology between 1980 and 2000. The ages ranged from 2.6 to 9.2 years. The most common symptom was blood-stained vaginal discharge/vaginal bleeding (49%). Duration of symptoms varied from 1 day to 2 years. Fifty-four percent of the patients recalled insertion of the foreign object, usually by the girl herself. All but three patients (91%) either recalled insertion of the foreign object and/or had vaginal bleeding or blood-stained or foul-smelling vaginal discharge, and/or visualization or palpation of the foreign body in physical examination. Symptoms resolved after removal of the foreign body followed by a single irrigation with Providon-Iod (Betadine). In the majority of patients a carefully obtained history and physical examination suggest the diagnosis of a vaginal foreign object. The leading symptoms are vaginal bleeding and blood-stained or foul smelling vaginal discharge. Removal of the foreign object followed by a single irrigation with Providon-Iod is the definitive treatment and does not require additional measures.
Patterns of nasal foreign body in northeast Malaysia: A five-year experience.
Yaroko, A A; Baharudin, A
2015-11-01
The aim of this study was to determine the common presentations and management outcomes in case of nasal foreign body. A retrospective study was carried out over 5 years, from January 2008 to December 2012. The total number of patients was 43; maximum age was 9 years. Patient biodata, clinical presentation, type of foreign body and management outcome were obtained and analyzed from the medical records of the Universiti Sains Malaysia Hospital. Of the total 43 patients, 60.5% were male and 39.5% female. The most frequent age at which nasal foreign bodies were found was 3 years (48.83%) and the least frequent age bracket was 7-9 years (2.33%). Most patients had foul smelling nasal discharge (34.88%) or were asymptomatic (34.88%); the least common presentation was nasal discomfort (2.33%). Seeds (23.26%) were the most common foreign body, followed by rubber and batteries (16.28%). In most cases (58.14%), the foreign body had been inserted into the right nostril; 39.53% were inserted into the left nostril, and 2.33% were bilateral. Foreign bodies were removed under general and local anesthesia in 53.49% and 41.86% of cases respectively; 4.65% were dislodged spontaneously. Nasal foreign bodies are encountered daily in our routine clinical practice in the pediatric age group. General anesthesia is required in uncooperative agitated patients to avoid complications. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Smith, Milton T; Wong, Roy K H
2007-04-01
The spectrum of gastrointestinal (GI) foreign bodies includes food bolus impaction in the esophagus, nonfood objects that are swallowed, and various objects that may be inserted into the rectum. The risk depends upon the type of object and its location. Fortunately, 80% to 90% of ingested foreign bodies will pass without intervention. Objects with sharp edges or pointed tips have the highest risk of complications, up to 35%. All objects impacted in the esophagus require urgent or emergent treatment. Rectal foreign bodies are usually removable transanally, although general anesthesia and operative intervention sometimes are required.
Internet Impact on the Insertion of Genitourinary Tract Foreign Bodies in Childhood
Sinopidis, Xenophon; Alexopoulos, Vasileios; Panagidis, Antonios; Ziova, Alexandra; Varvarigou, Anastasia; Georgiou, George
2012-01-01
Foreign body self-insertion into the urethra is an uncommon paraphilia. Variety in object form, motivation, clinical presentation, complications, and treatment options is a rule. In childhood it is very rare, and it is attributed to curiosity or mental disorders so far. However, the internet impact on daily life of all age groups has created a new category of sexual behavior in childhood and adolescence, the “internet induced paraphilia.” Such is the case of an electrical cable inserted in the urethra of a 12-year-old boy reported here, which is representative of this kind of impact. PMID:22997598
Infections and foreign bodies in ENT.
Kullar, Peter; Yates, Philip D
2012-10-30
Infections play a major role in the practice of ENT. Microbial penetration into tissues of the head and neck can initiate a focal reaction causing superficial self-resolving infections. However, some of these have the potential to develop into life-threatening disease. We provide an overview of the most common ENT infections with focus on the presentation, diagnosis and management. Foreign bodies of the ear, nose and throat are a common presentation to primary and emergency care. Most commonly these are seen in children and include plastic toys, beads and foodstuffs inserted into the ears and nose. Diagnosis is often delayed as insertion is usually not witnessed. In exceptional cases airway foreign bodies can present as a life-threatening emergency. Removal of foreign bodies can usually be achieved by a skilled practitioner with minimal complications. Methods of removal include suction catheters, syringing, and use of instrumentation. In adults, the treatment of oesophageal food bolus obstruction may require a combination of medical and surgical intervention.
Intraocular foreign-body hazard during vitrectomy.
Bovino, J A; Marcus, D F
1982-03-01
We noted two instances of forceps-induced fragmentation of the bar used for scleral plug storage during vitreous surgery. The silicone bar material was adherent to the plug in both cases. Because this represents a significant intraocular foreign body hazard, the scleral plug should be carefully inspected before insertion.
21 CFR 874.4710 - Esophagoscope (flexible or rigid) and accessories.
Code of Federal Regulations, 2013 CFR
2013-04-01
... disease, or to remove foreign bodies from the esophagus. When inserted, the device extends from the area.... 874.4710 Section 874.4710 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... generic type of device includes the flexible foreign body claw, flexible biopsy forceps, rigid biopsy...
21 CFR 874.4710 - Esophagoscope (flexible or rigid) and accessories.
Code of Federal Regulations, 2014 CFR
2014-04-01
... disease, or to remove foreign bodies from the esophagus. When inserted, the device extends from the area.... 874.4710 Section 874.4710 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... generic type of device includes the flexible foreign body claw, flexible biopsy forceps, rigid biopsy...
21 CFR 874.4710 - Esophagoscope (flexible or rigid) and accessories.
Code of Federal Regulations, 2012 CFR
2012-04-01
... disease, or to remove foreign bodies from the esophagus. When inserted, the device extends from the area.... 874.4710 Section 874.4710 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... generic type of device includes the flexible foreign body claw, flexible biopsy forceps, rigid biopsy...
McLemore, Jerri; Hallengren, Aaron L
2010-01-01
The authors present a case of a deceased man with numerous subcutaneous nodules identified as foreign bodies on radiographic films. The foreign bodies were gemstones inserted underneath the skin as a form of holistic medicine. The X-ray findings of this case and a review of the literature for similar subcutaneously implanted foreign bodies used in holistic, alternative, or folk medicine are presented. Copyright 2010 Elsevier Inc. All rights reserved.
Foreign body in the vagina of a four-year-old-girl: a childish prank or sexual abuse.
Sakhavar, Nahid; Teimoori, Batool; Ghasemi, Marzie
2014-06-01
Foreign body in the vagina is a common cause of vaginal discharge, which may be either purulent or hemorrhagic. This problem may produce symptoms or be asymptomatic for long periods of time and may result from ignorance, accident, malice, psychotic tendencies, attempts at sexual stimulation or sexual abuse. The current report presents the case of a girl that had inserted a foreign body in her vagina probably due to childish prank. The clinicians should always think of foreign bodies in the vagina in cases of chronic, antibiotic resistant vaginal discharge and lower abdominal pain especially in young girls.
Magnetic spheres as foreign body into the bladder.
Graziottin, Tulio M; de Freitas G Soares, Daniel; Da Ros, Carlos T; Sogari, Paulo R; Telöken, Cláudio; Laste, Paulo Roberto
2013-10-01
A great variety of foreign bodies in the lower urinary tract have been described; many of them are self-inflicted by the patient with masturbatory purposes. Depending on the nature of the foreign body the diagnostic and management might be challenging. We report a case of an unusual magnetic self-inserted foreign body into the bladder for autoerotism and briefly discuss the diagnostic and therapeutic implications in this challenging situation. We describe all the steps we have used to adequately diagnose the problem, describe the foreign body and treatments for the patient. Related articles were found by utilizing the PubMed database and are summarized in this study. The management approach must be planned according to the nature of the foreign body and should minimize bladder and urethral trauma. However, most of cases can be managed endoscopically. Removal of magnetic foreign body may be quite challenging, requiring high-level surgical skills and minimally invasive techniques resulting in fast recovery and low complication rate. © 2012 International Society for Sexual Medicine.
Foreign Body in the Vagina of A Four-Year-Old-Girl: A Childish Prank or Sexual Abuse
Sakhavar, Nahid; Teimoori, Batool; Ghasemi, Marzie
2014-01-01
Introduction: Foreign body in the vagina is a common cause of vaginal discharge, which may be either purulent or hemorrhagic. Case Presentation: This problem may produce symptoms or be asymptomatic for long periods of time and may result from ignorance, accident, malice, psychotic tendencies, attempts at sexual stimulation or sexual abuse. The current report presents the case of a girl that had inserted a foreign body in her vagina probably due to childish prank. Conclusions: The clinicians should always think of foreign bodies in the vagina in cases of chronic, antibiotic resistant vaginal discharge and lower abdominal pain especially in young girls. PMID:25032156
Hudak, Steven J.; McGeady, James; Shindel, Alan W.; Breyer, Benjamin N.
2013-01-01
Introduction Self-insertion of penile foreign bodies is performed worldwide, largely due to a perception that it will enhance sexual performance and virility. There are relatively few cases reported in the United States. Aim We report three cases of Hispanic men incarcerated in separate southwest United States prisons who utilized a similar technique to insert foreign bodies fabricated out of dominos into the subcutaneous tissues of the penis. Methods Details of the three cases were retrospectively reviewed. Main Outcome Measure Resolution of the case. Results In each case, an incarcerated Hispanic male or fellow inmate filed a domino into a unique shape for placement under the penile skin. Utilizing the tip of a ballpoint pen or a sharpened shard of plastic to create a puncture wound, each man inserted the domino fragment into the subcutaneous tissue of the penis. All three men presented with infection requiring operative removal. Conclusions Incarcerated males put themselves at risk for injury and infection when attempting penile enhancement with improvised equipment. PMID:22081893
Hudak, Steven J; McGeady, James; Shindel, Alan W; Breyer, Benjamin N
2012-02-01
Self-insertion of penile foreign bodies is performed worldwide, largely due to a perception that it will enhance sexual performance and virility. There are relatively few cases reported in the United States. We report three cases of Hispanic men incarcerated in separate southwest United States prisons who utilized a similar technique to insert foreign bodies fabricated out of dominos into the subcutaneous tissues of the penis. Details of the three cases were retrospectively reviewed. Resolution of the case. In each case, an incarcerated Hispanic male or fellow inmate filed a domino into a unique shape for placement under the penile skin. Utilizing the tip of a ballpoint pen or a sharpened shard of plastic to create a puncture wound, each man inserted the domino fragment into the subcutaneous tissue of the penis. All three men presented with infection requiring operative removal. Incarcerated males put themselves at risk for injury and infection when attempting penile enhancement with improvised equipment. © 2011 International Society for Sexual Medicine.
Intravaginal vibrator of long duration.
Ahmad, M
2002-03-01
Intravaginal foreign bodies of long duration are a rare entity and are seen in the practice of Obstetrics and Gynaecology, but patients may present to the Accident and Emergency department for their removal. Various bizarre objects have been inserted into the vagina and many patients are too embarrassed and will wait and try to remove them themselves rather than seek medical advice. Vaginal foreign bodies of long duration may be complicated by fistulas and such patients should be referred to the gynaecologist.
A rubber tube in the bladder as a complication of autoerotic stimulation of the urethra.
Stamatiou, Konstantinos; Moschouris, Hippocrates
2016-10-05
Self-insertion of foreign bodies in the urethra is most commonly associated with sexual or erotic arousal of adolescents with mental health disorders. Rarely it may practiced by healthy adults for masturbation. Migration of foreign bodies used for the abovementioned purpose from the urethra to adjacent organs is a relatively uncommon urologic problem that may cause serious complications which arose tardive. Presentation includes a variety of acute or chronic symptoms that depend of the underlying complications. The method of extraction depends on the shape, size and nature of the object and should be tailored according to the condition of the patient. In the present article we present a case of a rubber tube inserted to the urethra for erotic arousal purposes which migrated to the bladder during masturbation.
Foreign bodies in the aerodigestive tract in pediatric patients.
Higo, Ryuzaburo; Matsumoto, Yu; Ichimura, Keiichi; Kaga, Kimitaka
2003-12-01
To investigate pediatric foreign body cases in the aerodigestive tract, and to elucidate the characteristic problems in Japan. A total of 310 pediatric patients (age 15 or below), gathered from two medical university hospitals (University of Tokyo and Jichi Medical School), were included in this study. Data were collected by retrospective chart review and were statistically analyzed. Two-year-olds were the most common patients, and the range from age 1 to age 4 included 67.7% of all the patients. The most involved sites were the nose (39.4%) and the pharynx (38.4%), followed by the esophagus (12.9%) and the trachea-bronchi (6.5%). Fish bones and toys were the representative foreign bodies (30.7 and 13.6%, respectively). Other foreign bodies often encountered included coins, food, candy, peanuts and nuts, and batteries. The type of foreign body was closely related to the site in which foreign bodies were lodged: 77.3% of foreign bodies in the pharynx were fish bones, and toys were the most common impacted foreign body in the nose. In the esophagus, representative impacted foreign bodies were coins (35.7%), but disk-type battery ingestion has been increasing in recent years. Although most foreign bodies in the esophagus were safely removed, one case of a disk-type battery had a serious sequela. In the trachea-bronchi, peanuts, food, cotton, and coins were impacted. A rigid bronchoscope was basically used to remove foreign bodies, but in some cases, a fine flexible endoscope, with a channel for fiber forceps, was useful, because it could be inserted into narrow bronchi. Advance of a flexible endoscope will make it an excellent tool for diagnosis and management of the trachea-bronchial foreign body. Fish bones in the pharynx, which were closely related to Japanese eating habits, and toys in the nose, were the typical foreign bodies encountered in this study. In the esophagus, an increased incidence of disk-type battery ingestion has become a serious problem in recent years. Since prevention is the most essential way to manage foreign body cases, feedback from studies to public education should be encouraged.
A case of stapler pin in the root canal--extending beyond the apex.
Rao, A; Sudha, P
1999-01-01
There have been several reports describing the placement, by patients, of foreign objects into exposed pulp chambers and canals. In the present case, a 13-year-old patient reported with complaints of pain and a history of inserting a foreign object into the root canal of the left central incisor. On examination the foreign body was found to be a stapler pin which was projecting 5 millimeters from the apical foramen. Foreign bodies discovered from the root canal have varied from radiolucent objects like wooden tooth picks or tooth brush bristles to radioopaque materials like paper pins, needles, pencil leads etc. In the present case, despite our best efforts, the patient did not agree to undergo any treatment except for the extraction of the left central incisor.
Removal of press-through-packs impacted in the upper esophagus using an overtube.
Seo, Yeon-Seok; Park, Jong-Jae; Kim, Ji-Hoon; Kim, Jin-Yong; Yeon, Jong-Eun; Kim, Jae-Seon; Byun, Kwan-Soo; Bak, Young-Tae
2006-09-28
Foreign bodies in the upper esophagus should be removed as soon as possible to avoid serious complications. However, removals of foreign bodies in the upper esophagus are very difficult, especially if they have sharp edges, such as press-through-packs (PTPs). We experienced four cases of the impacted PTPs in the upper esophagus which was successfully extracted endoscopically with the overtube. Because two edges of PTPs were so firmly impacted in the esophageal wall in all cases, the PTPs were not movable in the upper esophagus. However, after insertion of the overtube, PTPs became movable and were successfully extracted and no serious complications occurred after extraction of PTPs. In one case, insertion of the overtube rapidly expanded the upper esophagus and PTP progressed to the gastric cavity and it could be extracted with the endoscopic protector hood. The endoscopic removal with the overtube was a simple, safe and effective technique for the removal of the impacted PTPs in upper esophagus.
Removal of press-through-packs impacted in the upper esophagus using an overtube
Seo, Yeon Seok; Park, Jong-Jae; Kim, Ji Hoon; Kim, Jin Yong; Yeon, Jong Eun; Kim, Jae Seon; Byun, Kwan Soo; Bak, Young-Tae
2006-01-01
Foreign bodies in the upper esophagus should be removed as soon as possible to avoid serious complications. However, removals of foreign bodies in the upper esophagus are very difficult, especially if they have sharp edges, such as press-through-packs (PTPs). We experienced four cases of the impacted PTPs in the upper esophagus which was successfully extracted endoscopically with the overtube. Because two edges of PTPs were so firmly impacted in the esophageal wall in all cases, the PTPs were not movable in the upper esophagus. However, after insertion of the overtube, PTPs became movable and were successfully extracted and no serious complications occurred after extraction of PTPs. In one case, insertion of the overtube rapidly expanded the upper esophagus and PTP progressed to the gastric cavity and it could be extracted with the endoscopic protector hood. The endoscopic removal with the overtube was a simple, safe and effective technique for the removal of the impacted PTPs in upper esophagus. PMID:17007065
D'Elia, Carolina; Curti, Pierpaolo; Cerruto, Maria Angela; Monaco, Carmelo; Artibani, Walter
2015-01-01
In the non-industrialized countries of Africa and Asia obstetric fistulas are more frequently caused by prolonged labour, whereas in countries with developed healthcare systems they are generally the result of complications of gynaecological surgery or, rarely, benign pathologies like inflammation or foreign bodies. A 22-year-old woman was brought to the gynaecology clinic because of foul-smelling vaginal discharge. On pelvic examination a ring-like foreign body was impacted between the anterior and posterior vaginal wall. MRI scan confirmed the presence of a cylindrical foreign body in the vagina and the patient revealed that she had 'involuntarily' inserted a plastic bubble bath cap into the vagina. At surgery removal of the cap was difficult and at the end of the manoeuver evidence of a huge urethro-vesico-vaginal fistula occurred. The patient was discharged with bilateral ureteral stents and suprapubic catheter. After 3 months we performed an end-to-end anastomotic urethroplasty to repair the urethral avulsion and restored the bladder/trigonal and vaginal/cervical defects with 3 layers of sutures; 3 months later the patient had no complaints. Complex genital fistulas represent an extremely debilitating morbidity. In our case, a vaginal approach was successful, but the choice between an abdominal or vaginal approach depends on the surgeon's experience and training. © 2015 S. Karger AG, Basel.
USDA-ARS?s Scientific Manuscript database
Newcastle disease virus (NDV) has been developed as a vector for vaccine and gene therapy purposes. However, the optimal insertion site for foreign gene expression remained to be determined. In the present study, we inserted the green fluorescence protein (GFP) gene into five different intergenic ...
Morimoto, Tomomi; Arii, Jun; Akashi, Hiroomi; Kawaguchi, Yasushi
2009-03-01
Information on sites in HSV genomes at which foreign gene(s) can be inserted without disrupting viral genes or affecting properties of the parental virus are important for basic research on HSV and development of HSV-based vectors for human therapy. The intergenic region between HSV-1 UL3 and UL4 genes has been reported to satisfy the requirements for such an insertion site. The UL3 and UL4 genes are oriented toward the intergenic region and, therefore, insertion of a foreign gene(s) into the region between the UL3 and UL4 polyadenylation signals should not disrupt any viral genes or transcriptional units. HSV-1 and HSV-2 each have more than 10 additional regions structurally similar to the intergenic region between UL3 and UL4. In the studies reported here, it has been demonstrated that insertion of a reporter gene expression cassette into several of the HSV-1 and HSV-2 intergenic regions has no effect on viral growth in cell culture or virulence in mice, suggesting that these multiple intergenic regions may be suitable HSV sites for insertion of foreign genes.
USDA-ARS?s Scientific Manuscript database
Newcastle disease virus (NDV), avian paramyxovirus type 1, has been developed as a vector to express foreign genes for vaccine and gene therapy purposes. The foreign genes are usually inserted into a non-coding region of the NDV genome as an independent transcription unit (ITU), which potentially a...
Sharma, Deepanshu; Pandey, Siddharth; Garg, Gaurav; Sankhwar, Satyanarayan
2018-05-26
Misdiagnosis of a urethral foreign body (FB) as urethral stricture leads to inadequate management and prolonged treatment duration. A 55-year-old male patient was referred with complaints of difficulty in voiding and poor urinary stream for 2 months. He initially presented at a primary healthcare centre and was misdiagnosed as urethral stricture and was scheduled for urethroplasty. Surprisingly, intraoperative cystourethroscopy performed by us revealed that the urethra had been obstructed by an FB. The FB was gently pushed into the bladder and retrieved. The postoperative course was uneventful. The present case represents a rare occurrence of polyembolokoilamania or insertion of a FB into any bodily orifice for sexual gratification. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Pichon, Nicolas, E-mail: nicolas.pichon@unilim.fr, E-mail: nicolas.pichon@chu-limoges.fr; Francois, Bruno; Pichon-Lefievre, Florence
2005-05-15
Rectal injuries caused by foreign bodies or iatrogenic insertions may lead to severe complications whose therapeutic management remains controversial. At times, both the rapid identification and treatment of subsequent active rectal bleeding may be challenging, especially when endoscopy fails to locate and control the arterial hemorrhage. We present the first two successful cases of middle rectal artery embolization in patients presenting with sustained bleeding and hemorrhagic shock.
Simultaneous wood and metal particle detection on dark-field radiography.
Braig, Eva-Maria; Birnbacher, Lorenz; Schaff, Florian; Gromann, Lukas; Fingerle, Alexander; Herzen, Julia; Rummeny, Ernst; Noël, Peter; Pfeiffer, Franz; Muenzel, Daniela
2018-01-01
Currently, the detection of retained wood is a frequent but challenging task in emergency care. The purpose of this study is to demonstrate improved foreign-body detection with the novel approach of preclinical X-ray dark-field radiography. At a preclinical dark-field x-ray radiography, setup resolution and sensitivity for simultaneous detection of wooden and metallic particles have been evaluated in a phantom study. A clinical setting has been simulated with a formalin fixated human hand where different typical foreign-body materials have been inserted. Signal-to-noise ratios (SNR) have been determined for all test objects. On the phantom, the SNR value for wood in the dark-field channel was strongly improved by a factor 6 compared to conventional radiography and even compared to the SNR of an aluminium structure of the same size in conventional radiography. Splinters of wood < 300 μm in diameter were clearly detected on the dark-field radiography. Dark-field radiography of the formalin-fixated human hand showed a clear signal for wooden particles that could not be identified on conventional radiography. x-ray dark-field radiography enables the simultaneous detection of wooden and metallic particles in the extremities. It has the potential to improve and simplify the current state-of-the-art foreign-body detection.
48 CFR 1352.237-73 - Foreign national visitor and guest access to departmental resources.
Code of Federal Regulations, 2010 CFR
2010-10-01
... Regulations System DEPARTMENT OF COMMERCE CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text... resources. As prescribed in 48 CFR 1337.110-70 (e), insert the following clause: Foreign National Visitor...; Bureau of Industry and Security Export Administrative Regulations Part 734, and [insert operating unit...
Tenke, Peter; Kovacs, Bela; Benkõ, Ria; Ashaber, David; Nagy, Elizabeth
2006-08-01
This study was one of the first to examine the in vivo levofloxacin adsorption to stent surfaces. The results demonstrated the ability of this antibiotic to adsorb to the conditioning film and to the surface of the inserted device, and showed that 1-2 weeks after the discontinuation of antibiotic administration some amount of the antibiotic still could be detected on them. The second aim of the investigation was to determine whether continuous or intermittent levofloxacin treatment is advantageous for the patients who have acute complicated urinary tract infection (UTI) caused by urinary obstruction. The results did not show any clinical or microbiological advantages of the continuous therapy.
Two hit hypothesis: an unusual complication following supra-pubic catheter insertion.
Nason, G J; Looney, A T; Kelly, M E; McGuire, B B; Mulvin, D W
2014-01-01
Osteomyelitis is an inflammation of the bone caused by an infection. Though bone is normally resistant to bacterial infection, events including trauma, presence of foreign bodies including prosthesis can act as a nidus for infection. Osteomyelitis is a rare but recognised complication of radiotherapy. Osteomyelitis of the pubis has scarcely been reported as a complication following urological procedures- prostatectomy, sling surgery and catheterisation. We report a rare complication of a gentleman post radiotherapy presenting with delayed osteomyelitis of the pubis following supra-pubic catheterisation.
Vaginal flora changes on Pap smears after insertion of levonorgestrel-releasing intrauterine device.
Donders, Gilbert G G; Berger, Judith; Heuninckx, Hélène; Bellen, Gert; Cornelis, Ann
2011-04-01
The levonorgestrel intrauterine system (LNG-IUS) combines a uterine foreign body and the continuous release of low-dose levonorgestrel for contraception. Its influence on the rate of vulvovaginal infections and flora disturbance is insufficiently known, but important for contraceptive advice in women, especially those who develop recurrent vaginosis or Candida vulvovaginitis. Slides of 286 women who had a Pap smear taken before and 1 to 2 years after placement of a LNG-IUS were blindly reviewed for the presence of abnormal vaginal flora (AVF), bacterial vaginosis (BV), aerobic vaginitis (AV) and Candida vaginitis (CV). Prior to insertion, there were no differences in vaginal flora abnormalities between women using different kinds of contraception. LNG-IUS users did not have different rates of AVF, BV, AV or CV, but the general risk to develop any infection was increased. Uterine bleeding after insertion did not seem to predict a different flora type. We found that Pap smears suggested more vaginal infections after 1 year of LNG-IUS use than prior to insertion of the device. Copyright © 2011 Elsevier Inc. All rights reserved.
Plastic laryngeal foreign bodies in children: a diagnostic challenge.
Bloom, David C; Christenson, Tom E; Manning, Scott C; Eksteen, Eduard C; Perkins, Jonathan A; Inglis, Andrew F; Stool, Sylvan E
2005-05-01
To review Children's Hospital and Regional Medical Center experience with pediatric airway foreign bodies, and examine the incidence and treatment of laryngeal foreign bodies. To determine if plastic laryngeal foreign bodies present differently than other laryngeal foreign bodies. A retrospective review of all cases of children (1874 patients) undergoing direct laryngoscopy and/or bronchoscopy from 1st January 1997 to 9th September 2003 at a tertiary care children's hospital. Patients with endoscopically documented laryngeal foreign bodies were identified and the medical record reviewed in more detail. Patient age, gender, foreign body location, foreign body type, duration of foreign body presence, radiographic findings, endoscopic findings and treatment complications were recorded. One hundred and five aspirated foreign bodies were identified. The nine laryngeal foreign bodies included five clear plastic radiolucent items, two radiolucent food items, and two sharp radioopaque pins. Time to diagnosis and treatment was on average 11.6 days with 17.6 days for thin/plastic foreign bodies and 1.6 days for metal/food foreign bodies. Laryngeal foreign bodies represent a small portion of all pediatric airway foreign bodies. Difficulty in identifying laryngeal foreign bodies, especially thin, plastic radiolucent foreign bodies can delay treatment. Thin plastic foreign bodies can present without radiographic findings, can be difficult to image during endoscopy and can be particularly difficult to diagnose. A history of choking and vocal changes is associated with laryngeal foreign bodies. Laryngeal foreign bodies should be in the differential diagnosis of all children presenting with atypical upper respiratory complaints especially if a history suggestive of witnessed aspiration and dysphonia can be obtained.
48 CFR 29.402-2 - Foreign cost-reimbursement contracts.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Foreign cost-reimbursement... GENERAL CONTRACTING REQUIREMENTS TAXES Contract Clauses 29.402-2 Foreign cost-reimbursement contracts. (a) The contracting officer shall insert the clause at 52.229-8, Taxes—Foreign Cost-Reimbursement...
Magalhães-Costa, Pedro; Carvalho, Liliana; Rodrigues, José Pedro; Túlio, Maria Ana; Marques, Susana; Carmo, Joana; Bispo, Miguel; Chagas, Cristina
2016-01-01
Gastrointestinal foreign bodies (FB) are comprised of food bolus impaction and intentionally or unintentionally ingested or inserted true FB. Food bolus impaction and true FB ingestion represent a recurrent problem and a true challenge in gastrointestinal endoscopy. More than 80-90% of the ingested true FB will pass spontaneously through the gastrointestinal tract without complications. However, in 10-20% of the cases an endoscopic intervention is deemed necessary. True FB ingestion has its greatest incidence in children, psychiatric patients and prisoners. On the other hand, food bolus impaction typically occurs in the elderly population with an underlying esophageal pathology. The most serious situations, with higher rates of complications, are associated with prolonged esophageal impaction, ingestion of sharp and long objects, button batteries and magnets. Physicians should recognize early alarm symptoms, such as complete dysphagia, distressed patients not able to manage secretions, or clinical signs of perforation. Although many papers are yearly published regarding this subject, our knowledge is mainly based on case-reports and retrospective series. Herein, the authors summarize the existing evidence and propose an algorithm for the best approach to FB ingestion.
Gill, S S; Pease, R A; Ashwin, C J; Gill, S S; Tait, N P
2012-09-01
Respiratory foreign body aspiration (FBA) is a common global health problem requiring prompt recognition and early treatment to prevent potentially fatal complications. The majority of FBAs are due to organic objects and treatment is usually via either endoscopic or surgical extraction. FBA of a straight hairpin has been described as a unique entity in the literature, occurring most commonly in females, particularly during adolescence. In the process of inserting hairpins, the pins will typically be between the teeth with the head tilted backwards, while tying their hair with both hands. This position increases the risk of aspiration, particularly if there is any sudden coughing or laughing. To our knowledge, this is the first case report of a 35-mm straight metallic hairpin foreign body that has been successfully retrieved by a radiological snare system under fluoroscopic guidance. This was achieved with the use of a split endotracheal tube, and therefore avoided the need for a thoracotomy in an adolescent female patient.
48 CFR 652.236-71 - Foreign Service Buildings Act, as Amended.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Foreign Service Buildings....236-71 Foreign Service Buildings Act, as Amended. As prescribed in 636.570(a), insert the following provision: Foreign Service Buildings Act, as Amended (APR 2004) (a) This solicitation is subject to Section...
Mumcuoglu, Tarkan; Ozge, Gokhan; Soykut, Bugra; Erdem, Onur; Gunal, Armagan; Acikel, Cengizhan
2015-03-01
Ocular siderosis is a rare sight-threatening complication that occurs after a penetrating ocular injury by an iron-containing foreign body. The purposes of this study were to (i) investigate the histopathology, electrophysiology and iron levels/accumulation in ocular siderosis using an animal (Guinea pig) model and (ii) determine the appropriate timing for follow-up foreign body-removal surgery. Thirty guinea pigs were divided into five groups (n = 6 animals/group). On day-1, an iron body was inserted into the vitreous of the right eye of all animals; the left eyes were left undisturbed and were used as controls. At the end of each week during the 5-week study period, electroretinography (ERG) was performed on all animals in one of the five groups. Each animal in that group was sacrificed, after which both eyes were enucleated for histopathological and pharmacological evaluation of intraocular iron. Accumulated iron levels of study eyes were significantly higher than those of control eyes (135.13 and 13.55 μg/g, respectively, p < 0.01). In addition, there was a significant decrease in electrophysiological responses of study eyes. During the first week, iron levels were higher in study eyes than control eyes, but neither histological iron accumulation nor decreased electrophysiological responses could be detected. By the end of the second week, increased iron accumulation was observed histologically in intraocular tissues, along with signs of retinal toxicity, as verified by decreased electrophysiological responses. The present study indicates that the 14th day after a penetrating eye injury by an iron-containing intraocular foreign body represents a clinically critical threshold, after which structural damage to and functional alterations in ocular tissues occur.
Review of ear, nose and throat foreign bodies in Sarawak General Hospital. A five year experience.
Chiun, Kian Chai; Tang, Ing Ping; Tan, Tee Yong; Jong, Doris Evelyn Yah Hui
2012-02-01
Ear, nose and throat foreign bodies are common in ENT clinical practice. This study was designed to establish the local data of otorhinolaryngeal foreign bodies in term of prevalence among paediatric and adult groups, the clinical features, types of foreign body at different sites, and laterality of foreign bodies. This study was carried out at ENT department, Sarawak General Hospital, Malaysia, from 1st January 2005 to 31st December 2009. A total of 1084 cases were included and statistically analyzed. Ear foreign bodies showed the highest incidence which was consisted of 480 (44.3%) cases, followed by nose in 270 (24.9%) cases, pharynx in 251 (23.2%) cases, esophagus in 57 (5.3%) cases and laryngo-tracheobronchial tree in 26 (2.4%) cases. Otorhinolaryngeal foreign bodies occurred more frequently in 0-10 year old age group which constituted 651 (60.1%) cases. The descending order of frequency for foreign body sites in adult was pharynx (17.2%), ear (12.8%), esophagus (3.1%), nose (1.7%) and laryngo-tracheobronchial tree (1.1%). The type of foreign bodies varies with age group and site of foreign body lodgement. In general, common foreign bodies in both adult and children were food related, with the additional of small objects such as plastic toy in paediatric group. Otorhinolaryngeal foreign bodies were found more frequently in children. The types of foreign body were different from age group and sites of foreign body lodgement. The local food constituted the highest incidence of ear, nose, and throat foreign bodies with additional of plastic toys in paediatric group.
Cross-sectional study examining four types of male penile and urethral "play".
Rinard, Katherine; Nelius, Thomas; Hogan, LaMicha; Young, Cathy; Roberts, Alden E; Armstrong, Myrna L
2010-12-01
To provide further quantitative and qualitative evidence about men who insert foreign liquids and objects into their penis and/or urethra. As part of a larger, cross-sectional study examining men (n = 445) with genital piercings (GP), 2 questions inquired whether the respondents had penile tattoos and/or inserted other materials, such as fluids and foreign objects, into their penis and urethra. Four different practices have been described in the literature: embedding (a) foreign objects and/or (b) liquids subcutaneously into penile tissue, as well as inserting (c) liquids and/or (d) foreign objects into the urethra. In our study, 354 (78%) men with GP responded to the 2 questions; 85 (24%) replied affirmatively and 68 (80%) provided comments. Respondents coined their practices penile and/or urethral "play." Two respondents embedded metal balls into their penis, 1 at age 13 injected water for penis enlargement; 11 inserted liquids into the urethra, and 63 reported insertion of 32 different objects, frequently urethral sounds or "sounding" (n = 33/52%) were mentioned. Major motivation themes focused on sexual stimulation and experimentation. Penile tattoos (n = 14) were also reported, mainly for esthetics. Few complications or STDs were reported. Basic demographic assumptions of those who participate in these actions were challenged, and this study provides evidence of a wider distribution of men using penile or urethral play, and "sounding." Clinician awareness of these practices are important to obtain accurate health histories, manage genitourinary tract complications, as well as provide applicable patient education. Copyright © 2010 Elsevier Inc. All rights reserved.
48 CFR 217.208-70 - Additional clauses.
Code of Federal Regulations, 2010 CFR
2010-10-01
... Foreign Military Sales Commitments, when an option may be used for foreign military sale requirements. (1) Use Alternate I when the foreign military sale country is not known at the time of solicitation or..., Surge Option, in solicitations and contracts. (1) Insert the percentage of increase the option...
Complete endoscopic management of a retained bullet in the bladder.
Friedman, Ariella A; Trinh, Quoc-Dien; Kaul, Sanjeev; Bhandari, Akshay
2013-01-01
A 25-year-old male gunshot victim presented at our institution with gross hematuria following Foley catheter insertion. Computed tomography and cystogram did not show a bladder perforation, but were notable for a left ischial fracture and the presence of a bullet within the bladder. After failed attempts at retrieving the bullet with a resectoscope and loop, as well as a cystoscope and stone crusher, a 26 French nephroscope was inserted transurethrally, and the bullet was successfully engaged and removed using a Perc NCircle (Cook Medical, Bloomington, IN) grasper. The extra-peritoneal injury was managed conservatively with catheter drainage. To our knowledge, this represents the first case of successful transurethral management of a retained intravesical bullet. Such an approach may benefit patients with retained intravesical bullets or other challenging intravesical foreign bodies and may be helpful in select circumstances to spare patients from more extensive surgeries.
[Unfixed Mesh Plug Migration from Inguinal Ring to Urinary Bladder].
Okada, Koichi; Nakayama, Jiro; Adachi, Shiro; Miyake, Osamu
2018-02-01
A 65-year-old man presented to a clinic with a chief complaint of macrohematuria and frequent urination. The computed tomographic scan and cystoscopy revealed a dome of bladder tumor. He was referred to our hospital with the diagnosis of bladder tumor. He had undergone bilateral inguinal hernia repair and magnetic resonance imaging suggested mesh plug migration on the urinary bladder inserted into the right inguinal lesion 11 years previously. Under the diagnosis of mesh plug migration, partial cystectomy with extraction of the foreign body was performed. After the surgery he was well and symptoms had disappeared.
Dorward, N L; Malik, N N; Illingworth, R D
1997-02-01
We report the case histories of two patients treated in our unit for cervical radiculopathy by anterior cervical discectomy and BOP grafting. Both grafts disintegrated within 6 weeks of insertion resulting in increased neurological deficit from cervical cord compression. At reoperation fibres from the grafts were found to have separated and the larger fragments had extruded into the vertebral canal. No evidence of infection was seen, but a foreign body reaction was found in one case. Following graft removal the patients improved symptomatically although one was left with permanent mild biceps weakness.
Factors predictive of risk for complications in patients with oesophageal foreign bodies.
Sung, Sang Hun; Jeon, Seong Woo; Son, Hyuk Su; Kim, Sung Kook; Jung, Min Kyu; Cho, Chang Min; Tak, Won Young; Kweon, Young Oh
2011-08-01
Reports on predictive risk factors associated with complications of ingested oesophageal foreign bodies are rare. The aim of this study was to determine the predictive risk factors associated with the complications of oesophageal foreign bodies. Three hundred sixteen cases with foreign bodies in the oesophagus were retrospectively investigated. The predictive risk factors for complications after foreign body ingestion were analysed by multivariate logistic regression, and included age, size and type of foreign body ingested, duration of impaction, and the level of foreign body impaction. The types of oesophageal foreign bodies included fish bones (37.0%), food (19.0%), and metals (18.4%). The complications associated with foreign bodies were ulcers (21.2%), lacerations (14.9%), erosions (12.0%), and perforation (1.9%). Multivariate analysis showed that the duration of impaction (p<0.001), and the type (p<0.001) and size of the foreign bodies (p<0.001) were significant independent risk factors associated with the development of complications in patients with oesophageal foreign bodies. In patients with oesophageal foreign bodies, the risk of complications was increased with a longer duration of impaction, bone type, and larger size. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Sink, Jacquelyn R; Kitsko, Dennis J; Mehta, Deepak K; Georg, Matthew W; Simons, Jeffrey P
2016-04-01
(1) To describe clinical and radiologic findings in patients with esophageal foreign bodies. (2) To examine the sensitivity and specificity of history, physical examination, and radiologic studies in children with suspected foreign body ingestion. A retrospective cohort study was performed evaluating all children who underwent esophagoscopy for suspected foreign body ingestion at our institution from 2006 to 2013. Five hundred forty-three patients were included (54% male). Average age was 4.7 years (SD = 4.1 years). Foreign bodies were identified on esophagoscopy in 497 cases (92%). Ingestion was witnessed in 23% of cases. Most common presenting symptoms were choking/gagging (49%), vomiting (47%), and dysphagia/odynophagia (42%). Most patients with foreign bodies had a normal exam (76%). Most foreign bodies were radiopaque (83%). In 59% of patients with normal chest radiographs, a foreign body was present. Sensitivity and specificity of 1 or more findings on history, physical examination, and imaging were 99% and 0%, 21% and 76%, and 83% and 100%, respectively. Most patients with esophageal foreign bodies are symptomatic. Although many patients will have a normal physical examination, an abnormal exam should increase suspicion for a foreign body. Most esophageal foreign bodies are radiopaque, but a normal chest radiograph cannot rule out a foreign body. © The Author(s) 2015.
Kim, S Y; Park, B; Kong, I G; Choi, H G
2016-12-01
This study aimed to analyse the types and locations of ingested foreign bodies according to different age groups, from infants to the elderly. A retrospective chart review. Tertiary referral centre. A total of 4682 patients who ingested foreign bodies from January 2006 through February 2014. The frequencies of foreign bodies were investigated in each age group. The types of foreign bodies were categorised into fish bones, chicken bones, seafood, tablets, food, metal, batteries, glass, teeth, plastics and others. The anatomic locations of the objects were classified as the oral cavity, tongue base, tonsils, oropharynx, hypopharynx, oesophagus, stomach and colon. The types, locations and origins of the foreign bodies were analysed according to the age groups. The frequency of foreign body ingestion was high in patients up to 14 years of age, after which the risk of foreign body ingestion markedly decreased. Fish bones were the most commonly suspected foreign bodies in all of the age groups. However, non-food-type foreign bodies were more common in both the young and elderly groups. The tonsils were the most common anatomic site of foreign body impaction except in the group of patients older than 65 years. The stomach and oesophagus were also common locations of foreign bodies in the groups of patients younger than 10 years (10.5%) and older than 65 years (39.4%). The frequency of foreign body ingestion was highest in young children. However, we observed specific age-based characteristics that indicate specific precautions to take to avoid foreign body ingestion. © 2015 John Wiley & Sons Ltd.
48 CFR 52.225-17 - Evaluation of Foreign Currency Offers.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Evaluation of Foreign Currency Offers. 52.225-17 Section 52.225-17 Federal Acquisition Regulations System FEDERAL ACQUISITION... Clauses 52.225-17 Evaluation of Foreign Currency Offers. As prescribed in 25.1103(c), insert the following...
48 CFR 52.225-13 - Restrictions on Certain Foreign Purchases.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Restrictions on Certain Foreign Purchases. 52.225-13 Section 52.225-13 Federal Acquisition Regulations System FEDERAL ACQUISITION... Clauses 52.225-13 Restrictions on Certain Foreign Purchases. As prescribed in 25.1103(a), insert the...
48 CFR 52.229-9 - Taxes-Cost-Reimbursement Contracts With Foreign Governments.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Taxes-Cost-Reimbursement... Provisions and Clauses 52.229-9 Taxes—Cost-Reimbursement Contracts With Foreign Governments. As prescribed in 29.402-2(b), insert the following clause: Taxes—Cost-Reimbursement Contracts With Foreign Governments...
Clinical experience of removing aerodigestive tract foreign bodies with rigid endoscopy in children.
Ozguner, I Faruk; Buyukyavuz, B Ilker; Savas, Cagri; Yavuz, M Sunay; Okutan, Huseyin
2004-10-01
This study was undertaken to document the aerodigestive tract foreign body accidents among children, and to investigate the circumstances surrounding these events. A review of the charts of pediatric patients admitted with the definitive or suspicious diagnosis of aerodigestive tract foreign bodies was carried out in the period between January 1, 1998 to December 31, 2002. There were 53 eligible children; 39 boys and 14 girls, with an age range of 7 months to 14 years. Food items were the most common airway foreign bodies and coins were the most common esophageal foreign bodies. Among the 32 patients who underwent bronchoscopy, no foreign body was identified in 9 patients. Among the 21 patients who underwent esophagoscopy, foreign body was removed in 19 patients. In 2 cases, large foreign bodies which we could not extract with forceps were pushed into the stomach. Foreign bodies in the airway and esophagus constitute a constant hazard in all age groups, which demands immediate approach and management. Although the rigid endoscopic removal of aerodigestive foreign bodies was successful in this series, the most effective treatment of foreign body accidents is their prevention.
All the wrong places: an unusual case of foreign body ingestion and inhalation.
Tammana, V S; Valluru, N; Sanderson, A
2012-09-01
Intentional ingestion of foreign bodies is common in psychiatric patients and prison inmates. Timing of endoscopy for ingested foreign bodies varies and depends on the type and location of the foreign body in the gastrointestinal tract. We present the case of a 26-year-old man who was brought from a correctional facility after confessing to have swallowed a few shower curtain hooks. Abdominal X-ray done in the emergency room revealed multiple foreign bodies in the stomach. An upper endoscopy was done in the emergency room with the use of an overtube. The first metal piece was caught by a snare and removed with the endoscope. All other foreign bodies which were present on the abdominal X-ray could not be visualized initially as there was retained food in the stomach. After multiple attempts, four other foreign bodies were found and each one was caught by the forceps and then the scope was removed with the forceps holding the foreign body. There was an additional foreign body in the right mainstem bronchus. The patient had coughed up the foreign body and swallowed it into the gastrointestinal tract. A computed tomography scan of chest and abdomen was done for evaluation, which showed the foreign body in the cecum. To our knowledge, this is the first case report of a patient intentionally transferring a foreign body from one organ system to another. Colonoscopy was done and the foreign body was removed rectally with a snare without any complications.
48 CFR 52.229-8 - Taxes-Foreign Cost-Reimbursement Contracts.
Code of Federal Regulations, 2010 CFR
2010-10-01
...-Reimbursement Contracts. 52.229-8 Section 52.229-8 Federal Acquisition Regulations System FEDERAL ACQUISITION... Clauses 52.229-8 Taxes—Foreign Cost-Reimbursement Contracts. As prescribed in 29.402-2(a), insert the following clause: Taxes—Foreign Cost-Reimbursement Contracts (MAR 1990) (a) Any tax or duty from which the...
Sneh-Arbib, O; Shiferstein, A; Dagan, N; Fein, S; Telem, L; Muchtar, E; Eliakim-Raz, N; Rubinovitch, B; Rubin, G; Rappaport, Z H; Paul, M
2013-12-01
Neurosurgery is characterized by a prolonged risk period for surgical site infection (SSI), mainly related to the presence of cerebrospinal fluid (CSF) drains. We aimed to examine factors associated with post-neurosurgical SSIs, focusing on post-operative factors. A prospective cohort study was conducted in a single center over a period of 18 months in Israel. Included were adult patients undergoing clean or clean-contaminated craniotomy, including craniotomies with external CSF drainage or shunts. SSIs were defined by the Centers for Disease Control and Prevention (CDC) criteria for healthcare-associated infections. All patients were followed up for 90 days and those with foreign body insertion for 1 year. We compared patients with and without SSI. A multivariable regression analysis for SSI was conducted including uncorrelated variables significantly associated with SSI. A total of 502 patients were included, with 138 (27.5%) undergoing emergent or urgent craniotomy. The overall SSI rate was 5.6% (28 patients), of which 3.2% (16 patients) were intracerebral. Non-elective surgery, external CSF drainage/monitoring devices, re-operation, and post-operative respiratory failure were independently associated with subsequent SSI. External CSF devices was the only significant risk factor for intracerebral SSIs (p < 0.001). Internal shunts or other foreign body insertions were not associated with SSIs. A phenotypically identical isolate to that causing the SSI was isolated from respiratory secretions prior to the SSI in 4/9 patients with microbiologically documented intracerebral SSIs. Patients with SSIs had longer hospital stay, poorer functional capacity on discharge, and higher 90-day mortality. We raise the possibility of post-operative infection acquisition through external CSF devices. Standard operating procedures for their maintenance are necessary.
NASA Astrophysics Data System (ADS)
Xu, Huijing; Weltman Hirschberg, Ahuva; Scholten, Kee; Berger, Theodore William; Song, Dong; Meng, Ellis
2018-02-01
Objective. The success of a cortical prosthetic device relies upon its ability to attain resolvable spikes from many neurons in particular neural networks over long periods of time. Traditionally, lifetimes of neural recordings are greatly limited by the body’s immune response against the foreign implant which causes neuronal death and glial scarring. This immune reaction is posited to be exacerbated by micromotion between the implant, which is often rigid, and the surrounding, soft brain tissue, and attenuates the quality of recordings over time. Approach. In an attempt to minimize the foreign body response to a penetrating neural array that records from multiple brain regions, Parylene C, a flexible, biocompatible polymer was used as the substrate material for a functional, proof-of-concept neural array with a reduced elastic modulus. This probe array was designed and fabricated to have 64 electrodes positioned to match the anatomy of the rat hippocampus and allow for simultaneous recordings between two cell-body layers of interest. A dissolvable brace was used for deep-brain penetration of the flexible array. Main results. Arrays were electrochemically characterized at the benchtop, and a novel insertion technique that restricts acute insertion injury enabled accurate target placement of four, bare, flexible arrays to greater than 4 mm deep into the rat brain. Arrays were tested acutely and in vivo recordings taken intra-operatively reveal spikes in both targeted regions of the hippocampus with spike amplitudes and noise levels similar to those recorded with microwires. Histological staining of a sham array implanted for one month reveals limited astrocytic scarring and neuronal death around the implant. Significance. This work represents one of the first examples of a penetrating polymer probe array that records from individual neurons in structures that lie deep within the brain.
Domeki, Yasushi; Kato, Hiroyuki
2015-07-01
An esophageal foreign body is the term for a foreign body in the esophagus. The 2 age groups most prone to this condition are children age 9 and under (and especially toddlers age 4 and under) and elderly individuals age 70 and over. A foreign body often lodges where the esophagus is most constricted. In toddlers, the foreign body is often currency or coins or a toy. In adults, the body is often a piece of fish, dentures, a piece of meat, a pin or needle, or a drug in its blister pack packaging. In children, an esophageal foreign body is treated by fluoroscopically guided removal of the body with a balloon catheter or magnetic catheter or removal of the body via endoscopy or direct esophagoscopy under general anesthesia. In adults, the best choice for treating an esophageal foreign body is removing the body with an endoscope but there are instances where surgery is performed because the body is hard to remove endoscopically, a puncture has occurred, or empyema or mediastinitis has developed. This paper reviews the diagnosis and treatment of an esophageal foreign body.
Endobronchial foreign bodies in Vietnamese adults are related to eating habits.
Nguyen, Lan Huu; Nguyen, Dung Huy; Tran, Thach Ngoc; Nguyen, Phung Tran; Thi, Quy Hoang; Aelony, Yossef; Homasson, Jean Paul Daniel
2010-04-01
A high percentage of bronchoscopically extracted foreign bodies in Ho Chi Minh City were pits of the sapote fruit, a finding previously unreported. This paper presents a review of foreign body extractions, which identifies the substances found, documents the diagnostic pathway and draws attention to the specific aspiration risk of the sapote pit. The records of 100 consecutive adults who were found to have a bronchial foreign body during flexible bronchoscopy were reviewed. In 83% of patients, the foreign body extraction was performed more than 2 weeks after the aspiration had occurred. In only 34% of patients was the diagnosis of an aspirated foreign body considered early in the patient's clinical course. The most frequent foreign bodies found were sapote pits (41%), followed by small bones (38%). Foreign bodies were lodged more frequently in the right bronchial tree (64%). In 98% of patients, the foreign bodies were successfully removed with the flexible scope. There was one postoperative death, which was not ascribed to the procedure. Physicians need to consider foreign body aspirations when evaluating patients with recurrent pneumonia, unexplained cough or atelectasis. Awareness of this problem might lead to public health measures that could reduce the incidence of these aspirations.
Tracheobronchial foreign bodies in children. Experience at ORL clinic Tuzla, 1954-2004.
Brkić, Fuad; Umihanić, Sekib
2007-06-01
To determine the clinical characteristics and the results of bronchoscopic treatment of children due to foreign body aspiration in a university hospital. Department of Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center Tuzla, Bosnia and Hercegovina. The analysis of the cases of aspirated foreign bodies within the period from January 1954 to December 2004. The analyzed patients were the children up to 14 years of age. All cases underwent the bronchoscopy. Each patient was analyzed for age, sex, nature and location of the foreign body, results of bronchoscopic removal, complications of bronchoscopy and presence of foreign bodies in the airways. Six hundred and sixty-two children who underwent bronchoscopy for removal of foreign body in the airways were evaluated. From evaluated children 66.8% were boys, ages ranging from 9 months to 14 years. Foreign bodies were more frequent in children under 3 years of age (65.2%). Most of the foreign bodies removed were organic (87.1%) and more frequently found in the right bronchial tree (53%). More attention is necessary to the prevention of aspirations. Prevention of aspiration of foreign bodies is better than cure. Public awareness through mass media needs attention to prevent foreign body inhalation.
Fluoroscopy-Guided Endoscopic Removal of Foreign Bodies.
Kim, Junhwan; Ahn, Ji Yong; So, Seol; Lee, Mingee; Oh, Kyunghwan; Jung, Hwoon-Yong
2017-03-01
In most cases of ingested foreign bodies, endoscopy is the first treatment of choice. Moreover, emergency endoscopic removal is required for sharp and pointed foreign bodies such as animal or fish bones, food boluses, and button batteries due to the increased risks of perforation, obstruction, and bleeding. Here, we presented two cases that needed emergency endoscopic removal of foreign bodies without sufficient fasting time. Foreign bodies could not be visualized by endoscopy due to food residue; therefore, fluoroscopic imaging was utilized for endoscopic removal of foreign bodies in both cases.
Ultrasonography in Detection of Vaginal Foreign Bodies in Girls: A Retrospective Study.
Yang, Xiuzhen; Sun, Liying; Ye, Jingjing; Li, Xiaoying; Tao, Ran
2017-12-01
In this study we investigated the sonographic features of vaginal foreign bodies in girls and the diagnostic role of combined transperineal and transabdominal ultrasonography in the detection of vaginal foreign bodies in this population. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A retrospective review of the records of 249 girls seen in the outpatient pediatric and adolescent gynecology clinic of our hospital and referred to our department for sonographic evaluation of suspected vaginal foreign bodies between 2013 and 2016 was performed. All patients were transperineally and transabdominally scanned using an ultrasound machine with 3-MHz and 7.5-MHz transducers. The sonographic features of the detected foreign bodies were recorded and reported. All patients also underwent pelvic radiography. The presence of foreign bodies was confirmed using vaginoscopy. Two hundred forty-nine patients were included in this study, and vaginal foreign bodies were detected in 181 patients. Vaginal foreign bodies often present in girls aged from 2 to 12 years old. The most common vaginal foreign bodies were toilet paper, beads, small parts of toys, cap of water color brush, and crayons. The overall sensitivity, specificity, positive and negative predictive values of transperineal/transabdominal sonography in the diagnosis of vaginal foreign bodies were 81%, 53%, 82%, and 51%, respectively. The sensitivity, specificity, and positive and negative predictive values of transabdominal sonography were 33%, 49%, 63%, and 21%, respectively. The sensitivity, specificity, and positive and negative predictive values of transperineal sonography were 64%, 49%, 77%, and 33%, respectively. Abnormal findings were detected using x-ray in only 43 of the 181 cases (23.7%). The sensitivity, specificity, and positive and negative predictive values of x-ray were 24%, 91%, 88%, and 31%, respectively. The size of the foreign bodies ranged from 2 mm to 35 mm. For foreign bodies larger than 5 mm, the rate of sonographic accuracy reached 100%. For foreign bodies smaller than 5 mm, 32 false positive results, and 34 false negative results were identified. One hundred thirty-nine of 181 foreign bodies were less than 2 cm from the vaginal orifice (77%). All foreign bodies were hyperechoic compared with adjacent tissues. Some vaginal foreign bodies had characteristic echo patterns. With the exception of 1 patient with a detained AAA battery that caused vaginal ulceration, the other patients had a full recovery. Vaginal foreign bodies were hyperechoic compared with adjacent tissues and often had characteristic echo patterns. The use of combined transperineal and transabdominal ultrasonography might be helpful in diagnosing foreign bodies, especially when the size of the foreign body is larger than 5 mm. Therefore, ultrasonography might be preferred for the initial evaluation of suspected vaginal foreign bodies, because it is a noninvasive, radiation-free, and inexpensive technique. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
Endoscopic management of foreign bodies in the upper-GI tract: experience with 1088 cases in China.
Li, Zhao-Shen; Sun, Zhen-Xing; Zou, Duo-Wu; Xu, Guo-Ming; Wu, Ren-Pei; Liao, Zhuan
2006-10-01
Reports on endoscopic management of ingested foreign bodies of the upper-GI tract in China are scarce. To report our experience and outcome in the management of ingestion of foreign bodies in Chinese patients. Between January 1980 and January 2005, a total of 1088 patients (685 men and 403 women; age range, 1 day to 96 years old) with suspected foreign bodies were admitted to our endoscopy center. All patients underwent endoscopic procedure after admission. Demographic and endoscopic data, including age, sex, and referral sources of patients, types, number and location of foreign bodies, associated upper-GI diseases, endoscopic methods, and accessory devices for removal of foreign bodies were collected and analyzed. A total of 1090 foreign bodies were found in 988 (90.8%) patients. The types of foreign bodies varied greatly: mainly food boluses, coins, fish bones, dental prostheses, or chicken bones. The foreign bodies were located in the pharynx (n = 12), the esophagus (n = 577), the stomach (n = 441), the duodenum (n = 50), and the surgical anastomosis (n = 10). The associated GI diseases (n = 88) included esophageal carcinoma (33.0%), stricture (23.9%), diverticulum (15.9%), postgastrectomy (11.4%), hiatal hernia (10.2%), and achalasia (5.7%). A rat-tooth forceps and a snare were the most frequently used accessory devices. The success rate for foreign-body removal was 94.1% (930/988). Ingestion of foreign bodies is a common clinic problem in China. Endoscopy procedures are frequently performed, and a high proportion of patients with foreign bodies require endoscopic intervention.
Gas turbine nozzle vane insert and methods of installation
Miller, William John; Predmore, Daniel Ross; Placko, James Michael
2002-01-01
A pair of hollow elongated insert bodies are disposed in one or more of the nozzle vane cavities of a nozzle stage of a gas turbine. Each insert body has an outer wall portion with apertures for impingement-cooling of nozzle wall portions in registration with the outer wall portion. The insert bodies are installed into the cavity separately and spreaders flex the bodies toward and to engage standoffs against wall portions of the nozzle whereby the designed impingement gap between the outer wall portions of the insert bodies and the nozzle wall portions is achieved. The spreaders are secured to the inner wall portions of the insert bodies and the bodies are secured to one another and to the nozzle vane by welding or brazing.
Is Radiologic Evaluation Necessary to Find out Foreign Bodies in Nasal Cavity?
Oh, Hoon; Min, Hyun Jin; Yang, Hoon Shik; Kim, Kyung Soo
2016-01-01
Although there were previous studies on the clinical aspects such as etiology, treatment modalities, studies regarding the necessity of radiologic evaluation for nasal foreign body were limited. The aim of this study is to evaluate the necessity and indication of radiologic evaluation for nasal foreign bodies. There are consecutive patients aged less than 10 years who presented with suspected foreign bodies in nasal cavity. We reviewed the patient's age and sex, including the methods of evaluation, management tools, and types of foreign bodies. There were 35 cases (11.4%) on whom radiographs were performed in the 24 uncooperative patients and 11 cooperative patients who were not identified with any foreign bodies via nasal endoscopy. Among them, only 4 cases had positive reports of foreign body and the others were normal radiologic findings. We suggest that the radiologic evaluation is always not necessary to find the location of nasal foreign bodies. It, however, should be performed in cases of negative findings of physical examination with anterior rhinoscopy or sinus endoscopy and unwitnessed foreign bodies to rule out metallic contents, especially button type battery.
Wang, Li-Gang; Zhang, Gen-Min
2010-06-01
To study the practicability of single-electrode metal detector by using it to take off foreign bodies from swine. The single-electrode metal detector was invented based on the theory of complementary oscillator. Twelve extremities were obtained from 3 Minnesota-Hormel stains 7-month old male swine. All the extremities were divided into 3 groups: lump metal foreign bodies were planted in group A, needle shape metal foreign bodies were planted in group B, and sand shapd metal foreign bodies were planted in group C. The self-invented single-electrode metal detector was used to take off these foreign bodies, and the taking times were recorded. After the operation, the X-ray was used to examine if the foreign bodies were still in the extremities of the swine. The foreign bodies were taken off completely in the 3 groups, and the average time were 38 s, 3 min and 12 s, and 3 min and 59 s respectively. The X-ray examination confirmed that the detector could take off the foreign bodies completely. This detector has satisfactory effect in animal experiment, which could detect and extract metal foreign bodies quickly and exactly without X-ray help duration the operation, and can be used in clinical cases secondly.
Construction and characterization of a recombinant invertebrate iridovirus.
Ozgen, Arzu; Muratoglu, Hacer; Demirbag, Zihni; Vlak, Just M; van Oers, Monique M; Nalcacioglu, Remziye
2014-08-30
Chilo iridescent virus (CIV), officially named Insect iridescent virus 6 (IIV6), is the type species of the genus Iridovirus (family Iridoviridae). In this paper we constructed a recombinant CIV, encoding the green fluorescent protein (GFP). This recombinant can be used to investigate viral replication dynamics. We showed that homologous recombination is a valid method to make CIV gene knockouts and to insert foreign genes. The CIV 157L gene, putatively encoding a non-functional inhibitor of apoptosis (IAP), was chosen as target for foreign gene insertion. The gfp open reading frame preceded by the viral mcp promoter was inserted into the 157L locus by homologous recombination in Anthonomus grandis BRL-AG-3A cells. Recombinant virus (rCIV-Δ157L-gfp) was purified by successive rounds of plaque purification. All plaques produced by the purified recombinant virus emitted green fluorescence due to the presence of GFP. One-step growth curves for recombinant and wild-type CIV were similar and the recombinant was fully infectious in vivo. Hence, CIV157L can be inactivated without altering the replication kinetics of the virus. Consequently, the CIV 157L locus can be used as a site for insertion of foreign DNA, e.g. to modify viral properties for insect biocontrol. Copyright © 2014 Elsevier B.V. All rights reserved.
Handheld Metal Detector for Metallic Foreign Body Ingestion in Pediatric Emergency.
Hamzah, Hazwani Binte; James, Vigil; Manickam, Suraj; Ganapathy, Sashikumar
2018-01-04
Foreign body ingestion is a common problem for which children present to the emergency department. The most common ingested foreign bodies among children are coins. Metal detector is an equipment, which measures a change in inductance of a coil when an electroconductive material is placed near it and produces an audio-visual signal. The present study was conducted to determine the effectiveness and feasibility of HMD in the local Pediatric population. This was a prospective study conducted in the pediatric emergency department among children presenting with history of foreign body ingestion. The outcome measured was presence or absence of metallic foreign body detected on handheld metal detector examination. During the study period, 36 patients with history of foreign body ingestion presented to the emergency department. Among these, 28 were metallic foreign body ingestions. Coins were the most common type of foreign body ingested. Among the metallic foreign bodies ingested, all the coins were accurately identified by the handheld metal detector. Non-coin metallic foreign bodies like metallic screw, needle and stapler pin were not identified by the handheld metal detector. The study demonstrates that handheld metal detector can be safely and reliably used as a screening tool in the process of detecting ingested coins. The plain radiograph still appears to be superior as it accurately localizes sharp metallic objects as well as cell batteries (button batteries) which need to be detected early and removed in order to prevent complications. Handheld metal detector is an effective tool that can be used in the follow up of patients to confirm whether the coin like metallic foreign body has been expelled. Handheld metal detector examination is more sensitive than traditional X-ray examination to detect radiolucent metallic foreign bodies like aluminium.
Risk factors for complications associated with upper gastrointestinal foreign bodies
Hong, Kyong Hee; Kim, Yoon Jae; Kim, Jae Hak; Chun, Song Wook; Kim, Hee Man; Cho, Jae Hee
2015-01-01
AIM: To investigate predictive risk factors associated with complications in the endoscopic removal of foreign bodies from the upper gastrointestinal tract. METHODS: We retrospectively reviewed the medical records of 194 patients with a diagnosis of foreign body impaction in the upper gastrointestinal tract, confirmed by endoscopy, at two university hospital in South Korea. Patient demographic data, including age, gender, intention to ingestion, symptoms at admission, and comorbidities, were collected. Clinical features of the foreign bodies, such as type, size, sharpness of edges, number, and location, were analyzed. Endoscopic data those were analyzed included duration of foreign body impaction, duration of endoscopic performance, endoscopic device, days of hospitalization, complication rate, 30-d mortality rate, and the number of operations related to foreign body removal. RESULTS: The types of upper gastrointestinal foreign bodies included fish bones, drugs, shells, meat, metal, and animal bones. The locations of impacted foreign bodies were the upper esophagus (57.2%), mid esophagus (28.4%), stomach (10.8%), and lower esophagus (3.6%). The median size of the foreign bodies was 26.2 ± 16.7 mm. Among 194 patients, endoscopic removal was achieved in 189, and complications developed in 51 patients (26.9%). Significant complications associated with foreign body impaction and removal included deep lacerations with minor bleeding (n = 31, 16%), ulcer (n = 11, 5.7%), perforation (n = 3, 1.5%), and abscess (n = 1, 0.5%). Four patients underwent operations because of incomplete endoscopic foreign body extraction. In multivariate analyses, risk factors for endoscopic complications and failure were sharpness (HR = 2.48, 95%CI: 1.07-5.72; P = 0.034) and a greater than 12-h duration of impaction (HR = 2.42, 95%CI: 1.12-5.25, P = 0.025). CONCLUSION: In cases of longer than 12 h since foreign body ingestion or sharp-pointed objects, rapid endoscopic intervention should be provided in patients with ingested foreign bodies. PMID:26185385
FOREIGN BODY REACTION TO BIOMATERIALS
Anderson, James M.; Rodriguez, Analiz; Chang, David T.
2008-01-01
The foreign body reaction composed of macrophages and foreign body giant cells is the end-stage response of the inflammatory and wound healing responses following implantation of a medical device, prosthesis, or biomaterial. A brief, focused overview of events leading to the foreign body reaction is presented. The major focus of this review is on factors that modulate the interaction of macrophages and foreign body giant cells on synthetic surfaces where the chemical, physical, and morphological characteristics of the synthetic surface are considered to play a role in modulating cellular events. These events in the foreign body reaction include protein adsorption, monocyte/macrophage adhesion, macrophage fusion to form foreign body giant cells, consequences of the foreign body response on biomaterials, and cross-talk between macrophages/foreign body giant cells and inflammatory/wound healing cells. Biomaterial surface properties play an important role in modulating the foreign body reaction in the first two to four weeks following implantation of a medical device, even though the foreign body reaction at the tissue/material interface is present for the in vivo lifetime of the medical device. An understanding of the foreign body reaction is important as the foreign body reaction may impact the biocompatibility (safety) of the medical device, prosthesis, or implanted biomaterial and may significantly impact short- and long-term tissue responses with tissue-engineered constructs containing proteins, cells, and other biological components for use in tissue engineering and regenerative medicine. Our perspective has been on the inflammatory and wound healing response to implanted materials, devices, and tissue-engineered constructs. The incorporation of biological components of allogeneic or xenogeneic origin as well as stem cells into tissue-engineered or regenerative approaches opens up a myriad of other challenges. An in depth understanding of how the immune system interacts with these cells and how biomaterials or tissue-engineered constructs influences these interactions may prove pivotal to the safety, biocompatibility, and function of the device or system under consideration. PMID:18162407
Image-guided percutaneous removal of ballistic foreign bodies secondary to air gun injuries.
Rothermund, Jacob L; Rabe, Andrew J; Zumberge, Nicholas A; Murakami, James W; Warren, Patrick S; Hogan, Mark J
2018-01-01
Ballistic injuries with retained foreign bodies from air guns is a relatively common problem, particularly in children and adolescents. If not removed in a timely fashion, the foreign bodies can result in complications, including pain and infection. Diagnostic methods to identify the presence of the foreign body run the entire gamut of radiology, particularly radiography, ultrasound (US) and computed tomography (CT). Removal of the foreign bodies can be performed by primary care, emergency, surgical, and radiologic clinicians, with or without imaging guidance. To evaluate the modalities of radiologic detection and the experience of image-guided ballistic foreign body removal related to air gun injuries within the interventional radiology department of a large pediatric hospital. A database of more than 1,000 foreign bodies that were removed with imaging guidance by the interventional radiologists at our institution was searched for ballistic foreign bodies from air guns. The location, dimensions, diagnostic modality, duration, complications and imaging modality used for removal were recorded. In addition, the use of sedation and anesthesia required for the procedures was also recorded. Sixty-one patients with ballistic foreign bodies were identified. All foreign bodies were metallic BBs or pellets. The age of the patients ranged from 5 to 20 years. The initial diagnostic modality to detect the foreign bodies was primarily radiography. The primary modality to assist in removal was US, closely followed by fluoroscopy. For the procedure, 32.7% of the patients required some level of sedation. Only two patients had an active infection at the time of the removal. The foreign bodies were primarily in the soft tissues; however, successful removal was also performed from intraosseous, intraglandular and intratendinous locations. All cases resulted in successful removal without complications. Image-guided removal of ballistic foreign bodies secondary to air guns is a very effective procedure that can obviate the need for open surgical procedures in children.
Foreign bodies retained in the vagina: a case report.
Nanda, Smiti; Singhal, Savita Rani; Marya, Ashima
2006-04-01
Foreign bodies have been found in the vagina in a variety of forms. A 3-year-old girl had a variety of foreign bodies in her vagina. One should always think of foreign bodies in the vagina in cases of vaginal discharge in childhood.
Use of Scheimpflug imaging in the management of intra-lenticular foreign body.
Singh, R; Ram, J; Gupta, R
2015-01-01
Asymptomatic traumatic intra-lenticular foreign body is very uncommon and few case reports have been published. To report a case of post-traumatic intra-lenticular foreign body and use of Scheimpflug imaging in its management. A 41-year-old male with history of injury to right eye during hammering a chisel 1 year back presented with decreased vision since 6 months. An intra-lenticular foreign body was found on slit lamp bio-microscopy and was confrmed by Scheimpflug imaging. Posterior capsule was intact on Scheimpflug imaging. Thus, Scheimpflug imaging helps in exact localization of the foreign body in the intralenticular space or behind the iris. We ruled out other foreign bodies by x-ray and ultrasonography of the orbit. The foreign body with post-traumatic cataract was removed using phacoemulsification and three piece foldable intraocular lens was implanted in the bag. An intra- lenticular foreign body may remain asymptomatic for months. Scheimpflug imaging can be useful in its localization. It can be removed during phacoemulsification. © NEPjOPH.
Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract of Adults
Yao, Chih-Chien; Wu, I-Ting; Lu, Lung-Sheng; Lin, Sheng-Chieh; Liang, Chih-Ming; Kuo, Yuan-Hung; Yang, Shih-Cheng; Wu, Cheng-Kun; Wang, Hsing-Ming; Kuo, Chung-Huang; Chiou, Shue-Shian; Wu, Keng-Liang; Chiu, Yi-Chun; Chuah, Seng-Kee; Tai, Wei-Chen
2015-01-01
Background. Foreign object ingestion and food bolus impaction are a common clinical problem. We report our clinical experiences in endoscopic management for adults, foreign body ingestion, and food bolus impaction. Method. A retrospective chart review study was conducted on adult patients with foreign body ingestion and food bolus impaction between January 2011 and November 2014. Patients with incomplete medical records were excluded. Results. A total of 198 patients (226 incidents) were included in the study (male/female: 1.54/1; age 57 ± 16 years). Among them, 168 foreign bodies were found successfully (74.3%). 75.6% of the foreign bodies were located in the esophagus. Food bolus impaction was most common (41.6%). 93.5% of foreign bodies in current study cohort were successfully extracted and 5 patients required surgical interventions. Comparisons between symptomatic and asymptomatic patients revealed that locations of foreign bodies in the pharynx and esophagus were the significant relevant factors (P < 0.001). Shorter time taken to initiate endoscopic interventions increased detection rate (289.75 ± 465.94 versus 471.06 ± 659.93 minutes, P = 0.028). Conclusion. Endoscopic management is a safe and highly effective procedure in extracting foreign body ingestion and food bolus impaction. Prompt endoscopic interventions can increase the chance of successful foreign bodies' detection. PMID:26258140
Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract of Adults.
Yao, Chih-Chien; Wu, I-Ting; Lu, Lung-Sheng; Lin, Sheng-Chieh; Liang, Chih-Ming; Kuo, Yuan-Hung; Yang, Shih-Cheng; Wu, Cheng-Kun; Wang, Hsing-Ming; Kuo, Chung-Huang; Chiou, Shue-Shian; Wu, Keng-Liang; Chiu, Yi-Chun; Chuah, Seng-Kee; Tai, Wei-Chen
2015-01-01
Foreign object ingestion and food bolus impaction are a common clinical problem. We report our clinical experiences in endoscopic management for adults, foreign body ingestion, and food bolus impaction. A retrospective chart review study was conducted on adult patients with foreign body ingestion and food bolus impaction between January 2011 and November 2014. Patients with incomplete medical records were excluded. A total of 198 patients (226 incidents) were included in the study (male/female: 1.54/1; age 57 ± 16 years). Among them, 168 foreign bodies were found successfully (74.3%). 75.6% of the foreign bodies were located in the esophagus. Food bolus impaction was most common (41.6%). 93.5% of foreign bodies in current study cohort were successfully extracted and 5 patients required surgical interventions. Comparisons between symptomatic and asymptomatic patients revealed that locations of foreign bodies in the pharynx and esophagus were the significant relevant factors (P < 0.001). Shorter time taken to initiate endoscopic interventions increased detection rate (289.75 ± 465.94 versus 471.06 ± 659.93 minutes, P = 0.028). Endoscopic management is a safe and highly effective procedure in extracting foreign body ingestion and food bolus impaction. Prompt endoscopic interventions can increase the chance of successful foreign bodies' detection.
Endoscopic management of foreign bodies in the upper gastrointestinal tract: A review
Sugawa, Choichi; Ono, Hiromi; Taleb, Mona; Lucas, Charles E
2014-01-01
Foreign body ingestion is a common condition, especially among children who represent 80% of these emergencies. The most frequently ingested foreign bodies in children are coins, toys, magnets and batteries. Most foreign body ingestions in adults occur while eating, leading to either bone or meat bolus impaction. Flexible endoscopy is the therapeutic method of choice for relieving food impaction and removing true foreign bodies with a success rate of over 95% and with minimal complications. This review describes a comprehensive approach towards patients presenting with foreign body ingestion. Recommendations are based on a review of the literature and extensive personal experience. PMID:25324918
Endoscopic management of foreign bodies in the upper gastrointestinal tract: A review.
Sugawa, Choichi; Ono, Hiromi; Taleb, Mona; Lucas, Charles E
2014-10-16
Foreign body ingestion is a common condition, especially among children who represent 80% of these emergencies. The most frequently ingested foreign bodies in children are coins, toys, magnets and batteries. Most foreign body ingestions in adults occur while eating, leading to either bone or meat bolus impaction. Flexible endoscopy is the therapeutic method of choice for relieving food impaction and removing true foreign bodies with a success rate of over 95% and with minimal complications. This review describes a comprehensive approach towards patients presenting with foreign body ingestion. Recommendations are based on a review of the literature and extensive personal experience.
PENETRATING OCULAR INJURY WITH RETAINED INTRAOCULAR FOREIGN BODY FROM DRYWALL.
Syed, Reema; Kim, Sung-Hye; Palacio, Agustina; Nunery, William R; Schaal, Shlomit
2018-03-23
To present a case of open globe injury and retained intraocular foreign body secondary to drywall. Interventional case report. A 21-year-old man presented with corneal laceration, iris defect, and vitreous hemorrhage after hammering drywall. Computed tomography scan was negative for intraocular foreign body, but a drywall intraretinal foreign body was found on 25-gauge vitrectomy. Intraoperative findings and 6-month follow-up are presented. Intraocular foreign body must always be suspected in all cases of penetrating ocular trauma. Although magnetic resonance imaging is ideal in diagnosing nonmetallic foreign bodies, computed tomography scan with Hounsfield units should be used in an emergency setting.
Yoo, Sylvia H; Rootman, Dan B; Goh, Alice; Savar, Aaron; Goldberg, Robert A
2016-01-01
A patient was found to have a metallic foreign body in the left anterior orbit on CT imaging, but the foreign body was not evident on clinical examination. On high-resolution ultrasonography, an object was identified in the left upper eyelid; however, the typical shadow with metallic foreign bodies was not seen. A high-power oscillating magnet was then applied to the eyelid, which revealed a subcutaneous metallic foreign body in the left upper eyelid. When used in conjunction, the high-resolution ultrasound and oscillating magnet successfully localized and facilitated retrieval of the metallic foreign body from the left upper eyelid.
Risk factors for granuloma formation in children induced by tracheobronchial foreign bodies.
Huang, Zhenghua; Zhou, Ai; Zhang, Jianya; Xie, Lisheng; Li, Qi
2015-12-01
The aim of this study was to analyze the risk factors for granuloma formation caused by plant-based tracheobronchial foreign bodies in children, and investigate the underlying pathogenesis. In this retrospective analysis of 153 cases with tracheobronchial foreign bodies (peanuts and watermelon seeds), 35 cases of granuloma formation as granulation group (G), and 118 cases of no granuloma formation as non-granulation group (NG) were studied. Clinical data pertaining to sex (S), age (A), foreign body surface smoothness (SF), foreign body shape (SH), foreign body oil release state (O), the location of foreign bodies (L), and foreign body retention time (T) were collected for statistical analysis. Univariate analysis showed no significant difference between the two groups (G and NG) with respect to S, A, SH and L. Significant factors based on univariate analysis included SF, O and T. Multivariate logistic regression analysis revealed that SF and T were independent risk factors associated with development of granuloma. SF, O and T had relationship with the granuloma formation. Local trauma caused by an irregular and sharp foreign body, and extended period of time represent the main factors causing granuloma formation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Ballistic Testing for Interceptor Body Armor Inserts Needs Improvement
2011-08-01
030, “Ballistic Testing and Product Quality Surveillance for the Interceptor Body Armor - Vest Components Need Improvement,” January 3, 2011. This...Body Armor Ballistic Inserts Interceptor Body Armor (IBA) is a modular body armor system that consists of an outer tactical vest , ballistic inserts...altitude tests was because the ceramic ballistic inserts are solid structures that are not sensitive to reduced pressure and moisture. PM SEQ offered no
Management of ingested foreign bodies in childhood: our experience and review of the literature.
Hachimi-Idrissi, S; Corne, L; Vandenplas, Y
1998-09-01
The management of foreign bodies in the gastrointestinal tract is not standardized. Retrospectively, we analysed the management of 174 cases of accidental ingestion of foreign bodies in children. No child had ingested more than one foreign object. The ingested foreign bodies were: coins, toy parts, jewels, batteries, 'sharp' materials such as needles and pins, fish and chicken bone, and 'large' amounts of food. Of the patients 51% had transient symptoms at the moment of ingestion, such as retrosternal pain, cyanosis and dysphasia. Attempts to extract the foreign body either by a magnet tube, endoscopy or McGill forceps was performed in 83 patients. The majority of the extracted foreign bodies were batteries and sharp materials. The outcome of all the patients was excellent. No complications were observed.
The missing "Bratz" doll: a case of vaginal foreign body.
Someshwar, Jean; Lutfi, Riad; Nield, Linda S
2007-12-01
Young female patients with gynecologic complaints, including vaginal discharge, commonly seek care in the emergency department. Prepubertal vaginal discharges have various potential etiologies including nonspecific vulvovaginitis, infections, inflammatory or dermatologic processes, precocious puberty, malignancy, anatomical anomaly, trauma, sexual abuse, and foreign body. We present the case of a 4-year-old girl with vaginal odor and discharge secondary to a foreign body. The foreign body was part of a toy, the lower half of the patient's missing "Bratz" (MGA Entertainment) doll. Although it is well known that a vaginal foreign body can cause a vaginal discharge, the unusual nature of the foreign body in this case and the revealing radiograph made this a case of particular interest.
Use of the blue cotton screen method with endoscopy to detect occult esophageal foreign bodies
Xia, Yan; Zhang, Fan; Xu, Weiran
2017-01-01
More than 20,000 cases of upper gastrointestinal foreign bodies (FBs) have been reported in the last 5 years in China. Early detection and treatment is vital in these patients. Differential diagnosis of esophageal injury and occult esophageal foreign bodies is challenging, particularly in the case of non-radio-opaque foreign bodies. A diagnostic technique with high accuracy and low risk is needed for clinical practice. We describe successful use of the “blue cotton screen method” to detect esophageal foreign bodies in 2 patients. The advantages and disadvantages of various diagnostic modalities in the management of patients with foreign body ingestion are presented. This technique is safer and more effective than traditional methods for foreign body impaction in the esophageal cavity. It could be applied for screening and in the differential diagnosis of esophageal injury and FBs in the esophageal lumen. PMID:29362659
Khan, M. D.; Kundi, N.; Mohammed, Z.; Nazeer, A. F.
1987-01-01
A survey of 198 patients (210 eyes) with intraocular or intraorbital foreign bodies is presented. Most were males between 16 and 30 years of age, and 6.1% of cases were bilateral. The commonest cause was a flying particle while using a hand hammer, followed by fragments of bomb and mine blasts. Intraorbital foreign bodies occurred in 78 eyes and intraocular foreign bodies in 132 eyes. Irreparable damage caused 13 eyes (6.2%) to be enucleated. Ten eyes developed severe endophthalmitis or panophthalmitis requiring evisceration. One hundred and thirty-four (63.8%) foreign bodies were removed, and 76 (36.2%) foreign bodies could not be removed. The causes of non-removal, the various complications, and the pattern of foreign bodies in the eye or orbit in Pakistan are discussed and compared with those of other regions. PMID:3663566
Correlative factors for the location of tracheobronchial foreign bodies in infants and children.
Xu, Ying; Feng, Rui-Ling; Jiang, Lan; Ren, Hong-Bo; Li, Qi
2018-02-01
This study aims to analyze factors related to the location of tracheobronchial foreign bodies in infants and children, and provide help in the assessment of the disease, surgical risk and prognosis. The clinical data of 1,060 pediatric patients with tracheobronchial foreign bodies diagnosed from January 2015 to December 2015 were retrospectively studied, the association of the location of the foreign bodies with age, gender, granulation formation, chest computed tomography and 3D reconstruction results, preoperative complications, operation time, and hospital stay was analyzed. The location of foreign bodies was not correlated with age, gender, operation time and length of hospital stay, but was correlated to granulation formation, chest computed tomography and 3D reconstruction results, and preoperative complications. The location of foreign bodies was correlated to granulation formation, the location of foreign bodies displayed by chest computed tomography, and preoperative complications.
Foreign bodies in tracheobronchial tree in children: a review of cases over a twenty-year period.
Yeh, L C; Li, H Y; Huang, T S
1998-03-01
Foreign body inhalation into the tracheobronchial tree of children is rather rare but serious problem. It may be hazardous and even cause fatal sequelae in the children if misdiagnosed and not managed promptly. We retrospectively reviewed the records of 81 patients with foreign bodies inhaled into the larynx, trachea and bronchi. The children were all treated during the 20-year period from July 1976 through June 1996 at Chang Gung Memorial Hospital. Of these patients, 82% were 36 months of age or younger. The male to female ratio was 3:1. All of the patients initially received flexible fiberoptic bronchoscopy to identify the foreign objects. The foreign bodies were removed by jet ventilation bronchoscopy with apneic techniques under general anesthesia. Peanuts were found to be the most common causative foreign body agent which occurred in 53 instances (65%). The most common manifestation was coughing, with subsequent dyspnea and audible wheezing. The foreign bodies were lodged in the left bronchus more than in the right. The most obvious radiologic evidence observed in aspirated children were emphysematous changes at same side of the foreign bodies caused by "expansile check-valve" phenomenon. Four patients showed radio-opaque objects on chest roentgenograms. Six patients required second extraction procedures due to the retained foreign bodies. Neither serious complications nor deaths occurred in these patients due to the foreign body inhalation. Early diagnosis and management is essential in children with foreign bodies in the airways to prevent morbidity or death. Small materials or food bits should be kept far away from young child.
Predictors of radiolucent foreign body aspiration.
Mortellaro, Vincent E; Iqbal, Corey; Fu, Roxanna; Curtis, Heather; Fike, Frankie B; St Peter, Shawn D
2013-09-01
Children frequently present for suspected foreign body aspiration, many have mild symptoms and/or negative radiographs raising the question of a radiolucent foreign body aspiration. Retrospective review of patients having bronchoscopy for suspected radiolucent foreign body aspiration from 2000 to 2010 collecting demographics, history, hospital presentation, radiographic, and operative details. Pearson's correlation was used between event history, presentation, radiographic details and bronchoscopically identified foreign body with P value <0.01. 138 patients, mean age 2.6 years, mean weight 15.6 kg, 68% male. Event symptoms: 81% witnessed events, 64% wheezing, 43% coughing, 39% choking, 6% stridor, and 0.7% lethargy. Hospital presentation: 70% persistent symptoms, wheezing 56%, coughing 15%, desaturations 11%, stridor 7%, choking 4%, and lethargy 1%. 92% of patients had a chest x-ray; air trapping found in 38%, and lung collapse in 21%. 2 patients received CT scans; 1 had lung collapse. Bronchoscopy identified foreign bodies in 93% of patients: food 68%, plastic 18%, non-descript 11%, rocks 3%. No correlations between event symptoms, hospital presentation, radiographs and foreign body presence. Event history, hospital presentation, and radiographs are insufficient in proving the absence of a radiolucent foreign body. Patients with suspected radiolucent foreign body aspiration should undergo diagnostic bronchoscopy prior to discharge. Copyright © 2013 Elsevier Inc. All rights reserved.
Foreign Bodies in Trachea: A 25-years of Experience.
Altuntas, Bayram; Aydın, Yener; Eroglu, Atilla
2016-06-01
Tracheobronchial foreign body aspirations may cause cardiopulmonary arrest and sudden death. The incidence in children is higher than in adults. Rapid diagnosis and treatment is live saving. In this paper, we aimed to present our experience in tracheal foreign body aspirations and rigid bronchoscopy for 25-years. From January 1990 to January 2015, 805 patients with suspected tracheobronchial foreign body aspiration were admitted to our department. Hundred and twelve patients with tracheal foreign body were included in this study. We evaluated patients' records, retrospectively. Age, gender, clinical symptoms, physical examination findings, radiological evidences, type of foreign body and intervention types were noted. Sixty-five of the patients were female (58%) and 47 patients were male (42%), and mean age was 8.1 years (8 month-58 years). Coughing was the main symptom (n=112, 100%). Other symptoms and findings included dyspnoea and bilateral decreased lung sounds (n=73, 65.1%), bilateral rhonchi (n=68, 60.7%) and cyanosis (n=41, 36.6%). Rigid bronchoscopy was performed in all patients. The most common foreign body was nuts (n=75, 67%). The main radiologic finding was radiopaque image of the related foreign body in 27 patients (n=27, 24.1%). Cardio-pulmonary arrest occurred in 11 patients and two of them died. Tracheobronchial aspirations of foreign bodies are life-threatening events. If not diagnosed and treated rapidly, distressful results can be seen. Warning people by skilled persons on this topic will reduce the incidence of foreign body aspirations.
Intraorbital foreign bodies--5 own cases and review of literature.
Markowski, Jarosław; Dziubdziela, Włodzimierz; Gierek, Tatiana; Witkowska, Małgorzata; Mrukwa-Kominek, Ewa; Niedzielska, Iwona; Paluch, Jarosław
2012-01-01
Five patients were surgically treated for intraorbital foreign body: a 14-year-old girl had a door glass splinter, a 23-year-old man a metallic foreign body--gunshot pellet, a 55-year-old man a splinter from a metallic bar, a 48-year-old patient the splinters of circular saw and 61-year-old man with shot. Two foreign bodies were removed using the Krönlein-Reese-Berk lateral orbitotomy, two others by Sewell medial orbitotomy and one with superior orbitotomy of Dandy-Naffziger. Radiographs and CT scans were used to identify and localize intraorbital foreign bodies. In one case we found coexistence foreign body (shot) and tumor--inflammation pseudotumor of the orbita. It is possible, that in this case long-time occupy foreign body in the orbita was a cause of that tumor. All foreign bodies were successfully removed, and postoperative course was uneventful. The Krönlein-Reese-Berk orbitotomy provides a satisfactory access to the lateral and posterior orbit, which is of particular importance in the case of a deeply penetrating foreign body (metallic or glass). Surgical removal of intraorbital foreign bodies is a classic example of an interdisciplinary therapeutic approach. Best outcome is usually a result of a team of an ophtalmologist, ENT surgeon, maxillary surgeon and possibly also neurosurgeon performing the operation. Copyright © 2012 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.
USDA-ARS?s Scientific Manuscript database
Objectives: Newcastle disease virus (NDV), a member of the Paramxoviridae family, has been developed as a vector to express foreign genes for vaccine and gene therapy purposes. The foreign genes are usually inserted into a non-coding region of the NDV genome as an independent transcription unit (ITU...
Foreign body in ear, nose and oropharynx: experience from a tertiary hospital.
Tiago, Romualdo Suzano Louzeiro; Salgado, Daniel Cauduro; Corrêa, Juliano Piotto; Pio, Márcio Ricardo Barros; Lambert, Ernani Edney
2006-01-01
The occurrence of foreign bodies in otorhinolaryngology is reason of constant searches for emergency services. To value the incidence of patients with foreign body, to analyze the clinical situation and the treatment in these cases. The prospective study was realized in 81 patients with diagnosis of foreign body of nose, ear or oropharynx in the otorhinolaryngology service of the Hospital do Servidor Público Municipal de São Paulo between april/2003 and march/2005. 57 cases of foreign body of ear, 13 cases of nose and 11 of oropharynx. These patients, 51.85% were men and 48.15% were women. The age average was 23 years old. The average of the evolution time was 18.36 days, being that 38.27% these cases were taken care in less 24 hours of evolution. Inside the total of patients, 83.95% received initial attendance in the otorhinolaryngology clinic, and 16.05% came of another service after some previous removal attempt. The most common symptom of the foreign bodies cases of oropharynx it was odinofagia present in 90.91% of the cases; in the foreign bodies of nose, the unilateral rhinorrhea and cacosmia were present in 46.15 of the cases; in the foreign bodies of ear, 38.60% evolved without symptoms and 28.07 with hipoacusia. The most frequent foreign body of oropharynx it was the fish spine (54.55%); in the nose it was the paper (30.77%); and in the ear it was the cotton (31.58%). The complications resulting of the presence of foreign body or about the manipulation of these had been found in 13 cases (16.05%). Most cases of foreign body conditions, in which a non-specialist professional or a non-professional person previously handles its removal, have a bad evolution with emerging complications. Such outcomes strengthen the fact that an otorhinolaryngologist using the proper equipment must treat patients with foreign body.
Intralenticular foreign body: a D-Day reminder.
Dhawahir-Scala, Felipe E; Kamal, A
2005-12-01
Intralenticular foreign bodies are not uncommon after penetrating eye injuries. This is an observational case report where a patient was found to have an embedded lenticular foreign body for more than 60 years. Following such a long period of time the patient has not experienced any significant cataract formation or compromised ocular function due to the foreign body.
Akpinar, Ibrahim; Sayin, Muhammet Rasit; Karabag, Turgut; Dogan, Sait Mesut; Aydin, Mustafa
2012-09-01
A foreign body such as a needle in the heart can be life-threatening. While this may occur accidentally, needles may be inserted into the body by psychiatric patients or in cases involving domestic violence. A needle can migrate through the thorax toward the heart. In drug users, needles may also reach the right ventricle via the peripheral veins. Cardiac injury can occur via the esophagus after swallowing a needle. The clinical outcome may vary from an asymptomatic situation to tamponade or shock, depending on how severely the cardiac structures are affected. In injuries involving the thorax, pneumothorax may cause sudden shortness of breath. Here, we report the case of a 34-year-old male prison inmate who accidentally lodged a pin in his left ventricle while asleep. As he has refused surgery, it was decided to follow the patient carefully. © 2012, Wiley Periodicals, Inc.
Severe Vaginal Burns in a 5-Year-Old Girl Due to an Alkaline Battery in the Vagina.
Semaan, Alexander; Klein, Tobias; Vahdad, Mohammad Reza; Boemers, Thomas M; Pohle, Rebecca
2015-10-01
The ingestion or insertion of alkaline batteries in the body can cause severe damage to hollow organs. We report here a case of severe vaginal burns in a young patient caused by an alkaline battery. A 5-year-old girl presented to our outpatient department with pelvic pain and vaginal discharge. Further workup suggested the presence of a vaginal foreign body. Under general anesthesia, an alkaline battery was removed from her vagina, which showed severe burns with partial-thickness necrosis. Complete healing was confirmed at 3 months after initial presentation. In this rare case of an alkaline battery present in the vagina of a prepubescent girl, we discuss the available treatment and management options in comparison to similar previously reported cases. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
A general insert label for peptide display on chimeric filamentous bacteriophages.
Kaplan, Gilad; Gershoni, Jonathan M
2012-01-01
The foreign insert intended to be displayed via recombinant phage proteins can have a negative effect on protein expression and phage assembly. A typical example is the case of display of peptides longer than 6 amino acid residues on the major coat protein, protein VIII of the filamentous bacteriophages M13 and fd. A solution to this problem has been the use of "two-gene systems" generating chimeric phages that concomitantly express wild-type protein VIII along with recombinant protein VIII. Although the two-gene systems are much more permissive in regard to insert length and composition, some cases can still adversely affect phage assembly. Although these phages genotypically contain the desired DNA of the insert, they appear to be phenotypically wild type. To avoid false-negative results when using chimeric phages in binding studies, it is necessary to confirm that the observed lack of phage recognition is not due to faulty assembly and display of the intended insert. Here we describe a strategy for generating antibodies that specifically recognize recombinant protein VIII regardless of the nature of its foreign insert. These antibodies can be used as a general monitor of the display of recombinant protein VIII into phage particles. Copyright © 2011 Elsevier Inc. All rights reserved.
Emergency admissions due to swallowed foreign bodies in adults
Erbil, Bülent; Karaca, Mehmet Ali; Aslaner, Mehmet Ali; İbrahimov, Zaur; Kunt, Mehmet Mahir; Akpinar, Erhan; Özmen, Mehmet Mahir
2013-01-01
AIM: To study a retrospective analysis of patients who presented to the emergency departments (ED) with complaints related to foreign body ingestions. METHODS: Patients older than 16 years of age who presented to the ED between January 1st and December 31st of 2010 with complaints related to swallowed foreign bodies were identified from electronic health records and patient charts. RESULTS: A total of 100 patients presented with a complaint of foreign body ingestion during the study period. Overall, an X-ray was performed on 75 patients, and a fiberoptic evaluation was performed on 45 patients. A foreign body was detected in 46 (46%) patients. The diagnostic yield of the X-ray was 27 (36%) out of 75 patients, while the diagnostic yield of the fiberoptic evaluations was 21 (47%) out of 45 patients. The detected foreign bodies were mostly located in the esophagus (17 out of 46 foreign bodies detected). When the types of ingested foreign bodies were evaluated, 52 (52%) patients reported ingesting food, and 19 (19%) patients reported swallowing pins. An X-ray was performed on 33 patients with accidental food ingestions but yielded a positive result in only two cases. In 12 out of 21 patients with accidental food ingestion who underwent fiberoptic evaluation, the foreign material was detected and removed. CONCLUSION: Plain radiography is helpful in the localization of radiopaque swollen foreign bodies, while fiberoptic methods are useful as both diagnostic and therapeutic tools, regardless of radiopacity. PMID:24151363
Emergency admissions due to swallowed foreign bodies in adults.
Erbil, Bülent; Karaca, Mehmet Ali; Aslaner, Mehmet Ali; Ibrahimov, Zaur; Kunt, Mehmet Mahir; Akpinar, Erhan; Özmen, Mehmet Mahir
2013-10-14
To study a retrospective analysis of patients who presented to the emergency departments (ED) with complaints related to foreign body ingestions. Patients older than 16 years of age who presented to the ED between January 1(st) and December 31(st) of 2010 with complaints related to swallowed foreign bodies were identified from electronic health records and patient charts. A total of 100 patients presented with a complaint of foreign body ingestion during the study period. Overall, an X-ray was performed on 75 patients, and a fiberoptic evaluation was performed on 45 patients. A foreign body was detected in 46 (46%) patients. The diagnostic yield of the X-ray was 27 (36%) out of 75 patients, while the diagnostic yield of the fiberoptic evaluations was 21 (47%) out of 45 patients. The detected foreign bodies were mostly located in the esophagus (17 out of 46 foreign bodies detected). When the types of ingested foreign bodies were evaluated, 52 (52%) patients reported ingesting food, and 19 (19%) patients reported swallowing pins. An X-ray was performed on 33 patients with accidental food ingestions but yielded a positive result in only two cases. In 12 out of 21 patients with accidental food ingestion who underwent fiberoptic evaluation, the foreign material was detected and removed. Plain radiography is helpful in the localization of radiopaque swollen foreign bodies, while fiberoptic methods are useful as both diagnostic and therapeutic tools, regardless of radiopacity.
Katsinelos, Panagiotis; Kountouras, Jannis; Paroutoglou, George; Zavos, Christos; Mimidis, Kostas; Chatzimavroudis, Grigoris
2006-10-01
Ingested foreign bodies and food bolus impaction are frequently seen in endoscopic practice. Successful foreign body and food bolus removal may depend on the method used, the choice of device, and the experience level of the endoscopist, although few papers report experience and outcome of tertiary centers. To investigate the effectiveness of our protocol designed for removal of ingested foreign bodies and food boluses. We retrospectively reviewed all patients with a diagnosis of foreign body ingestion and food bolus impaction from 1994 to 2005 identified by computer search. Patients were excluded if medical record was incomplete. The analysis included 171 patients. Foreign bodies and impacted food boluses were found in 77 and 62 patients, respectively. In 32 cases (23%), the foreign bodies passed spontaneously through the gastrointestinal tract. The overall success rate for endoscopic management was obtained in 137 patients (98.6%). Surgical removal of a foreign body was required in only 2 cases (1.4%). According to the type and location of the foreign object and food bolus we used Dormia baskets, retrieval forceps, polypectomy snares, and all sizes of Roth net. No complications relating to the endoscopic procedure were observed; 50 patients (35.2%) had an underlying esophageal disease. Endoscopic removal of upper gastrointestinal tract foreign bodies and food bolus impaction is efficacious and safe. Especially the Roth net is the best device for safe retrieval of food boluses and button disc batteries.
Pediatric foreign bodies and their management.
Kay, Marsha; Wyllie, Robert
2005-06-01
Ingestion of foreign bodies is a common pediatric problem, with more than 100,000 cases occurring each year. The vast majority of pediatric ingestions are accidental; increasing incidence of intentional ingestions starts in the adolescent age group. In the United States, the most common pediatric foreign bodies ingested are coins, followed by a variety of other objects, including toys, toy parts, sharp objects, batteries, bones, and food. In adolescents and adults, meat or food impactions are the most common accidental foreign body ingestion. Esophageal pathology underlies most cases of food impaction. Management of foreign body ingestions varies based on the object ingested, its location, and the patient's age and size. Esophageal foreign bodies as a group require early intervention because of their potential to cause respiratory symptoms and complications, esophageal erosions, or even an aortoesophageal fistula. Ingested batteries that lodge in the esophagus require urgent endoscopic removal even in the asymptomatic patient due to the high risk of complications. Sharp foreign bodies increase the foreign body complication rate from less than 1% to 15% to 35%, except for straight pins, which usually follow a relatively benign course unless multiple pins are ingested. Magnets are increasingly ingested, due to their ubiquitous nature and the perception that they do not pose a risk. Ingestion of multiple magnets creates a significant risk of obstruction, perforation, and fistula development. Methods to deal with foreign bodies include the suture technique, the double snare technique, and the combined forceps/snare technique for long, large, and sharp foreign bodies, along with newer equipment, such as retrieval nets and a variety of specialized forceps.
Unusual foreign bodies in the orofacial region.
Passi, Sidhi; Sharma, Neeraj
2012-01-01
Foreign bodies may be deposited in the oral cavity either by traumatic injury or iatrogenically. Among the commonly encountered iatrogenic foreign bodies are restorative materials like amalgam, obturation materials, broken instruments, needles, and so forth. The discovery of foreign bodies in the teeth is a special situation, which is often diagnosed accidentally. Detailed case history, clinical and radiographic examinations are necessary to come to a conclusion about the nature, size, location of the foreign body, and the difficulty involved in its retrieval. It is more common to find this situation in children as it is a well-known fact that children often tend to have the habit of placing foreign objects in the mouth. Sometimes the foreign objects get stuck in the root canals of the teeth, which the children do not reveal to their parents due to fear. These foreign objects may act as a potential source of infection and may later lead to a painful condition. This paper discusses the presence of unusual foreign bodies-a tip of the metallic compass, stapler pin, copper strip, and a broken sewing needle impregnated in the gingiva and their management.
Urethral masturbation and sexual disinhibition in dementia: a case report.
Rosenthal, Michal; Berkman, Pinhas; Shapira, Adi; Gil, Israel; Abramovitz, Jancu
2003-01-01
Urethral masturbation and sexual disinhibition as manifestations of behavioral and psychological symptoms of dementia (BPSD) are described in a 90-year-old patient who repeatedly self-inserted foreign bodies into his urethra. A diagnosis was made of late onset sexual disinhibition and hypersexuality in a patient with Dementia of the Alzheimer Type. Significant reduction of his sexual behavior was achieved with low doses of haloperidol. Similar symptoms are noted in Pick's disease, other fronto-temporal lesions, mania and following a seizure or treatment of Parkinson's disease, and have been described as Kluver-Busy-type. Clinicians should consider this diagnosis when investigating dysuria, cystitis, haematuria and urinary tract infections even in the very old.
Nasal foreign bodies in children: should they have a plain radiograph in the accident and emergency?
Glynn, Fergal; Amin, Mohamed; Kinsella, John
2008-04-01
To determine the proportion of children with nasal foreign bodies who had button batteries as the foreign body. To describe the clinical care and outcome of those children with a button battery foreign body. A retrospective review of all children presenting to the accident and emergency room with a nasal foreign body or unilateral nasal discharge during a 6-month period was assessed. Forty-four children were included. The most common object found was a plastic bead (27%), followed by foam, paper, or tissue fragments (23%); food matter represented 15%. A button battery was found in 3 patients (7%); other foreign bodies included stones, buttons, crayons, erasers, and a pellet. Thiry-six (82%) had their foreign body removed without anesthetic and 8 (18%) required a general anesthetic. All 3 children with a button battery went undiagnosed until examination in the operating theater. Because there was no previous indication of the presence of a button battery in the 3 children, the removal of the foreign body under general anesthesia was scheduled for the following day. The removal of the button batteries would have been expedited had a plain radiograph been obtained, possibly resulting in less morbidity for our patients. We recommend a plain radiograph in all children presenting with a nonvisible foreign body or unilateral nasal discharge.
Foreign Body in the Oral Cavity Mimicking a Benign Connective Tissue Tumor
Ram, Saravanan; Sedghizadeh, Parish P.
2013-01-01
Foreign bodies may be embedded in the oral cavity either by traumatic injury or iatrogenically. The commonly encountered iatrogenic foreign bodies are restorative materials like amalgam, obturation materials, broken instruments, needles, and impression materials. This paper describes an asymptomatic presentation of a foreign body in the oral mucosa which clinically appeared like a benign connective tissue tumor. PMID:23634307
Foreign body in the oral cavity mimicking a benign connective tissue tumor.
Puliyel, Divya; Balouch, Amir; Ram, Saravanan; Sedghizadeh, Parish P
2013-01-01
Foreign bodies may be embedded in the oral cavity either by traumatic injury or iatrogenically. The commonly encountered iatrogenic foreign bodies are restorative materials like amalgam, obturation materials, broken instruments, needles, and impression materials. This paper describes an asymptomatic presentation of a foreign body in the oral mucosa which clinically appeared like a benign connective tissue tumor.
Surgical treatment of late-diagnosed bronchial foreign body aspiration: a report of 23 cases.
Duan, Liang; Chen, Xiaofeng; Wang, Hao; Hu, Xuefei; Jiang, Gening
2014-07-01
Late-diagnosed bronchial foreign bodies can lead to irreversible changes in the bronchi and the lungs. To date, few reports are available concerning surgical treatment for this condition. The present report summarizes clinicopathological features and surgical treatment options for late-diagnosed bronchial foreign body aspiration. Clinical data of 23 patients who underwent surgical treatment for late-diagnosed bronchial foreign body aspiration in our hospital from 1980 to 2010 were reviewed. The patients included 17 male and six female patients, aged 6 to 66 years. To remove the foreign body, bronchotomy was performed in six patients and pulmonary resection in 17 patients. Foreign bodies were located on the right side in 17 cases and on the left side in six cases. The majority of the foreign bodies were of food origin. Postoperative bronchopleural fistula occurred in two patients. One patient died of renal failure subsequent to lung infections. Detailed history, awareness of potential foreign body aspiration and thorough bronchoscopic examination are helpful to avoid pulmonary resection. However, the latter is necessary in patients with the associated substantial lung lesions to prevent these from progressing into serious lung infections such as pulmonary suppuration or empyema. © 2013 John Wiley & Sons Ltd.
Foreign bodies in the ear, nose, and throat.
Heim, Steven W; Maughan, Karen L
2007-10-15
Foreign bodies in the ear, nose, and throat are occasionally seen in family medicine, usually in children. The most common foreign bodies are food, plastic toys, and small household items. Diagnosis is often delayed because the causative event is usually unobserved, the symptoms are nonspecific, and patients often are misdiagnosed initially. Most ear and nose foreign bodies can be removed by a skilled physician in the office with minimal risk of complications. Common removal methods include use of forceps, water irrigation, and suction catheter. Pharyngeal or tracheal foreign bodies are medical emergencies requiring surgical consultation. Radiography results are often normal. Flexible or rigid endoscopy usually is required to confirm the diagnosis and to remove the foreign body. Physicians need to have a high index of suspicion for foreign bodies in children with unexplained upper airway symptoms. It is important to understand the anatomy and the indications for subspecialist referral. The evidence is inadequate to make strong recommendations for specific removal techniques.
22 CFR 42.73 - Procedure in issuing visas.
Code of Federal Regulations, 2010 CFR
2010-04-01
... Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Issuance of Immigrant Visas § 42.73 Procedure in issuing visas. (a) Insertion of data. In issuing an immigrant visa, the issuing office shall insert the pertinent information in the...
Removal of impacted esophageal foreign bodies with a dual-channel endoscope: 19 cases
WANG, CHANGXIONG; CHEN, PING
2013-01-01
There have been few reports concerning the endoscopic removal of impacted esophageal foreign bodies from patients. The objective of this study was to evaluate the effectiveness of dual-channel endoscopy in managing foreign-body ingestions in patients. A total of 19 patients with foreign-body ingestions between September 2008 and July 2011 were selected from the Digestive Endoscope Center in Lishui, a typical middle-sized city in China. The patients underwent endoscopy following admission. The impacted foreign bodies were successfully removed from 18 patients without complications using a dual-channel endoscope. One patient underwent surgery for an ingested denture following the failure of the endoscopic removal method. This study demonstrates that dual-channel endoscopic management may be a useful option for removing ingested foreign bodies from the esophagus. PMID:23935752
Management of foreign body ingestions in children: button batteries and magnets.
Kodituwakku, Ronan; Palmer, Sarah; Paul, Siba Prosad
2017-04-27
Foreign body ingestion and foreign body aspiration commonly affect young children between 6 months and 6 years. A large number of these events remain unwitnessed and asymptomatic while the swallowed foreign body traverses the gastrointestinal tract and is passed in the stool. Recent literature has shown an increase in morbidity associated with button battery and (neomydium) magnet ingestions in children, particularly over the last decade. Early identification and management in a time critical manner is required in cases where button batteries get lodged in the oesophagus or multiple magnets are swallowed. Deaths, although rare, have been reported with these dangerous foreign body ingestions in children where diagnoses were delayed. Nurses through their direct contact with children in different clinical settings play a vital role in managing foreign body ingestions.
Vaginal foreign body presenting as bleeding with defecation in a child.
Abdessamad, Hasan M; Greenfield, Marjorie
2009-04-01
Symptoms secondary to a vaginal foreign body are responsible for approximately 4% of pediatric gynecologic outpatient visits.(1) The classic symptom is vaginal bleeding, but vaginal discharge, foul odor, irritation, abdominal pain, and hematuria have been described. We are reporting a case of a microscopic vaginal foreign body presenting as hematochezia in a preadolescent girl. This case is unique in that the patient presented with bleeding with defecation, without vaginal bleeding. Vaginal foreign bodies can present with diverse symptomatology. Physicians should consider the diagnosis of vaginal foreign body when presented with a young female patient with unexplained hematochezia.
Role of virtual bronchoscopy in children with a vegetable foreign body in the tracheobronchial tree.
Behera, G; Tripathy, N; Maru, Y K; Mundra, R K; Gupta, Y; Lodha, M
2014-12-01
Multidetector computed tomography virtual bronchoscopy is a non-invasive diagnostic tool which provides a three-dimensional view of the tracheobronchial airway. This study aimed to evaluate the usefulness of virtual bronchoscopy in cases of vegetable foreign body aspiration in children. The medical records of patients with a history of foreign body aspiration from August 2006 to August 2010 were reviewed. Data were collected regarding their clinical presentation and chest X-ray, virtual bronchoscopy and rigid bronchoscopy findings. Cases of metallic and other non-vegetable foreign bodies were excluded from the analysis. Patients with multidetector computed tomography virtual bronchoscopy showing features of vegetable foreign body were included in the analysis. For each patient, virtual bronchoscopy findings were reviewed and compared with those of rigid bronchoscopy. A total of 60 patients; all children ranging from 1 month to 8 years of age, were included. The mean age at presentation was 2.01 years. Rigid bronchoscopy confirmed the results of multidetector computed tomography virtual bronchoscopy (i.e. presence of foreign body, site of lodgement, and size and shape) in 59 patients. In the remaining case, a vegetable foreign body identified by virtual bronchoscopy was revealed by rigid bronchoscopy to be a thick mucus plug. Thus, the positive predictive value of virtual bronchoscopy was 98.3 per cent. Multidetector computed tomography virtual bronchoscopy is a sensitive and specific diagnostic tool for identifying radiolucent vegetable foreign bodies in the tracheobronchial tree. It can also provide a useful pre-operative road map for rigid bronchoscopy. Patients suspected of having an airway foreign body or chronic unexplained respiratory symptoms should undergo multidetector computed tomography virtual bronchoscopy to rule out a vegetable foreign body in the tracheobronchial tree and avoid general anaesthesia and invasive rigid bronchoscopy.
A Diagnostic Dilemma for the Pediatrician: Radiolucent Tracheobronchial Foreign Body.
Taşkınlar, Hakan; Bahadır, Gökhan Berktuğ; Erdoğan, Cankat; Yiğit, Doğakan; Avlan, Dinçer; Naycı, Ali
2017-06-01
The purpose of this study is to determine the role of clinical history, physical examinations, and radiological findings in the evaluation of patients with suspected radiolucent foreign body aspiration. The medical records of 236 children (under the age of 18 years), on whom a rigid bronchoscopy was performed between 1999 and 2015 because of suspected radiolucent foreign body aspiration, were analyzed retrospectively. Sensitivity, specificity, positive and negative predictive values of clinical history, physical examinations, and radiological findings were evaluated. In 71.1% of all cases, the children were under the age of 3 years. The bronchoscopy showed the presence of a foreign body in 52.9% of cases, with the locations of the foreign bodies being as follows: (1) right main bronchus, 47.2%; (2) left main bronchus, 36.0%; (3) trachea, 11.2%; (4) both bronchi, 5.6%. Organic foreign bodies were found in 78% of the patients, whereas inorganic foreign bodies were detected in 22% of the patients. The sensitivity and specificity of clinical history, physical examinations, and radiological findings were 98.4% and 54.9%, 47.2% and 74.7%, and 35.2% and 92.7%, respectively. Tracheobronchial foreign body aspirations usually occur prior to the age of 3 years, with the most frequently aspirated foreign bodies being food or items of a radiolucent nature. Clinical history, physical examinations, and radiological findings are not able to detect the presence of a radiolucent foreign body aspiration in children. Therefore, a bronchoscopy should be performed on children in whom a choking event has been witnessed, even in cases of normal radiological and clinical findings. Copyright © 2016. Published by Elsevier B.V.
Foreign body ingestion in children
Dereci, Selim; Koca, Tuğba; Serdaroğlu, Filiz; Akçam, Mustafa
2015-01-01
Aim: Foreign bodies ingested by the oral route enter into the gastrointestinal tract and are considered a significant health problem in the childhood. In this study, we evaluated the pediatric patients who presented to our hospital with the complaint of ingestion of foreign body. Material and Methods: The hospital records of all children who presented to our clinic because of ingestion of foreign body between January 2008 and January 2015 were examined retrospectively. The complaints at admission, the types of foreign bodies ingested, the localization of the foreign body in the gastrointestinal tract and the approaches and treatment methods used were examined. Results: Thirty-six (56%) of 64 patients included in the study were male and 28 (44%) were female and the mean age was 5.7±4.6 years (10 months–17 years). Thirty eight (59%) of 64 children who were included in the assessment were below the age of five years. The most common complaint at presentation was parental recognition of the ingested object and dysphagia. The most commonly ingested foreign bodies included coins, sewing pins, safety pins and hairclips. Nail clipper detected in the stomach, sewing pin which penetrated through the duodenal wall and stuck to hepatic parenchyma were the first pediatric cases in the literature. Upper esophagus was the most common location for foreign bodies. Endoscopic examinations were performed in 55 of 64 children. Conclusions: Early detection and treatment of ingested foreign bodies in the upper gastrointestinal system is important in terms of preventing possible complications. In our study, the most frequent foreign bodies detected in the upper digestive tract were coins and they were most frequently detected in the upper esophagus. Most of our patients were below the age of five years. Flexible endoscopic method was used commonly for treatment. PMID:26884693
Increase in pediatric magnet-related foreign bodies requiring emergency care.
Silverman, Jonathan A; Brown, Julie C; Willis, Margaret M; Ebel, Beth E
2013-12-01
We describe magnetic foreign body injuries among children and obtain national estimates of magnetic foreign body injury incidence over time. We searched the National Electronic Injury Surveillance System for cases of magnetic foreign bodies in children younger than 21 years in the United States, from 2002 to 2011. Cases were analyzed by location: alimentary or respiratory tract, nasal cavity, ear canal, or genital area. We identified 893 cases of magnetic foreign bodies, corresponding to 22,581 magnetic foreign body cases during a 10-year period (95% confidence interval [CI] 17,694 to 27,469). Most magnetic foreign bodies were ingested (74%) or intranasal (21%). Mean age was 5.2 years for ingested magnetic foreign bodies and 10.1 years for nasal magnetic foreign bodies (difference 4.9; 95% CI 4.1 to 5.6), suggesting different circumstances of injury. The incidence of pediatric magnet ingestions increased from 2002 to 2003 from 0.57 cases per 100,000 children per year (95% CI 0.22 to 0.92) to a peak in 2010 to 2011 of 3.06 cases per 100,000 children per year (95% CI 2.16 to 3.96). Most ingested magnetic foreign bodies (73%) and multiple magnet ingestions (91%) occurred in 2007 or later. Patients were admitted in 15.7% of multiple magnet ingestions versus 2.3% of single magnet ingestions (difference 13.4%; 95% CI 2.8% to 24.0%). Magnet-related injuries are an increasing public health problem for young children, as well for older children who may use magnets for play or to imitate piercings. Education and improved magnet safety standards may decrease the risk small magnets pose to children. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.
Updates in pediatric gastrointestinal foreign bodies.
Wright, Christian C; Closson, Forrest T
2013-10-01
Although most ingested foreign bodies in children pass spontaneously, certain foreign bodies can be harmful and they require special attention and emergent medical intervention to prevent significant morbidity and mortality. This article presents an overview of the epidemiology, diagnosis, management, and complications of foreign body ingestions in children. Particular attention is paid to coins, sharp objects, long objects, food bolus, caustic liquids, batteries, and magnets. Copyright © 2013 Elsevier Inc. All rights reserved.
Antoniou, Dimitris; Christopoulos-Geroulanos, George
2011-01-01
Although foreign body ingestion is a common problem in children, there are no clear guidelines regarding the management of ingested foreign bodies. The aim of this study was to evaluate the effectiveness of our protocol in the work-up and management of children with ingested foreign bodies. Between September 2002 and August 2010, a total of 675 children with suspected foreign body ingestion were seen in the emergency department. At initial presentation, the majority of foreign bodies were located in the stomach (n=392, 58.1%) followed by the small intestine (n=221, 32.7%) and esophagus (n=62, 9.2%). Based on our protocol, 84 (12.4%) patients were admitted at initial presentation, and 5 after a 48-hour observation period at home; 61 (9%) required prompt endoscopic removal. Sixty-eight (10.1%) patients returned for endoscopic removal after a four-week observation period, and 3 (0.4%) patients underwent delayed surgery due to complications. The overall success rate of endoscopic retrieval was 96.1%. There were no major complications. The majority of ingested foreign bodies will pass spontaneously and most children can be safely observed at home. Selective endoscopic intervention is the preferable method for the removal of ingested foreign bodies in pediatric patients.
Noninvasive photoacoustic detecting intraocular foreign bodies with an annular transducer array.
Yang, Diwu; Zeng, Lvming; Pan, Changning; Zhao, Xuehui; Ji, Xuanrong
2013-01-14
We present a fast photoacoustic imaging system based on an annular transducer array for detection of intraocular foreign bodies. An eight-channel data acquisition system is applied to capture the photoacoustic signals using multiplexing and the total time of data acquisition and transferring is within 3 s. A limited-view filtered back projection algorithm is used to reconstruct the photoacoustic images. Experimental models of intraocular metal and glass foreign bodies were constructed on ex vivo pig's eyes and clear photoacoustic images of intraocular foreign bodies were obtained. Experimental results demonstrate the photoacoustic imaging system holds the potential for in clinic detecting the intraocular foreign bodies.
Smith, Peter Mark; Harbias, Aman; Robinson, Richard; Palmer, Anne; Grey, Benjamin Robin
2016-01-01
Polyembolokoilamania refers to the practice of inserting foreign bodies (FBs) into natural orifices. A FB within the urethra is a relatively rare phenomenon with 646 cases recorded last year in the United Kingdom. Management of these patients presents technical challenges and complexities because of underlying psychiatric disorders that are often associated. This case illustrates a novel way of removing FBs from the genitourinary tract, requiring less resources, preventing hospital admission, and attempts to break the cycle of behavior, leading to recurrent attendance with polyembolokoilamania. A 38-year-old Caucasian male prisoner, with psychiatric history presented to the emergency department (ED) with a history of inserting FBs into his urethra on 12 different occasions over a 6-week period. Of these 12 attendances, 3 resulted in admission and 2 required emergency intervention in theater under general anesthesia. After the third attendance in 5 days, it was decided to use Isiris™, a single-use flexible cystoscopy device with a built-in ureteral stent grasper, to remove the FBs and check the integrity of the urethra. The procedure was performed within the ED, without the need for admission to a ward bed or general anesthesia. Furthermore, only two members of staff were required to remove all of the urethral FBs. Isiris, although marketed as a stent removal device, enabled us to remove all the patient's FBs in one procedure. Isiris is an easy to use device, similar to a flexible cystoscope, that a specialist nurse or resident would be familiar using. It allows efficient and safe removal of lower urinary tract FBs, even out of hours. It requires minimal staffing support and can be done in the ED. It has the potential to reduce associated sequela of urethral polyembolokoilamania, saving resources while preserving the availability of the emergency theater.
Endoscopic Management of Foreign Bodies in the Gastrointestinal Tract: A Review of the Literature
Andrade, Javier; Twersky, Yitzhak; Iqbal, Shahzad
2016-01-01
Foreign body ingestion is a common diagnosis that presents in emergency departments throughout the world. Distinct foreign bodies predispose to particular locations of impaction in the gastrointestinal tract, commonly meat boluses in the esophagus above a preexisting esophageal stricture or ring in adults and coins in children. Several other groups are at high risk of foreign body impaction, mentally handicapped individuals or those with psychiatric illness, abusers of drugs or alcohol, and the geriatric population. Patients with foreign body ingestion typically present with odynophagia, dysphagia, sensation of having an object stuck, chest pain, and nausea/vomiting. The majority of foreign bodies pass through the digestive system spontaneously without causing any harm, symptoms, or necessitating any further intervention. A well-documented clinical history and thorough physical exam is critical in making the diagnosis, if additional modalities are needed, a CT scan and diagnostic endoscopy are generally the preferred modalities. Various tools can be used to remove foreign bodies, and endoscopic treatment is safe and effective if performed by a skilled endoscopist. PMID:27807447
Unusual Foreign Bodies in the Orofacial Region
Passi, Sidhi; Sharma, Neeraj
2012-01-01
Foreign bodies may be deposited in the oral cavity either by traumatic injury or iatrogenically. Among the commonly encountered iatrogenic foreign bodies are restorative materials like amalgam, obturation materials, broken instruments, needles, and so forth. The discovery of foreign bodies in the teeth is a special situation, which is often diagnosed accidentally. Detailed case history, clinical and radiographic examinations are necessary to come to a conclusion about the nature, size, location of the foreign body, and the difficulty involved in its retrieval. It is more common to find this situation in children as it is a well-known fact that children often tend to have the habit of placing foreign objects in the mouth. Sometimes the foreign objects get stuck in the root canals of the teeth, which the children do not reveal to their parents due to fear. These foreign objects may act as a potential source of infection and may later lead to a painful condition. This paper discusses the presence of unusual foreign bodies—a tip of the metallic compass, stapler pin, copper strip, and a broken sewing needle impregnated in the gingiva and their management. PMID:22830058
Penis swelling due to foreign body reaction after injection of silicone.
Plaza, Tobias; Lautenschlager, Stephan
2010-09-01
A 19-year-old man presented with phimosis and painful swelling of the penis four weeks after augmentation with silicone in Thailand. Histology revealed a foreign body reaction to silicone. Infectious causes were ruled out. Granulomatous foreign body reactions to silicone are common, but there are few case reports on reactions following silicone injection for penis enlargement. Foreign body reactions should be included in the differential diagnosis of penis swelling.
ERIC Educational Resources Information Center
Palandra, Maria
2008-01-01
As interest in the study of foreign languages grows, more and more school and district leaders will be charged with the responsibility of establishing a language program. Some of the questions that they will need to answer include: What language and what model should be selected? How could another program be inserted in a school day already…
22 CFR 42.73 - Procedure in issuing visas.
Code of Federal Regulations, 2013 CFR
2013-04-01
... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Procedure in issuing visas. 42.73 Section 42.73 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Issuance of Immigrant Visas § 42.73 Procedure in issuing visas. (a) Insertion of...
22 CFR 42.73 - Procedure in issuing visas.
Code of Federal Regulations, 2014 CFR
2014-04-01
... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Procedure in issuing visas. 42.73 Section 42.73 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Issuance of Immigrant Visas § 42.73 Procedure in issuing visas. (a) Insertion of...
22 CFR 42.73 - Procedure in issuing visas.
Code of Federal Regulations, 2012 CFR
2012-04-01
... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Procedure in issuing visas. 42.73 Section 42.73 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Issuance of Immigrant Visas § 42.73 Procedure in issuing visas. (a) Insertion of...
22 CFR 42.73 - Procedure in issuing visas.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Procedure in issuing visas. 42.73 Section 42.73 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Issuance of Immigrant Visas § 42.73 Procedure in issuing visas. (a) Insertion of...
Suction-based grasping tool for removal of regular- and irregular-shaped intraocular foreign bodies.
Erlanger, Michael S; Velez-Montoya, Raul; Mackenzie, Douglas; Olson, Jeffrey L
2013-01-01
To describe a suction-based grasping tool for the surgical removal of irregular-shaped and nonferromagnetic intraocular foreign bodies. A surgical tool with suction capabilities, consisting of a stainless steel shaft with a plastic handle and a customizable and interchangeable suction tip, was designed in order to better engage and manipulate irregular-shaped in-traocular foreign bodies of various sizes and physical properties. The maximal suction force and surgical capabilities were assessed in the laboratory and on a cadaveric eye vitrectomy model. The suction force of the water-tight seal between the intraocular foreign body and the suction tip was estimated to be approximately 40 MN. During an open-sky vitrectomy in a porcine model, the device was successful in engaging and firmly securing foreign bodies of different sizes and shapes. The suction-based grasping tool enables removal of irregular-shaped and nonferromagnetic foreign bodies. Copyright 2013, SLACK Incorporated.
[Foreign body in the tricuspid valve with valvular insufficiency and right-left shunt].
Delebarre, P; Augustin-Normand, C; Capronier, C; Cramer, J; Godeau, P; Letac, B; Forman, J; Maurice, P; Ourbak, P
1987-05-01
We present the case of a 50-year old man who progressively developed tricuspid valve insufficiency with opening of a patent foramen ovale responsible for right-to-left shunt with polycythaemia. The tricuspid valve insufficiency was due to a foreign body, probably of surgical origin as suggested by its radiological image and by the patient's previous history. It would have been introduced, far away from the tricuspid valve (compound fracture of the wrist), several years previously. At surgery, we found the foreign body embedded in the valve system. As a possible mechanism for the mutilation, an undiagnosed endocarditis was suspected but could not be confirmed. Three cases tricuspid endocarditis (with foreign bodies in the right ventricle) and 3 cases of asymptomatic tricuspid valve foreign bodies have been published. Fifty-five cases of foreign bodies introduced peripherally and migrated into the heart, the pericardium and the pulmonary artery are reviewed.
Overtube-Assisted Foreign Body Removal: A Review of Endoscopic Management and Case Illustration.
Ofosu, Andrew; Ramai, Daryl; Reddy, Madhavi
2017-09-29
The ingestion of foreign bodies is a common medical emergency seen in both adults and children. In children, the most commonly ingested foreign bodies include coins, toys, magnets, and batteries. In adults, food bolus impaction represents the most common cause of foreign body ingestion. The majority of foreign bodies pass spontaneously. Sharp or pointed objects increase the risk of perforation. Emergent endoscopic intervention is indicated in cases of esophageal obstruction, ingestion of disk batteries, and sharp pointed objects in the esophagus. Flexible endoscopy is the therapeutic method of choice for removing foreign bodies. It is preferred due to its high success rate and low risk for complications. Additionally, the use of an overtube provides gastric and esophageal protection from mucosal laceration. We present a 27-year-old male who ingested six razor blades and a curtain hook and review endoscopic management.
Ureterovaginal fistula: A complication of a vaginal foreign body.
Lo, Tsia-Shu; Jaili, Sukanda Bin; Ibrahim, Rami; Kao, Chuan Chi; Uy-Patrimonio, Ma Clarissa
2018-02-01
To know the diagnostic tools and proper management of ureterovaginal fistula following neglected vaginal foreign body in order to achieve optimal outcome. A case of ureterovaginal fistula associated with a neglected vaginal foreign body. The patient was complaining of a foul-smelling vaginal discharge and lower abdominal pain. On vaginal examination, a hard and large foreign body was found. Examination under anesthesia was performed, and an aerosol cap was removed from her vagina. The patient developed urinary incontinence after removal of the foreign body. Subsequent work-up demonstrated the presence of a right ureterovaginal fistula. The patient underwent an abdominal ureteroneocystostomy. At one year follow up, the patient had fully recovered. Ureterovaginal fistula following neglected vaginal foreign body is a serious condition. Early diagnosis, treatment of infection and proper surgical management can improve the outcome and decrease complications. Copyright © 2018. Published by Elsevier B.V.
Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War Fighters
2013-10-01
training, with pre-test and post-test components. Physicians will undergo pre-testing with the removal of one wooden foreign body from a turkey breast ...project. The physicians are trained with a turkey breast simulator. They will be evaluated and measured on their performance and competency development...foreign bodies were the same. A 1 cm piece of a wooden toothpick was used to represent a traditional foreign body implanted in the cadaver tissue
Incidence of foreign bodies in aerodigestive tract in vindhya region: our experience.
Gupta, Richa; Poorey, V K
2014-06-01
Foreign bodies in aerodigestive tract are frequent occurrence and may lead to life threatening situation due to obstruction caused in respiratory passages. To present foreign body ingestion cases observed in a 5-year period at the S.S. Medical College and G.M. Hospital, Rewa (MP). The present study is a retrospective analysis including 108 patients of foreign bodies of aerodigestive tract of Vindhya region who presented to the S.S. Medical College and G.M. Hospital, Rewa from January 2008 to August 2012. About 92 patients of total 108 patients had evidence of foreign body in food passage with age ranging from 9 month to 85 years. Most patients 65 (70.65 %) belong to <10 year age group. Radiological evidence was found in 76 (82.6 %) patients. Most common foreign body was found to be coin 75 (81.52 %). The commonest site of lodgement was cricopharynx. About 16 patients of total 108 patients had evidence of foreign body in airway with age ranging from 9 months to 72 years. Most cases 8 (50 %) belong to <10 year age. Maximum cases showed vegetative foreign body with right bronchus (58.33 %) as commonest site of lodgement. Early detection by meticulous history, imaging modality and prompt management remains basis for favourable outcome and prevents future complications.
Proposal for methods of diagnosis of fish bone foreign body in the Esophagus.
Woo, Seung Hoon; Kim, Kyung Hee
2015-11-01
To investigate the methods of diagnosis of fish bone foreign body in the esophagus and suggest a diagnostic protocol. Prospective cohort study. A prospective study was performed on 286 patients with a history of fish bone foreign body impaction. Among them, 88 patients had negative findings in the oral cavity and laryngopharynx. Subsequent radiologic assessment of these patients included plain radiography and computed tomography (CT). Sixty-six patients showed positive findings in the esophagus, and an attempt was made to remove the obstruction using transnasal esophagoscopy. In 66 patients, a fish bone foreign body was detected in the esophagus by CT. In contrast, plain radiography detected a foreign body in only 30 patients. The overall detection rate of plain radiography compared with CT for fish bones was 45.5%. Plain radiography detected 35.9% of the simple type fish bones and 54.5% of the gill bone detected by CT. However, jaw bones had a detection rate of 100% with both methods. The fish bone foreign bodies were most commonly located in the upper esophagus (n=65, 98.5%), followed by the lower esophagus (n=1, 1.5%). CT is a useful method for identification of esophageal fish bone foreign bodies. Therefore, CT should be considered as the first-choice technique for the diagnosis of esophageal fish bone foreign body. 4. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.
Foreign body aspiration and language spoken at home: 10-year review.
Choroomi, S; Curotta, J
2011-07-01
To review foreign body aspiration cases encountered over a 10-year period in a tertiary paediatric hospital, and to assess correlation between foreign body type and language spoken at home. Retrospective chart review of all children undergoing direct laryngobronchoscopy for foreign body aspiration over a 10-year period. Age, sex, foreign body type, complications, hospital stay and home language were analysed. At direct laryngobronchoscopy, 132 children had foreign body aspiration (male:female ratio 1.31:1; mean age 32 months (2.67 years)). Mean hospital stay was 2.0 days. Foreign bodies most commonly comprised food matter (53/132; 40.1 per cent), followed by non-food matter (44/132; 33.33 per cent), a negative endoscopy (11/132; 8.33 per cent) and unknown composition (24/132; 18.2 per cent). Most parents spoke English (92/132, 69.7 per cent; vs non-English-speaking 40/132, 30.3 per cent), but non-English-speaking patients had disproportionately more food foreign bodies, and significantly more nut aspirations (p = 0.0065). Results constitute level 2b evidence. Patients from non-English speaking backgrounds had a significantly higher incidence of food (particularly nut) aspiration. Awareness-raising and public education is needed in relevant communities to prevent certain foods, particularly nuts, being given to children too young to chew and swallow them adequately.
Çelik, Necla; Arikan, Duygu
2013-11-01
This study was semi-experimentally conducted in order to determine knowledge levels of child development students about foreign body aspiration and to explore the effect of the training given to these students about foreign body aspiration upon their knowledge levels. The research was conducted with a total of 231 students who studied at the department of child development of two high schools and one vocational higher school in Erzincan Province located in the east of Turkiye between May 2011 and February 2012. The data were gathered using a questionnaire form of 38 questions. The training on foreign body aspiration (Power point presentation, video presentation and practice on a dummy) was provided in three phases. For the data evaluation; percentages, chi-square test and Mc Nemar test were used. It was found out in the study that 91.8% of the students did not take any training/course about foreign body aspiration and 55% confronted situations of foreign body aspirations (ear, nose, airway). After the training about foreign body aspiration; it was noted that the number of the students who knew risky behaviors for foreign body aspiration increased and the increase in the number of the students was at the highest level among high schools (p<0.05). It was seen that the training was most effective among the university students in terms of knowing first-aid intervention in case a foreign body would obstruct airway among the children aged<1 year (p<0.05). It was noted that the training which was applied on the dummy by using visual aids about foreign body aspiration increased the knowledge level of the students. Based on this finding, it may be recommended that nurses should perform their counseling and educator roles more actively for the families and those who are responsible for the baby care about foreign body aspiration by playing a more active role in the health care team. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Zhang, Xiaowen; Jiang, Yan; Fu, Tao; Zhang, Xiaoheng; Tu, Chunmei
2017-01-01
Objective This study was performed to identify the differences in clinical characteristics, operative methods, complications, and postoperative hospitalization stays for adults with esophageal foreign bodies with different durations of time from ingestion to effective treatment. Methods We retrospectively reviewed the medical records of 221 patients with a diagnosis of a foreign body in the esophagus, confirmed by rigid esophagoscopy, flexible esophagoscopy, or surgery. The differences between the two groups (Group A, ≤24 hours from ingestion to effective treatment; Group B, >24 hours from ingestion to effective treatment) were analyzed. Results Sharp foreign bodies comprised the majority of objects in the two groups, including jujube pits, bones (excluding fish bones), fish bones, dentures, and seafood shells. Foreign bodies located in the upper esophagus were more commonly observed in Group A than B. Significant differences were observed in the complication rate and length of postoperative hospitalization stays. Adults with esophageal foreign bodies had a high complication rate. Conclusions Rigid esophagoscopy can be used to remove sharp and bulky foreign bodies if more effective methods are unavailable. Effective treatment within 24 hours resulted in fewer complications and shorter postoperative hospitalization stays. PMID:28606025
[Foreign body ingestion in children: our experience and review of the literature].
Orofino, Antonio; Lanzillotto, Maria Paola; D'Amato, Michele; Rutigliano, Vincenzo; Fanelli, Benito
2009-01-01
Foreign body ingestion is a frequent event in paediatric population, especially in the first six years of life. Even if the event is normally cause of anxiety for the parents witness of the situation, fortunately most ingested foreign bodies ingestion, about 80-90%, pass spontaneously, 10-20% of cases needs an endoscopic intervention and only in less than 1% of cases surgery is necessary. Many authors suggest different guide-lines for diagnosis and therapy of foreign body ingestion in children. These purposes are discordant not only on potential danger of foreign body, but also on timing and last of waiting period before endoscopic extraction. Here we report our own experience: a retrospective review of three hundred consecutive paediatric cases of foreign body ingestion between June 2001 and February 2008. This study don't take in account patients with pathology either organic either functional, that can cause stop of food progression. We describe and discuss about medical diagnostic and therapeutic procedures that have been done during the time of hospitalization and performed according to classic and new international literature, with the objective to propose recommendations helpful for a correct management of children presenting with a history of suspected ingestion of a foreign body.
Chávez Rossell, Miguel
2012-01-01
The ingestion of a foreign body is one of the most common endoscopic emergencies. Foreign bodies in the upper gastrointestinal tract should be extracted as soon as possible to avoid serious complications such as perforation o bleeding. However, removals of foreign bodies with sharp edges are very difficult and can develop complications during their removal. Various devices have therefore been developed to prevent mucosal injury from the sharp edges during endoscopic extraction. We report a new technique for the successful foreign body extraction of upper digestive tract using the cap from six shooter variceal banding reused. We present 17 cases (9 males and 8 females). The types of foreign bodies removed were: chicken bones (n:7), fish bones (n:3), denture prosthesis (n:2), food bolus (n:2), long pin (n:1), golden thumb tack (n: 1) and press-through package (n:1). There were no complications. This new technique is safe and effective. Highlights its advantages: enhanced sight pharyngo esophageal junction, foreign bodies disimpact at that level, food bolus suck, avoid sharp object damage mucosal or scope and decrease time removal.
An Interesting Cause of Mechanical Small Bowel Obstruction.
Anantha Sathyanarayana, Sandeep; Deutsch, Gary B; Friedman, Barak
2015-12-01
Foreign body ingestion is a known cause of abdominal pain in pediatric population occurring between 6 months and 3 years of age (Wyllie Curr Opin Pediatr 18:563, 2006, Uyemura Am Fam Physician 72:287, 2005, Banerjee Indian J Pediatr 72:173, 2005). Most of the ingested foreign bodies pass spontaneously with 10-20 % requiring endoscopic retrieval, and <1 % of cases require a surgical intervention (Wyllie Curr Opin Pediatr 18:563, 2006, Uyemura Am Fam Physician 72:287, 2005, Shivakumar Indian J Pediatr 71:689, 2004). Presence of intestinal obstruction necessitates surgical intervention to extract the ingested foreign body. Initial abdominal plain radiograph should be obtained when foreign body ingestion is suspected, which differentiates a radiopaque from radiolucent foreign bodies. A computed tomography with 3D reconstruction (3D-CT) is recommended with radiolucent foreign bodies (Uyemura Am Fam Physician 72:287, 2005, Kazam Am J Emerg Med 23:897, 2005). After 24 h of expectant management, failure of spontaneous passage requires further intervention. Timely intervention to relieve the obstruction is pivotal to prevent undue complications. We present an interesting case of a boy who ingested a radiolucent foreign body diagnosed on 3D-CT, successfully treated with surgical extraction.
Neglected foreign body aspiration mimicking bronchial carcinoma.
Afghani, Reza; Khandashpour Ghomi, Mahmoud; Khandoozi, Seyed Reza; Yari, Behrouz
2016-07-01
Foreign body aspiration can occur in any age group, but it is more commonly seen in children. In adults, there is usually a predisposing condition that poses a risk of aspiration. If aspiration occurs, prompt diagnosis and extraction of the foreign body is needed to prevent early and late complications. We report a rare case of neglected foreign body aspiration in a 45-year-old schizophrenic opium addicted patient, which resulted in an occlusive lesion in the bronchus, mimicking bronchial carcinoma. © The Author(s) 2016.
Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War Fighters
2015-12-01
1 AD_________________ AWARD NUMBER: W81XWH-08-2-0162 TITLE: Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War...Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War Fighters 5a. CONTRACT NUMBER 5b. GRANT NUMBER: W81XWH-08-2-0162 5c...Purpose: To demonstrate that 1) ultrasound guided foreign body removal (USFBR) is superior to conventional surgery in the cadaver model, 2) USFBR can be
Su, Yuxi; Nan, Guoxin
2016-05-01
Embedment of metallic foreign bodies in the soft tissues is commonly encountered in the emergency room. Most foreign bodies are easily removed, but removal is difficult if the foreign body is very small or deeply embedded. To determine the usefulness of methylene blue staining in the surgical removal of tiny metallic foreign bodies embedded in the soft tissue. This prospective study involved 41 children treated between May 2007 and May 2012. The patients were randomly divided into a methylene blue group and a control group. In the control group, foreign bodies were located using a C-arm and removed via direct incision. In the methylene blue group, foreign bodies were located using a C-arm, marked with an injection of methylene blue and then removed surgically. The clinical outcomes, complications, operation time, surgical success rate, incision length, frequency of C-arm use, and length and depth of the foreign body were compared between the two groups. The surgical success rate was significantly higher in the methylene blue group. The average operation time was significantly shorter in the methylene blue group. The C-arm was used significantly less frequently in the methylene blue group than in the control group. The incision length was significantly shorter in the methylene blue group than in the control group. Methylene blue staining facilitated the location and removal of tiny metallic foreign bodies from the soft tissue, and significantly reduced operation time, incision length and radiation exposure compared to the conventional method. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.
Finkelstein, M; Legmann, A; Rubin, P A
1997-01-01
Intraorbital projectile metallic foreign bodies are associated with significant ocular and orbital injuries. The authors sought to evaluate epidemiologic factors, the incidence of associated ocular and orbital injury, and the nature and necessity of surgical intervention in these cases. Charts of all patients with projectile intraorbital metallic foreign bodies seen at our institution (27) over the preceding 7 years were evaluated with respect to age, sex, type of injury, associated ocular and orbital injuries, location of the projectile (anterior, epibulbar, or posterior), postinjury visual acuity, and surgical intervention. The majority of patients were male, between the ages of 11 and 30, and had BB pellet injuries. Thirteen projectiles were lodged anteriorly, 4 were in an epibulbar position, and the remaining 10 were posterior to the equator. Twelve of 13 anterior, and 4 of 4 epibulbar foreign bodies were removed surgically, whereas only 2 of 10 posterior foreign bodies required surgery. No case of surgical intervention resulted in a decrease of visual acuity. Associated ocular injuries were both more common and severe in patients with posteriorly located foreign bodies. Final visual acuity was better at presentation and at discharge in patients with anteriorly located foreign bodies. Intraorbital projectile metallic foreign bodies can be a source of significant ocular morbidity. Management of these cases is dependent on the location of the projectile. Ancillary radiographic studies can be helpful. Surgery to remove the projectile should be considered in each case, but foreign bodies that are not readily accessible often may be left safely in place. Closer regulation of the pellet gun industry, with an emphasis on education and protective eyewear use, would be helpful in reducing these injuries.
Clinical study of esophageal foreign bodies attributable to PTP material.
Sakakura, A; Yamamoto, Y; Terada, M; Takenaka, H; Ueda, N; Furuya, T
1997-10-01
Retrospective survey of patients with esophageal foreign bodies who were treated in the Osaka Medical College over the past 21 years, and the patients with esophageal foreign bodies attributed to press through package (PTP) who were treated at the Osaka Central Emergency Clinic, a representative holiday emergency institution in Japan, was carried out. The incidence of foreign bodies attributed to PTP material tends to increase throughout the period reviewed. The patients over 60 years of age accounted for 25/28 (89%) of all PTP patients in Osaka Medical College and 27/32 (84%) in Osaka Central Emergency Clinic, strongly suggesting that PTP dysphagia is most common in elderly patients. Diagnostic methods and preventive measures against PTP foreign bodies were discussed.
Case report: vertebral foreign body granuloma mimicking a skeletal metastasis.
Vossen, Josephina A; Bathaii, Seyed M; Hatfield, Bryce; Hayes, Curtis W
2018-06-01
Intraosseous foreign body granuloma formation related to migrated surgical material is a rarely reported condition with variable imaging appearance. In this case report, we describe a foreign body granuloma that occurred in a lumbar vertebral body one level above a prior surgical fusion. The lytic appearance mimicked a skeletal metastasis in a 65-year-old patient with recently diagnosed renal cell carcinoma. To the best of our knowledge, this is the first reported case of a lumbar vertebral foreign body granuloma occurring distant from the site of surgery, indistinguishable from skeletal metastasis on radiologic examination.
Coleman, John W; Wright, Kevin J; Wallace, Olivia L; Sharma, Palka; Arendt, Heather; Martinez, Jennifer; DeStefano, Joanne; Zamb, Timothy P; Zhang, Xinsheng; Parks, Christopher L
2015-03-01
Advancement of new vaccines based on live viral vectors requires sensitive assays to analyze in vivo replication, gene expression and genetic stability. In this study, attenuated canine distemper virus (CDV) was used as a vaccine delivery vector and duplex 2-step quantitative real-time RT-PCR (RT-qPCR) assays specific for genomic RNA (gRNA) or mRNA have been developed that concurrently quantify coding sequences for the CDV nucleocapsid protein (N) and a foreign vaccine antigen (SIV Gag). These amplicons, which had detection limits of about 10 copies per PCR reaction, were used to show that abdominal cavity lymphoid tissues were a primary site of CDV vector replication in infected ferrets, and importantly, CDV gRNA or mRNA was undetectable in brain tissue. In addition, the gRNA duplex assay was adapted for monitoring foreign gene insert genetic stability during in vivo replication by analyzing the ratio of CDV N and SIV gag genomic RNA copies over the course of vector infection. This measurement was found to be a sensitive probe for assessing the in vivo genetic stability of the foreign gene insert. Copyright © 2014 Elsevier B.V. All rights reserved.
Removal of a foreign body from the skull base using a customized computer-designed guide bar.
Wei, Ran; Xiang-Zhen, Liu; Bing, Guo; Da-Long, Shu; Ze-Ming, Tan
2010-06-01
Foreign bodies located at the base of the skull pose a surgical challenge. Here, a customized computer-designed surgical guide bar was designed to facilitate removal of a skull base foreign body. Within 24h of the patient's presentation, a guide bar and mounting platform were designed to remove a foreign body located adjacent to the transverse process of the atlas and pressing against the internal carotid artery. The foreign body was successfully located and removed using the custom designed guide bar and computer operative planning. Ten months postoperatively the patient was free of complaints and lacked any complications such as restricted opening of the mouth or false aneurysm. The inferior alveolar nerve damage noted immediately postoperatively (a consequence of mandibular osteotomy) was slightly reduced at follow-up, but labial numbness persisted. The navigation tools described herein were successfully employed to aid foreign body removal from the skull base. Copyright (c) 2009 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Management of ingested foreign bodies in childhood and review of the literature.
Arana, A; Hauser, B; Hachimi-Idrissi, S; Vandenplas, Y
2001-08-01
The management of ingested foreign bodies in children is not standardised. During a 15-year period, we recorded 325 consecutive paediatric cases of accidental ingestion of foreign bodies or with symptoms suggesting oesophageal obstruction presented at the emergency department or the paediatric gastroenterology unit. The foreign bodies that had to be removed were, in decreasing order of frequency: coins, toy parts, jewels, batteries, sharp materials such as needles and pins, fish and chicken bones, and "large" amounts of food. Only 54% of the patients had transient symptoms at the moment of ingestion, such as retrosternal pain, cyanosis and dysphagia. A minority (28, 9%) of foreign bodies could be removed with a McGill forceps; 65 (20%) were removed with a magnet probe. Endoscopic removal was performed in 82 cases (25%). In the majority of cases (150, 46%) natural elimination occurred. The outcome of all patients was uneventful. Recommendations for management of children presenting with a history of suspected accidental ingestion of a foreign body for the community paediatrician are proposed.
Management of retained foreign bodies in missile injuries of the maxillofacial region.
Bede, Salwan Yousif Hanna; Ahmed, Firas Taha
2011-07-01
This study evaluates 22 patients with retained foreign bodies in the maxillofacial region that were all caused by penetrating missile injuries. Surgical intervention for the retrieval of the foreign bodies was carried out in 20 patients through the existing wounds and through separate incisions; all patients were followed up for a minimum of 2 months during which all the complications were registered and managed. Preoperative imaging is a prerequisite for the accurate localization of the foreign body and the subsequent successful removal of it. All patients developed complications that were categorized in this study into those that result from the injury itself and those that occur because of the retrieval procedure, the latter category being mostly easily managed. In general, all foreign bodies in the maxillofacial region should be removed; the surgeon involved should weigh the benefits and the perils of the removal, and the patient should be well informed about the possibility of the failure of removal of the foreign body.
Foreign bodies in the larynx and tracheobronchial tree in children. A review of 225 cases.
Rothmann, B F; Boeckman, C R
1980-01-01
In a study of 225 patients with foreign bodies in the larynx, trachea and bronchi, 77% were 36 months of age or less. The male-female ratio was 2:1. Food or food derivatives were the causative agent in 70% of the cases, with 38% due to a portion of nut. The foreign body involved the right and left bronchus with equal frequency. A choking episode followed by an audible wheeze (55%) was the most common presenting complaint. Obstructive emphysema was demonstrated in 60% and was best demonstrated by inspiration-expiration chest roentgenograms or fluoroscopy. A radio-opaque object was seen in 13%. Two hundred ten foreign objects (93%) were removed by endoscopy. Four patients required pulmonary resection for bronchiectasis and in three patients bronchotomy was performed. Five patients expelled the foreign body spontaneously, two patients were transferred to another hospital, and one foreign body was not recovered. There was no mortality.
Virtopsy: postmortem imaging of laryngeal foreign bodies.
Oesterhelweg, Lars; Bolliger, Stephan A; Thali, Michael J; Ross, Steffen
2009-05-01
Death from corpora aliena in the larynx is a well-known entity in forensic pathology. The correct diagnosis of this cause of death is difficult without an autopsy, and misdiagnoses by external examination alone are common. To determine the postmortem usefulness of modern imaging techniques in the diagnosis of foreign bodies in the larynx, multislice computed tomography, magnetic resonance imaging, and postmortem full-body computed tomography-angiography were performed. Three decedents with a suspected foreign body in the larynx underwent the 3 different imaging techniques before medicolegal autopsy. Multislice computed tomography has a high diagnostic value in the noninvasive localization of a foreign body and abnormalities in the larynx. The differentiation between neoplasm or soft foreign bodies (eg, food) is possible, but difficult, by unenhanced multislice computed tomography. By magnetic resonance imaging, the discrimination of the soft tissue structures and soft foreign bodies is much easier. In addition to the postmortem multislice computed tomography, the combination with postmortem angiography will increase the diagnostic value. Postmortem, cross-sectional imaging methods are highly valuable procedures for the noninvasive detection of corpora aliena in the larynx.
Geraci, Girolamo; Sciume', Carmelo; Di Carlo, Giovanni; Picciurro, Antonino; Modica, Giuseppe
2016-11-04
Ingestion of foreign bodies and food impaction represent the second most common endoscopic emergency after bleeding. The aim of this paper is to report the management and the outcomes in 67 patients admitted for suspected ingestion of foreign body between December 2012 and December 2014. This retrospective study was conducted at Palermo University Hospitals, Italy, over a 2-year period. We reviewed patients' database (age, sex, type of foreign body and its anatomical location, treatments, and outcomes as complications, success rates, and mortalities). Foreign bodies were found in all of our 67 patients. Almost all were found in the stomach and lower esophagus (77 %). The types of foreign body were very different, but they were chiefly meat boluses, fishbones or cartilages, button battery and dental prostheses. In all patients it was possible to endoscopically remove the foreign body. Complications related to the endoscopic procedure were unfrequent (about 7 %) and have been treated conservatively. 5.9 % of patients had previous esophageal or laryngeal surgery, and 8.9 % had an underlying esophageal disease, such as a narrowing, dismotility or achalasia. Our experience with foreign bodies and food impaction emphasizes the importance of endoscopic approach and removal, simple and secure when performed by experienced hands and under conscious sedation in most cases. High success rates, lower incidence of minor complications, reduction of the need of surgery and reduced hospitalization time are the strengths of the endoscopic approach.
Yuan, Fangfang; Tang, Xiaowei; Gong, Wei; Su, Lei; Zhang, Yali
2018-01-01
Foreign body ingestion is a relatively common occurrence, which may lead to morbidity and mortality. The aim of the present study was to report the experience of management of upper gastrointestinal foreign bodies by endoscopy in a large center. All patients who presented at the Department of Gastroenterology at Nanfang Hospital (Guangzhou, China) with complaints regarding upper gastrointestinal (GI) foreign body ingestion from December 1987 to December 2013. Hospital medical charts and endoscopic records were examined to evaluate etiology, treatment, and outcomes for these patients. A total of 846 patients were enrolled in the present study, from which foreign bodies were detected in 737 (87.1%) patients via X-ray or endoscopy. The objects most frequently ingested were bones (n=395, 53.6%). The detected foreign bodies were predominantly located in the cervical esophagus (n=325, 44.1%). Endoscopic foreign body extraction was successful in 92.5% of cases, whereas surgery was required in 6 patients. The most frequently used endoscopic accessory devices were retrieval forceps (n=480, 65.1%). The complication rate was 6.9%, including mucosal laceration (n=10) and others, all of which were managed conservatively. Associated GI diseases were reported in 74 (10.0%) patients, including postesophagectomy (n=34) and others. In conclusion, the endoscopic procedure was safe and effective for the removal of foreign bodies from the upper gastrointestinal tract, with a high success rate and low complication rate. PMID:29434711
Witnessed and unwitnessed esophageal foreign bodies in children.
Louie, Jeffrey P; Alpern, Elizabeth R; Windreich, Randy M
2005-09-01
The purpose of this study was to describe the clinical presentation of children with either an unwitnessed or witnessed esophageal foreign body. Retrospective chart review was performed. Patients were identified using ICD-9 code for esophageal foreign body. Clinical data and management techniques, along with complications were abstracted. For the 5-year period of review, 255 patients were identified with an esophageal foreign body. 214 children had a witnessed ingestion. The mean age of the unwitnessed ingestion group was 2.3 years, compared to 4.6 years for a witnessed ingestion. In both groups, males and females were distributed equally and the most common ingested object was a coin. Bivariate, unadjusted analysis revealed that history of wheeze (OR, 4.35) and fever (OR, 11.15) had the largest association with patients who had an unwitnessed ingestion. Multivariate analysis indicated that any physical findings of wheeze, rhonchi, stridor, or retractions were associated significantly with a diagnosis of an unwitnessed foreign body. Children less than 2 years of age and with a documented fever are also predictive of an unwitnessed ingestion. Eleven children (4.3%) with esophageal abnormalities were also noted to have foreign bodies. Children who present to the emergency department two years old and younger, who have a documented fever and with respiratory findings should be considered at risk for having a retained esophageal foreign body. Children with esophageal abnormalities may also be at risk for retained esophageal foreign bodies.
Hidaka, Hiroshi; Obara, Taku; Kuriyama, Shinichi; Kurosawa, Shin; Katori, Yukio; Kobayashi, Toshimitsu
2013-10-01
Foreign body aspiration is a life-threatening emergency for children. Fried chicken is commonly available all over the world, but no cases have previously been reported addressing this food as a tracheobronchial foreign body. We report an extremely rare case of tracheobronchial aspiration of fried chicken complicated by severe bronchitis and postoperative atelectasis. To clarify predisposing factors related to bronchopulmonary complications, we also reviewed paediatric cases of tracheobronchial foreign bodies treated in our department over the past 14 years. We retrospectively reviewed a total of 77 cases of tracheobronchial foreign bodies from 1988 to 2011. The main outcome measure was duration of hospitalisation, reflecting postoperative therapy. Logistic regression analyses were conducted to determine risk factors for longer hospitalisation. Age, sex, and interval between the aspiration episode and bronchoscopy were not significantly associated with longer hospitalisation. Regarding kinds of foreign bodies, higher rates of longer hospitalisation were noted for patients who had aspirated peanut or animal material, as compared to patients who had aspirated non-organic material (odds ratio, 5.80; 95% confidence interval, 1.12-30.43). In terms of predicting the risk of pulmonary complications, the type of foreign body aspirated offers a more meaningful factor than the interval between aspiration and operation. Specifically, peanuts or animal material containing oils appear to be associated with a more prolonged pulmonary recovery even after retrieval of the foreign body. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
[Uncommon foreign body in a nose].
Alagić-Smailbegović, Jasminka; Hadzić, Edina; Sutalo, Kamenko; Resić, Mudzahid
2007-01-01
Foreign body in the nose most frequently occurs in childhood. It could be of various origin, pieces of toys, paper and uncommon metal body. Consequences include one- sided nasal breathing problem, nasal secretion and in some cases pain and secretion become purulent. The aim of this paper is to present uncommon foreign body in the nose. RTG diagnosis and extraction are the methods of choice.
Abdominal foreign body: late presentation as a rectus sheath abscess.
Noushif, M; Sivaprasad, S; Prashanth, A
2011-05-01
Intra-abdominal ingested foreign bodies are usually an incidental finding, typically encountered in mentally challenged patients. We present the case of a 65-year-old mentally sound woman who presented with recurrent abdominal pain and a lump in the hypogastrium. Evaluation revealed a rectus sheath abscess extending to the peritoneum, with a foreign body in situ. On enquiry, the patient revealed that she had accidentally ingested a tailoring needle 17 years ago. This case illustrates an unusual presentation of an ingested foreign body as a rectus sheath abscess after a long duration.
A light bulb moment: an unusual cause of foreign body aspiration in children.
Lau, C T; Lan, Lawrence; Wong, Kenneth; Tam, Paul Kwong Hang
2015-08-26
A 15-month-old girl developed persistent cough with no associated history of foreign body aspiration. Chest X-ray showed a U-shaped radiopaque foreign body, which was initially thought to be a hairpin, in the right main bronchus. Rigid bronchoscopy was performed and the foreign body turned out to be a light-emitting diode (LED) bulb. In this article, we report our experience of LED bulb aspiration in children, with the view to raise the awareness of clinicians about this potentially life-threatening emergency. 2015 BMJ Publishing Group Ltd.
Early surgical managment of penetrating ocular injuries involving the posterior segment.
Michels, R G
1976-09-01
Pars plana vitrectomy technic can be used in the early management of certain penetrating ocular injuries involving the posterior segment, including selected intraocular foreign bodies. This study reports the results of ten consecutive cases of intraocular foreign bodies in the posterior segment treated by a combination of vitrectomy (including lensectomy when necessary) and foreign-body extraction with forceps. The foreign body was successfully removed in nine of ten eyes, and nine of ten eyes were salvaged. This favorable experience using early vitreous surgery suggests that the vitrectomy technic can be used in other penetrating injuries involving the posterior segment that are not associated with intraocular foreign bodies. Possible indications for early vitrectomy are presented, including cases with a poor prognosis when managed by conventional methods.
Ingested foreign bodies in children: a report of two cases.
Singh, Gurjit; Sharma, Surendra; Khurade, Shrikant; Gooptu, Somnath
2014-01-01
Accidental foreign body ingestion and impaction of food bolus present as an emergency. Pediatric population is the most vulnerable. Since the act may go unnoticed, the child may present late. However, most foreign bodies pass spontaneously in the stools. Two children were brought with history of battery ingestion. In one case, an emergency gastro intestinal endoscopy had to be done for the foreign body removal which was made up of corroded battery. In the other case, no interventation was undertaken & an uncorroded battery passed per anum along with stools after 15 days of ingestion. Decision regarding immediate intervention or conservative approach will require consideration of the level of lodgement & type of foreign body. Prevention is possible if parents/guardians exercise control on their wards & are aware of implications of such an event.
Oesophageal foreign body and a double aortic arch: rare dual pathology.
O'Connor, T E; Cooney, T
2009-12-01
We report the rare case of an oesophageal foreign body which lodged above the site of oesophageal compression by a double aortic arch. Case report and a review of the literature surrounding the classification, embryology, diagnosis and management of vascular rings and slings. An eight-month-old male infant presented with symptoms of tracheal compression following ingestion of an oesophageal foreign body. Following removal of the oesophageal foreign body, the infant's symptoms improved initially. However, subsequent recurrence of respiratory symptoms lead to a repeat bronchoscopy and the diagnosis of a coexisting double aortic arch, causing tracheal and oesophageal compression. To our knowledge, this is only the second reported case of a double aortic arch being diagnosed in a patient following removal of an oesophageal foreign body.
Multidisciplinary surgical management of an unusual penetrating foreign body of the face.
Villarmé, A; Savoldelli, C; Jean-Baptiste, E; Guevara, N
2018-06-07
Facial injuries by penetrating foreign body are unusual and require specific multidisciplinary surgical management. This case report concerns a 20-year-old man who experienced a penetrating injury by a piece of wood to the face and describes the surgical approach to remove the wood and repair the injury. The foreign body had penetrated the infratemporal fossa, with an entry wound situated below the right eye and an exit wound in the neck, in contact with the left internal carotid artery. An adapted surgical strategy was necessary in view of the site of the foreign body. The internal carotid artery was controlled in order to follow the foreign body as far as its entry into the base of the skull. The proximity of the eye and carotid and jugular vessels and the deep penetration of the foreign body required the participation of interventional radiologists, head and neck and vascular surgeons and ophthalmologists. The site of the foreign body, precisely determined preoperatively, justified management by a multidisciplinary team to ensure rapid extraction, while limiting the risk of additional lesions. With a follow-up of 6 months, the patient did not present any sequelae of his facial injury. Copyright © 2018 Elsevier Masson SAS. All rights reserved.
Liao, Wenjing; Wen, Guangyi; Zhang, Xiaowen
2015-06-01
Button batteries have been recognized as one of the dangerous foreign bodies to children for more than 30 years, but few related studies have been published to give more concern in China. We reported 6 cases of button battery intake as foreign body in children. The Chinese literature on button battery as foreign body in children was reviewed. The interval between the accidental ingestion and battery removal ranged from 6 hours to 3 days. Two patients had no sequela, 3 patients had tracheoesophageal fistulas, and 1 patient had nasal septal perforation. Twenty-eight articles about button battery as foreign body in children were obtained by Chinese-language literature searches including 25 case reports, 2 health education articles, and 1 imaging article. In total, 172 cases of button battery intake as foreign body in children were identified, 23 and 10 of the 159 cases involving nasal button battery lodgment developed nasal septal perforation and nasal adhesion, respectively. Tracheoesophageal fistula was identified in 4 of the 12 ingestion cases. One case of button battery intake was in external auditory canal. A small number of children with button battery as foreign body were reported in China, which is 1 of the biggest countries with large population of children.
Predictors of recurrent ingestion of gastrointestinal foreign bodies.
Grimes, Ian C; Spier, Bret J; Swize, Lisa R; Lindstrom, Mary J; Pfau, Patrick R
2013-01-01
Gastrointestinal foreign bodies are commonly encountered; however, little knowledge exists as to the causes of foreign body ingestions and why they occur repeatedly in some patients. To identify and define patients at high risk for recurrent foreign body ingestion. A retrospective chart review of foreign body ingestion was conducted at a tertiary care medical centre over an 11-year period. Variables analyzed included age, sex, incarceration status, Diagnostic and Statistical Manual of Mental Disorders-IV diagnosis, success of endoscopy, type of sedation used, method of extraction, complications, presence of gastrointestinal pathology, and incidence of recurrent food impaction or foreign body. A total of 159 patients with a foreign body ingestion were identified. One hundred fourteen (77%) experienced a single episode of ingestion and 45 (23%) experienced multiple ingestions. Of the patients with multiple ingestions, 27 (60%) had recurrent food impactions while 18 (40%) ingested foreign objects. In the recurrent ingestor group, a psychiatric disorder had been diagnosed in 16 patients (35.6%) and there were 13 incarcerated individuals (28.9%). The average number of recurrences was 2.6 per patient (117 total recurrences). Individuals with a psychiatric disorder experienced 3.9 recurrences per patient, while prisoners averaged 4.1 recurrences per patient. The combination of a psychiatric disorder and being incarcerated was associated with the highest recurrence rate (4.33 per patient). Multivariable logistic regression revealed that male sex (OR 2.9; P=0.022), being incarcerated (OR 3.0; P=0.024) and the presence of a psychiatric disorder (OR 2.5; P=0.03) were risk factors for recurrent ingestion. Risk factors for recurrent ingestion of foreign bodies were male sex, being incarcerated and the presence of a psychiatric disorder.
Predictors of recurrent ingestion of gastrointestinal foreign bodies
Grimes, Ian C; Spier, Bret J; Swize, Lisa R; Lindstrom, Mary J; Pfau, Patrick R
2013-01-01
BACKGROUND: Gastrointestinal foreign bodies are commonly encountered; however, little knowledge exists as to the causes of foreign body ingestions and why they occur repeatedly in some patients. OBJECTIVE: To identify and define patients at high risk for recurrent foreign body ingestion. METHODS: A retrospective chart review of foreign body ingestion was conducted at a tertiary care medical centre over an 11-year period. Variables analyzed included age, sex, incarceration status, Diagnostic and Statistical Manual of Mental Disorders-IV diagnosis, success of endoscopy, type of sedation used, method of extraction, complications, presence of gastrointestinal pathology, and incidence of recurrent food impaction or foreign body. RESULTS: A total of 159 patients with a foreign body ingestion were identified. One hundred fourteen (77%) experienced a single episode of ingestion and 45 (23%) experienced multiple ingestions. Of the patients with multiple ingestions, 27 (60%) had recurrent food impactions while 18 (40%) ingested foreign objects. In the recurrent ingestor group, a psychiatric disorder had been diagnosed in 16 patients (35.6%) and there were 13 incarcerated individuals (28.9%). The average number of recurrences was 2.6 per patient (117 total recurrences). Individuals with a psychiatric disorder experienced 3.9 recurrences per patient, while prisoners averaged 4.1 recurrences per patient. The combination of a psychiatric disorder and being incarcerated was associated with the highest recurrence rate (4.33 per patient). Multivariable logistic regression revealed that male sex (OR 2.9; P=0.022), being incarcerated (OR 3.0; P=0.024) and the presence of a psychiatric disorder (OR 2.5; P=0.03) were risk factors for recurrent ingestion. CONCLUSION: Risk factors for recurrent ingestion of foreign bodies were male sex, being incarcerated and the presence of a psychiatric disorder. PMID:23378983
Stable zymomonas mobilis xylose and arabinose fermenting strains
Zhang, Min [Lakewood, CO; Chou, Yat-Chen [Taipei, TW
2008-04-08
The present invention briefly includes a transposon for stable insertion of foreign genes into a bacterial genome, comprising at least one operon having structural genes encoding enzymes selected from the group consisting of xylAxylB, araBAD and tal/tkt, and at least one promoter for expression of the structural genes in the bacterium, a pair of inverted insertion sequences, the operons contained inside the insertion sequences, and a transposase gene located outside of the insertion sequences. A plasmid shuttle vector for transformation of foreign genes into a bacterial genome, comprising at least one operon having structural genes encoding enzymes selected from the group consisting of xylAxylB, araBAD and tal/tkt, at least one promoter for expression of the structural genes in the bacterium, and at least two DNA fragments having homology with a gene in the bacterial genome to be transformed, is also provided.The transposon and shuttle vectors are useful in constructing significantly different Zymomonas mobilis strains, according to the present invention, which are useful in the conversion of the cellulose derived pentose sugars into fuels and chemicals, using traditional fermentation technology, because they are stable for expression in a non-selection medium.
Insurance status as a risk factor for foreign body ingestion or aspiration.
Arjmand, E M; Muntz, H R; Stratmann, S L
1997-10-18
To determine whether the lack of private health insurance places children at increased risk for foreign body ingestion or aspiration. Retrospective review. St. Louis Children's Hospital, a tertiary care center. Consecutive sample of 125 patients with esophageal or airway foreign bodies. Fifty percent of all patients had private health insurance. Fifty-six percent of all preschool patients and 20% of all school-age patients were uninsured (P < 0.01, Fisher's exact test). Eighty-five percent of patients with airway foreign bodies, and 84% of patients with esophageal foreign bodies were in the preschool group. Sixty-one percent of preschool patients and 21% of school-age patients with esophageal foreign bodies were uninsured (P < 0.05). Forty-six percent of preschool patients with food aspiration lacked health insurance (88% of these children were fed the aspirated item). No school-age group was available for comparison. Fifty percent of preschool children with aspiration of non food items were uninsured, as were 16% of their school-age counterparts. Insurance status must be considered as a risk factor for foreign body aspiration and ingestion. Preschool children are more likely to lack private health insurance than school-age children with the same diagnosis. In a majority of aspiration events, the child was being fed the inappropriate food item, perhaps indicating a lack of caretaker education and anticipatory guidance. A direct focus on 'passive protection', anticipatory guidance in clinics for all patients, and public education with emphasis on preventive care are proposed as means to decrease the incidence of airway and esophageal foreign bodies in children.
Saz, Eylem Ulaş; Arikan, Ciğdem; Ozgenç, Funda; Duyu, Muhterem; Ozananar, Yeliz
2010-06-01
We aimed to identify the presence of ingested metallic foreign bodies with handheld metal detector in the pediatric population. All children (n=40) known or suspected to have ingested a MFB and who presented to the Emergency Department of the Children's Hospital of Ege University were prospectively ascertained. All patients underwent both radiographic evaluation and handheld metal detector scanning of the chest and abdomen on their presentation. In the present prospective study, we compared handheld metal detector scanning with plain radiography. The end point of the study compared metallic foreign body findings with handheld metal detector vs radiological findings during an eight-month period. Forty subjects with possible metallic foreign body ingestion were enrolled into the study. The principle investigator scanned all subjects. Disease was defined by the presence of a foreign body in the gastrointestinal tract on radiograph. Radiographically, 35 foreign bodies were found, and handheld metal detector revealed 31 of them. The sensitivity of handheld metal detector was 88.6% (95% confidence interval [CI]: 72.1%-96.5%), specificity 100% (95% CI: 61.8%-100%), positive predictive value (PPV) 100% (95% CI: 85.8%-100%), and negative predictive value 55.5% (95% CI: 34.3%-84.6%). Handheld metal detector revealed that 2 metallic foreign bodies (1 pushpin, 1 coin) were localized to the chest, which was confirmed by radiography, and urgent removal was performed with endoscopy. Handheld metal detector scanning is an accurate, inexpensive, radiation-free screening tool and should be used for evaluation of patients suspected of ingesting metallic foreign bodies.
An Unusual Foreign Body in the Urinary Bladder Mimicking a Parasitic Worm
Schmitt, Bryan H.; Feder, Marc T.; Rokke, Denise L.; Moyer, Thomas P.
2012-01-01
We report an unusual case of a foreign body removed from the urinary bladder of a 63-year-old male which mimicked a parasitic worm. The foreign body was identified as an artificial fishing worm by morphological comparison to a similar commercially produced product and by infrared spectrum analysis. PMID:22535991
The foreign body response: at the interface of surgery and bioengineering.
Major, Melanie R; Wong, Victor W; Nelson, Emily R; Longaker, Michael T; Gurtner, Geoffrey C
2015-05-01
The surgical implantation of materials and devices has dramatically increased over the past decade. This trend is expected to continue with the broadening application of biomaterials and rapid expansion of aging populations. One major factor that limits the potential of implantable materials and devices is the foreign body response, an immunologic reaction characterized by chronic inflammation, foreign body giant cell formation, and fibrotic capsule formation. The English literature on the foreign body response to implanted materials and devices is reviewed. Fibrotic encapsulation can cause device malfunction and dramatically limit the function of an implanted medical device or material. Basic science studies suggest a role for immune and inflammatory pathways at the implant-host interface that drive the foreign body response. Current strategies that aim to modulate the host response and improve construct biocompatibility appear promising. This review article summarizes recent basic science, preclinical, and clinicopathologic studies examining the mechanisms driving the foreign body response, with particular focus on breast implants and synthetic meshes. Understanding these molecular and cellular mechanisms will be critical for achieving the full potential of implanted biomaterials to restore human tissues and organs.
Surgical Removal of Neglected Soft Tissue Foreign Bodies by Needle-Guided Technique
Ebrahimi, Ali; Radmanesh, Mohammad; Rabiei, Sohrab; kavoussi, Hossein
2013-01-01
Introduction: The phenomenon of neglected foreign bodies is a significant cause of morbidity in soft tissue injuries and may present to dermatologists as delayed wound healing, localized cellulitis and inflammation, abscess formation, or foreign body sensation. Localization and removal of neglected soft tissue foreign bodies (STFBs) is complex due to possible inflammation, indurations, granulated tissue, and fibrotic scar. This paper describes a simple method for the quick localization and (surgical) removal of neglected STFBs using two 23-gauge needles without ultrasonographic or fluoroscopic guidance. Materials and Methods: A technique based on the use of two 23-gauge needles was used in 41 neglected STFBs in order to achieve proper localization and fixation of foreign bodies during surgery. Results: Surgical removal was successful in 38 of 41 neglected STFBs (ranging from 2–13mm in diameter). Conclusion: The cross-needle-guided technique is an office-based procedure that allows the successful surgical removal of STFBs using minimal soft tissue exploration and dissection via proper localization, fixation, and propulsion of the foreign body toward the surface of the skin. PMID:24303416
Impacted thoracic foreign bodies after penetrating chest trauma.
Sersar, Sameh I; Albohiri, Khalid A; Abdelmohty, Hysam
2016-10-01
Retained foreign bodies in the chest may include shell fragments, bullets, shrapnel, pieces of clothing, bones, and rib fragments. The risks of removal of foreign bodies must be weighed against the complications of leaving them inside the chest. We treated 90 cases of retained intrathoracic foreign bodies in patients admitted to 3 tertiary centers in Saudi Arabia between March 2015 and March 2016. Sixty patients were injured by shrapnel, 26 had one or more bullets, 3 had broken rib fragments, and one had a metal screw. The chest wall was site of impaction in 48 cases, the lungs in 24, pleura in 14, and mediastinum in 4. Removal of the retained foreign body was carried out in 12 patients only: bullets in 9 cases, bone fragments in 2, and a metal screw in one. The predictors for removal were bullets, female sex, and mediastinal position with bilateral chest injury, especially with fracture ribs. Retained intrathoracic foreign bodies due to penetrating chest trauma are treated mainly conservatively unless there is another indication for chest exploration. © The Author(s) 2016.
Creswell, Caleb H; Kille, Tony L; Hoffman, Matthew R; Kennedy, Tabassum; Dailey, Seth H
2017-01-01
Foreign body ingestion occurs in not only children but also adults, particularly those with history of neurologic disease, alcohol use, or psychiatric disease. We present the case of a 40-year-old male with schizophrenia who presented to the emergency room with a long history of pharyngeal foreign body sensation which had recently progressed to include trismus, odynophagia, and dyspnea. Flexible laryngoscopy demonstrated fullness of the right posterior pharyngeal wall and computed tomography (CT) showed a linear opaque foreign body extending from the level of the oropharynx to the thyroid ala. Further history elicited that he stabbed himself in the pharynx two years prior with a toothbrush following a command hallucination. The toothbrush was removed uneventfully via an external approach. The patient was discharged with psychiatry follow-up. This case is unusual due to the submucosal location of the foreign body and the length of retention. It demonstrates the atypical nature which patients with comorbid psychiatric illness may present following foreign body injury and the use of an external surgical approach for the removal of a retained foreign body based on CT reconstruction.
Emergency endoscopic management of dietary foreign bodies in the esophagus.
Lin, Hsuan-Hwai; Lee, Shih-Chun; Chu, Heng-Cheng; Chang, Wei-Kuo; Chao, You-Chen; Hsieh, Tsai-Yuan
2007-07-01
We report our experience of endoscopy in the emergency management of dietary foreign bodies. One hundred thirty-six patients were admitted to the emergency department (ED) between January 1997 and October 2006 for the endoscopic removal of esophageal dietary foreign bodies. They had a mean age of 47.7 years, and 91 (67%) were women. Most of the ingested materials (98.5%) were successfully extracted using either flexible or rigid endoscope. The objects most frequently ingested were fish bones (48%) and chicken bones (46%). Most of the objects (84%) were lodged in the upper esophagus. Two patients with irretrievable foreign bodies or complicated perforations were taken to surgery. Because most of these foreign bodies lodged in the upper esophagus, physicians should take care of this area to avoid secondary injury or complications, especially with sharp bones.
Tsukiyama, Atsushi; Tagami, Takashi; Kim, Shiei; Yokota, Hiroyuki
2014-01-01
Computed tomography (CT) is useful for evaluating esophageal foreign bodies and detecting perforation. However, when evaluation is difficult owing to the previous use of barium as a contrast medium, 3-dimensional CT may facilitate accurate diagnosis. A 49-year-old man was transferred to our hospital with the diagnosis of esophageal perforation. Because barium had been used as a contrast medium for an esophagram performed at a previous hospital, horizontal CT and esophageal endoscopy could not be able to identify the foreign body or characterize the lesion. However, 3-dimensional CT clearly revealed an L-shaped foreign body and its anatomical relationships in the mediastinum. Accordingly, we removed the foreign body using an upper gastrointestinal endoscope. The foreign body was the premaxillary bone of a sea bream. The patient was discharged without complications.
Markov, G; Kondarev, G
1999-01-01
During 1991-1997 period 37 patients with foreign bodies in the esophagus were treated in our clinic. In 36 cases the foreign body was "starlet". That is a construction made for this special purpose. It lodges mainly in the upper digestive tract. The most usual localization is the middle third of the esophagus. Unlike the foreign bodies that impact there by accident the operative activity is very high in these cases. Out of the total number of 37 patients 22 were operated, in 7 cases an endoscopic extraction was performed and in one case the foreign body eliminated spontaneously. Three patients died before we performed any manipulations whatsoever and four of them refused any treatment. We offer methods for treating such patients which in our opinion are the most appropriate ones for this type of pathology.
Managing corneal foreign bodies in office-based general practice.
Fraenkel, Alison; Lee, Lawrence R; Lee, Graham A
2017-03-01
Patients with a corneal foreign body may first present to their general practitioner (GP). Safe and efficacious management of these presentations avoids sight-threatening and eye-threatening complications. Removal of a simple, superficial foreign body without a slit lamp is within The Royal Australian College of General Practitioners' (RACGP's) curriculum and scope of practice. Knowing the rele-vant procedural skills and indications for referral is equally important. The objective of this article is to provide an evidence-based and expert-based guide to the management of corneal foreign bodies in the GP's office. History is key to identifying patient characteristics and mechanisms of ocular injury that are red flags for referral. Examination tech-niques and methods of superficial foreign body removal without a slit lamp are outlined, as well as the procedural threshold for referral to an ophthalmologist.
Tracheobronchial foreign body aspiration in children.
Burton, E M; Brick, W G; Hall, J D; Riggs, W; Houston, C S
1996-02-01
In this retrospective study, we reviewed the demographic and radiographic findings of 155 children with bronchoscopy-proven tracheobronchial foreign body aspiration (FBA). Two thirds of the patients were male, and most were children between 1 and 2 years of age. An aspirated peanut accounted for one third of all cases. Foreign body location was distributed nearly evenly to the right and left primary bronchi; tracheal foreign body was noted in 16 patients. The most frequent symptoms of FBA were cough (85 patients) and wheezing (60 patients). Although most patients were seen within 1 day of aspiration, 30 patients had symptoms that lasted at least 1 week before diagnosis. The most common radiographic findings were unilateral or segmental hyperlucency (59) or atelectasis (38). The trachea was the site of the foreign body in one half of children with a normal chest radiograph and FBA.
Mok, Hoyin; Cheng, Xing; Xu, Qi; Zengel, James R; Parhy, Bandita; Zhao, Jackie; Wang, C. Kathy; Jin, Hong
2012-01-01
Live attenuated recombinant measles vaccine virus (MV) Edmonston-Zagreb (EZ) strain was evaluated as a viral vector to express the ectodomains of fusion protein of respiratory syncytial virus (RSV F) or glycoprotein 350 of Epstein-Barr virus (EBV gp350) as candidate vaccines for prophylaxis of RSV and EBV. The glycoprotein gene was inserted at the 1st or the 3rd position of the measles virus genome and the recombinant viruses were generated. Insertion of the foreign gene at the 3rd position had a minimal impact on viral replication in vitro. RSV F or EBV gp350 protein was secreted from infected cells. In cotton rats, EZ-RSV F and EZ-EBV gp350 induced MV- and insert-specific antibody responses. In addition, both vaccines also induced insert specific interferon gamma (IFN-γ) secreting T cell response. EZ-RSV F protected cotton rats from pulmonary replication of RSV A2 challenge infection. In rhesus macaques, although both EZ-RSV F and EZ-EBV gp350 induced MV specific neutralizing antibody responses, only RSV F specific antibody response was detected. Thus, the immunogenicity of the foreign antigens delivered by measles vaccine virus is dependent on the nature of the insert and the animal models used for vaccine evaluation. PMID:22383906
A mathematical model for foreign body reactions in 2D.
Su, Jianzhong; Gonzales, Humberto Perez; Todorov, Michail; Kojouharov, Hristo; Tang, Liping
2011-02-01
The foreign body reactions are commonly referred to the network of immune and inflammatory reactions of human or animals to foreign objects placed in tissues. They are basic biological processes, and are also highly relevant to bioengineering applications in implants, as fibrotic tissue formations surrounding medical implants have been found to substantially reduce the effectiveness of devices. Despite of intensive research on determining the mechanisms governing such complex responses, few mechanistic mathematical models have been developed to study such foreign body reactions. This study focuses on a kinetics-based predictive tool in order to analyze outcomes of multiple interactive complex reactions of various cells/proteins and biochemical processes and to understand transient behavior during the entire period (up to several months). A computational model in two spatial dimensions is constructed to investigate the time dynamics as well as spatial variation of foreign body reaction kinetics. The simulation results have been consistent with experimental data and the model can facilitate quantitative insights for study of foreign body reaction process in general.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sheth, Rahul; Someshwar, Vimal; Warawdekar, Gireesh
2007-02-15
Purpose. We report our experience of the retrieval of intravascular foreign body objects by the percutaneous use of the Gemini Dormia basket. Methods. Over a period of 2 years we attempted the percutaneous removal of intravascular foreign bodies in 26 patients. Twenty-six foreign bodies were removed: 8 intravascular stents, 4 embolization coils, 9 guidewires, 1 pacemaker lead, and 4 catheter fragments. The percutaneous retrieval was achieved with a combination of guide catheters and the Gemini Dormia basket. Results. Percutaneous retrieval was successful in 25 of 26 patients (96.2%). It was possible to remove all the intravascular foreign bodies with amore » combination of guide catheters and the Dormia basket. No complication occurred during the procedure, and no long-term complications were registered during the follow-up period, which ranged from 6 months to 32 months (mean 22.4 months overall). Conclusion. Percutaneous retrieval is an effective and safe technique that should be the first choice for removal of an intravascular foreign body.« less
Ultrasound detection of simulated intra-ocular foreign bodies by minimally trained personnel.
Sargsyan, Ashot E; Dulchavsky, Alexandria G; Adams, James; Melton, Shannon; Hamilton, Douglas R; Dulchavsky, Scott A
2008-01-01
To test the ability of non-expert ultrasound operators of divergent backgrounds to detect the presence, size, location, and composition of foreign bodies in an ocular model. High school students (N = 10) and NASA astronauts (N = 4) completed a brief ultrasound training session which focused on basic ultrasound principles and the detection of foreign bodies. The operators used portable ultrasound devices to detect foreign objects of varying location, size (0.5-2 mm), and material (glass, plastic, metal) in a gelatinous ocular model. Operator findings were compared to known foreign object parameters and ultrasound experts (N = 2) to determine accuracy across and between groups. Ultrasound had high sensitivity (astronauts 85%, students 87%, and experts 100%) and specificity (astronauts 81%, students 83%, and experts 95%) for the detection of foreign bodies. All user groups were able to accurately detect the presence of foreign bodies in this model (astronauts 84%, students 81%, and experts 97%). Astronaut and student sensitivity results for material (64% vs. 48%), size (60% vs. 46%), and position (77% vs. 64%) were not statistically different. Experts' results for material (85%), size (90%), and position (98%) were higher; however, the small sample size precluded statistical conclusions. Ultrasound can be used by operators with varying training to detect the presence, location, and composition of intraocular foreign bodies with high sensitivity, specificity, and accuracy.
A rare case of foreign body causing recurrent vaginal discharge in prepubertal child.
Gobbur, Vijayalakshmi R; Gobbur, Raghavendra H; Patil, Ashwini G; Endigeri, Preetish
2015-01-01
Vaginal discharge in prepubertal children is mainly due to hypoestrogenic state of vaginal mucosa making it thin and alkaline leading to mucosal invasion by pathogen. In a paediatric case with persistent foul smelling , blood stained vaginal discharge not responding to medical therapy, vaginal foreign body should always be ruled out. Here, we report a 3 -year -old girl with complaint of recurrent vaginal discharge occasionally blood stained not relieved despite few antibiotics courses. On X -ray pelvis, a radioopaque foreign body hair clip was seen. Under sedation foreign body was removed by forceps following which child became asymptomatic.
Ward, W Kenneth; Li, Allen G; Siddiqui, Yasmin; Federiuk, Isaac F; Wang, Xiao-Jing
2008-01-01
The purpose of this study was to better understand whether interleukin-13 (IL-13) and connective tissue growth factor (CTGF) are highly expressed during foreign body encapsulation of subcutaneous devices. Mock biosensors were implanted into rats for three lengths of time (7-, 21- and 48-55 days) to address different stages of the foreign body response. Using quantitative real-time PCR and immunofluorescence, the expression of IL13, CTGF, collagen 1, decorin and fibronectin were measured in this tissue. IL-13, a product of Th2 cells, was highly expressed at all time points, with greatest expression at day 21. The IL-13 expression was paralleled by increased presence of T-cells at all time points. CTGF was also found to be more highly expressed in foreign body tissue than in controls. Collagen and decorin were highly expressed at the middle and later stages. Given the increased expression of IL-13 and CTGF in foreign body tissue, and their roles in other fibrotic disorders, these cytokines may well contribute to the formation of the foreign body capsule. Since the peak gene expression of IL-13 occurred later than the previously-reported TGFbeta expression peak, IL-13 is probably not the major stimulus to TGFbeta expression during foreign body encapsulation and may contribute to fibrosis independently.
Williams, Paul; Jameson, Samuel; Bishop, Phyllis; Sawaya, David; Nowicki, Michael
2013-06-01
Esophageal foreign body impaction (EFBI) is a common problem requiring urgent endoscopy. EFBI may be the first sign of underlying esophageal pathology, yet mucosal biopsies are rarely performed. We report a retrospective analysis of 572 children requiring removal of an EFBI over a 12-year period by pediatric otolaryngologists (ENT), surgeons (PS), and gastroenterologists (PGI). The method of removal [direct laryngoscopy (DL), rigid endoscopy (RE), flexible endoscopy (FE)], type of foreign body (inanimate or food), whether mucosal biopsies were performed, and histologic findings of biopsy samples were recorded for each patient. Foreign body removal was most commonly performed by PGI (298 [52 %]); the remaining were equally distributed between ENT (136 [24 %]) and PS (138 [24 %]). The method of foreign body removal used by ENT was RE (89 %), DL (8 %), and FE (3 %). Pediatric surgery preferred FE (62 %), followed by RE (27 %) and DL (11 %). Pediatric gastroenterology used FE exclusively. Esophageal biopsies were never performed by ENT or PS; PGI performed esophageal biopsies more commonly in children with meat bolus impactions (50 %) than in children with inanimate foreign bodies (12 %). Mucosal pathology was more common in children with meat bolus impaction (100 %) than in children with inanimate foreign bodies (45 %). Esophageal mucosal biopsy should be considered for all children with EFBI not attributed to stricture, particularly those with meat bolus impaction.
Fischer, Kristin; Hendrix, Diane
2012-03-01
To describe six cases of conjunctivitis and ulcerative keratitis secondary to plant foreign bodies from weed-contaminated grass hay which were lodged within the temporal conjunctival fornix in a herd of alpacas. A total of 21 alpacas from the same farm developed blepharospasm and mucopurulent ocular discharge. Six of the 21 were evaluated at the University of Tennessee College of Veterinary Medicine within a 2-week period. The six animals evaluated received an ophthalmic examination including slit-lamp biomicroscopy, fluorescein staining, and topical corneal anesthesia for foreign body removal when necessary. Six animals had conjunctivitis characterized by hyperemia and mucopurulent discharge. Five animals had superficial ulcerative keratitis with intense corneal neovascularization and edema. In all cases, the keratitis was located at the temporal limbus. Seven plant foreign bodies were observed and were removed following topical corneal anesthesia in five animals. The plant seeds were identified as three common weed species found in orchard grass hay. Complete resolution of all clinical signs was achieved with foreign body removal and medical therapy. Fan-shaped temporal corneal ulcers may signify the presence of conjunctival foreign bodies in alpacas. Plant foreign bodies should be considered in addition to ocular infection when multiple animals of a herd are affected as outbreaks may occur with weed-contaminated hay. © 2011 American College of Veterinary Ophthalmologists.
Scholes, Melissa A; Jensen, Emily L
2016-09-01
To examine rates of otolaryngology intervention in children presenting to our emergency department with nasal foreign bodies, factors associated with otolaryngology involvement, rates of complications, and details on nasal button battery exposure. All patients presenting with a nasal foreign body to Children's Hospital Colorado from 2007 to 2012 were identified. Factors leading to referral to otolaryngology and operative intervention were examined, as well as complications. 102 patients were included. 36 (35%) patients were referred to the otolaryngology clinic, of which 58.9% required operating room intervention. 66 (64.7%) children had their nasal foreign bodies removed in the emergency room, however 30 (45%) of these were removed by an otolaryngology resident or attending physician. Overall, 64.7% of nasal foreign bodies required removal by otolaryngology. Of the 15 objects removed in the operating room, six were button batteries. No septal perforations occurred as a result of nasal button battery exposure. Multivariable logistic regression showed two significant predictors of OR removal: age and disc shaped objects. While emergency department providers are comfortable attempting removal of nasal foreign bodies, there was a high rate of otolaryngology intervention. Based on this data, there is a need to educate emergency room providers on nasal anatomy and techniques for nasal foreign body removal. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Optoacoustic multispectral imaging of radiolucent foreign bodies in tissue.
Page, Leland; Maswadi, Saher; Glickman, Randolph D
2013-01-01
Optoacoustic imaging is an emerging medical technology that uniquely combines the absorption contrast of optical imaging and the penetration depth of ultrasound. While it is not currently employed as a clinical imaging modality, the results of current research strongly support the use of optoacoustic-based methods in medical imaging. One such application is the diagnosis of the presence of soft tissue foreign bodies. Because many radiolucent foreign bodies have sufficient contrast for imaging in the optical domain, laser-induced optoacoustic imaging could be advantageous for the detection of such objects. Common foreign bodies have been scanned over a range of visible and near infrared wavelengths by using an optoacoustic method to obtain the spectroscopic properties of the materials commonly associated with these foreign bodies. The derived optical absorption spectra compared quite closely to the absorption spectra generated when using a conventional spectrophotometer. By using the probe-beam deflection technique, a novel, pressure-wave detection method, we successfully generated optoacoustic spectroscopic plots of a wooden foreign body embedded in a tissue phantom, which closely resembled the spectrum of the same object obtained in isolation. A practical application of such spectra is to assemble a library of spectroscopic data for radiolucent materials, from which specific characteristic wavelengths can be selected for use in optimizing imaging instrumentation and provide a basis for the identification of the material properties of particular foreign bodies.
Castaño-Jiménez, Paula A; Trent, Ava M; Bueno, Irene
2016-03-01
Anterior gastrointestinal tract obstruction by a foreign body has been reported in several avian species, most commonly in captive birds. It is often associated with behavioral issues that lead to compulsive consumption of bedding materials or bright moving objects. In penguins, foreign bodies are most commonly identified at necropsy and often are found in the ventriculus because of anatomic characteristics of the species. A captive African black-footed penguin ( Spheniscus demersus ) was diagnosed with a ventricular foreign body. The anatomic and physiologic differences that should be taken into account when surgically removing a ventricular foreign body in a penguin are described. These differences include the caudal location in the coelom and the large size of the ventriculus in proportion to the penguin's body size; the presence of a simple stomach, uniform in thickness and lacking muscular development; a simple gastrointestinal cycle (gastric contraction); and variability in pH of stomach contents. No complications were observed after surgery, and the bird recovered completely. Management of foreign bodies in birds should be based on the clinical signs of the individual bird, the species affected and its anatomic characteristics, the nature and location of the foreign body, available tools, and the preference and experience of the surgeon. This particular case demonstrates that the most indicated and preferred method is not always possible and that knowledge of biologic, anatomic, and physiologic differences of the species may allow the use of an alternative and more invasive approach with favorable outcomes.
Endoscopic management of suspected esophageal foreign body in adults.
Wu, W-T; Chiu, C-T; Kuo, C-J; Lin, C-J; Chu, Y-Y; Tsou, Y-K; Su, M-Y
2011-04-01
Foreign bodies should not be allowed to remain in the esophagus beyond 24 hours after presentation. However, some patients with esophageal foreign body ingestion do not come to the hospital immediately and may delay medical intervention from the time of ingestion. The aim of this study was to investigate the outcomes of adults with suspected esophageal foreign body ingestion according to the time of ingestion and types of foreign bodies. A total of 326 adult patients (151 men and 175 women) were analyzed, and divided into two groups according to the time period: within or beyond 24 hours from ingestion to endoscopic intervention. A total of 172 patients (52.7%) were found to have ingested foreign bodies; 73.5% were removed smoothly, 10.3% were treated by push technique and 16.0% with failed retrieval received alternative treatments. A higher proportion of patients in the beyond-24 hours group suffered from odynophagia (25.9 vs. 12.9%, P < 0.05). Negative identification of esophageal foreign bodies was more frequent in the beyond-24 hours group (67 vs. 40.2%, P < 0.05), but these patients showed higher proportions of esophageal ulcers (21.1 vs. 7.2%, P < 0.05). The beyond-24 hours group also showed a significantly higher rate of foreign bodies in the lower esophagus (40.0 vs. 15.3%, P < 0.05). Patients with esophageal food bolus impaction had significant delayed endoscopic intervention, longer therapeutic endoscopic time, higher proportions of esophageal cancer, stricture and fewer complications. Endoscopic intervention within 24 hours from the time of ingestion should be considered early in adults, because delaying intervention may produce more symptomatic esophageal ulcerations with odynophagia. © 2010 Copyright the Authors. Journal compilation © 2010, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.
Muirhead, J Fraser
2013-02-01
In 1792, a priest in Germany consulted a young doctor about a buried corneal foreign body hidden in a small, hard mass that partly covered the pupil. During removal of the foreign body, the doctor inspected the corneal incision with a microscope to confirm the suspected presence of the foreign body. This may be the first use of a microscope in eye surgery.
Techniques for Intravascular Foreign Body Retrieval
DOE Office of Scientific and Technical Information (OSTI.GOV)
Woodhouse, Joe B.; Uberoi, Raman, E-mail: raman.uberoi@orh.nhs.uk
2013-08-01
As endovascular therapies increase in frequency, the incidence of lost or embolized foreign bodies is increasing. The presence of an intravascular foreign body (IFB) is well recognized to have the potential to cause serious complications. IFB can embolize and impact critical sites such as the heart, with subsequent significant morbidity or mortality. Intravascular foreign bodies most commonly result from embolized central line fragments, but they can originate from many sources, both iatrogenic and noniatrogenic. The percutaneous approach in removing an IFB is widely perceived as the best way to retrieve endovascular foreign bodies. This minimally invasive approach has a highmore » success rate with a low associated morbidity, and it avoids the complications related to open surgical approaches. We examined the characteristics, causes, and incidence of endovascular embolizations and reviewed the various described techniques that have been used to facilitate subsequent explantation of such materials.« less
Corneal injury from a metallic foreign body: an occupational hazard.
Gumus, Koray; Karakucuk, Sarper; Mirza, Ertugrul
2007-09-01
To describe a patient with a corneal injury from a metallic foreign body caused by negligence, and to highlight the importance of measures that must be taken to prevent corneal injuries. A 21-year-old man experienced a foreign body sensation, pain, and redness in his left eye after he cut some iron material without using any eye protection. Slitlamp examination showed a thin, curled piece of iron material stuck into the cornea horizontally. The nasal part had penetrated the nasal tarsal conjunctiva below the upper lid. After removal of the foreign body, the cornea healed without scarring after a short follow-up. A corneal foreign body is a common cause of ocular morbidity and loss of working hours. Most workers do not use protective eyewear during work. By consistently wearing proper safety eyewear, which is the easiest and most effective preventive measure, loss of sight can easily be prevented after an eye injury.
Sugimoto, Mitsuru; Takagi, Tadayuki; Suzuki, Rei; Konno, Naoki; Asama, Hiroyuki; Sato, Yuki; Irie, Hiroki; Watanabe, Ko; Nakamura, Jun; Kikuchi, Hitomi; Waragai, Yuichi; Takasumi, Mika; Hikichi, Takuto; Ohira, Hiromasa
2018-06-14
To investigate the location to which a pancreatic stent should be inserted to prevent post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). Over a ten-year period at our hospital, 296 patients underwent their first ERCP procedure and had a pancreatic stent inserted; this study included 147 patients who had ERCP performed primarily for biliary investigation and had a pancreatic stent inserted to prevent PEP. We divided these patients into two groups: 131 patients with a stent inserted into the pancreatic head (head group) and 16 patients with a stent inserted up to the pancreatic body or tail (body/tail group). Patient characteristics and ERCP factors were compared between the groups. Pancreatic amylase isoenzyme (p-AMY) levels in the head group were significantly higher than those in the body/tail group [138.5 (7.0-2086) vs 78.5 (5.0-1266.5), P = 0.03] [median (range)]. No cases of PEP were detected in the body/tail group [head group, 12 (9.2%)]. Of the risk factors for post-ERCP hyperamylasemia (≥ p-AMY median, 131 IU/L), procedure time ≥ 60 min [odds ratio (OR) 2.65, 95%CI: 1.17-6.02, P = 0.02) and stent insertion into the pancreatic head (OR 3.80, 95%CI: 1.12-12.9, P = 0.03) were identified as independent risk factors by multivariate analysis. Stent insertion up to the pancreatic body or tail reduces the risk of post-ERCP hyperamylasemia and may reduce the risk of PEP.
The national cost burden of bronchial foreign body aspiration in children.
Kim, Irene A; Shapiro, Nina; Bhattacharyya, Neil
2015-05-01
Foreign body aspiration (FBA) continues to be a concerning pediatric problem, accounting for thousands of emergency room visits and more than 100 deaths each year in the United States. The costs incurred with hospitalizations and procedures following these events are the focus of this study. Retrospective review. The Nationwide Inpatient Sample from 2009 to 2011 was analyzed, and all cases with pediatric bronchial foreign body aspirations (International Classification of Diseases-9 codes: 934.0, 934.1, 934.8, and 934.9) were reviewed. Cases were analyzed to determine type of foreign body aspiration, procedural interventions performed, duration of inpatient stay, mortality rate, complications, and posthospitalization disposition. The median length of hospital stay and total costs associated with aspiration events were determined. An estimated 1,908 ± 273 pediatric bronchial FBA patients were admitted annually over the 3-year period (mean age, 3.6 ± 0.3 years; 61.3% ± 1.9% male). The ratio of foreign object aspiration to food aspiration was 5:3. Overall, 56%.0 ± 3.6% of the patients underwent a bronchoscopic procedure for foreign body removal; of those, 41.5% ± 2.5% had a foreign body removed at the time of the endoscopy. The hospital mortality rate associated with bronchial aspiration was 1.8% ± 0.4%; and 2.2% ± 0.5% of patients were diagnosed with anoxic brain injury. The median length of stay was 3 days (25th-75th interquartile range, 1-7 days).The median charges and actual costs per case were $20,820 ($10,800-$53,453) and $6,720 ($3,628-$16,723), respectively. The annual overall inpatient cost associated with pediatric bronchial foreign-body aspiration is approximately $12.8 million. Combined, the rate of death or anoxic brain injury associated with pediatric foreign body is approximately 4%. 2C. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.
Computed tomography diagnosis of a thoracic and abdominal penetrating foreign body in a dog
Appleby, Ryan; zur Linden, Alex; Singh, Ameet; Finck, Cyrielle; Crawford, Evan
2015-01-01
A 1.5-year-old, spayed female, mixed-breed dog was presented for hemoabdomen associated with an abdominal mass. Upon presentation bicavitary effusion was diagnosed. A penetrating intra-abdominal wooden foreign body was identified using computed tomography. This case describes a thoracic penetrating wooden foreign body causing bicavitary effusion following migration into the retroperitoneal space. PMID:26538669
A Rare Case of Foreign Body Causing Recurrent Vaginal Discharge in Prepubertal Child
Gobbur, Raghavendra.H.; Patil, Ashwini.G; Endigeri, Preetish
2015-01-01
Vaginal discharge in prepubertal children is mainly due to hypoestrogenic state of vaginal mucosa making it thin and alkaline leading to mucosal invasion by pathogen. In a paediatric case with persistent foul smelling , blood stained vaginal discharge not responding to medical therapy, vaginal foreign body should always be ruled out. Here, we report a 3 -year -old girl with complaint of recurrent vaginal discharge occasionally blood stained not relieved despite few antibiotics courses. On X -ray pelvis, a radioopaque foreign body hair clip was seen. Under sedation foreign body was removed by forceps following which child became asymptomatic. PMID:25738041
The catheter hub disinfection cap as esophageal foreign body.
Tawfik, Kareem O; Myer, Charles M; Shikary, Tasneem; Goldschneider, Kenneth R
2015-12-01
Disinfection caps are increasingly being used to prevent catheter-associated bloodstream infections. These devices, designed for continuous passive disinfection of catheter hubs, are typically small and often brightly colored. As such, they have the potential to become pediatric airway and esophageal foreign bodies. We report two patients who developed esophageal foreign body following ingestion of disinfection caps. Given the increasing use of these devices, it is imperative that health care providers be aware of this potential iatrogenic problem. We propose that the use of disinfection caps may not be appropriate in pediatric patients with risk factors for foreign body ingestion. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.
Surgical intervention for gastrointestinal foreign bodies in adults: a case series.
Syrakos, Theodoros; Zacharakis, Emmanouil; Antonitsis, Polichronis; Zacharakis, Evangelos; Spanos, Constantinos; Georgantis, G; Kiskinis, Dimitrios
2008-01-01
The aim of our study was to demonstrate our experience regarding the surgical treatment of complications after foreign body ingestion. From 1997 to 2005, we treated 16 adult patients (mean age 44.8 years, range 21-77), who presented with complications after foreign body ingestion. The complications treated were perforation-peritonitis: n = 7 (44%), intra-abdominal abscess formation: n = 5 (31%), upper gastrointestinal bleeding: n = 3 (19%) and inflammatory mass formation: n = 1 (6%) patient. The diagnosis was made intra-operatively in 13 (81.3%) of the cases. The commonest anatomical position of the perforation was the large bowel, in 7 (43%) of the cases. Bony food parts were the commonest foreign bodies accidentally swallowed, in 9 (56%) patients. The median hospital stay was 7 days (2-18), while no death occurred in the postoperative period among the patients of the study. The postoperative morbidity rate was 22.2%. The most common complication after foreign body ingestion was the perforation of the gastrointestinal tract. The risk of perforation was higher when sharp foreign bodies were ingested. The pre-operative diagnosis was difficult, and it was usually achieved intra-operatively. (c) 2008 S. Karger AG, Basel
Deroy, C; Corcuff, J Benoit; Billen, F; Hamaide, A
2015-10-01
To compare complication rates and outcomes after removal of oesophageal foreign bodies by endoscopy or by oesophagotomy. Retrospective evaluation of medical records of dogs with oesophageal foreign bodies treated by endoscopy and/or oesophagotomy. Postoperative clinical signs, management, length of hospitalisation, type and rate of complications, and time interval to return to eating conventional diet were compared. Thirty-nine dogs diagnosed with oesophageal foreign bodies between 1999 and 2011 were included in the study. Most common breeds included West Highland white terrier, Jack Russell terrier and shih-tzu. Successful endoscopic removal was possible in 24 out of 32 cases (Group 1), while surgical removal was successful in 15 out of 15 cases (7 of which had unsuccessful attempts at endoscopic removal) (Group 2). Length of hospitalisation, time to removal of gastrostomy tube and time to eat conventional diet did not differ between the groups. After foreign body removal, the incidence of oesophagitis, oesophageal stricture and perforation observed during repeated endoscopy were similar between the groups. In this retrospective study, removal of oesophageal foreign bodies either by oesophagoscopy or oesophagotomy had a similar outcome. © 2015 British Small Animal Veterinary Association.
Endodontic management of an unusual foreign body in a maxillary central incisor.
Chand, Keerthi; Joesph, Sam; Varughese, Jolly Mary; Nair, Mali G; Prasanth, Santhosh
2013-09-01
The discovery of foreign bodies in the teeth is often diagnosed accidentally. It is commonly seen in children. These foreign objects may act as a potential source of infection and may later lead to a painful condition. Detailed case history, clinical and radiographic examinations are necessary to come to a conclusion about the nature, size, and location of the foreign body, and the difficulty involved in its retrieval. This paper discusses the types of foreign objects found in and around the teeth and reports an unusual case of a stapler pin in the root canal of a tooth, its retrieval, and associated management of the involved teeth.
Oesophageal foreign bodies in dogs: factors affecting success of endoscopic retrieval.
Juvet, Florence; Pinilla, Manuel; Shiel, Robert E; Mooney, Carmel T
2010-03-01
Oesophageal foreign bodies are common in dogs. Endoscopic removal is a viable treatment option but few studies have assessed the clinical and radiographic features that would be useful in decision-making and prognosis.Dogs (n = 44) with oesophageal foreign bodies presented to the University Veterinary Hospital were assessed. Terriers and West Highland White Terriers were significantly overrepresented (p < 0.0001) and in those breeds the foreign body was significantly (p < 0.0001) more likely to be located caudal to the heart base. The majority (88.6%) of foreign bodies were bones or bone fragments.Group 1 (n = 30) included animals where endoscopic removal was successful and Group 2 (n = 14) animals where it was unsuccessful or not attempted because of evidence of oesophageal rupture. There was no statistically significant difference in age, sex, body weight, type, location and size of foreign body, recovery rate, short-term complications and long-term outcome between the two groups. Duration of signs prior to presentation and time to spontaneous oral feeding were significantly longer (p < 0.01 in each case) in Group 2 (five days and 120 hours, respectively) compared to Group 1 (2 days and 24 hours, respectively). Mortality was 11.1%. Long-term follow-up of 29 dogs suggested oesophageal stricture formation manageable by feeding alone in seven (24.1%) cases.Terriers appear predisposed to oesophageal foreign bodies. Success of endoscopic removal is adversely affected by duration of signs prior to presentation. Surgical removal negatively influences time to recovery. Stricture formation appears to be a relatively common complication and alternate measures for its prevention should be sought.
Oesophageal foreign bodies in dogs: factors affecting success of endoscopic retrieval
2010-01-01
Oesophageal foreign bodies are common in dogs. Endoscopic removal is a viable treatment option but few studies have assessed the clinical and radiographic features that would be useful in decision-making and prognosis. Dogs (n = 44) with oesophageal foreign bodies presented to the University Veterinary Hospital were assessed. Terriers and West Highland White Terriers were significantly overrepresented (p < 0.0001) and in those breeds the foreign body was significantly (p < 0.0001) more likely to be located caudal to the heart base. The majority (88.6%) of foreign bodies were bones or bone fragments. Group 1 (n = 30) included animals where endoscopic removal was successful and Group 2 (n = 14) animals where it was unsuccessful or not attempted because of evidence of oesophageal rupture. There was no statistically significant difference in age, sex, body weight, type, location and size of foreign body, recovery rate, short-term complications and long-term outcome between the two groups. Duration of signs prior to presentation and time to spontaneous oral feeding were significantly longer (p < 0.01 in each case) in Group 2 (five days and 120 hours, respectively) compared to Group 1 (2 days and 24 hours, respectively). Mortality was 11.1%. Long-term follow-up of 29 dogs suggested oesophageal stricture formation manageable by feeding alone in seven (24.1%) cases. Terriers appear predisposed to oesophageal foreign bodies. Success of endoscopic removal is adversely affected by duration of signs prior to presentation. Surgical removal negatively influences time to recovery. Stricture formation appears to be a relatively common complication and alternate measures for its prevention should be sought. PMID:21851744
Role of plasma fibronectin in the foreign body response to biomaterials.
Keselowsky, Benjamin G; Bridges, Amanda W; Burns, Kellie L; Tate, Ciara C; Babensee, Julia E; LaPlaca, Michelle C; García, Andrés J
2007-09-01
Host responses to biomaterials control the biological performance of implanted medical devices. Upon implantation, synthetic materials adsorb biomolecules, which trigger an inflammatory cascade comprising coagulation, leukocyte recruitment/adhesion, and foreign body reaction. The foreign body reaction and ensuing fibrous encapsulation severely limit the in vivo performance of numerous biomedical devices. While it is well established that plasma fibrinogen and secreted cytokines modulate leukocyte recruitment and maturation into foreign body giant cells, mediators of chronic inflammation and fibrous encapsulation of implanted biomaterials remain poorly understood. Using plasma fibronectin (pFN) conditional knock-out mice, we demonstrate that pFN modulates the foreign body response to polyethylene terephthalate disks implanted subcutaneously. Fibrous collagenous capsules were two-fold thicker in mice depleted of pFN compared to controls. In contrast, deletion of pFN did not alter acute leukocyte recruitment to the biomaterial, indicating that pFN modulates chronic fibrotic responses. The number of foreign body giant cells associated with the implant was three times higher in the absence of pFN while macrophage numbers were not different, suggesting that pFN regulates the formation of biomaterial-associated foreign body giant cells. Interestingly, cellular FN (cFN) was present in the capsules of both normal and pFN-depleted mice, suggesting that cFN could not compensate for the loss of pFN. These results implicate pFN in the host response to implanted materials and identify a potential target for therapeutic intervention to enhance the biological performance of biomedical devices.
Foreign bodies in a pediatric emergency department in South Africa.
Timmers, Maarten; Snoek, Kitty G; Gregori, Dario; Felix, Janine F; van Dijk, Monique; van As, Sebastian A B
2012-12-01
Foreign body-related pediatric trauma has a high incidence, but studies with large data sets are rare and typically stem from Western settings. The aim of this study was to identify characteristics of foreign body-related trauma in children treated at our trauma unit in South Africa. In this retrospective study, we analyzed all foreign body-related trauma admissions from 1991 to 2009. We collected detailed data including age, sex, type of foreign body, injury severity, and anatomical location of the foreign body. We analysed 8149 cases. Marginally more boys (54.9%) than girls were involved. The overall median age was 3 years (interquartile range, 2-6 years); 78.8% were younger than 7 years. The predominant anatomical sites were the respiratory tract and the gastrointestinal tract (39.1%); ears (23.9%); nose (19.4%); and extremities (8.8%). The commonest objects were coins (20.8 %), (parts of) jewelry (9.5%), and food (8.7%). Three quarters (74.5%) of patients presented between 1 and 2 hours after the injury (median, 1 hour). A total of 164 cases (2.0%) were marked as possible child abuse; 17 cases were filed as confirmed child abuse. Preventive parent education programs targeting foreign body-related injury should mainly focus on both sexes younger than 7 years. Parents should be taught to keep small objects out of reach of young children, especially coins, because these most often result in a trauma unit visit.
Olms, Kai; Randt, Thorsten; Reimers, Nils; Zander, Nils; Schulz, Arndt P
2014-01-01
Reconstructive osteotomies for the treatment of Hallux valgus are among the most prevalent procedures in foot and ankle surgery. The combination of biodegradable materials with an innovative method for fixation by application of ultrasonic energy facilitates a new bonding method for fractures or osteotomies. As clinical experience is still limited, the aim of this study was to assess the safety and performance of the SonicPin system for fixation of Austin/Chevron osteotomies. Chevron osteotomy was performed on 30 patients for the treatment of Hallux valgus. The used SonicPins were made from polylactide and are selectively melted into the cancellous bone structure during insertion by ultrasonic energy. Patients were followed for one year, which included X-ray and MRI examinations as well as evaluation of life quality by EQ-5D (EuroQol). The MRI after three months showed adequate bone healing in all cases and no signs of foreign body reactions, which was again confirmed by MRI 12 months postoperatively. The bony healing after 12 months was uneventful without any signs of foreign body reactions. In summary, based on the low complication rate and the significant improvement in health related quality of life (EQ-5D) reported in this study, fixation of an Austin/Chevron osteotomy with a SonicPin for treatment of Hallux valgus can be considered to be safe and efficient over the short term. Therapeutic Level III.
Olms, Kai; Randt, Thorsten; Reimers, Nils; Zander, Nils; Schulz, Arndt P.
2014-01-01
Reconstructive osteotomies for the treatment of Hallux valgus are among the most prevalent procedures in foot and ankle surgery. The combination of biodegradable materials with an innovative method for fixation by application of ultrasonic energy facilitates a new bonding method for fractures or osteotomies. As clinical experience is still limited, the aim of this study was to assess the safety and performance of the SonicPin system for fixation of Austin/Chevron osteotomies. Chevron osteotomy was performed on 30 patients for the treatment of Hallux valgus. The used SonicPins were made from polylactide and are selectively melted into the cancellous bone structure during insertion by ultrasonic energy. Patients were followed for one year, which included X-ray and MRI examinations as well as evaluation of life quality by EQ-5D (EuroQol). The MRI after three months showed adequate bone healing in all cases and no signs of foreign body reactions, which was again confirmed by MRI 12 months postoperatively. The bony healing after 12 months was uneventful without any signs of foreign body reactions. In summary, based on the low complication rate and the significant improvement in health related quality of life (EQ-5D) reported in this study, fixation of an Austin/Chevron osteotomy with a SonicPin for treatment of Hallux valgus can be considered to be safe and efficient over the short term. Level of Clinical Evidence: Therapeutic Level III. PMID:24851140
A cast metal core for a deformed implant body: case report.
Soeno, Kohyoh; Jimbo, Ryo; Sawase, Takashi; Taira, Yohsuke
2006-12-01
The present report consists of a clinical evaluation of an osseointegrated implant using a cast metal core instead of abutment for a deformed implant body. The intramobile connector insert for the implant in the mandibular left first premolar region broke 7 years after the superstructure was attached to the implant system. The intramobile connector insert was replaced, and the prosthesis was reattached, but the new intramobile connector insert broke again 2 weeks later. A thorough examination confirmed deformation of the upper section of the implant body in the mandibular left first molar region. Breakage of the new intramobile connector insert in the mandibular left first premolar region was believed to be due to deformation of the implant body in the mandibular left first molar region. Therefore, a cast metal core was used to deal with the deformation of the implant body in this region. Although slight bone resorption was observed around the implant body after 5 years, no major problems were found in the implant body itself.
Reticular foreign bodies. Causative or coincidence?
Farrow, C S
1999-07-01
A radiographically identified penetrating reticular foreign body is a near-certain cause of traumatic reticulitis, parareticular abscessation, or peritonitis. An extrareticular wire or nail is the most likely cause of reticulitis or peritonitis in an animal with compatible clinical signs. An immobile reticular foreign body may be trapped in the reticular mucosa, penetrating a mucosal fold (but not the reticular wall), or piercing the wall of the reticulum.
[Intrabronchial migratory cereal-ear, an unusual foreign body inhalation].
Douira-Khomsi, W; Merghni, A; Louati, H; Ben Hassine, L; Khemakhem, R; Ould Mohamed Sghair, Y; Jlidi, S; Hamzaoui, M; Chaouachi, B; Bellagha, I
2009-09-01
Bronchial foreign body inhalation is a frequent and potentially serious accident in children. It can provoke long-term complications such as bronchiectasis and recurrent pulmonary infections. The foreign body is generally blocked in a bronchus and induces obstructive emphysema with superinfection. We report 2 cases of bronchial inhalation of a migrating cereal-ear, eliminated by parietal fistulization, in 9- and 11-year-old boys.
Knife blade as a facial foreign body.
Gardner, P A; Righi, P; Shahbahrami, P B
1997-08-01
This case demonstrates the unpredictability of foreign bodies in the face. The retained knife blade eluded detection on two separate examinations. The essential components to making a correct diagnosis of a foreign body following a stabbing to the face include a thorough review of the mechanism of injury, a complete head and neck examination, a high index of suspicion, and plain radiographs of the face.
Musharova, Olga; Klimuk, Evgeny; Datsenko, Kirill A; Metlitskaya, Anastasia; Logacheva, Maria; Semenova, Ekaterina; Severinov, Konstantin; Savitskaya, Ekaterina
2017-04-07
During primed CRISPR adaptation spacers are preferentially selected from DNA recognized by CRISPR interference machinery, which in the case of Type I CRISPR-Cas systems consists of CRISPR RNA (crRNA) bound effector Cascade complex that locates complementary targets, and Cas3 executor nuclease/helicase. A complex of Cas1 and Cas2 proteins is capable of inserting new spacers in the CRISPR array. Here, we show that in Escherichia coli cells undergoing primed adaptation, spacer-sized fragments of foreign DNA are associated with Cas1. Based on sensitivity to digestion with nucleases, the associated DNA is not in a standard double-stranded state. Spacer-sized fragments are cut from one strand of foreign DNA in Cas1- and Cas3-dependent manner. These fragments are generated from much longer S1-nuclease sensitive fragments of foreign DNA that require Cas3 for their production. We propose that in the course of CRISPR interference Cas3 generates fragments of foreign DNA that are recognized by the Cas1-Cas2 adaptation complex, which excises spacer-sized fragments and channels them for insertion into CRISPR array. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.
FOREIGN-BODIES IN THE EAR, NOSE AND ESOPHOGUS IN PEDIATRIC AGE GROUP, AT MEKELLE HOSPITAL ETHIOPIA.
Hagos, Mekonnen
2015-04-01
The ingestion of foreign body is a common problem in children, some of which may cause damage or may be associated with toxicity. To evaluate and analyze the pattern of foreign bodies in children in the esophagus, ears and nose with review of the techniques for removal in the emergency department. From Sept 1, 2008 to May 30, 2010, a review of all children with foreign bodies in the esophagus, ears and in the nose was done to assess the patterns and treatment outcomes. The source and the study group were (N-72). Data concerning socio- demographics, characterization, presenting symptoms and signs, techniques of retrieval and outcomes were extracted and filled in a previously prepared protocol sheet. Descriptive analysis was done using SPSS- computer statistical software. During the study period, 72 children, victims of foreign bodies in the esophagus, ears and in the nose were included in the study. Of these 44 (61.1%), 28 (38.9%) were male and female children, respectively. The age ranged from 11 months to 14 years with (mean = 4 years). The most affected age group was between 0-5 years accounting for 46 (63.9%) followed by the age group between 6-10 years accounting for 20 (27.8%) of all cases. Males 44 (61.1%) were predominantly most affected than females 28 (38.8%). The location of foreign bodies in this study were in the ears 45 (62.5%), esophagus 17 (23.6%) and in the nose 10 (13.9%) in order of their frequency. Swallowed foreign bodies were successfully removed by Magill forceps. Foreign bodies in the ears and in the nose were removed by careful but different techniques depending on the type and the clinical condition of the patient at time of intervention. Our study revealed a higher number of patients with foreign bodies in the ears and in the esophagus. Only a small number ofpatients presented with FBS in the nose. Food items in the ears, in the nose and coins in the esophagus were items frequently observed. Early suspicion, early diagnosis and prompt intervention have attributed to reduce morbidities of major events.
Ear, Nose and Throat Foreign Bodies Removed under General Anaesthesia: A Retrospective Study.
Shunyu, Neizekhotuo Brian; Akhtar, Hanifa; Karim, Habib Md Rezaul; Lyngdoh, Nari M; Yunus, Md; Jamil, Md
2017-02-01
For Otorhinolaryngologist, removal of Foreign Bodies (FB) from the ear, nose and throat is one of the common emergency procedures done. Most of the cases especially of the ear and nose can be managed without General Anaesthesia (GA). But in some cases GA may be needed. There are very few studies that address the scenario of ear, nose and throat foreign body that required GA for its removal and the complications associated with it. This study was conducted with the aim to study the patient's profile, types and distribution of FB removed under GA, and the associated complications. The present study is a hospital based retrospective, cross-sectional study conducted in the Department of Otorhinolaryngology in association with Department of Anaesthesiology and Critical Care in North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India from year 2009 to 2014. Information was collected from indoor patient file and operation record book. Those patients where foreign body was not found after examination under GA were excluded. A total of 112 cases of foreign body in ear, nose and throat removed under GA were selected. There was variation of age from youngest case being 11 months to 74 years with a slight male predominance. Two third of the patients belonged to paediatric age group. Most of the FB were inanimate with high number of inorganic type found in majority. Foreign body in food passage was found in most cases. Coin and meat bone were the common FB in children and adults respectively. We found no complications related to removal of foreign body from the food passage and nose. But some complications were seen in foreign body of ear and tracheo-bronchial tree. Ear, nose and throat FB that required GA were seen in all age groups. FB of food passage constitute the majority. Type of foreign body varies between children and adults. In children most common types were related to toys and their part and food materials. In adults, food materials were most common.
Cho, Nakwon
1980-01-01
A positive acting valve suitable for operation in a corrosive environment is provided. The valve includes a hollow valve body defining an open-ended bore for receiving two, axially aligned, spaced-apart, cylindrical inserts. One insert, designated the seat insert, terminates inside the valve body in an annular face which lies within plane normal to the axis of the two inserts. An elastomeric O-ring seal is disposed in a groove extending about the annular face. The other insert, designated the wedge insert, terminates inside the valve body in at least two surfaces oppositely inclined with respect to each other and with respect to a plane normal to the axis of the two inserts. An elongated reciprocable gate, movable between the two inserts along a path normal to the axis of the two inserts, has a first flat face portion disposed adjacent and parallel to the annular face of the seat insert. The gate has a second face portion opposite to the first face portion provided with at least two oppositely inclined surfaces for mating with respective inclined surfaces of the wedge insert. An opening is provided through the gate which registers with a flow passage through the two inserts when the valve is open. Interaction of the respective inclined surfaces of the gate and wedge insert act to force the first flat face portion of the gate against the O-ring seal in the seat insert at the limits of gate displacement where it reaches its respective fully open and fully closed positions.
Zhang, Zhenyu; Zhao, Wei; Li, Deshan; Yang, Jinlong; Zsak, Laszlo; Yu, Qingzhong
2015-08-01
In the present study, we developed a novel approach for foreign gene expression by Newcastle disease virus (NDV) from a second ORF through an internal ribosomal entry site (IRES). Six NDV LaSota strain-based recombinant viruses vectoring the IRES and a red fluorescence protein (RFP) gene behind the nucleocapsid (NP), phosphoprotein (P), matrix (M), fusion (F), haemagglutinin-neuraminidase (HN) or large polymerase (L) gene ORF were generated using reverse genetics technology. The insertion of the second ORF slightly attenuated virus pathogenicity, but did not affect ability of the virus to grow. Quantitative measurements of RFP expression in virus-infected DF-1 cells revealed that the abundance of viral mRNAs and red fluorescence intensity were positively correlated with the gene order of NDV, 3'-NP-P-M-F-HN-L-5', proving the sequential transcription mechanism for NDV. The results herein suggest that the level of foreign gene expression could be regulated by selecting the second ORF insertion site to maximize the efficacy of vaccine and gene therapy.
Endodontic management of an unusual foreign body in a maxillary central incisor
Chand, Keerthi; Joesph, Sam; Varughese, Jolly Mary; Nair, Mali G; Prasanth, Santhosh
2013-01-01
The discovery of foreign bodies in the teeth is often diagnosed accidentally. It is commonly seen in children. These foreign objects may act as a potential source of infection and may later lead to a painful condition. Detailed case history, clinical and radiographic examinations are necessary to come to a conclusion about the nature, size, and location of the foreign body, and the difficulty involved in its retrieval. This paper discusses the types of foreign objects found in and around the teeth and reports an unusual case of a stapler pin in the root canal of a tooth, its retrieval, and associated management of the involved teeth. PMID:24082582
Foreign body aspiration in adult airways: therapeutic approach
Hewlett, Justin C.; Rickman, Otis B.; Lentz, Robert J.; Prakash, Udaya B.
2017-01-01
Tracheobronchial foreign body (FB) aspiration is an uncommon but potentially life-threatening event in adults. Symptoms typically consist of a choking event followed by cough and dyspnea, however, these findings are inconsistent and symptoms may mimic more chronic lung diseases such as asthma or chronic obstructive pulmonary disease. Chest radiography and computed tomography can provide information regarding the location and characteristics of foreign bodies and aid in diagnosis. Bronchoscopy remains the gold standard for diagnosis and management of FB aspiration. The authors describe the typical clinical presentation, diagnostic evaluation, and bronchoscopic management of foreign bodies in adult airways with a focus on bronchoscopic techniques and potential complications of FB extraction. PMID:29221325
Ingested bone fragment in the bowel: Two cases and a review of the literature.
Emir, Seyfi; Ozkan, Zeynep; Altınsoy, Hasan Baki; Yazar, Fatih Mehmet; Sözen, Selim; Bali, Ilhan
2013-10-16
Generally, ingested foreign bodies are excreted from the digestive tract without any complications or morbidity. In adults, ingestion of foreign bodies frequently occurs in alcoholics and elderly individuals with dentures. The most commonly ingested foreign bodies are food stuffs or their parts, such as fish bones or fragments of bone and phytobezoars. Sharp foreign bodies like fish and chicken bones can lead to intestinal perforation and peritonitis. We report herein two cases, one of bowel perforation and another of anal impaction, both caused by ingested bone fragments. Complications due to ingested bone fragments are not common and preoperative diagnosis remains a challenge and therefore it must be considered in susceptible cases.
Hearing aid silicone impression material as a foreign body in the middle ear.
Lee, Hyun-Min; Yi, Keun-Ik; Jung, Jae-Hoon; Lee, Il-Woo
We report an extremely rare case of hearing aid silicone impression material as a foreign body in the middle ear. Symptoms of the patient were otorrhea and vertigo after taking of a mold impression on his only hearing ear, and the symptoms mimicked chronic otitis media. A temporal bone CT scan revealed foreign body material in the middle ear and Eustachian tube. An intact canal wall mastoidectomy with a facial recess approach and type IV tympanoplasty was performed to remove the silicone impression material. In addition to the case report, we review the literature regarding impression material foreign bodies. Copyright © 2016 Elsevier Inc. All rights reserved.
Investigations of foreign bodies in the fore-stomach of cattle at Ngoma Slaughterhouse, Rwanda.
Mushonga, Borden; Habarugira, Gervais; Musabyemungu, Aline; Udahemuka, Jean C; Jaja, Festus I; Pepe, Dunisani
2015-07-30
Ingestion of indigestible foreign bodies in cattle is a pathological condition of both economic and health importance. It is has mostly been reported in association with feed scarcity. The aim of this study was to investigate the occurrence and nature of indigestible foreign materials in abattoir fore-stomach specimens in Ngoma district, Rwanda. Each chamber was opened by incision, then given a thorough macroscopic examination by visual inspection and palpation for the presence of foreign materials. The results show that there is an overall occurrence of 17.4% foreign bodies in cattle. The highest occurrence (25.3%) was recorded in June (the driest month). Results further show that the majority of the foreign bodies were plastics (65.0%). More foreign bodies (29.5%) were found in older animals (5 years and above) than in younger and middle-aged animals (16.5 % and 6.0%, respectively). There was a higher prevalence of foreign bodies in female cattle (20.0%) than in males (15.7%). The presence of cassette tape, as observed in the study, has not been reported elsewhere. The high representation of plastics in animals (65.5%) in the light of a government plastic bag ban in supermarkets presents a major challenge to livestock production in Rwanda. What is disturbing is that it is not known if this problem is increasing or decreasing as there are no previous studies for comparison. However, the results will serve as a reference point for future studies to understand the true trend and true burden of plastic bags in livestock.
Intraorbital foreign body projectile as a consideration for unilateral pupillary defect
2012-01-01
Intraorbital foreign bodies are frequently the result of high-velocity injuries with varying clinical presentations. The resultant diagnosis, management, and outcome depend on the type of foreign body present, anatomical location, tissue disruption, and symptomatology. A patient who presented to the Emergency Department with a large intraorbital foreign body projectile that was not evident clinically, but found incidentally on computed tomography and subsequent plain films is reported. The emergency room physician needs to be aware of the differential diagnosis of a unilateral irregular pupil with or without visual acuity changes. The differential diagnosis for any trauma patient with an irregular pupil with significant visual loss must include intraorbital foreign body and associated injury to the optic nerve directly or via orbital compartment syndrome secondary to hemorrhage and/or edema. Patients with significantly decreased visual acuity may benefit from emergent surgical intervention. In patients with intact visual acuity, the patient must be monitored closely for any visual changes as this may require emergent surgical intervention. PMID:22390406
Foreign body aspiration in children: A study of children who lived or died following aspiration.
Mohammad, Maha; Saleem, Mohammad; Mahseeri, Mohamad; Alabdallat, Imad; Alomari, Ali; Za'atreh, Ala'; Qudaisat, Ibraheem; Shudifat, Abdulrahman; Nasri Alzoubi, Mohammad
2017-07-01
Foreign body aspiration (FBA) is a preventable cause of mortality and morbidity in children. We conducted a chart review of children who presented to a university hospital due to FBA in the period 1999-2014. Children were either managed with bronchoscopy for removal of the foreign body or died due to FBA. A total of 103 children were seen due to FBA including 27 deaths. The majority of children were boys and were less than 3 years old. Most aspirated foreign bodies were food-related, mainly peanuts. The majority of children presented with acute choking incidents, a smaller number presented with recurrent chest infections, and few children's choking incidents were unwitnessed. X-ray had a high rate of false negatives and bronchoscopy was the gold standard technique for assessment and management. Aspiration of foreign bodies is a preventable, life-threatening condition that calls for increased parent education and awareness. Copyright © 2017 Elsevier B.V. All rights reserved.
[Foreign bodies aspiration in pediatrics. 15-year experience. Analysis of 337 cases].
Aguirre Vázquez, I R; Blanco Rodríguez, G; Penchyna Grub, J; Teyssier Morales, G; Serrano Salas, A L
2013-01-01
Foreign body aspiration is a pediatric urgency that occurs primarily between 1 and 3 years old. The aim of this paper is to present the symptomatology, clinical and radiological findings, and the therapeutic used in our hospital with patients with foreign body aspiration diagnosis from 1995 until 2011. Patient's age was between 0 and 16 years old. We included 337 patients; where males predominate (205). The medium age was 23 months. The most frequent foreign bodies founded were seeds (192) in 57% and metallic objects in 18.3%. Cough (74.5%), dyspnea (70%), cyanosis (42.4%) and stridor (26%), were the main symptoms. Right bronchus was the most frequent localization (37.7%). In 21% of the patients the reference diagnostic was wrong due to treating it as a respiratory infection. All foreign bodies were extracted by rigid bronchoscopy. No deaths were reported in any proceeding. In our experience, infants are the most affected group, and the primordial symptoms are cough and dyspnea. Organic objects had the highest prevalence of aspiration.
Detecting Foreign Bodies in a Head Laceration
Fowler, Thomas R.; Crellin, Steven J.; Greenberg, Marna Rayl
2015-01-01
Open wounds represent a potential area of medicolegal risk if foreign bodies are not identified prior to wound closure. The importance of imaging of lacerations was underscored by a recent case where a 20-year-old male collided with a friend's mouth on a trampoline sustaining a simple, superficial scalp laceration. The wound was evaluated in typical fashion including irrigation and local exploration and was prepared for closure. The friend was then evaluated and noted to have multiple extensive dental fractures. An increased index of suspicion generated further evaluation of the first patient's wound. Plain radiography obtained of the first patient's skull was noted to have bony foreign bodies consistent with teeth, which were then removed after further exploration. Superficial wounds are common and complications arising from retained foreign bodies are a potential source of substantial morbidity and consequently medical litigation. This case serves as a reminder to be vigilant and maintain a high index of suspicion regarding the potential for foreign body. PMID:25802770
Detecting foreign bodies in a head laceration.
Fowler, Thomas R; Crellin, Steven J; Greenberg, Marna Rayl
2015-01-01
Open wounds represent a potential area of medicolegal risk if foreign bodies are not identified prior to wound closure. The importance of imaging of lacerations was underscored by a recent case where a 20-year-old male collided with a friend's mouth on a trampoline sustaining a simple, superficial scalp laceration. The wound was evaluated in typical fashion including irrigation and local exploration and was prepared for closure. The friend was then evaluated and noted to have multiple extensive dental fractures. An increased index of suspicion generated further evaluation of the first patient's wound. Plain radiography obtained of the first patient's skull was noted to have bony foreign bodies consistent with teeth, which were then removed after further exploration. Superficial wounds are common and complications arising from retained foreign bodies are a potential source of substantial morbidity and consequently medical litigation. This case serves as a reminder to be vigilant and maintain a high index of suspicion regarding the potential for foreign body.
Late sequelae of retained foreign bodies after world war II missile injuries.
Surov, Alexey; Thermann, Florian; Behrmann, Curd; Spielmann, Rolf-Peter; Kornhuber, Malte
2012-09-01
A number of people injured during the second world war harbour foreign bodies such as grenade splinters or bullets in some part of the body. Most of these metal fragments remain clinically silent. Some of them, however, may cause delayed complications. The purpose of this study was to determine the characteristics of delayed complications associated with foreign bodies after world war II injuries. 159 patients with retained foreign bodies after world war II injuries were retrospectively identified radiologically in our data bases in the time interval from 1997 to 2009. Diverse delayed complications secondary to the metal objects were diagnosed in 3 cases (2%): one patient with grenade splinter migration into the choledochal duct, one case with pseudotumoural tissue reaction, and one patient with late osteomyelitis. The time from injury to clinical presentation varied from 56 to 61 years. PubMed and Medline were screened for additional cases with delayed sequelae after foreign body acquisition during the 2nd world war. A 30 year search period from 1980 up to date was selected. 15 cases were identified here. Our study demonstrates that health consequences of the 2nd world war extend into the present time, and therefore physicians should be aware of the presence of hidden foreign bodies and their different possible late reactions. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.
Foreign body aspiration in dentistry: a review.
Cameron, S M; Whitlock, W L; Tabor, M S
1996-08-01
This article reviews the dangers of aspirating foreign bodies of dental origin. Two illustrative cases are presented, including an unusual case involving aspiration of an elastomeric impression material. The authors describe the techniques used to identify the foreign body. A radiodensimetric study of four impression materials demonstrates the difficulty of identifying most impression materials. The authors also present some strategies for reducing the risk of aspiration during dental procedures.
Foreign body aspiration in infants and toddlers: recent trends in British Columbia.
Morley, Rebecca E; Ludemann, Jeffrey P; Moxham, J Paul; Kozak, Frederick K; Riding, Keith H
2004-02-01
The objectives of this study were to (1) examine recent trends in the demographics and presentation of children with foreign body aspiration at British Columbia's Children's Hospital and (2) develop safety guidelines regarding feeding nuts and other hard, crunchy foods to infants and toddlers. The methods used were a retrospective chart review and a review of swallowing mechanics in early childhood. Between July 1997 and July 2001, 51 children under 3 years of age underwent rigid bronchoscopy for suspected foreign body aspiration. Of these patients, 27 (53%) were 18 months of age or younger. Of these 27 infants and toddlers, 24 (89%) had a witnessed choking event and 22 (81%) had an airway foreign body. Nuts, raw carrots, and popcorn kernels accounted for 14 (64%) of the foreign bodies aspirated by these infants and toddlers. Before 2 years of age, children are poorly equipped to grind and swallow hard, crunchy food because they lack second molars and are still adjusting to the descent of the larynx. Infants and toddlers in British Columbia have been aspirating foreign bodies at an alarmingly high rate. Most cases would have been prevented with better public awareness. Caregivers should be informed that children under 3 years of age should never be fed nuts or other hard, crunchy foods. A public awareness campaign is warranted.
Webb, Joanna; Graham, Jennifer; Fordham, Margaret; DeCubellis, Julie; Buckley, Faith; Hobbs, Joshua; Berent, Allyson; Weisse, Chick
2017-08-15
CASE DESCRIPTION 3 ferrets (Mustela putorius furo), aged 1 to 2 years, were referred for evaluation of a 4-day to 2-week history of gastrointestinal signs, including anorexia, regurgitation, and vomiting. CLINICAL FINDINGS All 3 ferrets had clinical signs suggestive of dysphagia or esophagitis on initial examination. Esophagoscopy, barium-contrast esophagography, or both revealed foreign bodies with mucosal inflammation in 1 patient and an esophageal foreign body with stricture in 2 patients. One of the latter ferrets had a recent history of gastrotomy to remove a foreign body. TREATMENT AND OUTCOME 1 ferret was treated with endoscopic retrieval of the foreign bodies. Esophageal stricture was treated in 2 ferrets by means of endoscopic balloon dilation accompanied by placement of an esophageal stent in 1 ferret. After resolution of clinical signs and completion of all prescribed treatments, 2 of 3 ferrets successfully transitioned to a regular hard kibble diet; 1 ferret remained on a soft diet for 2 years. All owners were satisfied with the outcome of treatment. CLINICAL RELEVANCE Ferrets are prone to foreign body ingestion. Results of this small series of cases suggested that minimally invasive techniques may be useful for the management of esophageal disease in this species.
Unusual presentation of cactus spines in the flank of an elderly man: a case report
2010-01-01
Introduction Splinters and spines of plant matter are common foreign bodies in skin wounds of the extremities, and often present embedded in the dermis or subcutaneous tissue. Vegetative foreign bodies are highly inflammatory and, if not completely removed, can cause infection, toxic reactions, or granuloma formation. Older patients are at increased risk for infection from untreated plant foreign bodies. The most common error in plant splinter and spine management is failure to detect their presence. Case presentation Here we report a case of cactus spines in an 84-year-old Caucasian man presenting on the right flank as multiple, red papules with spiny extensions. This presentation was unusual both in location and the spinous character of the lesions, and only after punch biopsy analysis was a diagnosis of cactus matter spines made. Conclusions Our patient presented with an unusual case of cactus spines that required histopathology for identification. Skin lesions with neglected foreign bodies are a common cause of malpractice claims. If not removed, foreign bodies of the skin, particularly in elderly individuals, can result in inflammatory and infectious sequela. This report underscores the importance of thoroughly evaluating penetrating skin lesions for the presence of foreign bodies, such as splinters and spines. PMID:20500838
Nasal Foreign Bodies: A Sweet Experiment.
Leopard, D C; Williams, R G
2015-10-01
It is generally accepted that paediatric intranasal foreign bodies should be removed in the emergency setting. In the case of a difficult to access dissolvable foreign body in an uncooperative child, the question must be raised regarding whether or not a watch and wait strategy is more appropriate. We ask: How long does it take for popular sweets (candy) to dissolve in the human nose? Five popular UK sweets were placed in the right nasal cavity of a 29-year-old male (the author) with no sino-nasal disease. Time taken to dissolve was recorded. All five sweets were completely dissolved in under one hour. A watch and wait strategy in favour of examination under anaesthetic may be a viable option in some cases. Limitations of the study include the age of the participant and size of the sweets. It is also important in practice that the clinician is able to elicit an accurate history regarding the exact nature of the foreign body. It remains prudent to perform an examination under anaesthetic of an uncooperative child with a solid or unknown nasal foreign body. However, if the clinician can be certain the foreign body is a small sugar or chocolate based sweet only, a watch and wait strategy may be a reasonable choice. © 2015 John Wiley & Sons Ltd.
Kamakura, Takefumi; Nadol, Joseph B
2016-09-01
Cochlear implantation is an effective, established procedure for patients with profound deafness. Although implant electrodes have been considered as biocompatible prostheses, surgical insertion of the electrode induces various changes within the cochlea. Immediate changes include insertional trauma to the cochlea. Delayed changes include a tissue response consisting of inflammation, fibrosis and neo-osteogenesis induced by trauma and an immunologic reaction to a foreign body. The goal of this study was to evaluate the effect of these delayed changes on the word recognition scores achieved post-operatively. Seventeen temporal bones from patients who in life had undergone cochlear implantation were prepared for light microscopy. We digitally calculated the volume of fibrous tissue and new bone within the cochlea using Amira(®) three-dimensional reconstruction software and assessed the correlations of various clinical and histologic factors. The postoperative CNC word score was positively correlated with total spiral ganglion cell count. Fibrous tissue and new bone were found within the cochlea of all seventeen specimens. The postoperative CNC word score was negatively correlated with the % volume of new bone within the scala tympani, scala media/vestibuli and the cochlea, but not with the % volume of fibrous tissue. The % volume of new bone in the scala media/vestibuli was positively correlated with the degree of intracochlear insertional trauma, especially trauma to the basilar membrane. Our results revealed that the % volume of new bone as well as residual total spiral ganglion cell count are important factors influencing post-implant hearing performance. New bone formation may be reduced by limiting insertional trauma and increasing the biocompatibility of the electrodes. Copyright © 2016 Elsevier B.V. All rights reserved.
Kamakura, Takefumi; Nadol, Joseph B
2016-01-01
Cochlear implantation is an effective, established procedure for patients with profound deafness. Although implant electrodes have been considered as biocompatible prostheses, surgical insertion of the electrode induces various changes within the cochlea. Immediate changes include insertional trauma to the cochlea. Delayed changes include a tissue response consisting of inflammation, fibrosis and neo-osteogenesis induced by trauma and an immunologic reaction to a foreign body. The goal of this study was to evaluate the effect of these delayed changes on the word recognition scores achieved post-operatively. Seventeen temporal bones from patients who in life had undergone cochlear implantation were prepared for light microscopy. We digitally calculated the volume of fibrous tissue and new bone within the cochlea using Amira® three-dimensional reconstruction software and assessed the correlations of various clinical and histologic factors. The postoperative CNC word score was positively correlated with total spiral ganglion cell count. Fibrous tissue and new bone were found within the cochlea of all seventeen specimens. The postoperative CNC word score was negatively correlated with the % volume of new bone within the scala tympani, scala media/vestibuli and the cochlea, but not with the % volume of fibrous tissue. The % volume of new bone in the scala media/vestibuli was positively correlated with the degree of intracochlear insertional trauma, especially trauma to the basilar membrane. Our results revealed that the % volume of new bone as well as residual total spiral ganglion cell count are important factors influencing post-implant hearing performance. New bone formation may be reduced by limiting insertional trauma and increasing the biocompatibility of the electrodes. PMID:27371868
[Foreign body aspiration in children: ten-years experience at the Ha'Emek Medical Center].
Shlizerman, Lev; Ashkenazi, Dror; Mazzawi, Salim; Rakover, Yosef
2006-08-01
Foreign body aspiration is common in young children. Delay in treatment may lead to complications and an emergency bronchoscopy must be performed in suspicious cases. Prevention is the most critical element needed to reduce this morbidity. To examine the demographic data of children at high risk of foreign body aspiration in order to develop precautionary measures oriented to this population. A retrospective review was prepared of all the charts of children under 16 years old who underwent bronchoscopy for suspected foreign body aspiration in Ha'Emek Medical Center during the period 1994-2004. The review presented a total of 136 children who had undergone bronchoscopy. Foreign bodies were found in 73% of the cases. Two thirds of the patients were male and two thirds were children less then two years old. The incidence of bronchoscopies that were positive for foreign bodies was higher in children less then two years old (82.6%) compared with older children (57.1%), p = 0.001. The incidence of Arab children was higher when compared to Jewish children and significantly higher than their percentage in the general child population (p = 0.001). The rate of bronchoscopies was 11 procedures per 100,000 children per year. In the majority of cases food was aspirated (82%) especially nuts and seeds. We found that children under the age of two years, male children and Arab children were at the highest risk of foreign body aspiration. Nuts and seeds are particularly dangerous and it is recommended to prevent young children from eating them. Well-defined public education programs should achieve prevention.
Braun, U; Gansohr, B; Flückiger, M
2003-04-01
The goal of this study was to describe the findings in four cows with non-magnetic reticular foreign bodies composed of copper. The cows were referred to our clinic because of reduced appetite and a marked decrease in milk production. Based on the clinical findings, a tentative diagnosis of traumatic reticuloperitonitis was made in all cows. The reticulum of all cows was then examined ultrasonographically and radiographically. In all cows, radiographs of the reticulum showed wire-shaped foreign bodies, ranging from 3 to 7 cm in length, which appeared to have penetrated the reticular wall. Two cows (No. 3, 4) had a magnet in the reticulum close to the foreign body but there was no direct contact between the two. A magnet was administered to cows No. 1 and 2, and radiography of the reticulum was performed for a second time the following day. The magnets were observed in the reticulum; however, they did not contact the foreign bodies. Because all the magnets were correctly placed in the reticulum yet, despite close proximity, did not contact the foreign bodies, the latter were thought to be non-magnetic. Cow No. 1 was slaughtered. Left flank laparoruminotomy was performed in the remaining three cows. In all cows, copper foreign bodies ranging in length from 3.0 to 7.0 cm, were found in the reticulum. They had penetrated the reticular wall and were not attached to magnets. The radiographic findings described in the present study are strongly indicative of a non-magnetic foreign body. Ruminotomy is the treatment of choice but slaughter may also be considered.
Wooden Foreign Body in the Skull Base: How Did We Miss It?
Jusué-Torres, Ignacio; Burks, S Shelby; Levine, Corinna G; Bhatia, Rita G; Casiano, Roy; Bullock, Ross
2016-08-01
Timely detection of intraorbital and skull base wooden foreign bodies is crucial. Wooden foreign bodies are difficult to detect on imaging. The radiologist may fail to identify wooden foreign bodies on two thirds of initial scans and can miss them in almost one third of total cases. A 66-year-old woman sustained a penetrating injury through the left upper eyelid with a small tree branch. The branch was immediately removed in the field, and she was provided with prompt medical care at a local hospital. Initial computed tomography (CT) scan diagnosis was "posttraumatic sinusitis," and this was treated empirically with vancomycin and piperacillin/tazobactam. On the eighth day after injury, she developed progressive swelling and pain of her eyelid with left trigeminal/supraorbital numbness and complete left ophthalmoplegia. A new CT scan showed an open "track" from the region of the left upper orbit/superior rectus to the contralateral sphenoid sinus, which raised suspicion for a retained foreign body. Further imaging confirmed the suspicion. Endoscopic sinus surgery was performed with extraction of the wooden object and evacuation of the left orbital infection. This case indicates that intraorbital and skull base wooden foreign bodies are elusive, demanding a high index of suspicion from both clinicians and radiologists to identify retained material in the setting of ocular or sinus trauma. For better identification of wooden foreign bodies, bone windows on CT should have a width of -1000 Hounsfield units with a soft tissue window level of -500 Hounsfield units. Published by Elsevier Inc.
Laparoscopic mesh fixation using laser-assisted tissue soldering in a porcine model.
Lanzafame, Raymond J; Soltz, Barbara A; Stadler, Istvan; Soltz, Robert
2009-01-01
Animal studies using open surgical models indicate that collagen solder is capable of fixation of surgical meshes without interfering with tissue integration, increasing adhesions, or increasing inflammation intraperitoneally. This study describes development of instrumentation and techniques for laparoscopic herniorrhaphy using laser-assisted soldering technology. Anesthetized 20 kg to 25 kg female Yorkshire pigs underwent laparoscopy with a 3-trocar technique. Parietex TET, Parietex TEC, and Prolene mesh segments (5 x 5 cm) were embedded in 55% collagen solder. Segments were inserted by using a specially designed introducer and affixed to the peritoneum by using prototype laser devices (1.45 micro, 4.5 W continuous wave, 5-mm spot, 55 degrees C set temperature) and a custom laparoscopic handpiece (IPOM). Parietex PCO mesh was inserted and affixed using the Endo-hernia stapler (Control). Animals were recovered and underwent second-look laparoscopy at 6 weeks. Mesh sites were harvested after animals were euthanized. The mesh-solder constructs were easily inserted and affixed in an IPOM approach. Prolene mesh tended to curl at its edges as the solder was melted. Postoperative healing was similar to that in Control segments in all cases. Collagen-based tissue soldering permits normal wound healing and may mitigate or reduce the use of staples or other foreign bodies for laparoscopic mesh fixation, prevent tissue ischemia and possibly nerve entrapment, which result in severe postoperative pain and morbidity. Laser-assisted mesh fixation is a promising alternative for laparoscopic herniorrhaphy. Further development of this strategy is warranted.
[A morbidity study of intraocular foreign bodies].
Mocanu, C; Bădescu, S
1993-01-01
190 patients presenting intraocular foreign bodies, hospitalized between 1981-1991, are examined. The study of accidents: cases showed a clear prevalence of work accidents--127 cases (66.84%); 86 of these cases occurred in industry (45.26%), the rest of 41 occurred in agriculture (21.58%). The professions most exposed to such accidents are those of locksmith, mechanic in agriculture or automobile industry. The postsurgical evolution and the incidence of complications show that intraocular foreign bodies are wosse-making factors of ocular plagues, because of anatomical structures disorganization, transparency modifications and infectious complications implied, which determined the diminishing of visual acuity in 88.08% of cases. The big percentage of work accidents in the etiology of intraocular foreign bodies emphasize the great importance of foreign the work-protection rules (regarding a especially the wearing of protection glasses) and of introducing of automation in technological processes involving great risks.
A virus vector based on Canine Herpesvirus for vaccine applications in canids.
Strive, T; Hardy, C M; Wright, J; Reubel, G H
2007-01-31
Canine Herpesvirus (CHV) is being developed as a virus vector for the vaccination of European red foxes. However, initial studies using recombinant CHV vaccines in foxes revealed viral attenuation and lack of antibody response to inserted foreign antigens. These findings were attributed both to inactivation of the thymidine kinase (TK) gene and excess foreign genetic material in the recombinant viral genome. In this study, we report an improved CHV-bacterial artificial chromosome (BAC) vector system designed to overcome attenuation in foxes. A non-essential region was identified in the CHV genome as an alternative insertion site for foreign genes. Replacement of a guanine/cytosine (GC)-rich intergenic region between UL21 and UL22 of CHV with a marker gene did not change growth behaviour in vitro, showing that this region is not essential for virus growth in cell culture. We subsequently produced a CHV-BAC vector with an intact TK gene in which the bacterial genes and the antigen expression cassette were inserted into this GC-rich locus. Unlike earlier constructs, the new CHV-BAC allowed self-excision of the bacterial genes via homologous recombination after transfection of BACs into cell culture. The BAC-CHV system was used to produce a recombinant virus that constitutively expressed porcine zona pellucida subunit C protein between the UL21 and UL22 genes of CHV. Complete self-excision of the bacterial genes from CHV was achieved within one round of replication whilst retaining antigen gene expression.
Impalement of an unusual foreign body on the temporomandibular joint causing severe trismus.
Ito, Ryohei; Kubota, Kosei; Furudate, Ken; Nakagawa, Hiroshi; Kon, Takao; Tamura, Yoshihiro; Kobayashi, Wataru
2016-12-01
A penetrating injury by a foreign body is comparatively common in the oral and maxillofacial region. On the other hand, injury to the temporomandibular joint (TMJ) by a foreign object is very rare. The TMJ is an anatomically narrow space surrounded by hard bony processes. An unusual case of trauma with severe trismus caused by a foreign body that impaled the TMJ is reported. A 55-year-old man presented with a 5 × 1-cm laceration to the right cheek caused by a flying object propelled during the use of a lawn mower. The edge of the foreign body had a metallic wire, which became imbedded in the wound. His jaw opening was severely limited. Computed tomography revealed that the foreign body was 3 mm in diameter and was impaled on the articular capsule. The object was successfully removed, and the wound and interior of the TMJ were irrigated. Rehabilitation of mouth opening was started on postoperative day 3. On day 9, mouth opening had improved to 35 mm, and he was discharged. After 1 year, mouth opening was 45 mm with no sign of any TMJ disorders. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Rigid spine reinforced polymer microelectrode array probe and method of fabrication
Tabada, Phillipe; Pannu, Satinderpall S
2014-05-27
A rigid spine-reinforced microelectrode array probe and fabrication method. The probe includes a flexible elongated probe body with conductive lines enclosed within a polymeric material. The conductive lines connect microelectrodes found near an insertion end of the probe to respective leads at a connector end of the probe. The probe also includes a rigid spine, such as made from titanium, fixedly attached to the probe body to structurally reinforce the probe body and enable the typically flexible probe body to penetrate and be inserted into tissue, such as neural tissue. By attaching or otherwise fabricating the rigid spine to connect to only an insertion section of the probe body, an integrally connected cable section of the probe body may remain flexible.
Piston and connecting rod assembly
NASA Technical Reports Server (NTRS)
Brogdon, James William (Inventor); Gill, David Keith (Inventor); Chatten, John K. (Inventor)
2001-01-01
A piston and connecting rod assembly includes a piston crown, a piston skirt, a connecting rod, and a bearing insert. The piston skirt is a component separate from the piston crown and is connected to the piston crown to provide a piston body. The bearing insert is a component separate from the piston crown and the piston skirt and is fixedly disposed within the piston body. A bearing surface of a connecting rod contacts the bearing insert to thereby movably associate the connecting rod and the piston body.
Thermographic techniques and adapted algorithms for automatic detection of foreign bodies in food
NASA Astrophysics Data System (ADS)
Meinlschmidt, Peter; Maergner, Volker
2003-04-01
At the moment foreign substances in food are detected mainly by using mechanical and optical methods as well as ultrasonic technique and than they are removed from the further process. These techniques detect a large portion of the foreign substances due to their different mass (mechanical sieving), their different colour (optical method) and their different surface density (ultrasonic detection). Despite the numerous different methods a considerable portion of the foreign substances remain undetected. In order to recognise materials still undetected, a complementary detection method would be desirable removing the foreign substances not registered by the a.m. methods from the production process. In a project with 13 partner from the food industry, the Fraunhofer - Institut für Holzforschung (WKI) and the Technische Unsiversität are trying to adapt thermography for the detection of foreign bodies in the food industry. After the initial tests turned out to be very promising for the differentiation of food stuffs and foreign substances, more and detailed investigation were carried out to develop suitable algorithms for automatic detection of foreign bodies. In order to achieve -besides the mere visual detection of foreign substances- also an automatic detection under production conditions, numerous experiences in image processing and pattern recognition are exploited. Results for the detection of foreign bodies will be presented at the conference showing the different advantages and disadvantages of using grey - level, statistical and morphological image processing techniques.
Travel of a mis-swallowed long spoon to the jejunum
Song, Yan; Guo, Hua; Wu, Jian-Yong
2009-01-01
Foreign-body ingestion is a relatively common presentation at emergency departments, but long metallic spoon swallowing is an infrequent occurrence. Unlike most cases of foreign-body ingestion, there have been no reported cases of long foreign bodies reaching the jejunum. We report a rare case of a coffee spoon that was swallowed accidentally and passed through the pylorus and duodenal loop and reached the jejunum, with no complications. PMID:19842235
Retrieval of bronchial foreign body with central lumen using a flexible bronchoscope.
Wong, Kin-Sun; Lai, Shen-Hao; Lien, Reyin; Hsia, Shao-Hsuan
2002-02-25
A 5 year-old boy aspirated a metal spring accidentally. The right bronchial foreign body was removed by threading the alligator of a biopsy forceps through the lumen of the spring while opening its jaws distally. This case illustrates that a foreign body with a central lumen in a child can be successfully removed using a flexible bronchoscope, thus obviating the need for general anesthesia and rigid bronchoscopy.
McKenzie, Jennifer; Cooper Murphy, Megan; Broome, Cameron; Tayari, Hamaseh; Gutierrez-Quintana, Rodrigo
2017-07-20
A 4-year-old Border collie was presented with one episode of collapse, altered mentation, and a suspected pharyngeal stick injury. Magnetic resonance imaging (MRI) and computed tomography showed a linear foreign body penetrating the right oropharynx, through the foramen ovale and the brain parenchyma. The foreign body was surgically removed and medical treatment initiated. Complete resolution of clinical signs was noted at recheck 8 weeks later. Repeat MRI showed chronic secondary changes in the brain parenchyma. To the authors' knowledge, this is the first report of the advanced imaging findings and successful treatment of a penetrating oropharyngeal intracranial foreign body in a dog. © 2017 American College of Veterinary Radiology.
Birk, Michael; Bauerfeind, Peter; Deprez, Pierre H; Häfner, Michael; Hartmann, Dirk; Hassan, Cesare; Hucl, Tomas; Lesur, Gilles; Aabakken, Lars; Meining, Alexander
2016-05-01
This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the removal of foreign bodies in the upper gastrointestinal tract in adults. Recommendations Nonendoscopic measures 1 ESGE recommends diagnostic evaluation based on the patient's history and symptoms. ESGE recommends a physical examination focused on the patient's general condition and to assess signs of any complications (strong recommendation, low quality evidence). 2 ESGE does not recommend radiological evaluation for patients with nonbony food bolus impaction without complications. We recommend plain radiography to assess the presence, location, size, configuration, and number of ingested foreign bodies if ingestion of radiopaque objects is suspected or type of object is unknown (strong recommendation, low quality evidence). 3 ESGE recommends computed tomography (CT) scan in all patients with suspected perforation or other complication that may require surgery (strong recommendation, low quality evidence). 4 ESGE does not recommend barium swallow, because of the risk of aspiration and worsening of the endoscopic visualization (strong recommendation, low quality evidence). 5 ESGE recommends clinical observation without the need for endoscopic removal for management of asymptomatic patients with ingestion of blunt and small objects (except batteries and magnets). If feasible, outpatient management is appropriate (strong recommendation, low quality evidence). 6 ESGE recommends close observation in asymptomatic individuals who have concealed packets of drugs by swallowing ("body packing"). We recommend against endoscopic retrieval. We recommend surgical referral in cases of suspected packet rupture, failure of packets to progress, or intestinal obstruction (strong recommendation, low quality evidence). Endoscopic measures 7 ESGE recommends emergent (preferably within 2 hours, but at the latest within 6 hours) therapeutic esophagogastroduodenoscopy for foreign bodies inducing complete esophageal obstruction, and for sharp-pointed objects or batteries in the esophagus. We recommend urgent (within 24 hours) therapeutic esophagogastroduodenoscopy for other esophageal foreign bodies without complete obstruction (strong recommendation, low quality evidence). 8 ESGE suggests treatment of food bolus impaction in the esophagus by gently pushing the bolus into the stomach. If this procedure is not successful, retrieval should be considered (weak recommendation, low quality evidence). The effectiveness of medical treatment of esophageal food bolus impaction is debated. It is therefore recommended, that medical treatment should not delay endoscopy (strong recommendation, low quality evidence). 9 In cases of food bolus impaction, ESGE recommends a diagnostic work-up for potential underlying disease, including histological evaluation, in addition to therapeutic endoscopy (strong recommendation, low quality evidence). 10 ESGE recommends urgent (within 24 hours) therapeutic esophagogastroduodenoscopy for foreign bodies in the stomach such as sharp-pointed objects, magnets, batteries and large/long objects. We suggest nonurgent (within 72 hours) therapeutic esophagogastroduodenoscopy for medium-sized blunt foreign bodies in the stomach (strong recommendation, low quality evidence). 11 ESGE recommends the use of a protective device in order to avoid esophagogastric/pharyngeal damage and aspiration during endoscopic extraction of sharp-pointed foreign bodies. Endotracheal intubation should be considered in the case of high risk of aspiration (strong recommendation, low quality evidence). 12 ESGE suggests the use of suitable extraction devices according to the type and location of the ingested foreign body (weak recommendation, low quality evidence). 13 After successful and uncomplicated endoscopic removal of ingested foreign bodies, ESGE suggests that the patient may be discharged. If foreign bodies are not or cannot be removed, a case-by-case approach depending on the size and type of the foreign body is suggested (weak recommendation, low quality evidence). © Georg Thieme Verlag KG Stuttgart · New York.
[Cocaine smuggling in the gastrointestinal tract--the case report with the review of literature].
Ciszowski, Krzysztof; Hydzik, Piotr; Waldman, Wojciech; Sein Anand, Jacek
2005-01-01
Body-packing is the way of psychoactive substances smuggling by swallowing of carefully prepared packages with drugs into the gastrointestinal tract or by insertion them into the vagina or the rectum, especially in order to avoid finding them by the custom service. Cocaine, as well as opiates, is the one of the most often smuggled drugs by so called body-packers. In the present study the first case of the body-packer from Malopolska region in Poland, who was observed in the Toxicology Department of the Collegium Medicum UJ, was described. The 29-year-old man swallowed 60 packages containing cocaine with a total net weight of about 500 grams. The plain abdominal radiography revealed multiple shadows of foreign bodies in the gastrointestinal tract, but the results of blood and urine cocaine measurements were negative. During the 37-hours stay in our department the patient was monitored (blood pressure, heart rate, temperature), laxatives and oral fluids were administered. All the packages were evacuated through the natural way and it was followed up by the control abdominal radiography. No symptoms of acute cocaine intoxication or any other complications were observed. According to the case there is also the thorough review of literature presented including the kinds of body-packing, the diagnostic methods used in recognizing of body-packers and the ways of their treatment taking into consideration the conservative management as well as surgical methods.
Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War Fighters
2014-10-01
test with the removal of one wooden foreign body from a turkey breast that simulated the tissue of a human with documentation of procedural omissions...subjects practicing removal of both wooden and metal foreign bodies from a turkey breast while the trainers taught them ways to improve their...Part 2 was an educational efficacy research project. The physicians were trained with a turkey breast simulator. They were evaluated and measured on
Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War Fighters
2010-10-01
research project. The physicians are trained with a turkey breast simulator. They will be evaluated and measured on their performance and competency...The anatomical m aterials used were hum an cadaver thighs. To remain consistent, all foreign bodies were the same. A 1 cm piece of a wooden ...the subcutaneous fat and not the muscle which made locating the foreign body easier. The wooden toothpicks were colo red which the surgeon commented
An unusual presentation of a chronic ingested foreign body in an adult.
Kropf, Jesse A H; Jeanmonod, Rebecca; Yen, David M
2013-01-01
Sore throat is a common complaint for patients presenting to the emergency department (ED). Although most are caused by viral and bacterial sources, an ingested foreign body must be considered in the right patient population. Retained foreign bodies occur in both children and adults. In children, the objects are usually non-food items, whereas adults are more likely to have impacted food boluses. Typically, patients present acutely, and chronic foreign bodies are rare, especially in adults. We use an unusual presentation of a retained foreign body in a previously undiagnosed Zenker diverticulum to review ingested foreign bodies and Zenker diverticuli. We report the case of an 82-year-old woman who presented to the ED with a chief complaint of 12 h of worsening pharyngitis and odynophagia. She reported she had a capsule endoscopy performed approximately 4 months earlier during which the device had malfunctioned and no images were transmitted from beyond the esophagus. A soft tissue film of the neck showed the endoscopic capsule retained at the level of the clavicles. Esophagogastroduodenoscopy demonstrated a previously undiagnosed Zenker diverticulum containing the endoscope capsule. This was subsequently removed with laryngoscopy. Complaints related to sore throat commonly have a simple explanation. Recurrent symptoms and a physical examination inconsistent with common explanations require the differential to be broadened and less common causes considered. Copyright © 2013 Elsevier Inc. All rights reserved.
Tracheo-bronchial foreign bodies: a retrospective study and review of literature.
Jaswal, Abhishek; Jana, Utpal; Maiti, Pradip Kumar
2014-01-01
Tracheobronchial foreign body aspiration is a common emergency in childhood constituting major cause of mortality. Although ample studies regarding airway foreign bodies are present in western literature, studies in Indian context are however lacking. The aim of the study is to present an epidemiological data regarding airway foreign bodies in Indian context thereby helping to analyze the situation with regard to our socio-economic condition. Retrospective file review of all case (n = 82) that underwent rigid bronchoscopy for suspected tracheo-bronchial foreign body over a period of 7 years (2001-2008) in the department of otolaryngology of a tertiary care centre of eastern India. Patient characteristics, history, clinical, radiographic and bronchoscopic findings were noted in an attempt to define the epidemiology, clinical presentation, management and associated morbidity. Most common age of presentation was between 1 and 3 years (56.4%). Most common symptom in our study was Cough, wheezing and respiratory distress (63.4%). Most common clinical signs at presentation were diminished breath sound in unilateral lung field seen in 36.6% cases. Most common radiological finding on chest radiograph was collapse seen in 41.65% cases. Most common type of foreign body below 3 years of age was food material (seeds, beans) removed in 48.78%. Complications were encountered in 14.6% cases of which most common complication was bronchospasm and acute respiratory distress seen in 41.6% cases.
Huang, Yan-Ming; Yan, Hua; Cai, Jin-Hong; Li, Hai-Bo
2017-01-01
To introduce a novel approach in removal of anterior chamber angle foreign body (ACFB) using a prism contact lens and 23-gauge foreign body forceps. Data of 42 eyes of 42 patients who had undergone removal of ACFB using a prism contact lens and 23-gauge foreign body forceps from January 2008 to October 2013 were collected and analyzed. Twenty eyes in group A received the conventional approach by using toothed forceps through corneal limbus incision, and 22 eyes in group B underwent the novel method through the opposite corneal limbus incision. The success rate of ACFB once removal was 75% (15/20) in group A, and 100% (22/22) in group B. The average operation time of group A was significantly longer compared with group B (34.9±9.88min vs 22.13±8.85min; P <0.05). The average size of corneal limbus incision in group A was significantly larger than that of group B (4.85±1.89 mm vs 3.95±1.17 mm; P <0.05). The corneal limbus incision suturing were conducted in all eyes in group A, and only 5 eyes in group B. Removal of ACFB using a prism contact lens and 23-gauge foreign body forceps is a safer, more effective, and convenient technique compared with the conventional approach.
Aerodigestive tract foreign bodies in the older child and adolescent.
Lemberg, P S; Darrow, D H; Holinger, L D
1996-04-01
This study was undertaken in order to establish the incidence of aerodigestive tract foreign body accidents among older children and adolescents, and to investigate the circumstances surrounding these events. A review of patients treated over a 5-year period identified 367 children from whom aerodigestive tract foreign bodies were removed. Seventeen percent of these patients were 5 years of age or older. Among these children, 88% aspirated nonfood items, half of which were school supplies; 78% of the group 5 years old and under aspirated food items. Among older children with esophageal foreign bodies, 31% had food impactions, compared with 7% in the younger group; 70% of these children had a history of some anatomic abnormality of the esophagus. These data suggest that older children and adolescents represent a distinct group of patients at risk for foreign body accidents. Pediatricians and parents of children in this age group should discourage the practice of using the oral cavity as a repository for school supplies, and should stress the need for adequate preparation and mastication of food, particularly among children with esophageal abnormalities.
A Case of Retained Graphite Anterior Chamber Foreign Body Masquerading as Stromal Keratitis
Han, Eun Ryung; Wee, Won Ryang; Lee, Jin Hak
2011-01-01
We report a case of a retained graphite anterior chamber foreign body that was masquerading as stromal keratitis. A 28-year-old male visited with complaints of visual disturbance and hyperemia in his right eye for four weeks. On initial examination, he presented with a stromal edema involving the inferior half of the cornea, epithelial microcysts, and moderate chamber inflammation. Suspecting herpetic stromal keratitis, he was treated with anti-viral and anti-inflammatory agents. One month after the initial visit, anterior chamber inflammation was improved and his visual acuity recovered to 20/20, but subtle corneal edema still remained. On tapering the medication, after three months, a foreign body was incidentally identified in the inferior chamber angle and was surgically removed resulting in complete resolution of corneal edema. The removed foreign body was a fragment of graphite and he subsequently disclosed a trauma with mechanical pencil 12 years earlier. This case showed that the presence of an anterior chamber foreign body should always be considered in the differential diagnosis of idiopathic localized corneal edema. PMID:21461226
Metallic foreign body in the sphenoid sinus after ballistic injury: a case report.
Akhaddar, A; Abouchadi, A; Jidal, M; Gazzaz, M; Elmostarchid, B; Naama, O; Rzin, A; Boucetta, M
2008-05-01
Paranasal sinus injuries by foreign bodies have a lower incidence compared with facial injuries. Among them, penetrating maxillofacial injuries to the sphenoid sinus and skull base remain rare. We report the case of a 41-year-old man who presented with, after a missile-related maxillofacial injury, a metallic foreign body enclosed within the sphenoid sinus with carotid-canal fracture. Angiographic evaluation showed a mass in the right internal carotid artery. The foreign object was successfully extracted through a transmaxillary sublabial approach with a good outcome. We discuss the extensive preoperative evaluation and interdisciplinary management of this unusual injury.
Pulse granuloma as a complication following dental trauma in children.
Padmanabhan, Makkada Yuvaraj; Aparna, Radhakrishnan; Karthikeyani, Shanmugasundaram; Dinakar, Jayakumar; Manickaraj, Menaka
2013-01-01
Contamination and subsequent retention of foreign bodies within wound surfaces may negatively influence healing following maxillofacial injuries. Larger foreign bodies that produce embedded or impalement injuries of soft tissues are easily detected. However, smaller contaminants, such as sand, gravel, food particles, wood splinters, and glass fibers, may not be easily identified in the initial examination, and their remnants may remain within the injury site even after debridement. Tissue reactions depend on the host response, type of foreign body, and nature of the wound surface. The purposes of this report are to: (1) detail the diagnosis and management of a peripheral pulse granuloma following retention of food particles within gingival sulci during a dental injury; and (2) provide a brief review of the diagnosis of foreign body-induced granulomas following maxillofacial injuries in children.
Cranial injury caused by penetrating non-missile foreign body: an autopsy case.
Eren, B; Türkmen, N; Toprak Ergönen, A; Gündogmus, U N
2012-10-01
Presented case was 32-year-old male marble worker, who underwent industrial accident at workplace. On gross physical examination; on forehead region round skin wound in 0.9 cm diameter was detected, radiological examination showed the image of metallic object. in the skull cavity. Brain dissection showed obvious brain injury, haemorrahge explaining the pattern of injury caused by the metallic bodys path, from left frontal lobe to the left cerebellar hemisphere was identified. We presented rare case of penetrating injury of the cranial region caused by non-missile foreign body. cranial injury - non-missile foreign body - autopsy.
Lim, C B B; Goldin, R D; Darzi, A; Hanna, G B
2008-08-01
Staples are made of titanium, which elicits minimal tissue reaction. The authors have encountered foreign body reaction associated with stapled human gastrointestinal anastomoses, although the literature has no reports of this. The aim of this study was to identify the refractile foreign materials causing this reaction. Histological sections were taken from 14 gastrointestinal specimens from patients with a history of a stapled anastomosis within the specimen excised. These were reviewed by light and polarization microscopy. Scanning electron microscopy and energy dispersive X-ray analysis were carried out on these sections, staples and stapler cartridges used for gastrointestinal surgery. Foreign bodies rich in fluorine were found in three patients, and those rich in carbon in 12. Other elements identified included oxygen, calcium, sodium, potassium, magnesium, aluminium and silicon. One specimen was found to contain titanium with no surrounding foreign body reaction. Stapler cartridges contained carbon, oxygen, fluorine, calcium, sodium, potassium, magnesium, aluminium, silicon and traces of titanium. Staples were composed of pure titanium with some fibrous material on the surface containing elements found in stapler cartridges. The presence of foreign body reaction was confirmed in stapled human gastrointestinal anastomoses. The source of refractile materials eliciting this reaction was the stapler cartridges. (c) 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
A review on mechanical considerations for chronically-implanted neural probes
NASA Astrophysics Data System (ADS)
Lecomte, Aziliz; Descamps, Emeline; Bergaud, Christian
2018-06-01
This review intends to present a comprehensive analysis of the mechanical considerations for chronically-implanted neural probes. Failure of neural electrical recordings or stimulation over time has shown to arise from foreign body reaction and device material stability. It seems that devices that match most closely with the mechanical properties of the brain would be more likely to reduce the mechanical stress at the probe/tissue interface, thus improving body acceptance. The use of low Young’s modulus polymers instead of hard substrates is one way to enhance this mechanical mimetism, though compliance can be achieved through a variety of means. The reduction of probe width and thickness in comparison to a designated length, the use of soft hydrogel coatings and the release in device tethering to the skull, can also improve device compliance. Paradoxically, the more compliant the device, the more likely it will fail during the insertion process in the brain. Strategies have multiplied this past decade to offer partial or temporary stiffness to the device to overcome this buckling effect. A detailed description of the probe insertion mechanisms is provided to analyze potential sources of implantation failure and the need for a mechanically-enhancing structure. This leads us to present an overview of the strategies that have been put in place over the last ten years to overcome buckling issues. Particularly, great emphasis is put on bioresorbable polymers and their assessment for neural applications. Finally, a discussion is provided on some of the key features for the design of mechanically-reliable, polymer-based next generation of chronic neuroprosthetic devices.
Nozzle insert for mixed mode fuel injector
Lawrence, Keith E [Peoria, IL
2006-11-21
A fuel injector includes a homogenous charge nozzle outlet set and a conventional nozzle outlet set controlled respectively, by first and second needle valve members. The homogeneous charged nozzle outlet set is defined by a nozzle insert that is attached to an injector body, which defines the conventional nozzle outlet set. The nozzle insert is a one piece metallic component with a large diameter segment separated from a small diameter segment by an annular engagement surface. One of the needle valve members is guided on an outer surface of the nozzle insert, and the nozzle insert has an interference fit attachment to the injector body.
Foreign bodies in the aerodigestive tract.
Lawson, V G; Middleton, W G
1986-04-01
Foreign bodies in the aerodigestive tract are common. They may cause minimal disturbance of function, severe morbidity or even sudden death. They enter the aerodigestive tract because of haste during eating, disturbances in physical function, impairments due to extreme youth or age, or contamination of food with foreign bodies. Common symptoms are pain, dysphagia, odynophagia, cough, airway distress, hemoptysis and hematemesis. Signs include point tenderness, respiratory distress and surgical emphysema. Clinical, radiological and endoscopic investigations are described, as are principles of crisis and elective management.
Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War Fighters
2009-10-28
with a turkey breast simulator. They will be evaluated and measured on their performance and competency development with USFBR. Part 3 is a clinical...The anatom ical m aterials used were hum an cadaver thighs. To rem ain consistent, all foreign bodies were the sam e. A 1 cm piece of a wooden ...uscle which m ade locating the foreign body easier. The wooden toothpicks were colored which the surgeon com mented helped when searching for the
An unexpected cause of vaginal bleeding: the role of pelvic radiography.
Kyrgios, Ioannis; Emmanouilidou, Eleftheria; Theodoridis, Theodoros; Galli-Tsinopoulou, Assimina
2014-02-14
Vaginal bleeding and/or discharge in young girls may result from infection, urological problems, endocrine causes, bleeding disorders, dermatological conditions, trauma, sexual abuse, masses or foreign bodies. We report a case of excessive vaginal bleeding caused by a foreign body in a prepubertal girl with emphasis on the diagnostic challenges and pitfalls regarding imaging techniques. In our patient, although invasive and expensive investigations had been initially made, the foreign body was last detected only when a plain pelvic radiography was performed.
Multimodality imaging of foreign bodies of the musculoskeletal system.
Jarraya, Mohamed; Hayashi, Daichi; de Villiers, Richard V; Roemer, Frank W; Murakami, Akira M; Cossi, Alda; Guermazi, Ali
2014-07-01
The purpose of this article is to clarify the most relevant points in managing suspected foreign bodies of the musculoskeletal system on the basis of a literature review and published reports with cases to illustrate each type on different imaging modalities. Foreign bodies of the musculoskeletal system are a common problem in emergency departments, with more than a third missed in the initial clinical evaluation. These retained objects may result in various complications and also offer fertile ground for litigation.
[Intestinal volvulus caused by the ingestion of magnet balls: unexpected risk in children].
Kubačková, D; Nosek, J; Třeška, V; Vacek, V; Pizingerová, K
2015-05-01
The occurrence of swallowed foreign bodies in the digestive system is a common problem in children with the highest incidence in children aged six months to five years. Most swallowed objects leave the human body per vias naturales while 10-20% of swallowed foreign bodies need to be removed with an endoscope. Serious and life-threatening situations are caused by the ingestion of foreign bodies in about 1% of all cases. The authors present a case of a two-year-old girl diagnosed with acute abdomen for which she was operated on. A small bowel volvulus and several intestinal fistulas were found intraoperatively. The cause of this finding was the ingestion of magnetic balls and a swallowed metal body drawn to them by magnetic force. If more than one magnetic body is ingested, it is necessary to admit the patient to hospital and to remove these foreign bodies using an endoscope. The position of the magnets which is not changing in a location inaccessible for an endoscope during 2448 hours is an indication for urgent operation.
Evaluation of participants' perception and taste thresholds with a zirconia palatal plate.
Wada, Takeshi; Takano, Tomofumi; Tasaka, Akinori; Ueda, Takayuki; Sakurai, Kaoru
2016-10-01
Zirconia and cobalt-chromium can withstand a similar degree of loading. Therefore, using a zirconia base for removable dentures could allow the thickness of the palatal area to be reduced similarly to metal base dentures. We hypothesized that zirconia palatal plate for removable dentures provides a high level of participants' perception without influencing taste thresholds. The purpose of this study was to evaluate the participants' perception and taste thresholds of zirconia palatal plate. Palatal plates fabricated using acrylic resin, zirconia, and cobalt-chromium alloy were inserted into healthy individuals. Taste thresholds were investigated using the whole-mouth gustatory test, and participants' perception was evaluated using the 100-mm visual analog scale to assess the ease of pronunciation, ease of swallowing, sensation of temperature, metallic taste, sensation of foreign body, subjective sensory about weight, adhesiveness of chewing gum, and general satisfaction. For the taste thresholds, no significant differences were noted in sweet, salty, sour, bitter, or umami tastes among participants wearing no plate, or the resin, zirconia, and metal plates. Speech was easier and foreign body sensation was lower with the zirconia plate than with the resin plate. Evaluation of the adhesiveness of chewing gum showed that chewing gum does not readily adhere to the zirconia plate in comparison with the metal plate. The comprehensive participants' perception of the zirconia plate was evaluated as being superior to the resin plate. A zirconia palatal plate provides a high level of participants' perception without influencing taste thresholds. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Berchialla, Paola; Scarinzi, Cecilia; Snidero, Silvia; Gregori, Dario
2016-08-01
Risk Assessment is the systematic study of decisions subject to uncertain consequences. An increasing interest has been focused on modeling techniques like Bayesian Networks since their capability of (1) combining in the probabilistic framework different type of evidence including both expert judgments and objective data; (2) overturning previous beliefs in the light of the new information being received and (3) making predictions even with incomplete data. In this work, we proposed a comparison among Bayesian Networks and other classical Quantitative Risk Assessment techniques such as Neural Networks, Classification Trees, Random Forests and Logistic Regression models. Hybrid approaches, combining both Classification Trees and Bayesian Networks, were also considered. Among Bayesian Networks, a clear distinction between purely data-driven approach and combination of expert knowledge with objective data is made. The aim of this paper consists in evaluating among this models which best can be applied, in the framework of Quantitative Risk Assessment, to assess the safety of children who are exposed to the risk of inhalation/insertion/aspiration of consumer products. The issue of preventing injuries in children is of paramount importance, in particular where product design is involved: quantifying the risk associated to product characteristics can be of great usefulness in addressing the product safety design regulation. Data of the European Registry of Foreign Bodies Injuries formed the starting evidence for risk assessment. Results showed that Bayesian Networks appeared to have both the ease of interpretability and accuracy in making prediction, even if simpler models like logistic regression still performed well. © The Author(s) 2013.
Lorenz, Jonas; Kubesch, Alica; Korzinskas, Tadas; Barbeck, Mike; Landes, Constantin; Sader, Robert A; Kirkpatrick, Charles J; Ghanaati, Shahram
2015-12-01
This study compared the material-specific tissue response to the synthetic, hydroxyapatite-based bone substitute material NanoBone (NB) with that of the xenogeneic, bovine-based bone substitute material Bio-Oss (BO). The sinus cavities of 14 human patients were augmented with NB and BO in a split-mouth design. Six months after augmentation, bone biopsies were extracted for histological and histomorphometric investigation prior to dental implant insertion. The following were evaluated: the cellular inflammatory pattern, the induction of multinucleated giant cells, vascularization, the relative amounts of newly formed bone, connective tissue, and the remaining bone substitute material. NB granules were well integrated in the peri-implant tissue and were surrounded by newly formed bone tissue. Multinucleated giant cells were visible on the surfaces of the remaining granules. BO granules were integrated into the newly formed bone tissue, which originated from active osteoblasts on their surface. Histomorphometric analysis showed a significantly higher number of multinucleated giant cells and blood vessels in the NB group compared to the BO group. No statistical differences were observed in regard to connective tissue, remaining bone substitute, and newly formed bone. The results of this study highlight the different cellular reactions to synthetic and xenogeneic bone substitute materials. The significantly higher number of multinucleated giant cells within the NB implantation bed seems to have no effect on its biodegradation. Accordingly, the multinucleated giant cells observed within the NB implantation bed have characteristics more similar to those of foreign body giant cells than to those of osteoclasts.
Alopecia with foreign body granulomas induced by Radiesse injection: A case report.
Liu, Ren-Feng; Kuo, Tseng-Tong; Chao, Yen-Yu; Huang, Yu-Huei
2018-02-26
Radiesse is a soft tissue filler which has been widely used for cosmetic enhancement. The safety of Radiesse has been thoroughly investigated via numerous studies. A late-onset complication of Radiesse injection consists of foreign body granulomas, with only three case reports in over 10 years of clinical use. Herein, we describe the case of a patient who experienced alopecia with foreign body granulomas at the injection region one month after receiving a Radiesse injection. To our knowledge, this is the first report in the English literature of alopecia as an adverse event associated with Radiesse injection. The present case reminded physicians to evaluate more cautiously the necessity of injecting filler into hair-bearing area for lifting purpose. This procedure may cause foreign body granulomatous reaction, which may result in hair loss at the injection region.
Management and endoscopic techniques for digestive foreign body and food bolus impaction.
Chauvin, Armelle; Viala, Jerome; Marteau, Philippe; Hermann, Philippe; Dray, Xavier
2013-07-01
Ingested foreign bodies, food bolus impaction, migration or retention of medical devices are frequent, in children as well as in adults. Most of these foreign bodies will naturally pass through the gastro-intestinal tract. Complications are rare but sometimes severe (oesophageal perforations are the most frequent and most feared). We aimed to review the literature on therapeutic management of digestive foreign bodies and food bolus impaction, with special focus on endoscopic indications, material, timing and techniques for removal. The role of the gastroenterologist is to recognise specific situations and to plan endoscopic removal in a timely manner with the most adequate conditions and extraction tools. Risk factors and underlying pathology, for example eosinophilic esophagitis, must be investigated and if necessary treated. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Foreign body granuloma of the penis caused by occupational glass fibre exposure.
Hinnen, U; Elsner, P; Barraud, M; Burg, G
1997-01-01
We report a patient who presented with the suspected diagnosis of syphilis. Clinical findings included a penile ulcer, positive history of syphilis more than 20 years ago, and positive syphilis serology (TPHA, FTA-Abs). A biopsy showed a plasma-cell rich inflammation with granuloma formation. Since a birefractory structure was observed in the biopsy possibly corresponding to a foreign body, the patient's occupational exposure was investigated. Working in the fiber reinforced plastics industry, he was heavily exposed to glass fibre that was even detected on the inside of his underwear. Taking the serological pattern into account that was not consistent with active syphilis, a penile ulcer following a foreign body reaction was diagnosed. This case report demonstrates the difficulties of differentiating foreign body granuloma of the genital region from venereal diseases with granuloma formation. Images PMID:9582491
Water used to visualize and remove hidden foreign bodies from the external ear canal.
Peltola, T J; Saarento, R
1992-02-01
Small foreign bodies lodged anteriorly in the tympanic sulcus are usually not visible, due to the curve of the external ear canal. Such objects can be seen with the aid of an otomicroscope and micromirror or with an endoscope, and removed by irrigation. If irrigation fails, epithelial migration on the tympanic membrane may remove lodged foreign bodies, although this may take months. Our new method, which uses water to locate small objects lodged in the tympanic sulcus, includes irrigation of the ear, adjustment of the water level to the middle curve of the external ear canal, and use of the water surface as a concave lens, making the tympanic sulcus visible. With otomicroscopy a curved ear probe can then be used to remove lodged foreign bodies from behind the curve.
Szostak, Katarzyna M.; Grand, Laszlo; Constandinou, Timothy G.
2017-01-01
Implantable neural interfaces for central nervous system research have been designed with wire, polymer, or micromachining technologies over the past 70 years. Research on biocompatible materials, ideal probe shapes, and insertion methods has resulted in building more and more capable neural interfaces. Although the trend is promising, the long-term reliability of such devices has not yet met the required criteria for chronic human application. The performance of neural interfaces in chronic settings often degrades due to foreign body response to the implant that is initiated by the surgical procedure, and related to the probe structure, and material properties used in fabricating the neural interface. In this review, we identify the key requirements for neural interfaces for intracortical recording, describe the three different types of probes—microwire, micromachined, and polymer-based probes; their materials, fabrication methods, and discuss their characteristics and related challenges. PMID:29270103
Plantar fascia: imaging diagnosis and guided treatment.
McNally, Eugene G; Shetty, Shilpa
2010-09-01
Plantar fasciopathy is a common cause of heel pain. This article covers the imaging anatomy of the hindfoot, the imaging findings on ultrasound and magnetic resonance imaging (MRI) of plantar fasciopathy, plantar fibromas, trauma, Achilles tendonopathy, neural compression, stress fractures of the os calcis and other heel pad lesions. Thickening of the plantar fascia insertion more than 5 mm either on ultrasound or MRI is suggestive of plantar fasciopathy. Ultrasound is superior to MRI for diagnosis of plantar fibroma as small low signal lesions on MRI are similar to the normal plantar fascia signal. Ultrasound demonstrates low echogenicity compared with the echogenic plantar fascia. Penetrating injuries can appear bizarre due to associated foreign body impaction and infection. Achilles tendonopathy can cause heel pain and should be considered as a possible diagnosis. Treatment options include physical therapy, ECSWT, corticosteroid injection, and dry needling. Percutaneous US guided treatment methods will be described. Thieme Medical Publishers.
Szostak, Katarzyna M; Grand, Laszlo; Constandinou, Timothy G
2017-01-01
Implantable neural interfaces for central nervous system research have been designed with wire, polymer, or micromachining technologies over the past 70 years. Research on biocompatible materials, ideal probe shapes, and insertion methods has resulted in building more and more capable neural interfaces. Although the trend is promising, the long-term reliability of such devices has not yet met the required criteria for chronic human application. The performance of neural interfaces in chronic settings often degrades due to foreign body response to the implant that is initiated by the surgical procedure, and related to the probe structure, and material properties used in fabricating the neural interface. In this review, we identify the key requirements for neural interfaces for intracortical recording, describe the three different types of probes-microwire, micromachined, and polymer-based probes; their materials, fabrication methods, and discuss their characteristics and related challenges.
Computed intraoperative navigation guidance--a preliminary report on a new technique.
Enislidis, G; Wagner, A; Ploder, O; Ewers, R
1997-08-01
To assess the value of a computer-assisted three-dimensional guidance system (Virtual Patient System) in maxillofacial operations. Laboratory and open clinical study. Teaching Hospital, Austria. 6 patients undergoing various procedures including removal of foreign body (n=3) and biopsy, maxillary advancement, and insertion of implants (n=1 each). Storage of computed tomographic (CT) pictures on an optical disc, and imposition of intraoperative video images on to these. The resulting display is shown to the surgeon on a micromonitor in his head-up display for guidance during the operations. To improve orientation during complex or minimally invasive maxillofacial procedures and to make such operations easier and less traumatic. Successful transferral of computed navigation technology into an operation room environment and positive evaluation of the method by the surgeons involved. Computer-assisted three-dimensional guidance systems have the potential for making complex or minimally invasive procedures easier to do, thereby reducing postoperative morbidity.
Ultrasonographic and radiographic findings in 503 cattle with traumatic reticuloperitonitis.
Braun, Ueli; Gerspach, Christian; Warislohner, Sonja; Nuss, Karl; Ohlerth, Stefanie
2018-05-26
This study involved 503 cattle with traumatic reticuloperitonitis (TRP), 494 of which underwent ultrasonographic and 484 radiographic examination of the reticulum. Ultrasonography revealed changes in the reticulum and/or peritoneum suggestive of peritonitis in 403 (83%) cattle, a decrease in the amplitude of reticular contractions in 244 (54%) and reduced or absent reticular motility in 173 (37%). A total of 536 foreign bodies were seen on 465 (96%) radiographs and a magnet was seen on 311 (64%) radiographs. Of the 536 foreign bodies, 300 (56%) were not attached to a magnet and 236 (44%) were attached. Of 300 radiographs showing foreign bodies not attached to a magnet, the foreign body was lying flat on the floor of the reticulum on 98 (18%) radiographs, was at an angle of greater than 30 degrees to the ventral aspect of the reticulum on 54 (10%), had penetrated the dorsal reticular wall on 76 (14%), had perforated the reticulum on 64 (12%) and was completely outside of the reticulum on 8 (1%) radiographs. Ultrasonography provides information about the scale and localisation of inflammatory changes of the peritoneum, and radiography allows the visualisation of ferromagnetic foreign bodies and magnets. Copyright © 2018. Published by Elsevier Ltd.
NASA Astrophysics Data System (ADS)
Khalighi, Mohammad Mehdi; Delso, Gaspar; Maramraju, Sri Harsha; Deller, Timothy W.; Levin, Craig S.; Glover, Gary H.
2016-10-01
A silicon photomultiplier (SiPM)-based time-of-flight capable PET detector has been integrated with a 70 cm wide-bore 3T MR scanner for simultaneous whole-body imaging (MR750w, GE Healthcare, Waukesha, WI). After insertion of the PET detector, the final PET/MR bore is 60 cm wide (SIGNA PET/MR, GE Healthcare, Waukesha, WI). The MR performance was compared before and after the PET ring insertion. B0 homogeneity, B1+ uniformity of the body coil along with peak B1+, coherent noise, and FBIRN (Function Biomedical Informatics Research Network) tests are used to compare the MR performance. It is shown that B0 homogeneity and coherent noise have not changed according to the system specifications. Peak B1+ is increased by 33% and B1+ inhomogeneity is increased by 4% after PET ring insertion due to a smaller diameter body coil design. The FBIRN test shows similar temporal stability before and after PET ring insertion. Due to a smaller body coil on the PET/MR system, the signal fluctuation to noise ratio (SFNR) and SNR for body receive coil, are improved by 40% and 160% for Echo Planar Imaging (EPI) and spiral sequences respectively. Comparison using RF- and gradient-intensive clinical sequences shows inserting the PET detectors into the wide-bore MRI has not compromised the MR image quality according to these tests.
Complications in children from foreign bodies in the airway.
Rodríguez, Hugo; Cuestas, Giselle; Botto, Hugo; Nieto, Mary; Cocciaglia, Alejandro; Passali, Desiderio; Gregori, Dario
2016-01-01
Foreign body aspiration in childhood is a common and potentially serious problem. Complications may be the result of the aspiration episode itself, delayed diagnosis or treatment. We describe our experience in a paediatric hospital in Argentina. We retrospectively evaluated 56 patients with complications due to foreign body aspiration recorded in the Susy Safe Project between January 2010 and November 2013. The clinical variables analysed were sex, age at time of aspiration, foreign body location and type, time elapsed from the event until object removal, extraction technique, complications, need for hospitalisation and circumstances of the event. 58.9% of the cases described occurred in males, with high presence of adults (76.8%) at the time of aspiration. The incidence was slightly higher in children older than 3 years. In 37 cases (66.1%), the foreign body was located in bronchus; sunflower seeds and ballpoint caps were the most common foreign objects. Only in 10 cases (17.9%) was the object extracted within 24h of the event. The most common complications were pneumonia (18 cases), granuloma (15 cases) and mucosal erosion (9 cases). Hospitalisation was necessary for 41 patients. Early diagnosis and immediate control through specialised teams are essential to ensure proper treatment, usually endoscopic, without risk of complications. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.
MRI-induced soft tissue pain: incidental finding of a 15-year-old foreign body
El Sayed Omar, Theofilos; El-Khani, Ussamah; Nehme, Jean
2013-01-01
We present the case of an 82-year-old woman who developed intense right middle finger pain during MRI scan This alerted the clinical team to the incidental finding of a 15-year-old metallic foreign body in the distal phalanx of the right middle finger. This case report is a reminder that the responsible clinician should be vigilant when screening for metallic foreign body on completion of the MRI checklist, and should adopt a low threshold for plain imaging prior to MRI. PMID:23417938
Endoscopic management of ingested foreign bodies and food impactions.
Malick, K Jane
2013-01-01
Endoscopy plays a major role in the management of foreign bodies and food impactions. Because of their frequent occurrence and potential for complications, it is important for the gastroenterology nurse and associate to gain an understanding of the incidence, diagnosis, and management of patients who present with ingested foreign bodies or food impaction. This article summarizes the clinical approach to patient: assessment, preparation for endoscopic procedure, preparation of endoscopic accessories, and follow-up care. Finally, an interesting case presentation highlights key components of caring for patients requiring endoscopic intervention.
[Recommendations for the prevention of organic foreign bodies aspiration].
Rodríguez, Hugo; Cuestas, Giselle; Gregori, Darío; Lorenzoni, Giulia; Tortosa, Susana; Rodríguez D'Aquila, Máximo; Rodríguez D'Aquila, Juan A; Carrera, Sandra; Passali, Desiderio
2017-10-01
Foreign body aspiration remains a common and potentially serious pediatric problem. Most aspirated foreign bodies are food. The education of parents and caregivers about choking hazards and how to avoid them is critical to reduce the incidence of these events. The pediatricians play a key role in promoting injury prevention. We indicate the main characteristics of hazardous food and we present recommendations on age-appropriate meals, adequate forms of food preparation and behavioral rules at mealtimes in order to reduce food choking. Sociedad Argentina de Pediatría.
Windshield safety glass foreign body masquerading as a root fragment.
Gray, S T
1994-02-01
A 42-year-old woman presented with a persistent radiopacity suggestive of an apparent root fragment after full dental clearance. This was caused by a foreign body lying within the buccal soft tissues. The foreign body was identified as a portion of soda-lime-silica glass which had penetrated during a road traffic accident but which had remained undetected for 6 years. Following its removal, further chemical analyses were undertaken to compare the radiographic characteristics of the windscreen glass in this case with other glass samples.
Safety and accuracy of a new long-term subconjunctival glucose sensor.
Hasslacher, Christoph; Auffarth, Gerd; Platten, Isabell; Rabsilber, Tanja; Smith, Beate; Kulozik, Felix; Knuth, Monika; Nikolaus, Katharina; Müller, Achim
2012-09-01
A new biosensor has been developed by EyeSense (Großostheim, Germany) that is placed into the conjunctiva of one eye to measure the glucose concentration of the surrounding tissue in a non-invasive manner. In the present study we investigated the correlation between glucose concentrations measured by the EyeSense implant and those determined by finger prick testing, as well as the tolerability and safety of the implant over a 16-week period. The study was performed in 28 diabetic patients. The biosensor was inserted under local anesthesia and sterile conditions. Correlations between capillary glucose measured by laboratory methods and interstitial glucose determined by the biosensor were investigated by inducing increases and decreases in glucose values between 60 and 300 mg/dL. Most patients experienced a mild subconjunctival hemorrhage postoperatively. Except for the minor sensation of the presence of foreign body, the implants were well tolerated. Three patients lost the ocular mini insert spontaneously, whereas there was a function failure of the insert in four patients. Error grid analysis showed that the percentage of data pairs in the acceptable ranges (zone A and B) was very high (>96%). However, there was a shift from zone A to zone B during observation. This was due primarily to an increase in the lag time between capillary and interstitial measured glucose. he present study demonstrates good tolerability and measurement performance of the biosensor. The reasons for an increase in the lag time are still unknown; local reactions may be involved. © 2012 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.
Laparoscopic Mesh Fixation Using Laser-Assisted Tissue Soldering in a Porcine Model
Soltz, Barbara A.; Stadler, Istvan; Soltz, Robert
2009-01-01
Background and Objective: Animal studies using open surgical models indicate that collagen solder is capable of fixation of surgical meshes without interfering with tissue integration, increasing adhesions, or increasing inflammation intraperitoneally. This study describes development of instrumentation and techniques for laparoscopic herniorrhaphy using laser-assisted soldering technology. Study Design and Methods: Anesthetized 20 kg to 25 kg female Yorkshire pigs underwent laparoscopy with a 3-trocar technique. Parietex TET, Parietex TEC, and Prolene mesh segments (5 × 5 cm) were embedded in 55% collagen solder. Segments were inserted by using a specially designed introducer and affixed to the peritoneum by using prototype laser devices (1.45 µ, 4.5 W continuous wave, 5-mm spot, 55° C set temperature) and a custom laparoscopic handpiece (IPOM). Parietex PCO mesh was inserted and affixed using the Endo-hernia stapler (Control). Animals were recovered and underwent second-look laparoscopy at 6 weeks. Mesh sites were harvested after animals were euthanized. Results: The mesh-solder constructs were easily inserted and affixed in an IPOM approach. Prolene mesh tended to curl at its edges as the solder was melted. Postoperative healing was similar to that in Control segments in all cases. Discussion and Conclusion: Collagen-based tissue soldering permits normal wound healing and may mitigate or reduce the use of staples or other foreign bodies for laparoscopic mesh fixation, prevent tissue ischemia and possibly nerve entrapment, which result in severe postoperative pain and morbidity. Laser-assisted mesh fixation is a promising alternative for laparoscopic herniorrhaphy. Further development of this strategy is warranted. PMID:19793465
26 CFR 1.957-1 - Definition of controlled foreign corporation.
Code of Federal Regulations, 2011 CFR
2011-04-01
... of that body of persons exercising, with respect to such corporation, the powers ordinarily exercised...-half of the members of such governing body of such foreign corporation, either to cast a vote deciding an evenly divided vote of such body or, for the duration of any deadlock which may arise, to exercise...
26 CFR 1.957-1 - Definition of controlled foreign corporation.
Code of Federal Regulations, 2014 CFR
2014-04-01
... of that body of persons exercising, with respect to such corporation, the powers ordinarily exercised...-half of the members of such governing body of such foreign corporation, either to cast a vote deciding an evenly divided vote of such body or, for the duration of any deadlock which may arise, to exercise...
26 CFR 1.957-1 - Definition of controlled foreign corporation.
Code of Federal Regulations, 2013 CFR
2013-04-01
... of that body of persons exercising, with respect to such corporation, the powers ordinarily exercised...-half of the members of such governing body of such foreign corporation, either to cast a vote deciding an evenly divided vote of such body or, for the duration of any deadlock which may arise, to exercise...
26 CFR 1.957-1 - Definition of controlled foreign corporation.
Code of Federal Regulations, 2012 CFR
2012-04-01
... of that body of persons exercising, with respect to such corporation, the powers ordinarily exercised...-half of the members of such governing body of such foreign corporation, either to cast a vote deciding an evenly divided vote of such body or, for the duration of any deadlock which may arise, to exercise...
Food choking hazards in children.
Sidell, Douglas R; Kim, Irene A; Coker, Tumaini R; Moreno, Candice; Shapiro, Nina L
2013-12-01
To review the literature on pediatric food choking risks, with the long-term goal of supporting legislation regulating the production, labeling, and distribution of high-risk foods. A PubMed search (Keywords: choking, obstruction, asphyxiation, foreign body, food) was conducted in July-September 2010 with publication dates ranging from 1966 to 2010. Articles related to pediatric foreign body aspiration (FBA) were selected by three independent reviewers. 1145 articles were initially identified. Abstracts were then screened utilizing a tool designed to isolate relevant pediatric choking events; this tool helped to only select abstracts which presented data on patients younger than 18 years of age who had choked on food items. Through this, a total of 72 pertinent articles were isolated (55 observational studies, 17 case reports/series). For each study, patient age, sex, foreign body location, presenting signs and symptoms, utility of radiographic studies, and type of foreign body detected in the majority of study participants were determined. A "majority" of patients for each study was predetermined arbitrarily to be 2/3 of the studied population. The majority of patients in each observational study was determined to be: male (87% of all studies) and age <5 years (95% of all studies). Aspirated foreign bodies were mostly detected in the right main bronchus foreign body (72% of all studies), and there were abnormal radiographic signs (81% of all studies) at the time of evaluation. Food-object foreign bodies were the most frequent factors associated with choking (94% of all studies). Childhood aspiration of food-objects is a significant public health issue. Although there is substantial legislation regulating non-food items that pose a choking hazard, equivalent guidelines do not exist for high-risk foods. Our study identifies and confirms several risk factors for pediatric FBA events. In doing so, it echoes the concerns and suggestions of various groups in supporting the development of legislation which may reduce the incidence of food-object aspiration. Copyright © 2013. Published by Elsevier Ireland Ltd.
31 CFR 800.213 - Foreign government.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Foreign government. 800.213 Section... TAKEOVERS BY FOREIGN PERSONS Definitions § 800.213 Foreign government. The term foreign government means any government or body exercising governmental functions, other than the United States Government or a...
31 CFR 800.213 - Foreign government.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Foreign government. 800.213 Section... TAKEOVERS BY FOREIGN PERSONS Definitions § 800.213 Foreign government. The term foreign government means any government or body exercising governmental functions, other than the United States Government or a...
31 CFR 800.213 - Foreign government.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Foreign government. 800.213 Section... TAKEOVERS BY FOREIGN PERSONS Definitions § 800.213 Foreign government. The term foreign government means any government or body exercising governmental functions, other than the United States Government or a...
31 CFR 800.213 - Foreign government.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Foreign government. 800.213 Section... TAKEOVERS BY FOREIGN PERSONS Definitions § 800.213 Foreign government. The term foreign government means any government or body exercising governmental functions, other than the United States Government or a...
31 CFR 800.213 - Foreign government.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Foreign government. 800.213 Section... TAKEOVERS BY FOREIGN PERSONS Definitions § 800.213 Foreign government. The term foreign government means any government or body exercising governmental functions, other than the United States Government or a...
Electronic School. Supplement.
ERIC Educational Resources Information Center
American School Board Journal, 1997
1997-01-01
This supplementary insert describes developments in computer uses in education. Feature articles discuss connecting rural schools to computer networks through affordable wireless transmission, using the Internet to teach foreign languages, and forging links between the school and home through technology. Other columns discuss updates on the…
Yoshida, Asuka; Samal, Siba K.
2017-01-01
Avian paramyxovirus serotype 3 (APMV-3) causes infection in a wide variety of avian species, but it does not cause apparent diseases in chickens. On the contrary, APMV-1, also known as Newcastle disease virus (NDV), can cause severe disease in chickens. Currently, natural low virulence strains of NDV are used as live-attenuated vaccines throughout the world. NDV is also being evaluated as a vaccine vector against poultry pathogens. However, due to routine vaccination programs, chickens often possess pre-existing antibodies against NDV, which may cause the chickens to be less sensitive to recombinant NDV vaccines expressing antigens of other avian pathogens. Therefore, it may be possible for an APMV-3 vector vaccine to circumvent this issue. In this study, we determined the optimal insertion site in the genome of APMV-3 for high level expression of a foreign gene. We generated recombinant APMV-3 viruses expressing the green fluorescent protein (GFP) by inserting the GFP gene at five different intergenic regions in the genome. The levels of GFP transcription and translation were evaluated. Interestingly, the levels of GFP transcription and translation did not follow the 3′-to-5′ attenuation mechanism of non-segmented, negative-sense RNA viruses. The insertion of GFP gene into the P-M gene junction resulted in higher level of expression of GFP than when the gene was inserted into the upstream N-P gene junction. Unlike NDV, insertion of GFP did not attenuate the growth efficiency of AMPV-3. Thus, APMV-3 could be a more useful vaccine vector for avian pathogens than NDV. PMID:28473820
Yoshida, Asuka; Samal, Siba K
2017-01-01
Avian paramyxovirus serotype 3 (APMV-3) causes infection in a wide variety of avian species, but it does not cause apparent diseases in chickens. On the contrary, APMV-1, also known as Newcastle disease virus (NDV), can cause severe disease in chickens. Currently, natural low virulence strains of NDV are used as live-attenuated vaccines throughout the world. NDV is also being evaluated as a vaccine vector against poultry pathogens. However, due to routine vaccination programs, chickens often possess pre-existing antibodies against NDV, which may cause the chickens to be less sensitive to recombinant NDV vaccines expressing antigens of other avian pathogens. Therefore, it may be possible for an APMV-3 vector vaccine to circumvent this issue. In this study, we determined the optimal insertion site in the genome of APMV-3 for high level expression of a foreign gene. We generated recombinant APMV-3 viruses expressing the green fluorescent protein (GFP) by inserting the GFP gene at five different intergenic regions in the genome. The levels of GFP transcription and translation were evaluated. Interestingly, the levels of GFP transcription and translation did not follow the 3'-to-5' attenuation mechanism of non-segmented, negative-sense RNA viruses. The insertion of GFP gene into the P-M gene junction resulted in higher level of expression of GFP than when the gene was inserted into the upstream N-P gene junction. Unlike NDV, insertion of GFP did not attenuate the growth efficiency of AMPV-3. Thus, APMV-3 could be a more useful vaccine vector for avian pathogens than NDV.
Fatal aspiration of foreign bodies in infants and children.
Bamber, Andrew R; Pryce, Jeremy; Ashworth, Michael; Sebire, Neil J
2014-02-01
To investigate the frequency, circumstances, demographics and autopsy findings of infants and children dying as a result of foreign body aspiration. Retrospective review of autopsy cases in children aged between seven days and 18 years, at one specialist centre over a 16-year period, in which death was the result of aspiration of a foreign body. Ten cases were identified out of a total autopsy population of 2165. Only one individual had an underlying diagnosis potentially contributing to aspiration. All but one case involved aspiration of food, with grapes being a feature of four cases. In cases with a prolonged survival interval, autopsy demonstrated bronchopneumonia and hypoxic-ischaemic encephalopathy. In the remaining cases autopsy findings were non-specific. Fatal aspiration of a foreign body is rare in this population. The cases involve normal children who aspirate food, particularly grapes. There are typically minimal, non-specific findings at autopsy.
Photoacoustic tomography of foreign bodies in soft biological tissue.
Cai, Xin; Kim, Chulhong; Pramanik, Manojit; Wang, Lihong V
2011-04-01
In detecting small foreign bodies in soft biological tissue, ultrasound imaging suffers from poor sensitivity (52.6%) and specificity (47.2%). Hence, alternative imaging methods are needed. Photoacoustic (PA) imaging takes advantage of strong optical absorption contrast and high ultrasonic resolution. A PA imaging system is employed to detect foreign bodies in biological tissues. To achieve deep penetration, we use near-infrared light ranging from 750 to 800 nm and a 5-MHz spherically focused ultrasonic transducer. PA images were obtained from various targets including glass, wood, cloth, plastic, and metal embedded more than 1 cm deep in chicken tissue. The locations and sizes of the targets from the PA images agreed well with those of the actual samples. Spectroscopic PA imaging was also performed on the objects. These results suggest that PA imaging can potentially be a useful intraoperative imaging tool to identify foreign bodies.
Yang, Zeyin; Yang, Xiaohong
2013-07-01
The patient was male, 20 years old, and complained of pain, bleeding and decreased vision after the right eye was injured by nail for an hour. right exophthalmos, conjunctival edema, skin laceration at the lower eyelid of right eye, limitation of eye movement, asymmetric eyes and weak light-reflecting. X-ray showed: metallic foreign body shadow in the right orbit, 0.5 cm x 0.4 cm approximately. Orbit and paranasal sinus CT showed: 1 hematoma of the right eye and inside. 2 high density foreign body embedded in the bone wall of the inside of right orbit and ethmoid. 3 medial wall fracture of right eye orbit. 4 bilateral maxillary sinus and right ethmoidal sinus effusion. 5 slightly left side of nasal septum. The patient was initially diagnosed as foreign body in right ethmoidal sinus, skin laceration of right lower eyelid, retrobulbar hematoma.
Silicone impression material foreign body in the middle ear: Two case reports and literature review.
Suzuki, Nobuyoshi; Okamura, Koji; Yano, Takuya; Moteki, Hideaki; Kitoh, Ryosuke; Takumi, Yutaka; Usami, Shin-ichi
2015-10-01
We report two cases of impression material foreign body in the middle ear. The first case had been affected with chronic otitis media. The silicone flowed into the middle ear through a tympanic membrane perforation during the process of making an ear mold. About 4 years and 8 months after, the patient had severe vertigo and deafness. We found bone erosion of the prominence of the lateral semicircular canal and diagnosed labyrinthitis caused by silicone impression material. In the second case silicone flowed into the canal wall down mastoid cavity. Both cases required surgery to remove the foreign body. The clinical courses in such cases are variable and timing of surgery is sometimes difficult. In addition to reporting these two cases, we present here a review of the literature regarding impression material foreign bodies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Leith, R; O'Connell, A C
2013-10-01
Young children habitually place objects in their mouths to discover and learn about the world and it is considered a normal stage of early childhood development. Ingestion and aspiration of foreign objects predominantly occurs in preschool toddlers with a peak incidence at age three years, and can have serious consequences. A 2-year-old boy presented to the Dublin Dental University Hospital with a tooth-coloured mass tightly adherent to a lower primary incisor. The lesion surrounded the cervical third of the crown on the lower right primary central incisor and extended subgingivally. The tooth was mobile but with minimal inflammation. The tooth was subsequently extracted under general anaesthesia to reveal that the mass was in fact a foreign body, although this was originally thought unlikely as a cause. The patient underwent an unremarkable recovery. The case of a foreign body disguised as a tooth-like abnormality was only identified under general anaesthesia, and even then it was impossible to prise the object from the tooth in situ. Misdiagnosis of impacted foreign bodies in young children presents complicated diagnostic problems.
Igarashi, Yutaka; Yokobori, Shoji; Yoshino, Yudai; Masuno, Tomohiko; Miyauchi, Masato; Yokota, Hiroyuki
2017-10-01
In Japan, the number of patients with foreign body airway obstruction by food is rapidly increasing with the increase in the population of the elderly and a leading cause of unexpected death. This study aimed to determine the factors that influence prognosis of these patients. This is a retrospective single institutional study. A total of 155 patients were included. We collected the variables from the medical records and analyzed them to determine the factors associated with patient outcome. Patient outcomes were evaluated using cerebral performance categories (CPCs) when patients were discharged or transferred to other hospitals. A favorable outcome was defined as CPC 1 or 2, and an unfavorable outcome was defined as CPC 3, 4, or 5. A higher proportion of patients with favorable outcomes than unfavorable outcomes had a witness present at the accident scene (68.8% vs. 44.7%, P=0.0154). Patients whose foreign body were removed by a bystander at the accident scene had a significantly high rate of favorable outcome than those whose foreign body were removed by emergency medical technicians or emergency physician at the scene (73.7% vs. 31.8%, P<0.0075) and at the hospital after transfer (73.7% vs. 9.6%, P<0.0001). The presence of a witness to the aspiration and removal of the airway obstruction of patients by bystanders at the accident scene improves outcomes in patients with foreign body airway obstruction. When airway obstruction occurs, bystanders should remove foreign bodies immediately. Copyright © 2017 Elsevier Inc. All rights reserved.
Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-09
... request would add deodorant/antiperspirant and body wash gift sets and certain foreign components to the... the duty rates during customs entry procedures that apply to deodorant/antiperspirant and body wash...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Madin, Mark Michael; Wicks, Christopher Donald
A cam carrier assembly includes a body made of a material lighter than aluminum. The body has a first side operably coupled with a cylinder head and a second side having bearing surfaces with bearing inserts. The bearing inserts support the camshaft. A series of apertures extend between the first and second sides of the body. Lobes of the camshaft operably couple with the valves of the cylinder head through the series of apertures extending between the first and second sides of the body.
Active role of a human genomic insert in replication of a yeast artificial chromosome.
van Brabant, A J; Fangman, W L; Brewer, B J
1999-06-01
Yeast artificial chromosomes (YACs) are a common tool for cloning eukaryotic DNA. The manner by which large pieces of foreign DNA are assimilated by yeast cells into a functional chromosome is poorly understood, as is the reason why some of them are stably maintained and some are not. We examined the replication of a stable YAC containing a 240-kb insert of DNA from the human T-cell receptor beta locus. The human insert contains multiple sites that serve as origins of replication. The activity of these origins appears to require the yeast ARS consensus sequence and, as with yeast origins, additional flanking sequences. In addition, the origins in the human insert exhibit a spacing, a range of activation efficiencies, and a variation in times of activation during S phase similar to those found for normal yeast chromosomes. We propose that an appropriate combination of replication origin density, activation times, and initiation efficiencies is necessary for the successful maintenance of YAC inserts.
Management of tracheo-bronchial foreign bodies in children.
Sisenda, T M; Khwa-Otsyula, B O; Wambani, J O
2002-11-01
To review alternative surgical and anaesthetic options in the management of foreign bodies lodged in the tracheobronchial tree in children aged below 10 years. A five year retrospective secondary data analysis. Three hospitals based in Eldoret Municipality, Kenya. Outcome variables included morbidity and mortality. Of the thirty two children studied, 74.1% had bronchoscopy and 25.9% thoracotomy. The overall mortality rate was 3.3%. Foreign bodies in the tracheo-bronchial tree are a major cause of morbidity and mortality in children aged below 10 years. In settings where appropriate equipment is inadequate, timely thoracotomy may be life saving.
An unusual intracranial metallic foreign bodies and panhypopituitarism.
Lakouichmi, Mohammed; Baïzri, Hicham; Mouhsine, Abdelilah; Boukhira, Abderrahmane; Akhaddar, Ali
2014-01-01
A 49 years old man, with a history of aggression at the age of 18 years by a pair of scissors, who consulted for unilateral migraine headaches look straight. Paraclinical explorations concluded that trauma to anterior pituitary by a metallic foreign body from the right nostril to the sella, responsible for panhypopituitarism and sinusitis. The headaches are frequent causes of consultation, often treated symptomatically but rarely explored. The direct trauma to the pituitary gland, by a metallic foreign body, is exceptional. We report the case of neglected panhypopituitarism, discovered 31 years after injury with a pair of scissors.
An unusual intracranial metallic foreign bodies and panhypopituitarism
Lakouichmi, Mohammed; Baïzri, Hicham; Mouhsine, Abdelilah; Boukhira, Abderrahmane; Akhaddar, Ali
2014-01-01
A 49 years old man, with a history of aggression at the age of 18 years by a pair of scissors, who consulted for unilateral migraine headaches look straight. Paraclinical explorations concluded that trauma to anterior pituitary by a metallic foreign body from the right nostril to the sella, responsible for panhypopituitarism and sinusitis. The headaches are frequent causes of consultation, often treated symptomatically but rarely explored. The direct trauma to the pituitary gland, by a metallic foreign body, is exceptional. We report the case of neglected panhypopituitarism, discovered 31 years after injury with a pair of scissors. PMID:25667695
Spontaneous passage of long, sharp gastrointestinal foreign body in a child.
Karthikeyan, Vilvapathy Senguttuvan; Ansari, Mohammed Gaffoor; Suresh, Ramasamy; Easwaran, Bettaiyagowder
2015-01-19
Foreign body (FB) ingestion is a common problem in children. Up to 90% of these FBs pass spontaneously. FBs reaching the stomach usually pass out spontaneously. Exceptions to this spontaneous passage include a long FB that cannot cross the pylorus, duodenum or ileocaecal junction. We present a case of a 9-year boy who accidentally ingested a long paper pin, which spontaneously passed in 26 h. This case is being reported to highlight the successful spontaneous passage of a 4 cm long sharp foreign body in a child. 2015 BMJ Publishing Group Ltd.
Fatal hemothorax following management of an esophageal foreign body.
Cohn, Leah A; Stoll, Melissa R; Branson, Keith R; Roudabush, Alice D; Kerl, Marie E; Langdon, Paige F; Johannes, Chad M
2003-01-01
A 10.8-year-old, spayed female toy poodle presented with an esophageal foreign body. The foreign body was removed endoscopically, and a gastrostomy tube was placed to provide nutritional support during esophageal healing. The gastrostomy tube was later removed by endoscopic retrieval of the bulb through the esophagus. Immediately afterward, the dog developed hemothorax and eventually died. It was determined that many small arterial branches were avulsed from the aorta. The involved sections of aorta histopathogically evidenced medial necrosis, which was believed to be related to a prior disruption of blood flow through the vasa vasorum.
Langer, D; Petermann, C; Lübbers, H; Lankisch, P G
1999-04-01
In the great majority of cases of long-standing intrathoracic foreign bodies, patients are asymptomatic. However, symptoms may occur years later from the migration of the foreign body. We report on a 70-year-old patient who developed relapsing pneumonia due to obstruction of a bronchial branch of the left apical group by a migrating infantry bullet impacting 53 years ago. This was not diagnosed until the second attack of pneumonia in 1998. The bullet remains were removed bronchoscopically and the pneumonia resolved completely without further complications.
Khan, M Sarwar; Kirkland, P M; Kumar, R
2002-02-01
Firework injuries can manifest themselves in many different ways; usually as an explosive or burn injury. This case describes an unusual presentation of a firework penetrating injury resulting in a sharp coiled metal foreign body travelling through a small entry wound in the neck and subsequently lodging itself in the tracheobronchial tree. A foreign body such as this can potentially travel a considerable distance through the soft tissues and end up in an unsuspecting distant site. There must, therefore, be a high index of suspicion with the appropriate radiological investigations for appropriate management of such cases.
Increasing trend in retained rectal foreign bodies.
Ayantunde, Abraham A; Unluer, Zynep
2016-10-27
To highlight the rising trend in hospital presentation of foreign bodies retained in the rectum over a 5-year period. Retrospective review of the cases of retained rectal foreign bodies between 2008 and 2012 was performed. Patients' clinical data and yearly case presentation with data relating to hospital episodes were collected. Data analysis was by SPSS Inc. Chicago, IL, United States. Twenty-five patients presented over a 5-year period with a mean age of 39 (17-62) years and M: F ratio of 2:1. A progressive rise in cases was noted from 2008 to 2012 with 3, 4, 4, 6, 8 recorded patients per year respectively. The majority of the impacted rectal objects were used for self-/partner-eroticism. The commonest retained foreign bodies were sex vibrators and dildos. Ninty-six percent of the patients required extraction while one passed spontaneously. Two and three patients had retrieval in the Emergency Department and on the ward respectively while 19 patients needed examination under anaesthesia for extraction. The mean hospital stay was 19 (2-38) h. Associated psychosocial issues included depression, deliberate self-harm, illicit drug abuse, anxiety and alcoholism. There were no psychosocial problems identified in 15 patients. There is a progressive rise in hospital presentation of impacted rectal foreign bodies with increasing use of different objects for sexual arousal.
Boomer, Laura A; Watkins, Daniel J; O'Donovan, Julie; Kenney, Brian D; Yates, Andrew R; Besner, Gail E
2015-03-01
Penetrating thoracic trauma is relatively rare in the pediatric population. Embolization of foreign bodies from penetrating trauma is very uncommon. We present a case of a 6-year-old boy with a penetrating foreign body from a projectile dislodged from a lawn mower. Imaging demonstrated a foreign body that embolized to the left pulmonary artery, which was successfully treated non-operatively. We reviewed the penetrating thoracic trauma patients in the trauma registry at our institution between 1/1/03 and 12/31/12. Data collected included demographic data, procedures performed, complications and outcome. Sixty-five patients were identified with a diagnosis of penetrating thoracic trauma. Fourteen of the patients had low velocity penetrating trauma and 51 had high velocity injuries. Patients with high velocity injuries were more likely to be older and less likely to be Caucasian. There were no statistically significant differences between patients with low vs. high velocity injuries regarding severity scores or length of stay. There were no statistically significant differences in procedures required between patients with low and high velocity injuries. Penetrating thoracic trauma is rare in children. The case presented here represents the only report of cardiac foreign body embolus we could identify in a pediatric patient.
Kelloniemi, Jani; Mäkinen, Kristiina; Valkonen, Jari P T
2006-05-01
Potato virus A (PVA), a potyvirus with a (+)ssRNA genome translated to a large polyprotein, was engineered and used as a gene vector for expression of heterologous proteins in plants. Foreign genes including jellyfish GFP (Aequorea victoria) encoding the green fluorescent protein (GFP, 27 kDa) and the genes of human origin (Homo sapiens) encoding a soluble resistance-related calcium-binding protein (sorcin, 22 kDa) and the catechol-O-methyltransferase (S-COMT; 25 kDa) were cloned between the cistrons for the viral replicase and coat protein (CP). The inserts caused no adverse effects on viral infectivity and virulence, and the inserted sequences remained intact in progeny viruses in the systemically infected leaves. The heterologous proteins were released from the viral polyprotein following cleavage by the main viral proteinase, NIa, at engineered proteolytic processing sites flanking the insert. Active GFP, as indicated by green fluorescence, and S-COMT with high levels of enzymatic activity were produced. In contrast, no sorcin was detected despite the expected equimolar amounts of the foreign and viral proteins being expressed as a polyprotein. These data reveal inherent differences between heterologous proteins in their suitability for production in plants.
Non food foreign body injuries.
Slapak, Ivo; Passali, Francesco Maria; Gulati, Achal
2012-05-14
The aim of the present study is to acquire a better understanding of Non Food Foreign Bodies (NFFB) injuries in children with particular regard to the quantification of the risk of complications and hospitalization associated with patient characteristics, FB features, FB location and circumstances of the accident, as emerging from the SUSY Safe Web-Registry. The present study uses data provided by the SUSY Safe Project, a DG SANCO co-funded project which was aimed to collect as many scientific data as possible regarding Foreign Bodies (FB) injuries in children aged 0-14 years and to serve as a basis for a knowledge-based consumer protection activity in the Europe market. FBs were characterized by size, shape and consistency. Descriptive statistics (absolute and relative number or median, I and III quartile according to the categorical or continuous variable, respectively) were calculated for each considered non food item characteristics; FB features distribution by children class age and site of obstruction were assessed. Two different outcomes were considered: hospitalization and complication. FBs which most frequently cause complications were identified. The association between children age, adult presence, object characteristics and outcomes was computed using crude odds ratios and the related 95% confidence intervals. 16,878 FB injuries in children aged 0-14 yrs have been recorded in the Susy Safe databases. FB type was specified in 10,564 cases; among them 7820 (74%) were due to a non food item. Almost two thirds of injuries occurred in patients 3 years or more old. 53% of patients were males, while 47% were females. When injury happened, the great part of children (86%) was playing. Almost 30% (2339) of injuries happened under adults' supervision. Complications occurred in 299 cases and the most documented was infections (10% of cases) followed by perforation (5%). The inhalation/aspiration of a FB, as well as the ingestion and the insertion in the orifices of a FB may result in significant morbidity. Particularly, long-standing or hazardous foreign bodies can cause extensive damage. Some objects, because of their composition, contour, or location, are particularly hazardous: for instance, objects with sharp edges pose a significant risk of laceration and perforation, while fragments of toys have been found only in 2 cases. Parents are frequently unconscious of hazard related with some objects and they are not adequately able to promptly recognize dangerous objects and risky situations. Moreover, also clinicians seem to pay little attention to adult role in the dynamic of the accident: in fact in case series descriptions, data regarding adult presence are often under-reported. On the contrary, since many injuries to children cannot be prevented without some degree of active behavior on the part of parents, the dissemination of information regarding safe behaviors and the implementation of educational strategies aiming to improve parent's attention toward this issue could be fundamental in preventing injuries and need to be promoted by family pediatricians and health practitioners. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
48 CFR 925.7004 - Contract clause.
Code of Federal Regulations, 2010 CFR
2010-10-01
... FOREIGN ACQUISITION Acquisition of Nuclear Hot Cell Services 925.7004 Contract clause. The contracting officer shall insert the clause at 952.225-70, Subcontracting for Nuclear Hot Cell Services, in solicitations and contracts involving nuclear hot cell services. This clause does not flow down to second-tier...
22 CFR 41.12 - Classification symbols.
Code of Federal Regulations, 2014 CFR
2014-04-01
... Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Classification of Nonimmigrants § 41.12 Classification symbols. A visa... appropriate visa symbol to show the classification of the alien. The symbol shall be inserted in the space...
22 CFR 41.12 - Classification symbols.
Code of Federal Regulations, 2013 CFR
2013-04-01
... Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Classification of Nonimmigrants § 41.12 Classification symbols. A visa... appropriate visa symbol to show the classification of the alien. The symbol shall be inserted in the space...
22 CFR 41.12 - Classification symbols.
Code of Federal Regulations, 2012 CFR
2012-04-01
... Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Classification of Nonimmigrants § 41.12 Classification symbols. A visa... appropriate visa symbol to show the classification of the alien. The symbol shall be inserted in the space...
48 CFR 925.7004 - Contract clause.
Code of Federal Regulations, 2012 CFR
2012-10-01
... FOREIGN ACQUISITION Acquisition of Nuclear Hot Cell Services 925.7004 Contract clause. The contracting officer shall insert the clause at 952.225-70, Subcontracting for Nuclear Hot Cell Services, in solicitations and contracts involving nuclear hot cell services. This clause does not flow down to second-tier...
48 CFR 925.7004 - Contract clause.
Code of Federal Regulations, 2014 CFR
2014-10-01
... FOREIGN ACQUISITION Acquisition of Nuclear Hot Cell Services 925.7004 Contract clause. The contracting officer shall insert the clause at 952.225-70, Subcontracting for Nuclear Hot Cell Services, in solicitations and contracts involving nuclear hot cell services. This clause does not flow down to second-tier...
48 CFR 925.7004 - Contract clause.
Code of Federal Regulations, 2013 CFR
2013-10-01
... FOREIGN ACQUISITION Acquisition of Nuclear Hot Cell Services 925.7004 Contract clause. The contracting officer shall insert the clause at 952.225-70, Subcontracting for Nuclear Hot Cell Services, in solicitations and contracts involving nuclear hot cell services. This clause does not flow down to second-tier...
48 CFR 925.7004 - Contract clause.
Code of Federal Regulations, 2011 CFR
2011-10-01
... FOREIGN ACQUISITION Acquisition of Nuclear Hot Cell Services 925.7004 Contract clause. The contracting officer shall insert the clause at 952.225-70, Subcontracting for Nuclear Hot Cell Services, in solicitations and contracts involving nuclear hot cell services. This clause does not flow down to second-tier...
[Three cases of an intracranial wooden foreign body].
Fujimoto, S; Onuma, T; Amagasa, M; Okudaira, Y
1987-07-01
Three cases of intracranial wooden foreign body are reported discussing the diagnostic and therapeutic problems. First case is a 50-year-old man. After drinking, he drove a bike and fell to the ground. On admission the wooden foreign body could not been detected in appearance. CT scan showed low density area similar to air in bilateral anterior horn of lateral ventricle. The patient was treated for traumatic pneumocephalus at first. Later, it proved that he was stabbed with a foreign body penetrating into the contralateral frontal lobe through the left nasal cavity. It was extracted by endonasal approach by otolaryngologist, fortunately without trouble. The foreign body was a branch of tree. The second case is an 18-year-old man. He was driving a car, and suffered injury. He was stabbed with a wooden stake penetrating into his left eye. Immediately, bifrontal craniotomy was performed and the stake was withdrawn carefully. Moreover bone fragments were removed. The third case is a 61-year-old man. When he cut the timber by chain saw, a piece of wood hit and stabbed his right eye directly. Immediately right front temporal craniotomy was performed. The piece of wood was withdrawn from the right eye, and pieces of glass, wood and bone fragments were evacuated. It is difficult to confirm intracranial foreign body accurately by means of only plain skull film and usual CT scans. It is necessary to utilize various function of CT scanner. For example, it is useful to know CT values or select measure mode with window width and level or make reconstruction image to sagittal or coronal section, and so on.(ABSTRACT TRUNCATED AT 250 WORDS)
Esophageal foreign bodies in pediatric patients: a thirteen-year retrospective study.
Rybojad, Beata; Niedzielska, Grazyna; Niedzielski, Artur; Rudnicka-Drozak, Ewa; Rybojad, Pawel
2012-01-01
We discuss clinical symptoms and radiological findings of variable esophageal foreign bodies as well as therapeutic procedures in Caucasian pediatric patients. A retrospective study of 192 cases of suspected esophageal foreign bodies between 1998 and 2010 was conducted. Data were statistically analyzed by chi-square test. A foreign body was removed from a digestive tract of 163 children aged 6 months to 15 years (mean age 4.9). Most objects were located within cricopharyngeal sphincter. Dysphagia occurred in 43%, followed by vomiting (29%) and drooling (28%). The most common objects were coins. Plain chest X-rays demonstrated aberrations in 132 cases, and in doubtful situations an esophagram test was ordered. In the group of thirty-seven patients whose radiograms were normal, esophagoscopy revealed fifteen more objects, which were eventually successfully removed. No major complications occurred. Esophagram should be a second X-ray examination if an object is not detected in plain chest X-ray. We recommend a rigid esophagoscopy under general anesthesia in doubtful cases as a safe treatment for pediatric patients.
Fan, Jian; Wang, Ming-Ming; Liu, Yu-Ping
2017-01-01
Abstract Penetrating sacral injuries are very rare, but foreign bodies that penetrate the sacrum often cause pain, cerebrospinal fluid leakage, and neurological symptoms. Careful preoperative medical and imaging examinations, determining the position of the foreign body, and surgical exploration are essential in the management of such cases. We present the case of a woman who visited our emergency department with a broken sewing needle in her sacrum. The incident occurred when the patient accidentally sat on the needle while sewing by hand. Pain while sitting was the main clinical finding after the accident. The patient was treated successfully by surgical exploration aided by a permanent magnet. At follow-up a few months later, she was symptom-free. In clinical practice physicians often encounter patients with metallic foreign bodies. Permanent magnets play an important role in the removal of metallic foreign bodies, and emergency department physicians should master the methods and techniques. PMID:29318191
Fan, Jian; Wang, Ming-Ming; Liu, Yu-Ping
2017-01-01
Penetrating sacral injuries are very rare, but foreign bodies that penetrate the sacrum often cause pain, cerebrospinal fluid leakage, and neurological symptoms. Careful preoperative medical and imaging examinations, determining the position of the foreign body, and surgical exploration are essential in the management of such cases. We present the case of a woman who visited our emergency department with a broken sewing needle in her sacrum. The incident occurred when the patient accidentally sat on the needle while sewing by hand. Pain while sitting was the main clinical finding after the accident. The patient was treated successfully by surgical exploration aided by a permanent magnet. At follow-up a few months later, she was symptom-free. In clinical practice physicians often encounter patients with metallic foreign bodies. Permanent magnets play an important role in the removal of metallic foreign bodies, and emergency department physicians should master the methods and techniques.
Use of a video laryngoscope to facilitate removal of a long, sharp-pointed blade from the esophagus.
Hiller, Kenneth N; Hagberg, Carin A
2016-08-01
Initial management of ingested esophageal foreign bodies involves airway assessment, determination of the requirement for and timing of therapeutic intervention, risk mitigation during removal, and identification of all indicated equipment for retrieval. Long, sharp-pointed objects lodged in the esophagus require emergent attention and should be retrieved endoscopically, if perforation has not occurred. Inducing general anesthesia and rapidly securing the airway can minimize the risk of aspiration, mitigate any effects of tracheal compression, avoid the potential of exacerbating existing trauma, and provide optimal conditions for removal of long, sharp-pointed esophageal foreign bodies. Video laryngoscopy provides improved recognition of anatomical structures in both normal and difficult airways, enabling assessment for hypopharyngeal and glottic trauma resulting from foreign body ingestion. The indirect view of video laryngoscopy also facilitates the coordinated manipulation of the airway by both the anesthesiologist and the surgeon as they visualize the anatomy together while securing the airway and removing the foreign body. Copyright © 2016 Elsevier Inc. All rights reserved.
A sticky situation: management of spray polyurethane foam insulation in body orifices.
Sowerby, Robert J; Sowerby, Leigh J; Vinden, Chris
2011-11-01
Spray polyurethane foam insulation is commonly used in the construction industry to fill gaps, seal, and insulate. We present three cases of intentional spray foam insertion in body orifices and discuss the management of such situations in the emergency department. This series includes a case of oral foam insertion used in a suicide attempt by suffocation and two cases of rectal insertion. All of these cases had potential long-term consequences; one was life-threatening. To our knowledge, this is the first published report on the medical management and removal of foam insulation from body orifices. In all three cases, the foam insulation material was successfully removed after allowing the material to harden.
Taheri, Abolfazl; Mehmandari, Sina Navaei; Shahidi, Mojtaba; Mehdizadeh, Hamidreza; Mirlohi, Seyyed Mohammad Javad; Aref, Nasrin Mohammadi; Avanaki, Mahsa Alborzi; Khosravi, Mohammad Hossein
2017-12-01
To evaluate the prevalence of external ear complications among Iranian aural foreign body users attending to otolaryngology clinic of our hospital. In this cross-sectional study patients attending to Otolaryngology clinics of Baqiyatallah hospital were enrolled regardless of their age, gender and reason of attending. Patients between 15 and 60 years of age were included in the present study. Those with positive history of chronic ear diseases, ear surgery, congenital ear disorders, trauma to ear or head and neck region or shock wave trauma were excluded from the study. Demographic information as well as data on chief complaint, educational level, frequency and type of used foreign body and findings of physical examination and Otoscopy by a single otolaryngologist were recorded in a predesigned checklist. Eventually 362 patients (232 male and 130 female) with a mean age of 40.32 ± 16.90 years underwent analysis. Of all patients 244 (67.2%) were using a kind of aural foreign body frequently and Cotton bud was the most popular (63.5%) used foreign body among patients. Drying ear canal was the most common (54.9%) reason of using AFBs among study individuals followed by itching (29.5%) and pyorrhea (11.06%). Also 11 (4.5%) patients were using AFBs as a habit with no specific reason. Itching was the most prevalent symptom reported by both aural foreign body users (78%) and non-users (45.5%); however it was significantly higher among AFB users (p = 0.026). Also hearing loss was significantly more reported by AFB users (p = 0.033). A majority of patients had normal physical examination in both AFB users and non-users group. Inflammation of ear canal was significantly more detected in AFB users (p = 0.004). In addition, rate of right ear wax impaction was higher among AFB users (p = 0.016). In conclusion we realized that 67.2% of patients attending to Otolaryngology clinic of our hospital were using a kind of aural foreign bodies and itching was the most common chief complaint of these patients.
Scapular insertion of the rabbit latissimus dorsi muscle: gross anatomy and fibre-type composition.
Barron, D J; Etherington, P J; Winlove, C P; Pepper, J R
2001-01-01
This paper defines the characteristics and significance of the scapular insertion of the latissimus dorsi muscle (LDM) of the rabbit. In a study of the New Zealand White species (n = 10) the scapular insertion was found to be a consistent anatomical feature of the LDM that made up 12.3% (+/-2.3) of the total muscle weight. The fibres arise from the medial aspect of the body of the LDM and run in a caudocranial direction to be inserted into a broad, thin tendon beneath the scapula ridge. This is morphologically different from the scapular component of the human LDM which is a well-recognized but inconsistent feature and consists of no more than a small leash of fibres running around the lower pole of the scapula. The scapular insertion was deeper red in colour than the body of the muscle and fibre-typing demonstrated a mean slow-fibre composition of 49% (+/-2.6) compared to 16% (+/-1.7) for the body of the muscle (p < 0.01). Mapping of the fibre types throughout the remainder of the LDM confirmed that the body of the muscle was of fast phenotype but with significantly more slow fibres in the superomedial segment of the muscle than elsewhere. This region of the muscle contributes mainly to the scapular insertion and it is proposed that this part of the muscle takes on a predominantly postural role in stabilising the scapula during movement of the forelimb.
Peyret, Hadrien; Gehin, Annick; Thuenemann, Eva C.; Blond, Donatienne; El Turabi, Aadil; Beales, Lucy; Clarke, Dean; Gilbert, Robert J. C.; Fry, Elizabeth E.; Stuart, David I.; Holmes, Kris; Stonehouse, Nicola J.; Whelan, Mike; Rosenberg, William; Lomonossoff, George P.; Rowlands, David J.
2015-01-01
The core protein of the hepatitis B virus, HBcAg, assembles into highly immunogenic virus-like particles (HBc VLPs) when expressed in a variety of heterologous systems. Specifically, the major insertion region (MIR) on the HBcAg protein allows the insertion of foreign sequences, which are then exposed on the tips of surface spike structures on the outside of the assembled particle. Here, we present a novel strategy which aids the display of whole proteins on the surface of HBc particles. This strategy, named tandem core, is based on the production of the HBcAg dimer as a single polypeptide chain by tandem fusion of two HBcAg open reading frames. This allows the insertion of large heterologous sequences in only one of the two MIRs in each spike, without compromising VLP formation. We present the use of tandem core technology in both plant and bacterial expression systems. The results show that tandem core particles can be produced with unmodified MIRs, or with one MIR in each tandem dimer modified to contain the entire sequence of GFP or of a camelid nanobody. Both inserted proteins are correctly folded and the nanobody fused to the surface of the tandem core particle (which we name tandibody) retains the ability to bind to its cognate antigen. This technology paves the way for the display of natively folded proteins on the surface of HBc particles either through direct fusion or through non-covalent attachment via a nanobody. PMID:25830365
Rabah, Samar O; Lee, Chaehee; Hajrah, Nahid H; Makki, Rania M; Alharby, Hesham F; Alhebshi, Alawiah M; Sabir, Jamal S M; Jansen, Robert K; Ruhlman, Tracey A
2017-11-01
In plant evolution, intracellular gene transfer (IGT) is a prevalent, ongoing process. While nuclear and mitochondrial genomes are known to integrate foreign DNA via IGT and horizontal gene transfer (HGT), plastid genomes (plastomes) have resisted foreign DNA incorporation and only recently has IGT been uncovered in the plastomes of a few land plants. In this study, we completed plastome sequences for l0 crop species and describe a number of structural features including variation in gene and intron content, inversions, and expansion and contraction of the inverted repeat (IR). We identified a putative in cinnamon ( J. Presl) and other sequenced Lauraceae and an apparent functional transfer of to the nucleus of quinoa ( Willd.). In the orchard tree cashew ( L.), we report the insertion of an ∼6.7-kb fragment of mitochondrial DNA into the plastome IR. BLASTn analyses returned high identity hits to mitogenome sequences including an intact open reading frame. Using three plastome markers for five species of , we generated a phylogeny to investigate the distribution and timing of the insertion. Four species share the insertion, suggesting that this event occurred <20 million yr ago in a single clade in the genus. Our study extends the observation of mitochondrial to plastome IGT to include long-lived tree species. While previous studies have suggested possible mechanisms facilitating IGT to the plastome, more examples of this phenomenon, along with more complete mitogenome sequences, will be required before a common, or variable, mechanism can be elucidated. Copyright © 2017 Crop Science Society of America.
A rare cause of gastric obstruction: Lighters swallowing.
Aday, Ulas; Tardu, Ali; Yagci, Mehmet Ali; Yonder, Huseyin
2015-01-01
The majority of swallowed foreign bodies are thrown spontaneously without causing complications in the digestive system. Multiple number of foreign bodies may be swallowed by psychiatric patients which delay diagnosis and increase the complication rate. Long and hard objects cannot pass through the pylorus, and may cause obstruction, ulceration, bleeding and perforation. Endoscopy is used as an effective method in such cases. An exploratory laparatomy was performed after unsuccessful endoscopic foreign object removal in a 28-year-old schizophrenic patient with gastric outlet obstruction due to multiple cigarette lighter swallowing. Ten lighters were removed from the stomach through gastrotomy and one more lighter was removed from the descending colon by milking through the anus. The aim of this paper is to discuss encountered difficulties in psychiatric patients who underwent surgery due to intake of foreign bodies.
[Local foreign body reactions to biodegradable implants. A classification].
Hoffmann, R; Weller, A; Helling, H J; Krettek, C; Rehm, K E
1997-08-01
Biodegradable implants are increasingly used in orthopedic and trauma surgery. Many different implants consisting of different biodegradable polymers are currently available. Different factors contribute to the biocompatibility of these implants, and local foreign-body reactions remain a matter of concern. Therefore, it is mandatory to document and compare the tissue reactions caused by various biodegradable implants in experimental or clinical studies. We have developed a standardized system of classification based on our previous experimental and clinical observations. Foreign-body reactions are differentiated into osteolysis (0-0 to 0-4), extra-articular (EA-0 to EA-4) and intraarticular (IA-0 to A-4) soft-tissue reactions.
An unusual case of intraorbital foreign body and its management
Mukherjee, Bipasha; Goel, Shubhra; Subramanian, Nirmala
2011-01-01
Intraorbital foreign bodies are usually the result of accidental trauma and can lead to considerable morbidity. We report an unusual case of an industrial injury in a plastic manufacuring unit wherein hot molten plastic splashed and solidified inside the orbit. The resultant increased intraorbital pressure led to loss of vision in that eye. The extreme temperature of the foreign body caused extensive thermal damage to the surrounding adnexal structures. Staged reconstructive surgery was undertaken to repair the damage, with an acceptable final cosmetic outcome. Employment of protective eye wear to prevent such accidents in high-risk occupations should be made mandatory. PMID:21157077
21 CFR 524.1982 - Proparacaine ophthalmic solution.
Code of Federal Regulations, 2014 CFR
2014-04-01
... is used as an anesthetic in cauterization of corneal ulcers, removal of foreign bodies and sutures from the cornea, and measurement of intraocular pressure (tonometry) when glaucoma is suspected; as an... cauterization of corneal ulcers, removal of foreign bodies and sutures from the cornea, and measurement of...
Uy, Harvey S; Kenyon, Kenneth R
2013-11-01
To compare the anatomic and refractive outcomes in eyes having phacoemulsification with 1 of 3 clear corneal incision (CCI) closure methods. Ambulatory surgical center, Makati, Philippines. Prospective randomized clinical trial. Patients having phacoemulsification cataract surgery had wound closure using no additional treatment (control), a single 10-0 nylon suture, or a liquid adhesive ocular bandage (Ocuseal). The main outcome measures were wound-edge closure rates, surgically induced astigmatism (SIA), foreign-body sensation, and intraocular pressure (IOP) 1, 3, 5, 7, and 14 days postoperatively. The study evaluated 90 eyes. There was a significant improvement in wound-edge closure rates in the suture group and the ocular bandage group compared with the control group (P<.001). A significant increase in SIA occurred in the sutured group but not in the control or ocular bandage groups (P<.001). The ocular bandage group had significantly less foreign-body sensation than the control and suture groups (P<.001). There were no significant differences in IOP between the groups (P=.515). The liquid adhesive ocular bandage resulted in improved wound-edge closure, reduced SIA, and diminished foreign-body sensation. Suturing was associated with improved wound-edge closure but increased SIA and foreign-body sensation. Unsutured incisions led to delayed wound-edge closure and increased foreign-body sensation. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
Swallowed foreign bodies in adults.
Ambe, Peter; Weber, Sebastian A; Schauer, Mathias; Knoefel, Wolfram T
2012-12-01
Foreign-body ingestion is a common event most often seen in children from 6 months to 6 years of age. In adults, foreign bodies are usually ingested accidentally together with food. This happens more commonly in persons with certain pathological changes of the gastrointestinal tract. We present a selective review of pertinent literature retrieved by a search in the PubMed database. The foreign bodies most commonly ingested by adults are fish bones and chicken bones. The clinical approach to the problem depends on the type of material ingested and on the patient's symptoms and physical findings. In about 80% of cases, the ingested material passes uneventfully through the gastrointestinal tract; endoscopy is performed in about 20% of cases, and surgery in less than 1%. Emergency esophagogastroduodenoscopy (EGD) is recommended when the esophagus is completely occluded (because of the risk of aspiration and/or pressure necrosis), when the ingested object has a sharp point or edge (because of the risk of perforation, with ensuing mediastinitis or peritonitis), and when a battery has been ingested (because of the risk of necrosis and fistula formation). For non-occluding esophageal foreign bodies, including magnets, an urgent but non-emergency EGD within 12 to 24 hours is recommended. Most patients can be treated conservatively by observation alone, but there should be a low threshold for deciding to proceed to endoscopic retrieval. Surgery is reserved for complicated cases.
Foreign bodies ingestion: what responsibility?
Ricci, Serafino; Massoni, Francesco; Schiffino, Luigi; Pelosi, Marcello; Salesi, Marialucia
2014-03-01
The ingestion of foreign bodies is one of the most important and difficult emergencies for a physician to diagnose. Accidental ingestion is more common in children, in patients with dental implants, in individuals with mental disability and in drug users. Voluntary ingestion is found in patients who are psychologically unstable, in prisoners or those who attempt suicide. Foreign bodies may be divided into food as fish bones, chicken bones, food bolus, meat, etc. or real foreign bodies such as orthodontic implants, needles, pins, glass, coins, etc. The authors present a case of management, from the medicolegal point of view, of a female patient age 80, who complained, for some weeks of modest pain in the left iliac fossa, and afterwards the endoscopy showed a toothpick into the wall of the sigmoid colon. Assessed of the clinical status of the patient presented severe cardiac comorbidities so that before processing the patient to a second resolutive endoscopy, it was necessary to obtain the hemodynamic stability. However the management of cases of accidental ingestion of foreign bodies is particularly difficult. Medical errors can arise from the very first contact with the patient resulting in delays in appropriate treatment. The doctor to avoid compromising its position on medical liability, must use all the knowledge and diligence known by the art and science of medicine. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Increasing trend in retained rectal foreign bodies
Ayantunde, Abraham A; Unluer, Zynep
2016-01-01
AIM To highlight the rising trend in hospital presentation of foreign bodies retained in the rectum over a 5-year period. METHODS Retrospective review of the cases of retained rectal foreign bodies between 2008 and 2012 was performed. Patients’ clinical data and yearly case presentation with data relating to hospital episodes were collected. Data analysis was by SPSS Inc. Chicago, IL, United States. RESULTS Twenty-five patients presented over a 5-year period with a mean age of 39 (17-62) years and M: F ratio of 2:1. A progressive rise in cases was noted from 2008 to 2012 with 3, 4, 4, 6, 8 recorded patients per year respectively. The majority of the impacted rectal objects were used for self-/partner-eroticism. The commonest retained foreign bodies were sex vibrators and dildos. Ninty-six percent of the patients required extraction while one passed spontaneously. Two and three patients had retrieval in the Emergency Department and on the ward respectively while 19 patients needed examination under anaesthesia for extraction. The mean hospital stay was 19 (2-38) h. Associated psychosocial issues included depression, deliberate self-harm, illicit drug abuse, anxiety and alcoholism. There were no psychosocial problems identified in 15 patients. CONCLUSION There is a progressive rise in hospital presentation of impacted rectal foreign bodies with increasing use of different objects for sexual arousal. PMID:27830039
Manson, William C; Ryan, James G; Ladner, Heidi; Gupta, Sanjey
2011-01-01
Introduction We compared the immediate cosmetic outcome of metallic foreign-body removal by emergency medicine (EM) residents with ultrasound guidance and conventional radiography. Methods This single-blinded, randomized, crossover study evaluated the ability of EM residents to remove metallic pins embedded in pigs' feet. Before the experiment, we embedded 1.5-cm metallic pins into numbered pigs' feet. We randomly assigned 14 EM residents to use either ultrasound or radiography to help remove the foreign body. Residents had minimal ultrasound experience. After a brief lecture, we provided residents with a scalpel, laceration kit, a bedside portable ultrasound machine, nipple markers, paper clips, a dedicated radiograph technician, and radiograph machine 20 feet away. After removal, 3 board-certified emergency physicians, who were blinded to the study group, evaluated the soft-tissue model by using a standardized form. They recorded incision length and cosmetic appearance on the Visual Analog Scale. Results In total, 28 foreign bodies were removed. No significant difference in the time of removal (P = 0.12), cosmetic appearance (P = 0.96), or incision length (P = 0.76) was found. Conclusion This study showed no difference between bedside ultrasound and radiography in assisting EM residents with metallic foreign-body removal from soft tissue. No significant difference was found in removal time or cosmetic outcome when comparing ultrasound with radiography. PMID:22224139
Syed, Reema; Kim, Sung-Hye; Palacio, Agustina; Nunery, William R; Schaal, Shlomit
2017-06-06
The study was inspired after the authors encountered a patient with a penetrating globe injury due to drywall, who had retained intraocular drywall foreign body. Computed tomography (CT) was read as normal in this patient. Open globe injury with drywall has never been reported previously in the literature and there are no previous studies describing its radiographic features. The case report is described in detail elsewhere. This was an experimental study. An ex vivo model of 15 porcine eyes with 1 mm to 5 mm fragments of implanted drywall, 2 vitreous only samples with drywall and 3 control eyes were used. Eyes and vitreous samples were CT scanned on Days 0, 1, and 3 postimplantation. Computed ocular images were analyzed by masked observers. Size and radiodensity of intraocular drywall were measured using Hounsfield units (HUs) over time. Intraocular drywall was hyperdense on CT. All sizes studied were detectable on Day 0 of scanning. Mean intraocular drywall foreign body density was 171 ± 52 Hounsfield units (70-237) depending on fragment size. Intraocular drywall foreign body decreased in size whereas Hounsfield unit intensity increased over time. Drywall dissolves in the eye and becomes denser over time as air in the drywall is replaced by fluid. This study identified Hounsfield Units specific to intraocular drywall foreign body over time.
Plickert, H D; Tichy, A; Hirt, R A
2014-03-01
To compare characteristics of nasal discharge caused by different intranasal aetiologies in dogs. Medical records of 105 dogs with nasal discharge due to intranasal disease were retrospectively reviewed with special focus on composition, severity, duration and localisation of discharge. On the basis of diagnostic findings, cases were classified into different disease groups and characteristics of discharge were compared between groups. Cases were classified as having non-specific rhinitis (n=42), nasal neoplasia (n=23), foreign bodies (n=21), nasal mycosis (n=7) and miscellaneous disorders (n=13). Dogs with foreign bodies or nasal mycosis were significantly younger. Mucous components of discharge occurred more often in non-specific rhinitis and nasal neoplasia, although haemorrhagic components predominated in nasal neoplasia when discharge lasted ê14 days. Pure or mixed haemorrhagic discharge was significantly more common with nasal neoplasia, foreign bodies and nasal mycosis. Purulent components were associated with longer duration of discharge and predominantly seen in non-specific rhinitis and foreign bodies. Dogs with foreign bodies were presented earlier and sneezing was more frequent. Nasal stridor was significantly more often observed in dogs with nasal neoplasia. Characteristics of nasal discharge and associated clinical signs might aid in planning the diagnostic approach, but a combination of diagnostic techniques is still required to confirm a diagnosis. © 2014 British Small Animal Veterinary Association.
Scarf pin-related hijab syndrome: A new name for an unusual type of foreign body aspiration
Kakamad, Fahmi H.; Bakir, Delan Ahmed
2017-01-01
Background Foreign body aspiration refers to the inhalation of an object into the respiratory system and is a serious and potentially fatal event. A distinct group of patients has recently been recognized among Muslim nations. These patients include women who wear headscarves and place the safety pin in their mouth prior to securing the veils, leading to accidental foreign body aspiration. The aim of this study was to analyze the main presentation, diagnosis, treatment, and outcome of patients with scarf pin aspiration. Methods This prospective study involved patients with a history of scarf pin aspiration admitted to a single center during an 18-month period. Their main presentation, diagnosis, treatment, and outcome were analyzed. Results In total, 27 patients were included. The needle was extracted by flexible bronchoscopy in 12 (44.4%) patients, rigid bronchoscopy in 13 (48.1%), and thoracotomy in 2 (74%). One patient died during rigid bronchoscopy. All remaining 26 patients were satisfied with the postsurgical outcome at a mean follow-up of 1 week. Conclusions Scarf pin aspiration differs from other types of foreign body aspiration considering the specific population affected, and its management algorithm may thus differ from that of other foreign bodies. The left main bronchus is the most common site of pin impaction. Rigid bronchoscopy is the most commonly performed procedure for successful retrieval. PMID:28627978
Scarf pin-related hijab syndrome: A new name for an unusual type of foreign body aspiration.
Baram, Aram; Kakamad, Fahmi H; Bakir, Delan Ahmed
2017-12-01
Background Foreign body aspiration refers to the inhalation of an object into the respiratory system and is a serious and potentially fatal event. A distinct group of patients has recently been recognized among Muslim nations. These patients include women who wear headscarves and place the safety pin in their mouth prior to securing the veils, leading to accidental foreign body aspiration. The aim of this study was to analyze the main presentation, diagnosis, treatment, and outcome of patients with scarf pin aspiration. Methods This prospective study involved patients with a history of scarf pin aspiration admitted to a single center during an 18-month period. Their main presentation, diagnosis, treatment, and outcome were analyzed. Results In total, 27 patients were included. The needle was extracted by flexible bronchoscopy in 12 (44.4%) patients, rigid bronchoscopy in 13 (48.1%), and thoracotomy in 2 (74%). One patient died during rigid bronchoscopy. All remaining 26 patients were satisfied with the postsurgical outcome at a mean follow-up of 1 week. Conclusions Scarf pin aspiration differs from other types of foreign body aspiration considering the specific population affected, and its management algorithm may thus differ from that of other foreign bodies. The left main bronchus is the most common site of pin impaction. Rigid bronchoscopy is the most commonly performed procedure for successful retrieval.
Computer vision for foreign body detection and removal in the food industry
USDA-ARS?s Scientific Manuscript database
Computer vision inspection systems are often used for quality control, product grading, defect detection and other product evaluation issues. This chapter focuses on the use of computer vision inspection systems that detect foreign bodies and remove them from the product stream. Specifically, we wi...
48 CFR 52.208-4 - Vehicle Lease Payments.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 48 Federal Acquisition Regulations System 2 2014-10-01 2014-10-01 false Vehicle Lease Payments. 52....208-4 Vehicle Lease Payments. As prescribed in 8.1104(a), insert the following clause in solicitations and contracts for leasing motor vehicles, unless the motor vehicles are leased in foreign countries...
48 CFR 52.208-6 - Marking of Leased Vehicles.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 48 Federal Acquisition Regulations System 2 2014-10-01 2014-10-01 false Marking of Leased Vehicles....208-6 Marking of Leased Vehicles. As prescribed in 8.1104(c), insert the following clause in solicitations and contracts for leasing motor vehicles, unless the motor vehicles are leased in foreign...
48 CFR 52.208-5 - Condition of Leased Vehicles.
Code of Federal Regulations, 2014 CFR
2014-10-01
... Vehicles. 52.208-5 Section 52.208-5 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION....208-5 Condition of Leased Vehicles. As prescribed in 8.1104(b), insert the following clause in solicitations and contracts for leasing motor vehicles, unless the motor vehicles are leased in foreign...
48 CFR 652.225-70 - Arab League Boycott of Israel.
Code of Federal Regulations, 2010 CFR
2010-10-01
... Israel. 652.225-70 Section 652.225-70 Federal Acquisition Regulations System DEPARTMENT OF STATE CLAUSES... League Boycott of Israel. As prescribed in 625.7002(a), insert the following provision: Arab League Boycott of Israel (AUG 1999) (a) Definitions. As used in this provision: Foreign person means any person...
48 CFR 3052.209-70 - Prohibition on contracts with corporate expatriates.
Code of Federal Regulations, 2010 CFR
2010-10-01
... have substantial business activities in the foreign country in which or under the law of which the... with corporate expatriates. 3052.209-70 Section 3052.209-70 Federal Acquisition Regulations System... contracts with corporate expatriates. As prescribed at (HSAR) 48 CFR 3009.104-75, insert the following...
Neulander, Endre Z; Tiktinsky, Alex; Romanowsky, Igor; Kaneti, Jacob
2010-02-01
Vaginal foreign bodies in children usually present with foul-smelling discharge and/or vaginal bleeding. Rarely, these basic clinical diagnostic signs are not present. We report on a 5(1/2)-year-old girl with recurrent lower urinary tract infection as the sole presentation of multiple vaginal foreign bodies. Ultrasound of the lower urinary tract was inconclusive, and cystography indicated for recurrent urinary tract infections was declined by the patient in an outpatient setting. Cystography under general anesthesia raised the suspicion of foreign vaginal objects, and the definitive diagnosis was made by vaginoscopy. The relevant literature covering this subject is reviewed. High level of suspicion and strict basic diagnostic protocol are the most important steps for a timely diagnosis of this condition. Copyright 2010 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
Foreign bodies; or, how did Darwin invent the symptom?
Rowlinson, Matthew
2010-01-01
Beginning with a discussion of the sources in Darwin's writing for Freud's theory of the hysterical symptom, this essay proceeds to a symptomatic reading of Darwin himself. With reference to "The Origin of Species," "The Descent of Man," and "The Expression of the Emotions," this essay shows that Darwin's theories of involuntary expressive behavior and of aesthetic preference in sexual selection are linked by their role in his understanding of racial difference and also by their reliance on the idea that learned habits can be inherited as instincts, a view often identified with Lamarck. They are thus at once theories of the foreign body and theories that appear as foreigners within the body of Darwin's work.
TRAUMATIC (FOREIGN BODY) PERICARDITIS IN A TOCO TOUCAN (RAMPHASTOS TOCO).
Máinez, Mireia; Rosell, Jorge; Such, Roger; Cardona, Teresa; Juan-Sallés, Carles
2016-12-01
An approximately 10-yr-old, captive-born female toco toucan ( Ramphastos toco ) was presented due to an acute onset of depression and apathy. On visual and physical examination, it showed an abnormal posture and dehydration, respectively. Serum biochemistry revealed hyperuricemia (39.4 mg/dl) and elevated glutamic oxaloacetic transaminase (GOT; 1,050 U/L). Radiographs demonstrated an enlargement of the cardiac silhouette. The bird died 7 days after presentation, despite treatment with enrofloxacin, allopurinol, a preparation of hepatorenal protectors, and complex B vitamins with dextrose. Necropsy revealed severe fibrinohemorrhagic pericarditis with a 15 mm long and 2.5 mm diameter, rigid foreign body in the pericardial exudate. Microscopically, this foreign body was of vegetal origin.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Tapping, C. R.; Gallo, A.; Silva, R. J. De
2012-12-15
We present a case of endovascular retrieval of a penetrating foreign body that was originally lodged in the mediastinum and then migrated to the hepatic vein. The steel nail entered the thorax and traversed the left lung causing a pneumothorax. The patient underwent a thoracotomy, but the foreign body had migrated from its original mediastinal position. A postsurgical CT showed that the object was below the right hemidiaphragm. Diagnostic venogram demonstrated that the object was in the main hepatic vein. Using a double-snare technique, the object was safely and successfully removed from the hepatic vein via the right common femoralmore » vein.« less
Branch retinal artery occlusion post-penetrating globe injury with intraocular foreign body.
Nagpal, Manish; Chaudhary, Pranita; Jain, Ashish
2018-01-01
Intraocular foreign body (IOFB) in cases of penetrating eye injury accounts for an important indication of vitreoretinal intervention following ocular trauma. Vascular occlusion as a complication of IOFB is rare. Here we present a case of a 34-year-old male with post-traumatic cataract and an intraocular metallic foreign body (IOFB) lodged in the superficial layers of the retina inferotemporal to the disc, causing an inferotemporal branch retinal artery occlusion. The case was managed by lensectomy with pars plana vitrectomy and IOFB removal followed by a second procedure of secondary IOL implantation. Final best-corrected visual acuity improved to 6/24. This case highlights an unusual sequelae following penetrating ocular trauma.
Endovascular retrieval of dental needle retained in the internal carotid artery.
Moore, Kenneth; Khan, Nickalus R; Michael, L Madison; Arthur, Adam S; Hoit, Daniel
2017-03-08
Intravascular foreign bodies are a known complication of medical and dental procedures. Dental anesthetic needles may be broken off and retained in the oropharynx. These needles have occasionally been reported to migrate through the oral mucosa in to deeper structures. Here we present the case of a 57-year-old man who had a retained dental needle that had migrated into his internal carotid artery. The needle was removed using endovascular techniques. To our knowledge, this is the first report of a retained dental needle being retrieved using this method. We review the literature on intravascular foreign bodies, retained dental needles, and endovascular techniques for retrieval of such foreign bodies. 2017 BMJ Publishing Group Ltd.
Retrobulbar lymphoma associated with a ballistic foreign body in a cat.
Robat, C; Bemelmans, I; Marescaux, L
2016-04-01
A seven-year-old domestic shorthair cat, adopted 5 years previously with a corneal perforation of the left eye, was presented for investigation of a left orbital mass. Computed tomography revealed a metallic foreign body within a contrast-enhancing, heterogeneous orbital mass. Large cell lymphoma was diagnosed from a fine needle aspirate. The cat staged negatively and was treated with L-asparaginase, prednisolone and three fractions of radiation therapy. A rapid clinical remission was obtained and the cat remained in remission for 3 years after therapy. This is the first report of large cell lymphoma likely occurring secondary to a foreign body. © 2015 British Small Animal Veterinary Association.
A recombinant rabies virus carrying GFP between N and P affects viral transcription in vitro.
Luo, Jun; Zhao, Jing; Tian, Qin; Mo, Weiyu; Wang, Yifei; Chen, Hao; Guo, Xiaofeng
2016-06-01
Several studies have demonstrated the rabies virus to be a perfect potential vaccine vector to insert foreign genes into the target genome. For this study, a green fluorescent protein (GFP) gene was cloned into the rabies virus (RABV) genome between the N and P gene. CT dinucleotide was inserted as intergenic region. The recombinant high egg passage Flury strain (HEP-Flury) of RABV, carrying GFP (rHEP-NP-GFP), was generated in BHK-21 cells using reverse genetics. According to the viral growth kinetics assay, the addition of GFP between N and P gene has little effect on the viral growth compared to the parental strain HEP-Flury. Quantitative real-time PCR (qPCR) indicated that rHEP-NP-GFP showed different viral gene transcription, especially for G gene, compared to HEP-Flury. The same is true for one other recombinant RABV carrying GFP between G and L gene in NA cells. In addition, parent HEP-Flury showed more expression of innate immune-related molecules in NA cells. Compared to HEP-Flury, Western blotting (WB) indicated that insertion of a foreign gene following N gene enhanced the expression of M and G proteins. According to the qPCR and WB, GFP expression levels of rHEP-NP-GFP were significantly higher than rHEP-GFP. This study indicates HEP-Flury as valid vector to express exogenous genes between N and P.
Work Satisfaction: Critical Factors for Foreign-Born Faculty
ERIC Educational Resources Information Center
Paris, Susan G.
2017-01-01
Many higher education institutions seek to attract and retain diverse faculty in an effort to intentionally diversify campuses and make their college campuses more inclusive. The development of a diverse faculty body that matches the diversity of the student body is crucial, but the representation of foreign-born with doctoral degrees that are…
Obstructive parotitis from extraorally introduced foreign body in the Stensen duct.
Levine, George; Clark, Matthew; Mandel, Louis
2013-12-01
A rare phenomenon, the extraoral traumatic penetration of a foreign body into the lumen of the parotid duct, is described. The ensuing obstructive symptomatology and its diagnostic approach and therapy are reviewed. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
ERIC Educational Resources Information Center
Rashid, Farhan; Davies, Laura; Iftikhar, S. Y.
2010-01-01
The pica phenomenon, where non-edible substances are repeatedly consumed, has been linked with developmental and behavioural disorders, particularly autism. The clinical presentation of foreign body ingestion in patients with autism is discussed, and recommendations for caregivers are provided based on the available literature. An 18-year-old man…
Whitt, Michael A; Geisbert, Thomas W; Mire, Chad E
2016-01-01
There are many avenues for making an effective vaccine against viruses. Depending on the virus these can include one of the following: inactivation of whole virions; attenuation of viruses; recombinant viral proteins; non-replication-competent virus particles; or surrogate virus vector systems such as vesicular stomatitis virus (VSV). VSV is a prototypic enveloped animal virus that has been used for over four decades to study virus replication, entry, and assembly due to its ability to replicate to high titers in a wide variety of mammalian and insect cells. The use of reverse genetics to recover infectious and single-cycle replicating VSV from plasmid DNA transfected in cell culture began a revolution in the study of recombinant VSV (rVSV). This platform can be manipulated to study the viral genetic sequences and proteins important in the virus life cycle. Additionally, foreign genes can be inserted between naturally occurring or generated start/stop signals and polyadenylation sites within the VSV genome. VSV has a tolerance for foreign gene expression which has led to numerous rVSVs reported in the literature. Of particular interest are the very effective single-dose rVSV vaccine vectors against high-containment viruses such as filoviruses, henipaviruses, and arenaviruses. Herein we describe the methods for selecting foreign antigenic genes, selecting the location within the VSV genome for insertion, generation of rVSV using reverse genetics, and proper vaccine study designs.
Foreign body aspiration in children.
Lima, João A B; Fischer, Gilberto Bueno
2002-12-01
Foreign body aspiration is a common accident in children and represents an important cause of morbidity and mortality. Diagnosis of this condition demands a high degree of suspicion since physical examination and basic radiology exams have low sensitivity. It is more frequent in children younger than 3 years of age, predominantly boys. Food materials are most commonly involved, particularly peanuts, although this could change according to regional feeding habits. The right main bronchus is the site where foreign bodies are most commonly found. Radiographical findings are not diagnostic, but the presence of unilateral obstructive emphysema or atelectasis are important clues. A rigid endoscopy is indicated whenever there is a suggestive history, since delays in removing foreign bodies can lead to severe bronchial sequelae. In developing countries this type of accident may be more relevant due to the lack of resources and awareness, which can lead to late diagnosis and treatment. Routine preventive measures must be taught to caregivers in order to reduce the incidence. Health care professionals should also be made more aware of the prevalence of this condition.
Menarche? A Case of Abdominal Pain and Vaginal Bleeding in a Preadolescent Girl.
Riney, Lauren C; Reed, Jennifer L; Kruger, Laura L; Brody, Alan J; Pomerantz, Wendy J
2015-11-01
Abdominal pain is one of the most common complaints in the pediatric ED. Because of the broad range of potential diagnoses, it can pose challenges in diagnosis and therapy in the preadolescent girl. An 11-year-old previously healthy girl presented to our pediatric ED with fever, decreased appetite, vaginal bleeding, and abdominal pain. Initial evaluation yielded elevated creatinine levels, leukocytosis with bandemia, elevated inflammatory markers, and urine concerning for a urinary tract infection. She began receiving antibiotics for presumed pyelonephritis and was admitted to the hospital. After worsening respiratory status and continued abdominal pain, a computed tomography scan was obtained and a pelvic foreign body and abscess were identified. Adolescent gynecology was consulted for examination under anesthesia for abscess drainage and foreign body removal. A foreign body in the vagina or uterus can present as vaginal discharge, vaginal bleeding, abdominal pain, dysuria, or hematuria. Because symptoms can be diverse, an intravaginal or uterine foreign body should be considered in the preteen female patient presenting to the ED with abdominal pain. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
Unal, Melih H; Aydin, Ali; Sonmez, Murat; Ayata, Ali; Ersanli, Dilaver
2008-01-01
To evaluate the prognostic value of the Ocular Trauma Score (OTS) in cases of deadly weapon-related open-globe injuries with intraocular foreign bodies. A retrospective, interventional case series included 20 eyes of 20 patients who had deadly weapon-related open-globe injuries with intraocular foreign bodies. The OTS was calculated for each patient by adding the determined numbers of OTS variables at presentation (initial visual acuity, rupture, endophthalmitis, perforating injury, retinal detachment, and afferent pupillary defect). Patients were categorized based on their score (category 1 through 5). Final visual acuities in the OTS categories were calculated and compared to those in OTS study group. No statistically significant difference was found between the categorical distributions of the study patients and those in the OTS study group. No patient in the study was in category 5. The OTS, which was designed to predict visual outcomes of general ocular trauma, may also provide reliable information about the prognosis of deadly weapon-related open-globe injuries with intraocular foreign bodies.
A case of retained wooden foreign body in orbit.
Lee, Jin A; Lee, Hae Young
2002-12-01
A 41-year-old man visited our clinic complaining of esodeviation of the right eye. He had been operated on for corneal laceration 3 years before. One month later, exodeviation of the right eye had developed. The result of computed tomography (CT) was reported as orbital abscess and cellulitis. Although antibiotic treatment was administered for 2 weeks, the exodeviation didn't improve. On ocular examinations performed in our hospital in November-2001, his right eye was esotropic and had a relative afferent pupillary defect. Vision of the right eye was decreased to 0.02. Fundus examination showed optic atrophy. A new CT scan disclosed a foreign body introduced into the right medial orbital wall, nasal cavity and ethmoidal sinus. Although foreign body was surgically removed, vision and eye movement were not improved. In the case of a patient who has undergone orbital trauma, complete history taking and physical examinations must be performed. On suspicion of a foreign body, imaging study such as CT or MRI must be performed. However, because CT findings can be variable, careful follow-up is needed.
Wen, Xin; Su, Jinzhu; Cui, Li; Wang, Juan; Zuo, Lujie
2015-02-01
To analyze the distribution and drug susceptibility of the pathogenic bacteria in the airway secretions in children with tracheobronchial foreign bodies so as to assist physicians in clinical prescription. Sputum specimens of 1 125 children with tracheobronchial foreign bodies were collected in removal of the foreign bodies by rigid bronchoscope, and the drug susceptibility test was performed. Pathogenic bacteria were detected in 218 (19.4%) of 1 125 sputum specimens. Among the pathogenic bacteria, 126 (57.79%) strains were gram-negative bacilli, consisting of 76 (34.86%) strains of Haemophilus influenzae, 10 (4.59%) strains of Escherichia coli, 7 (3.21%) strains of Sewer enterobacter, 7 (3.21%) strains of Pseudomonas aeruginosa, and 6 (2.75%) strains of Klebsiella bacillus; and 92 (42.21%) strains were gram-positive bacilli, consisting of 80 (36.69%) strains of Streptococcus pneumonia and 10 (4.59%) strains of Escherichia coli. Most of detected gram-negative bacilli were highly sensitive to cefepime, ceftazidine, imipenem and amikacin, no strains were resistant to meropenem and ciprofloxacin. None of the detected gram-positive bacilli were resistant to cefepime, vancomycin, levofloxacin and teicoplanin. The Haemophilus influenzae of gram-negative bacilli and the Streptococcus pneumonia of gram-positive bacilli are the main pathogenic bacteria existing in the airway secretions of children with tracheobronchial foreign bodies. The Haemophilus influenzae were highly sensitive to cephalosporin, imipenem and amikacin, and the Streptococcus pneumonia to cefepime, vancomycin, levofloxacin and teicoplanin.
Herde, Katja; Hartmann, Sonja; Brehm, Ralph; Kilian, Olaf; Heiss, Christian; Hild, Anne; Alt, Volker; Bergmann, Martin; Schnettler, Reinhard; Wenisch, Sabine
2007-11-01
In bone a role of connexin 43 has been implicated with the fusion of mononuclear precursors of the monocyte/macrophage lineage into multinucleated cells. In order to investigate the putative role of connexin 43 in formation of bone osteoclast-like foreign body giant cells which are formed in response to implantation of biomaterials, nanoparticulate hydroxyapatite had been implanted into defects of minipig femura. After 20 days the defect areas were harvested and connexin 43 expression and synthesis were investigated by using immunohistochemistry, Western Blot, and in situ hybridization within macrophages and osteoclast-like foreign body giant cells. Morphological analysis of gap junctions is performed ultrastructurally. As shown on protein and mRNA level numerous connexin 43 positive macrophages and foreign body giant cells (FBGC) were localized within the granulation tissue and along the surfaces of the implanted hydroxyapatite (HA). Besides, the formation of FBGC by fusion of macrophages could be shown ultrastructurally. Connexin 43 labeling observed on the protein and mRNA level could be attributed to gap junctions identified ultrastructurally between macrophages, between FBGC, and between FBGC and macrophages. Annular gap junctions in the cytoplasm of FBGC pointed to degradation of the channels, and the ubiquination that had occurred in the course of degradation was confirmed by Western blot analysis. All in all, the presently observed pattern of connexin 43 labeling refers to an functional role of gap junctional communication in the formation of osteoclast-like foreign body giant cells formed in response to implantation of the nanoparticulate HA.
Foreign body reaction to acellular dermal matrix allograft in biologic glenoid resurfacing.
Namdari, Surena; Melnic, Christopher; Huffman, G Russell
2013-08-01
Biologic glenoid resurfacing is a treatment option for young patients with glenohumeral arthritis. An optimal synthetic graft for glenoid resurfacing should allow repopulation with host cells, be durable enough to tolerate suture fixation and forces across the joint, and present no host inflammatory response. We report two cases of giant cell reaction to GraftJacket(®) after biologic glenoid resurfacing. Two patients who underwent hemiarthroplasty and biologic glenoid resurfacing using GraftJacket(®) had a foreign body giant cell reaction that required revision surgery. Intraoperatively, both patients were observed to have a well-fixed humeral component and a dense, erythematous, synovitic membrane overlying the glenoid. Pathology specimens showed a benign reactive synovium, chronic inflammation, and foreign body giant cell reaction. After débridement and conversion to total shoulder arthroplasty, both patients continued to be pain-free at greater than 1-year followup. Multinucleated giant cell and mononuclear cell responses have been observed in an animal model after use of GraftJacket(®). Although the use of acellular matrix-based scaffold for biologic glenoid resurfacing is not new, the possibility of foreign body reaction as a source of persistent symptoms has not been described. Given the lack of data to indicate an advantage to biologic resurfacing of the glenoid over hemiarthroplasty alone, resurfacing should not introduce significant additional surgical complications. We suggest foreign body reaction be considered in the differential diagnosis for a persistently painful shoulder after biologic glenoid resurfacing using an acellular allograft patch.
Macrophage polarization in response to ECM coated polypropylene mesh
Wolf, MT; Dearth, CL; Ranallo, CA; LoPresti, S; Carey, LE; Daly, KA; Brown, BN; Badylak, SF
2015-01-01
The host response to implanted biomaterials is a highly regulated process that influences device functionality and clinical outcome. Non-degradable biomaterials, such as knitted polypropylene mesh, frequently elicit a chronic foreign body reaction with resultant fibrosis. Previous studies have shown that an extracellular matrix (ECM) hydrogel coating of polypropylene mesh reduces the intensity of the foreign body reaction, though the mode of action is unknown. Macrophage participation plays a key role in the development of the foreign body reaction to biomaterials, and therefore the present study investigated macrophage polarization following mesh implantation. Spatiotemporal analysis of macrophage polarization was conducted in response to uncoated polypropylene mesh and mesh coated with hydrated and dry forms of ECM hydrogels derived from either dermis or urinary bladder. Pro-inflammatory M1 macrophages (CD86+/CD68+), alternatively activated M2 macrophages (CD206+/CD68+), and foreign body giant cells were quantified between 3-35 days. Uncoated polypropylene mesh elicited a dominant M1 response at the mesh fiber surface, which was decreased by each ECM coating type beginning at 7 days. The diminished M1 response was accompanied by a reduction in the number of foreign body giant cells at 14 and 35 days, though there was a minimal effect upon the number of M2 macrophages at any time. These results show that ECM coatings attenuate the M1 macrophage response and increase the M2/M1 ratio to polypropylene mesh in vivo. PMID:24856104
18-gauge needle cap as adjunct to prevent kinking of endotracheal tube.
Chan, Fuan Chiang; Kawamoto, Henry K; Bradley, James P
2012-11-01
A self-retaining Dingman mouth retractor is widely used to keep the mouth open during cleft palate and intraoral surgery. The airway is at risk of being crushed or occluded as the gag (tongue plate) of the Dingman mouth retractor is being pushed against the endotracheal tube.Kinking of the endotracheal tube between the teeth and Dingman mouth retractor has been reported even with the oral Ring-Adair-Elwyn or flexometallic or armored endotracheal tubes. To minimize kinking of the endotracheal tube and its consequent complications, we routinely insert an 18-gauge needle cap at the potential space between the teeth and the tongue plate (gag) of the Dingman mouth retractor, which is situated lateral to the endotracheal tube. In our experience of approximately 5000 intraoral cases using a Dingman mouth retractor and 18-gauge needle cap, we have not had any tooth avulsion or aspiration of the 18-gauge foreign body while maintaining a consistent and secured airway during cleft palate and intraoral surgery.
Gunduz, Yasemin; Vatan, Mehmet Bulent; Osken, Altug; Cakar, Mehmet Akif
2012-01-01
Central venous catheterisation allows delivery of medications, intravenous fluids, parenteral nutrition, haemodialysis and monitoring of haemodynamic variables. Various complications may occur during and after the procedure. However, the complete guidewire retention has rarely been reported. In this report, we have presented a complete guidewire retention as a result of inadvertent catheter insertion. After 17 months of the first operation performed upon the diagnosis of Fournier's gangrene, the patient was admitted to the cardiology polyclinic with a recurrent chest pain. Echocardiography showed a wire-shaped foreign body within the right part of the heart, and a fluoroscopic examination showed a guidewire reaching from the superior vena cava to the right external iliac vein. In retrospect, the wire was already visible on the postoperative chest x-rays and CT taken while the patient was still in intensive care unit, but its presence was overlooked at that time. The guidewire was retrieved completely during a surgery. PMID:23166171
[Occult bronchial foreign bodies - analysis of own material].
Szafrański, Wojciech; Dobielski, Jarosław; Papiewski, Wojciech; Czechowska, Urszula
2013-01-01
The aspiration of a foreign body is usually combined with acute clinical symptoms requiring immediate medical intervention. Nevertheless, in approximately one third of patients the symptoms of aspiration are less prominent; such a clinical condition is called occult bronchial foreign body (OBFB). The aim of our study was to assess the frequency of OBFB in the pulmonary unit of a district hospital and to evaluate the diagnostic difficulties and treatment modalities in such patients. The examined group consisted of patients hospitalized in the Department of Lung Diseases in Radom District Hospital. A retrospective analysis of medical records was preformed. In the period 1978-2008 - 12 patients (10 males, 2 females) were hospitalized due to OBFB. The foreign bodies occluded the bronchi over 2 months (3 to 7) in 4 patients. The moment of aspiration was not remembered by 8 patients. Cases of OBFB were rare. In the presented material the frequency was 4 per 10,000 hospitalizations and 8 per 10,000 bronchoscopies. In our region of 600,000 population the index of hospitalization due to OBFB in adults (〉 14 years of age) was 0.07 per 100,000 inhabitants/year. Foreign bodies mainly included bone fragments (5 cases), vegetal remnants - clove of garlic, ear of corn (3 patients), and other food remnants (2 patients). Occasionally other aspirates were found, such as a wooden peg or a piece of plastic. The aspiration took place mostly during meals. The patients developed one or more of the following symptoms: purulent pneumonia (3 cases), pleural empyema (1 case), atelectasis (5 cases), and recurrent bronchitis and pneumonia (2 cases). The foreign body (fragments of plants) was mimicking a bronchial tumour in 4 patients. Fibre optic or rigid bronchoscopy was applied successfully in 11 patients. Only one patient needed surgical intervention. OBFB is a rare condition, but has to be taken into consideration as a cause of chest radiological pathology and in patients with chronic and/or recurrent inflammatory disease of the respiratory system.
Di Guglielmo, Matthew; Savage, Jillian; Gould, Sharon; Murphy, Stephen
2017-05-01
Abdominal pain in female adolescents is a common presentation to both the emergency department and the outpatient pediatric clinic. The broad differential diagnosis for abdominal pain requires a high index of suspicion to make an accurate diagnosis of foreign body ingestion as the etiology. Foreign body ingestion occurs in all age groups, but sequelae of gastrointestinal tract perforation in children are rare. Treatment for perforation requires consultation of the pediatric general surgeon. Clinicians should take care to not overlook subtle imaging findings or dietary/exposure history, even in the context of a patient with known history of abdominal pain. We report the accidental ingestion of a wire bristle from a grill cleaning brush by a female adolescent. The patient, previously treated and seen for constipation and irritable bowel syndrome in the outpatient gastroenterology clinic, was referred to the emergency department after identification of a foreign body on abdominal radiography. Emergency department physicians discovered the history of grilling and consumption of grilled food, facilitating diagnosis of a wire bristle as the foreign body. The metallic foreign body had migrated to the colon, where it perforated and lodged into the abdominal wall, causing acute, focal symptoms. Observation in the hospital with pain control and infection management allowed for elective laparoscopy. The surgical team removed the object with minimal morbidity and avoided laparotomy. Reports of unintended ingestion of wire bristles have been increasingly reported in the literature; however, most focus on injury to the upper airway or upper digestive tract and subsequent endoscopic or laryngoscopic removal. Most reports detail injury in adult patients, pediatric case reports with digestive tract injury are uncommon, and foreign body removal after lower digestive tract injury in children from a wire bristle has not been reported. We caution pediatric emergency medicine and ambulatory providers to consider such an ingestion and perforation in the differential diagnosis of acute-onset, focal, and localizable abdominal pain in children.
Nation, Javan; Jiang, Wen
2017-01-01
To test the ability of a handheld metal detector (HHMD) to identify the presence and location of ingested metallic foreign bodies (MFBs) in children. Prospective case series enrolling children suspected of metallic foreign body ingestion presenting to the Emergency Department. Thirty-eight children were enrolled and the HHMD was used to detect the presence and location of a MFB. Results were compared to standard radiographic studies. Thirty-seven of the 38 ingested foreign bodies were MFBs. Of the 37 MFBs, the HHMD positively identified 33, and 4 were missed by HHMD but identified on radiography. When positive, the location indicated by HHMD correlated 100% with radiograph. There were 33 true positives, 0 false positives, 4 false negatives, and 1 true negative. This resulted in a sensitivity of 89% (95% CI of 75%-96%) and specificity of 100% (95% CI of 2.5%-100%). Our study demonstrates the accuracy of HHMD in the identification and localization of metallic foreign bodies. We propose an emergency room foreign body protocol that uses HHMD as an early screening tool in triage in order to expedite the process of obtaining Otolaryngology consultation and potentially shorten the wait time to the operating room or discharge. In instances were outside films are previously performed, HHMD use may be able to minimize the overall radiation exposure to children by obviating the need for repeat radiographs. As the sensitivity is not 100%, a negative HHMD screening does not negate the need for a standard radiograph in order to avoid missed MFBs. HHMD is best suited for detection of coins, which accounts for the majority of the MFB ingestions, and may not be suitable for all metallic objects since the amount of metal may decrease its sensitivity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Classification of Foreign Body Reactions due to Industrial Silicone Injection.
Harlim, Ago; Kanoko, Mpu; Aisah, Siti
2018-05-02
A foreign body reaction (FBR) is a typical tissue response to a biomaterial that has been injected or implanted in human body tissue. There has been a lack of data on the classification of foreign body reaction to silicone injection, which can describe the pattern of body tissue responses to silicone. Determine the foreign body reaction to silicone injection. We modified the classification proposed by Duranti and colleagues, which has categorized a FBR to hyaluronic acid injection into a new classification of an FBR to silicone injection. A cohort study of 31 women suffering from silicone-induced granulomas on their chin was conducted. Granulomatous tissue and submental skin were stained with hematoxylin-eosin and evaluated. Our data revealed that there were at least 7 categories of FBRs to silicone injection that could be developed. Categories 1 to 4 showed inflammatory activity, and categories 5 to 8 showed tissue repair by fibrosis. Using histopathological staining, we are able to sequence the steps of body reactions to silicone injection. Initial inflammatory reaction is then replaced by fibrosis process repairing the damaged tissues. The process depends on the host immune tolerance.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
ERIC Educational Resources Information Center
Sadeghi, Elahe; Afghari, Akbar; Zarei, Gholam-Reza
2016-01-01
Reading comprehension has been the main concern for second language learners and researchers. Today with rising interests towards Vygotskyan Sociocultural Theory (SCT), attempts have been made to insert Vygotskyan approach into Foreign/Second Language classrooms emphasizing the role of scaffolding and meaningful interactions to promote learners'…
24 CFR 3280.605 - Joints and connections.
Code of Federal Regulations, 2013 CFR
2013-04-01
... of the fitting. Plastic pipe and copper tubing shall be inserted to the full depth of the solder cup..., cutting oil and foreign matter shall be removed. Pipe joint cement or thread lubricant shall be of... connected to a public water system, made with solder having not more than 0.2 percent lead. (4) Plastic pipe...
24 CFR 3280.605 - Joints and connections.
Code of Federal Regulations, 2012 CFR
2012-04-01
... of the fitting. Plastic pipe and copper tubing shall be inserted to the full depth of the solder cup..., cutting oil and foreign matter shall be removed. Pipe joint cement or thread lubricant shall be of... connected to a public water system, made with solder having not more than 0.2 percent lead. (4) Plastic pipe...
From a Bureaucratic to a Critical-Sociocultural Model of Policymaking in Colombia
ERIC Educational Resources Information Center
Correa, Doris; Wilches, Jaime Usma
2013-01-01
In the context of the National Bilingual Program 2004-2019, currently called "Program for Strengthening the Development of Competencies in a Foreign Language," the Colombian government has implemented a series of actions to raise the level of English proficiency of teachers and students and insert the country into globalization…
Problems associated with gene transfer and opportunities for microgravity environments
NASA Astrophysics Data System (ADS)
Tennessen, Daniel J.
1997-01-01
The method of crop improvement by gene transfer is becoming increasingly routine with transgenic foods and ornamental crops now being marketed to consumers. However, biological processes of plants, and the physical barriers of current protocols continue to limit the application of gene transfer in many commercial crops. The goal of this paper is to outline the current limitations of gene transfer and to hypothesize possible opportunities for use of microgravity to overcome such limitations. The limitations detailed in this paper include host-range specificity of Agrobacterium mediated transformation, probability of gene insertion, position effects of the inserted genes, gene copy number, stability of foreign gene expression in host plants, and regeneration of recalcitrant plant species. Microgravity offers an opportunity for gene transfer where cell growth kinetics, DNA synthesis, and genetic recombination rates can be altered. Such biological conditions may enhance the ability for recombination of reporter genes and other genes of interest to agriculture. Proposed studies would be useful for understanding instability of foreign gene expression and may lead to stable transformed plants. Other aspects of gene transfer in microgravity are discussed.
ERIC Educational Resources Information Center
Mariano Beraldo, Carolina; Rondon Lopes, Érika; Hage, Raduan; Hage, Maria Cristina F. N. S.
2017-01-01
Ingested or penetrating foreign bodies are common in veterinary medicine. When they are radiolucent, these objects become a diagnostic challenge, but they can be investigated sonographically. However, successful object identification depends on the skill of the sonographer. Considering that these cases appear randomly during hospital routines, it…
[Laryngeal diphtheria in a young woman causes diagnostic difficulties--case report].
Garlicki, A; Bociaga, M; Krukowiecki, J; Kluba-Wojewoda, U
1996-01-01
A case of severe laryngeal diphtheria in a young woman was presented. Initially, the presence of a foreign body in the larynx of this patient was suspected. The differential diagnosis of a foreign body should include diphtheric laryngitis as this may cause obstruction of the respiratory tract. This can lead to severe complications.
An unusual foreign body in the preputial sac.
Jaiswal, A K
1992-01-01
A 28 year old Indian male presented with an unusual foreign body, a penicillin bottle containing tincture of iodine, in the preputial sac. The purpose of introducing the bottle was to tickle his glans penis as a form of masturbation. The bottle was so firmly impacted that it could be removed only under general anaesthesia. Images PMID:1427809
ERIC Educational Resources Information Center
Mavilidi, Myrto-Foteini; Okely, Anthony D.; Chandler, Paul; Cliff, Dylan P.; Paas, Fred
2015-01-01
Research suggests that integrating human movement into a cognitive learning task can be effective for learning due to its cognitive and physiological effects. In this study, the learning effects of enacting words through whole-body movements (i.e., physical exercise) and part-body movements (i.e., gestures) were investigated in a foreign language…
Foreign body granuloma formation secondary to silicone injection.
Schwartzfarb, Elissa M; Hametti, Juan Martin; Romanelli, Paolo; Ricotti, Carlos
2008-07-15
Injectable silicone has been used extensively over the last 40 years for soft tissue augmentation. Although considered biologically inert, this material has been implicated in a variety of adverse reactions including granulomas, disfiguring nodules, and lymphedema, sometimes with latent periods of decades. Often these complications are a result of the use of industrial grade products injected by unlicensed or unskilled practitioners. Here we report a case of foreign body granuloma in the thigh secondary to silicone injection in the buttocks. Initially the patient did not disclose a cosmetic contouring procedure administered by a nonprofessional nine months earlier, making diagnosis difficult. We remind clinicians to include foreign body granulomas in the differential diagnosis of apparent cellulitis and to question patients about the use of injectable fillers.
Clostridium perfringens panophthalmitis and orbital cellulitis: a case report.
Guedira, Ghita; Taright, Nabil; Blin, Hélène; Fattoum, Thameur; Leroy, Jordan; El Samad, Youssef; Milazzo, Solange; Hamdad, Farida
2018-04-10
Clostridium perfringens is an uncommon pathogen in endophthalmitis, causing rapid destruction of ocular tissues. Clostridium perfringens infection typically occurs after penetrating injury with soil-contaminated foreign bodies. Here, we describe the case of a 17-year-old male who sustained a penetrating injury with a metallic intraocular foreign body and who rapidly developed severe C. perfringens panophthalmitis with orbital cellulitis. He was managed by systemic and intravitreal antibiotics, resulting in preservation of the globe, but a poor visual outcome. Clostridial endophthalmitis secondary to penetrating injuries is a fulminant infection, almost always resulting in loss of the globe in the case of advanced infection. When feasible, early vitrectomy and intravitreal antibiotics should be considered in patients with penetrating eye injuries with contaminated foreign bodies.
Spiering, Martin J
2015-01-01
The human body regularly encounters and combats many pathogenic organisms and toxic molecules. Its ensuing responses to these disease-causing agents involve two interrelated systems: innate immunity and adaptive (or acquired) immunity. Innate immunity is active at several levels, both at potential points of entry and inside the body (see figure). For example, the skin represents a physical barrier preventing pathogens from invading internal tissues. Digestive enzymes destroy microbes that enter the stomach with food. Macrophages and lymphocytes, equipped with molecular detectors, such as Toll-like receptors (TLRs), which latch onto foreign structures and activate cellular defenses, patrol the inside of the body. These immune cells sense and devour microbes, damaged cells, and other foreign materials in the body. Certain proteins in the blood (such as proteins of the complement system and those released by natural killer cells, along with antimicrobial host-defense peptides) attach to foreign organisms and toxins to initiate their destruction.
Jia, Xinzheng; Lin, Huiran; Nie, Qinghua; Zhang, Xiquan; Lamont, Susan J
2016-11-03
Body weight is one of the most important quantitative traits with high heritability in chicken. We previously mapped a quantitative trait locus (QTL) for body weight by genome-wide association study (GWAS) in an F2 chicken resource population. To identify the causal mutations linked to this QTL, expression profiles were determined on livers of high-weight and low-weight chicken lines by microarray. Combining the expression pattern with SNP effects by GWAS, miR-16 was identified as the most likely potential candidate with a 3.8-fold decrease in high-weight lines. Re-sequencing revealed that a 54-bp insertion mutation in the upstream region of miR-15a-16 displayed high allele frequencies in high-weight commercial broiler line. This mutation resulted in lower miR-16 expression by introducing three novel splicing sites instead of the missing 5' terminal splicing of mature miR-16. Elevating miR-16 significantly inhibited DF-1 chicken embryo cell proliferation, consistent with a role in suppression of cellular growth. The 54-bp insertion was significantly associated with increased body weight, bone size and muscle mass. Also, the insertion mutation tended towards fixation in commercial broilers (Fst > 0.4). Our findings revealed a novel causative mutation for body weight regulation that aids our basic understanding of growth regulation in birds.
Jia, Xinzheng; Lin, Huiran; Nie, Qinghua; Zhang, Xiquan; Lamont, Susan J.
2016-01-01
Body weight is one of the most important quantitative traits with high heritability in chicken. We previously mapped a quantitative trait locus (QTL) for body weight by genome-wide association study (GWAS) in an F2 chicken resource population. To identify the causal mutations linked to this QTL, expression profiles were determined on livers of high-weight and low-weight chicken lines by microarray. Combining the expression pattern with SNP effects by GWAS, miR-16 was identified as the most likely potential candidate with a 3.8-fold decrease in high-weight lines. Re-sequencing revealed that a 54-bp insertion mutation in the upstream region of miR-15a-16 displayed high allele frequencies in high-weight commercial broiler line. This mutation resulted in lower miR-16 expression by introducing three novel splicing sites instead of the missing 5′ terminal splicing of mature miR-16. Elevating miR-16 significantly inhibited DF-1 chicken embryo cell proliferation, consistent with a role in suppression of cellular growth. The 54-bp insertion was significantly associated with increased body weight, bone size and muscle mass. Also, the insertion mutation tended towards fixation in commercial broilers (Fst > 0.4). Our findings revealed a novel causative mutation for body weight regulation that aids our basic understanding of growth regulation in birds. PMID:27808177
Orbitocranial wooden foreign body: a pre-, intra-, and postoperative chronicle: case report.
Dunn, Ian F; Kim, Dong H; Rubin, Peter A; Blinder, Russell; Gates, Jonathan; Golby, Alexandra J
2009-08-01
Intraorbital wooden foreign bodies--usually from a low-velocity puncture--are elusive and demand a low threshold for further imaging. In patients with traumatic injuries, orbital and intracranial air from fractures may be present, and it is particularly easy to overlook a wooden fragment A 53-year-old equestrian was kicked in the face by the rear hoof of a horse. The event was captured on video by her husband. Although no obvious entry point in and around the eye was observed, her ocular examination was notable for superior orbital fissure syndrome and increasing intraocular pressure in the left eye. Closer inspection revealed a 5-mm laceration above her superior lid margin; imaging revealed a foreign body at the orbital apex with apparent communication with the cranial vault. We proceeded with cranio-orbital exploration because of the risk of continued ocular damage in the setting of increasing intraocular pressure and the potential for infection of both the eye and the intracranial space from a suspected foreign body. A 3.0 cm x 0.5 cm fragment was found lodged in the orbital apex and removed. The patient recovered well after surgery and a course of antibiotics and has returned to riding. This case report presents an algorithm for approaching cranio-orbital foreign objects of unclear identity and the favorable outcomes that may be achieved.
Clinical evaluation of succinylated collagen bandage lenses for ophthalmic applications.
Hadassah, J; Prakash, D; Sehgal, P K; Agarwal, A; Bhuvaneshwari, N
2008-01-01
To study whether succinylated collagen bandage lenses (SCBL) prepared from modified bovine collagen (succinylated collagen) can replace other bandage lenses presently employed to treat various corneal conditions like filamentary keratitis, dry eyes, recurrent corneal erosions, foreign body removal and epithelial trauma. This observational case study included 32 patients (22 female and 10 male): 8 patients for filamentary keratitis (25%), 10 patients for dry eyes (31%), 4 patients for recurrent corneal erosions (13%), 7 patients for foreign body removal (22%) and 3 patients for epithelial trauma (9%). Their eyes were evaluated for biocompatibility, in vivo transparency, patient comfort, corneal fit, best corrected visual acuity (BCVA), tear fluid level and dissolution rate of SCBL. This was carried out over a 24-hour period of time. SCBL exhibited good transparency and remained transparent throughout the period of study (between 0 and 24 h) in the eyes of patients. SCBL did not cause any irritation, discomfort and foreign body sensation in the eye and eyes remained comfortable throughout the experiment. BCVA in the control group of patients was 1.00 (20/20). Mean (+/-SD) BCVA before inserting SCBL (in decimal equivalent) was 0.31 (20/60) +/- 0.18 (range 0.1- 0.66). BCVA (+/-SD) changed to 0.25 (20/80) +/- 0.18 4 h after the application of SCBL and 0.27 (20/70) +/- 0.18 24 h after the application of SCBL, with a safety index of 1.20. The mean (+/-SD) tear fluid level before application of SCBL was 11.9 +/- 5.39 h (range 3-24 mm) and changed to 13.9 +/- 5.68 h (range 5-28 mm) after 4 h of application of SCBL and 15.9 +/- 5.72 h (range 7-30 mm) after 24 h with a safety index of 13 mm. The mean (+/-SD) dissolution rate of SCBL in the control group of patients was 17.8 +/- 8.65 h (range 10-24 h) and the mean (+/-SD) dissolution rate in the experimental group was 22.2 +/- 9.29 h (range 10-24 h). We report the use of SCBL in various corneal conditions. The present study showed that SCBL has complete corneal fit and good comfort in human eyes. Transparency was maintained for a longer period along with fair visual acuity and improvement in tear fluid levels. The disadvantages of other bandage lenses presently used to treat various corneal conditions could be overcome by the use of SCBL lenses. Copyright 2008 S. Karger AG, Basel.
Palta, Renee; Sahota, Amandeep; Bemarki, Ali; Salama, Paul; Simpson, Nicole; Laine, Loren
2009-03-01
Previous reports of foreign-body ingestions focused primarily on accidental ingestions. To describe the characteristics and management of foreign-body ingestions, with predominantly intentional ingestion, in a lower socioeconomic status population. A retrospective case series. An urban county hospital. Patients >/=17 years old, with foreign-body ingestions between 2000 and 2006. Characteristics of ingestion cases, endoscopic extraction, need for surgery, and complications. Among 262 cases, 92% were intentional, 85% involved psychiatric patients, and 84% occurred in patients with prior ingestions. The time from ingestion to presentation was >48 hours in 168 cases (64%). The overall success rate for endoscopic extraction was 90% (165/183 cases). Surgery was performed in 30 cases (11%) and was more common for objects beyond the pylorus versus objects above the pylorus (16/43 [37%] vs 10/151 [7%], respectively) and in cases with a greater delay from ingestion to presentation (25/168 [15%] if >48 hours vs 4/77 [5%] if =48 hours) and from presentation to intervention (15/40 [38%] if >48 hours vs 14/165 [8%] if =48 hours). Perforation occurred in 16 cases (6%), with 6 perforations noted after endoscopy. A retrospective review of medical records. Foreign-body ingestions in an urban county hospital occurred primarily in psychiatric patients who had repeated episodes of intentional ingestions. Endoscopic extraction was unsuccessful in 10% of cases. Long delays from ingestion to presentation and intervention may account for relatively high rates of surgery and perforation. Strategies to prevent ingestions and delays in endoscopic management are needed in this population.
Finite element analysis of blunt foreign body impact on the cornea after PRK and LASIK.
Mousavi, Seyed Jamaleddin; Nassiri, Nariman; Masoumi, Nafiseh; Nassiri, Nader; Majdi-N, Mercede; Farzaneh, Solmaz; Djalilian, Ali R; Peyman, Gholam A
2012-01-01
To investigate the effect of blunt foreign body impact on a human cornea after photorefractive keratectomy (PRK) and LASIK using a simulation model. Computational simulations were performed using a finite element analysis program (LS-Dyna, Livermore Software Technology Corp). The blunt foreign body was set to impact at the center of the corneal surface models (after PRK and LASIK) with thicknesses of 500, 450, 400, 350, and 300 μm. Corneal rupture was assumed to occur at a peak stress of 9.45 MPa and at a strain of 18%. The foreign body projectile was blunt in shape, made from aluminum, contained plastic-kinematic properties, and had a density of 2700 kg/m(3). The projectile was launched at the center of the cornea with velocities ranging from 20 to 60 m/s. The threshold of impact velocities creating rupture in corneal thicknesses of 500, 450, 400, 350, and 300 μm were 33, 32.8, 30.7, 27.9, and 22.8 m/s, respectively, in the PRK model. In the LASIK model, the thresholds creating rupture in the stromal bed of the corneas with thicknesses of 500, 450, 400, 350, and 300 μm were 40, 38.1, 35.6, 31.5, and 26.7 m/s, respectively. The 110-μm corneal flap in the LASIK model ruptured at all velocities. Ruptures occurred at lower velocities in the PRK cornea model than in the corneal stromal bed of the LASIK model following blunt foreign body impact. Copyright 2012, SLACK Incorporated.
Liu, Shiqi; Li, Qifeng; Li, Yumei; Lv, Yi; Niu, Jianhua; Xu, Quan; Zhao, Jingru; Chen, Yajun; Wang, Dayong; Bai, Ruimiao
2018-06-01
This case study is concerning the meticulous observation of the moving process and track of 2 ingested needles using interval x-ray radiography, trying to localize the foreign bodies and reduce unnecessary exploration of digestive tract. An unusual case of a 1-year, 9-month-old female baby, with incarcerated hernia perforation caused by sewing needles with sharp ends, was reported herein. The patient had swallowed 2 sewing needles. One needle was excreted uneventfully after 8 days. On the contrary, the other needle stabbed the ileocecal junction wall into the right side of inguinal hernia sac after 9 days, and the patient received successful operation management. Interval x-ray confirmed that 1 needle-like foreign body moving down in 8 days until excretion along with feces. However, the other pierced into the incarcerated hernia. Preoperative x-ray radiography successfully monitored the moving process and tract of the sewing needles. Considering the penetrating-migrating nature of the foreign bodies, once the sharp-pointed objects were located, they should be removed as the mortality and risk of related complications may be increased. Interval x-ray radiography represents a meticulous preoperative monitoring method of the moving process and tract of needle-like foreign bodies. Interval x-ray with real-time images accurately detecting the moving foreign bodies could be help to reduce the unnecessary exploration of digestive tract and subsequently prevent possible complications. Based on the basic findings from the interval x-ray, treatment choices of endoscopic removal and surgical intervention may be attempted.
Rueda, P; Hurtado, A; del Barrio, M; Martínez-Torrecuadrada, J L; Kamstrup, S; Leclerc, C; Casal, J I
1999-10-10
An antigen-delivery system based on hybrid virus-like particles (VLPs) formed by the self-assembly of the capsid VP2 protein of canine parvovirus (CPV) and expressing foreign peptides was investigated. In this report, we have studied the effects of inserting the poliovirus C3:B epitope in the four loops and the C terminus of the CPV VP2 on the particle structure and immunogenicity. Epitope insertions in the four loops allowed the recovery of capsids in all of the mutants. However, only insertions of the C3:B epitope in VP2 residue 225 of the loop 2 were able to elicit a significant anti-peptide antibody response, but not poliovirus-neutralizing antibodies, probably because residue 225 is located in an small depression of the surface. To fine modulate the insertion site in loop 2, a cassette-mutagenesis was carried out to insert the epitope in adjacent positions 226, 227, and 228. The epitope C3:B inserted into these positions was well recognized by the specific monoclonal antibody C3 by immunoelectron microscopy. BALB/c mice immunized with these chimeric C3:B CPV:VLPs were able to elicit an strong neutralizing antibody response (>3 log(10) units) against poliovirus type 1 (Mahoney strain). Therefore, minor displacements in the insertion place cause dramatic changes in the accessibility of the epitope and the induction of antibody responses. Copyright 1999 Academic Press.
22 CFR 92.66 - Depositions taken before foreign officials or other persons in a foreign country.
Code of Federal Regulations, 2010 CFR
2010-04-01
... accompanied by a complete translation into the language (or into one of the languages) of the country of... pertain. The name and address of the American judicial body from which the letters rogatory issued should..., and bearing the title of the action and the name and address of the American judicial body from which...
22 CFR 92.66 - Depositions taken before foreign officials or other persons in a foreign country.
Code of Federal Regulations, 2012 CFR
2012-04-01
... accompanied by a complete translation into the language (or into one of the languages) of the country of... pertain. The name and address of the American judicial body from which the letters rogatory issued should..., and bearing the title of the action and the name and address of the American judicial body from which...
22 CFR 92.66 - Depositions taken before foreign officials or other persons in a foreign country.
Code of Federal Regulations, 2014 CFR
2014-04-01
... accompanied by a complete translation into the language (or into one of the languages) of the country of... pertain. The name and address of the American judicial body from which the letters rogatory issued should..., and bearing the title of the action and the name and address of the American judicial body from which...
22 CFR 92.66 - Depositions taken before foreign officials or other persons in a foreign country.
Code of Federal Regulations, 2011 CFR
2011-04-01
... accompanied by a complete translation into the language (or into one of the languages) of the country of... pertain. The name and address of the American judicial body from which the letters rogatory issued should..., and bearing the title of the action and the name and address of the American judicial body from which...
22 CFR 92.66 - Depositions taken before foreign officials or other persons in a foreign country.
Code of Federal Regulations, 2013 CFR
2013-04-01
... accompanied by a complete translation into the language (or into one of the languages) of the country of... pertain. The name and address of the American judicial body from which the letters rogatory issued should..., and bearing the title of the action and the name and address of the American judicial body from which...
Forced Suffocation of Infants with Baby Wipes: A Previously Undescribed Form of Child Abuse
ERIC Educational Resources Information Center
Krugman, Scott D.; Lantz, Patrick E.; Sinal, Sara; De Jong, Allan R.; Coffman, Kathryn
2007-01-01
Background: Foreign body aspiration in children is commonly seen in emergency departments and carries a significant mortality. Abusive foreign body suffocation is not well described. Methods: We present a case-series of four infants who presented with aspiration of a baby wipe. Results: Each child was found to be a victim of child physical abuse…
Demographic and Clinical Findings in Children Undergoing Bronchoscopy for Foreign Body Aspiration.
Safari, Mojgan; Manesh, Mohammad Reza Hashemi
2016-01-01
Foreign body aspiration (FBA) is a significant cause of airway distress, mortality, and morbidity in children. Diagnosis of FBA can be challenging and is sometimes delayed for weeks or even months. If not diagnosed and treated promptly, FBA can result in serious consequences. For this retrospective study, we investigated the medical records of 89 children who underwent bronchoscopy for suspected FBA and recorded relevant demographic, clinical, and treatment data. Of the 89 patients identified for this study, 51 had a definitive diagnosis of FBA. Among these patients, choking, chronic cough and wheezing, cyanosis, and dyspnea were the most frequent symptoms of FBA. The foreign bodies were located in the left bronchus (45.1%), the right bronchus (35.3%), the trachea (15.7%), and in both the right and left bronchi (3.9%). Seeds were the most prevalent foreign body, found in 39.2% of the patients. Lack of complete medical history in patients with suspected FBA is one of the main causes of delayed FBA diagnosis. Bronchoscopy is considered the definitive diagnostic method for FBA and should be conducted in all patients with suspected FBA because of the low risk of complications and reduced probability that FBA diagnosis and treatment will be delayed.
Weiler, A; Helling, H J; Kirch, U; Zirbes, T K; Rehm, K E
1996-05-01
Foreign-body reaction to polyglycolide (PGA) implants has been described in man. Many animal experiments have verified the mechanical properties of fixation devices made from PGA, but a significant foreign-body reaction has not been described. We studied the effect of PGA rods in 12 sheep with standardised osteochondral fractures of the medial femoral condyle fixed with uncoloured, self-reinforced PGA rods (Biofix). Radiographs were taken at intervals ranging from two weeks to two years, and the sheep were killed at intervals ranging from six to 24 months. All knees were examined histologically. Eleven of the 12 fractures healed radiologically and histologically. Moderate to severe osteolysis was seen at four to six weeks with maximum changes at 12 weeks in ten animals. Six knees showed fistula-like connections between the implant site and the joint space. Three developed synovitis, one with inflammatory changes involving the whole cartilage and one with destruction of the medial condyle. Although in our study osteochondral fractures fixed with PGA rods healed reliably, there were frequent, significant foreign-body reactions. Caution is needed when considering the use of PGA fixation devices in vulnerable regions such as the knee.
Olson, Michael D; Saw, Jessica; Visscher, Sue L; Balakrishnan, Karthik
2018-07-01
The purpose of this study is to investigate the relative cost and safety of ear foreign body (FB) removal via conscious sedation in the emergency department. A retrospective review of patients presenting from 2000 to 2015 to the emergency department at Mayo Clinic, Rochester, Minnesota was performed. 63 patients requiring sedation for ear foreign body removal were identified. Descriptive data, safety data, and costs were obtained for the study. There were no appreciable differences in patient safety outcomes and otologic outcomes in patients who received sedation in the emergency department or anesthesia in the operating room for FB removal. Cost analysis demonstrated increased cost associated with operating room utilization verses conscious sedation in the emergency department, with the greatest cost increase being in patients evaluated first in the emergency department and then sent to the operating room. Ear foreign body removal in the emergency department is shows a similar safety profile to removal in the operating room, but at a markedly lower cost. Emergency department conscious sedation should be considered a viable option in appropriately selected patients with this common problem given these results. Copyright © 2018. Published by Elsevier B.V.
He, Jie; Shi, Wodong
2017-12-01
Resorbable materials have been recommended for orbital fractures repair. Many literatures reported the advantages of resorbable materials in clinical applications, but few reports about complications. In this study, we encountered a 14-year-old boy treated for the orbital fracture by using resorbable plate, in whom inflammatory foreign body reaction was detected. In addition, this patient had repeated history of skin allergy and upper respiratory tract infection. Intraoperative observation showed that the resorbable material near the orbital rim was covered by granulation and inflammatory tissues, without purulent secretions. The histological examination revealed inflammatory foreign body reaction to the resorbable plate. Debridement was taken to remove the mass on the left lower eyelid. At the outpatient examination, a small amount of granulation tissue was found at the incision. Then, secondary surgery for exploration and removal of the resorbable material was carried, 9 months after the first surgery. One month after the surgery, the skin retraction, ectropion, and edema gradually improved. Inadequate degradation of resorbable materials and patient's medical history of allergies may cause an inflammatory foreign body reaction. Therefore, it is prudent to choose resorbable materials for patients.
Inflammatory foreign body reaction caused by resorbable materials used for orbital fractures repair
He, Jie; Shi, Wodong
2017-01-01
Abstract Rationale: Resorbable materials have been recommended for orbital fractures repair. Many literatures reported the advantages of resorbable materials in clinical applications, but few reports about complications. Patient concerns: In this study, we encountered a 14-year-old boy treated for the orbital fracture by using resorbable plate, in whom inflammatory foreign body reaction was detected. In addition, this patient had repeated history of skin allergy and upper respiratory tract infection. Diagnoses: Intraoperative observation showed that the resorbable material near the orbital rim was covered by granulation and inflammatory tissues, without purulent secretions. The histological examination revealed inflammatory foreign body reaction to the resorbable plate. Interventions: Debridement was taken to remove the mass on the left lower eyelid. At the outpatient examination, a small amount of granulation tissue was found at the incision. Then, secondary surgery for exploration and removal of the resorbable material was carried, 9 months after the first surgery. Outcomes: One month after the surgery, the skin retraction, ectropion, and edema gradually improved. Lessons: Inadequate degradation of resorbable materials and patient's medical history of allergies may cause an inflammatory foreign body reaction. Therefore, it is prudent to choose resorbable materials for patients. PMID:29245243
Diagnostic value of computed tomography in dogs with chronic nasal disease.
Saunders, Jimmy H; van Bree, Henri; Gielen, Ingrid; de Rooster, Hilde
2003-01-01
Computed tomographic (CT) studies of 80 dogs with chronic nasal disease (nasal neoplasia (n = 19), nasal aspergillosis (n = 46), nonspecific rhinitis (n = 11), and foreign body rhinitis (n = 4)) were reviewed retrospectively by two independent observers. Each observer filled out a custom-designed list to record his or her interpretation of the CT signs and selected a diagnosis. Accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for the diagnosis of each disease. The agreement between observers was evaluated. The CT signs corresponded to those previously described in the literature. CT had an accuracy greater than 90% for each observer in all disease processes. The sensitivity, specificity, PPV, and NPV were greater than 80% in all dogs with the exception of the PPV of foreign body rhinitis (80% for observer A and 44% for observer B). There was a substantial, to almost perfect, agreement between the two observers regarding the CT signs and diagnosis. This study indicates a high accuracy of CT for diagnosis of dogs with chronic nasal disease. The differentiation between nasal aspergillosis restricted to the nasal passages and foreign body rhinitis may be difficult when the foreign body is not visible.
Comparison of Two Foreign Body Retrieval Devices with Adjustable Loops in a Swine Model
DOE Office of Scientific and Technical Information (OSTI.GOV)
Konya, Andras
2006-12-15
The purpose of the study was to compare two similar foreign body retrieval devices, the Texan{sup TM} (TX) and the Texan LONGhorn{sup TM} (TX-LG), in a swine model. Both devices feature a {<=}30-mm adjustable loop. Capture times and total procedure times for retrieving foreign bodies from the infrarenal aorta, inferior vena cava, and stomach were compared. All attempts with both devices (TX, n = 15; TX-LG, n = 14) were successful. Foreign bodies in the vasculature were captured quickly using both devices (mean {+-} SD, 88 {+-} 106 sec for TX vs 67 {+-} 42 sec for TX-LG) with nomore » significant difference between them. The TX-LG, however, allowed significantly better capture times than the TX in the stomach (p = 0.022), Overall, capture times for the TX-LG were significantly better than for the TX (p = 0.029). There was no significant difference between the total procedure times in any anatomic region. TX-LG performed significantly better than the TX in the stomach and therefore overall. The better torque control and maneuverability of TX-LG resulted in better performance in large anatomic spaces.« less
Ernst, Benjamin J; Velez-Montoya, Raul; Kujundzic, Damir; Kujundzic, Elmira; Olson, Jeffrey L
2013-07-01
To evaluate and compare the perfluorocarbon liquid, silicone oil, and viscoelastic against standard saline, in their ability to dampen the impact force of a foreign body, dropped within the eye. In an experimental surgical model in where cohesive and adhesive forces of the substances are not enough to float heavy-than-water foreign bodies. A model of ophthalmic surgery was constructed. A BB pellet was dropped from 24 mm onto a force transducer through four different fluids: balanced salt solution, perfluoro-n-octane, viscoelastic, and silicone oil. The impact energy (force) for each case was measured and recorded by the force transducer. The mean force of impact for each fluid was compared using the Student t-test. Silicone oil resulted in the lowest force of impact. Both silicone oil and viscoelastic dampened the impact an order of magnitude more than perfluoro-n-octane and balanced salt solution. Silicone oil and viscoelastic cushioned the force from a dropped BB. They may be useful adjuncts to prevent iatrogenic retinal injury during vitrectomy for intraocular foreign body removal. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.
The Effects of Foreign Language Learning on Creativity
ERIC Educational Resources Information Center
Ghonsooly, Behzad; Showqi, Sara
2012-01-01
The present study investigates the possible influence of foreign language learning on individuals' divergent thinking abilities. Unlike the large body of research devoted to unfolding the effect of bilingualism on cognitive functions, foreign language learning has gained little attention. This study aimed at bringing into attention the distinctive…
ERIC Educational Resources Information Center
Kacenga, George F.
2017-01-01
Foreign educational credential assessment is responsive to assessors' social, economic, and cultural stimuli. Academic institutions, industries, and governmental bodies treat placement specialists' recommendations as signals of cross-cultural productive capacity, giving significance to the methodology of foreign education-system analysis. A…
Migrating pharyngeal foreign bodies: a series of four cases of saw-toothed fish bones.
Chung, Sung Min; Kim, Han Su; Park, Eun Hee
2008-09-01
Pharyngeal foreign bodies are common problems seen at emergency rooms or ENT outpatient clinics, and fish bones are the most common foreign bodies encountered in East Asia and in Korea. One of the rare complications of a swallowed sharp fish bone is its migration from the site of entry into the subcutaneous tissues of the neck. We present four unusual cases of ingested fish bones that migrated out of the upper digestive tract to the neck. In the first case, this caused a recurrent deep neck infection for 2 years; in the second case, there was penetration of the facial artery; in the third case, there was a hematoma of the floor of the mouth; in the fourth case, there was a retropharyngeal abscess.
Acute otalgia in Nigerian children.
Ijaduola, T G
1985-12-01
A study of 112 referred children with acute otalgia labeled 'acute otitis media' by the referring physicians was carried out at the E.N.T. clinic of Lagos University Teaching Hospital in 1981-1982. Only 11% of these were actually due to acute otitis media, reflecting poor technique at otoscopy. Of the acute otalgia cases 56% were due to ear pathology while 44% resulted from referred pain. Otological causes included foreign body in the ear (23%), acute otitis media (11%), otitis externa (10%), secretory otitis media (6%) and myringitis bullosa haemorrhagica (4%). Cases due to referred otalgia were from tonsillitis (21%), foreign body in the pharynx (5%), traditional uvulectomy (5%), and foreign body in the nose (2%). Thus, there is a need for more careful examination of the ear in all cases of acute otalgia.
Anatomic Double Bundle single tunnel Foreign Material Free ACL-Reconstruction – a technical note
Felmet, Gernot
2011-01-01
Summary The anterior cruciate ligament (ACL) consists of two bundles, the anteromedial (AM) and posterolateral bundle (PM). Double bundle reconstructions appear to give better rotational stability. The usual technique is to make two tunnels in the femur and two in the tibia. This is difficult and in small knees may not even be possible. We have developed a foreign material free press fit fixation for double bundle ACL reconstruction using a single femoral tunnel (R). This is based on the ALL PRESS FIT ACL reconstruction. It is suitable for the most common medium and, otherwise difficult, small sizes of knees. Method: Using diamond edged wet grinding hollow reamers, bone cylinders in different diameters are harvested from the implantation tunnels of the tibia and femur and used for the press fit fixation. Using the press fit technique the graft is first fixed in tibia. It is then similarly fixed under tension in the femoral side with the knee in 120 degree flexion. This is called Bottom To Top Fixation (BTT). On extending the knee the graft tension is self adapting. Depending on the size of the individual knee, the diameter of the femoral bone plug is varied from 8 to 13 mm to achieve an anatomic spread with a double bundle-like insertion. The tibia tunnel can be applied with two 7 or 8 mm diameter tunnels overlapping to a semi oval tunnel between 10 to 13 mm. Results: Since May 2003 we have carried out ACL-reconstructions with Hamstring grafts without foreign material using the ALL PRESS FIT technique. Initially, an 8 mm press fit fixation was used proximally with good results. Since April 2008, the range of diameters was increased up to 13 mm. The results of the Lachman tests have been good to excellent. Results of the Pivot shift test suggested more stability with femoral broader diameters of 9,5 to 13 mm. Conclusions: The foreign material free fixation of ham-string in the ALL PRESS FIT Bottom To Top Fixation is a successful method for ACL Reconstruction. The Diamond Instruments and tubed guiding devices are precise, reliable and easy to manage. On this basis a double bundle reconstruction is achieved using a single tunnel. A broad anatomic femoral insertion with autogenous bone plugs inserted near the cortex seems to improve rotational stability. PMID:23738263
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wiebe, David J.; Carlson, Andrew; Stoker, Kyle C.
A transition duct system for routing a gas flow in a combustion turbine engine is provided. The transition duct system includes one or more converging flow joint inserts forming a trailing edge at an intersection between adjacent transition ducts. The converging flow joint insert may be contained within a converging flow joint insert receiver and may be disconnected from the transition duct bodies by which the converging flow joint insert is positioned. Being disconnected eliminates stress formation within the converging flow joint insert, thereby enhancing the life of the insert. The converging flow joint insert may be removable such thatmore » the insert can be replaced once worn beyond design limits.« less
Handbook. Midwest Center for Off-Campus Studies.
ERIC Educational Resources Information Center
Midwest Center for Off-Campus Studies, Lincoln, IL.
The Midwest Center for Off-Campus Studies offers students the opportunity to learn in a holistic manner by inserting them into a new community, either domestic or foreign, so that they can not only see the physical characteristics of the site, but can experience learning. Although the Center is at present an association of five Illinois two-year…
Assessing the intrauterine device.
Mishell, D R
1975-01-01
The data that have accumulated in the 15 years of use of the IUD are examined, the problems involved in attempting to derive meaningful data are discussed and important research directions are highlighted in an attempt to assess the IUD as a contraceptive measure in light of negative reports appearing in the news media. Reliable epidemiologic information about IUD experience before 1970 are available in the reports of the Cooperative Statistical Program. Currently available IUD designs include the Lippes loop, copper-7, double coil, copper T and progesterone T. It has been observed that several factors may be responsible for the variation in performance of IUDs. These include: patient population, physician experience, side effect tolerance, clinic attitude and additional contraceptives (whether a patient is encouraged to use additional contraception with the IUD). The only valid method of comparison of different IUDs is to perform randomized insertion of the devices in the same clinic using the same personnel and the same time period and to analyze the methods by life table analysis. Medical problems in IUD use were discussed including bleeding (either heavy and/or prolonged menses or intermenstrual bleeding), perforation, pregnancy with an IUD in situ, and infection. The contraceptive action of the IUD is associated with the production of a local sterile inflammatory reaction caused by the presence of the foreign body in the uterus. Research should be directed toward improving the design of IUD inserters because placement of the IUD within the uterine cavity is of extreme importance for IUD effectiveness.
Arazi, T; Slutsky, S G; Shiboleth, Y M; Wang, Y; Rubinstein, M; Barak, S; Yang, J; Gal-On, A
2001-04-27
Plant virus vectors provide an attractive biotechnological tool for the transient expression of foreign genes in whole plants. As yet there has been no use of recombinant viruses for the improvement of commercial crops. This is mainly because the viruses used to create vectors usually cause significant yield loss and can be transmitted in the field. A novel attenuated zucchini yellow mosaic potyvirus (AG) was used for the development of an environmentally safe non-pathogenic virus vector. The suitability of AG as an expression vector in plants was tested by analysis of two infectious viral constructs, each containing a distinct gene insertion site. Introduction of a foreign viral coat protein gene into AG genome between the P1 and HC-Pro genes, resulted in no expression in planta. In contrast, the same gene was stably expressed when inserted between NIb and CP genes, suggesting that this site is more suitable for a gene vector. Virus-mediated expression of reporter genes was observed in squash and cucumber leaves, stems, roots and edible fruit. Furthermore, AG stably expressed human interferon-alpha 2, an important human anti-viral drug, without affecting plant development and yield. Interferon biological activity was measured in cucumber and squash fruit. Together, these data corroborate a biotechnological utility of AG as a non-pathogenic vector for the expression of a foreign gene, as a benefit trait, in cucurbits and their edible fruit.
Shiryazdi, S M; Heiranizadeh, N; Soltani, H R
2013-06-01
An 8-year-old girl was taken to an outpatient clinic of surgery suffering from rectorrhagia and purulent, smelly vaginal discharge. Colonoscopy and biopsy were done before referring and sulfasalazine regime was administrated for probable colitis. The surgeon performed a rigid rectosigmoidoscopy under general anesthesia and no positive evidence was found. Having examined the hymen, it was found to be intact but a purulent discharge was observed. After drying the discharge, a black foreign body was seen in the bottom of the vagina and brought out by a fine forceps. It was a toy's wheel. The patient and her mother both denied foreign body abusing history. It was recommended she go for a psychological consultation. Generally speaking, all young patients suffering from vaginal or rectal bleeding with or without discharge should have their vagina checked for a foreign body. What is recommended in such cases is to undergo sonography or plain radiography before considering invasive or non-invasive procedures for evaluating anal and sigmoid abnormalities. Last but not least, a vaginal irrigation, precise examination of hymen, and posterior fossa can prove very useful for detecting simple vaginal bodies that can lead to various vaginal, rectal and abdominal complications. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
Intraorbital foreign body: A rifle bullet removed 20 years after the accident.
Clarós, P; Fokouo, J V F; Clarós, A
2017-02-01
Trauma of the orbit and eyeball is common, but intraorbital bullet is a relatively rare event. The authors report the management of a patient with chorioretinitis sclopetaria secondary to a gunshot wound twenty years previously. The clinical, diagnostic and therapeutic aspects of this unusual case of intraorbital foreign body are discussed. Copyright © 2016. Published by Elsevier Masson SAS.
Ingested and Aspirated Foreign Bodies.
Green, S Sarah
2015-10-01
Esophageal and aspirated foreign bodies have important clinical significance, and both should be considered carefully when the history or physical examination findings raise sufficient suspicion. The published evidence regarding the diagnosis and management of foreign body ingestion or aspiration is weighted disproportionately with observational studies, case controls, expert opinion, and systematic reviews. Most of the publications would receive a categorization of C (observational studies including case-control and cohort design) and D (expert opinion, case reports, and clinical reasoning). One of the few prospective studies examining the diagnostic evaluation of foreign body aspiration in children could be considered level B evidence (randomized clinical trials, systematic reviews, or diagnostic studies with minor limitations). This study found that the medical history is the most important predictive part of the evaluation. There is evidence for considering bronchoscopy if there is significant history suggestive of foreign body aspiration, even in the setting of normal physical examination findings. (28). Most ingested foreign bodies spontaneously pass without incident. However, special attention should be paid to objects in the esophagus as well as to batteries and magnets. Based on a systematic review of the literature (level B evidence) and the potential for rapid and life-threatening damage, batteries in the esophagus should be removed immediately. (10) Other objects, such as coins, may be observed for passage in an asymptomatic patient. In addition, given the high risk of significant complications, ingestion of high-powered magnets should be quickly and carefully evaluated. Although single magnets are likely to pass without complication, multiple magnets or magnets ingested with other metal objects can cause significant damage and should be removed if there is any concern for mural entrapment, bowel perforation, or failure to progress. (10)(16)(17)(18)(19). Lastly, another systematic review of the literature (level B evidence) about the aspiration of food objects in children suggests that this is a significant public health concern with potentially devastating consequences. Despite clear legislation and regulation by the Consumer Product Safety Commission regarding toys, there is no similar regulation of high-risk foods. The data suggest that there is opportunity for improvement in legislation about the production and packaging of high-risk items as well as in the education of caregivers. (22)
Youssef, J A; McKinley, T O; Yerby, S A; McLain, R F
1999-06-01
A bending analysis of pedicle screws inserted into vertebral body analogues. Intravertebral and intrapedicular pedicle screw bending moments were studied as a function of sagittal insertion angle. To determine how the pedicle screw bending moment is affected by changes in the insertion angle. There is a significant incidence of failure when pedicle screws are used to instrument unstable spinal segments. Extrinsic factors that affect screw bending failure have been poorly characterized. Previous work has demonstrated that intrapedicular pedicle screw bending moments are significantly affected by the sagittal location and depth of pedicle screw placement. Pedicle screw transducers were inserted in analogue vertebrae at one of three orientations: 7 degrees cephalad (toward the superior endplate), 7 degrees caudal (toward the inferior endplate), or parallel to the superior endplate (control). An axial load was applied to the superior endplate of the vertebra, and screw bending moments were recorded directly from the transducers. Screws angled 7 degrees cephalad developed significantly greater mean intrapedicular bending moments compared with screws inserted caudal or control screws. There was no significant difference in bending moments realized within the vertebral body for the three screw positions. Angulating pedicle screws toward the superior endplate increased bending moments within the pedicle. If attention to optimal screw insertion technique can reduce bending moments and potential for screw failure without increasing morbidity, surgical risk, or operative time, then proper insertion technique takes on new importance.
... a possible complication of other respiratory problems, including cystic fibrosis, inhaled foreign objects, lung tumors, fluid in the ... plugs also are common in children, people with cystic fibrosis and during severe asthma attacks. Foreign body. Atelectasis ...
ERIC Educational Resources Information Center
Wijayanto, Agus; Prasetyarini, Aryati; Hikmat, Mauly Halwat
2017-01-01
A growing body of literature has investigated impoliteness in many domains. Nevertheless, little research has examined impoliteness done by foreign language learners. Impoliteness used in interlanguage complaints by English as a foreign language learners was observed. The effects of interlocutors' different status levels and social distance on the…
Foreign Language Learners' Beliefs about CALL: The Case of a U.S. Midwestern University
ERIC Educational Resources Information Center
Sydorenko, Tetyana; Hsieh, Ching-Ni; Ahn, Seongmee; Arnold, Nike
2017-01-01
A significant body of research has examined language learners' attitudes toward particular technologies used in foreign language classrooms. However, literature is scarce on foreign language learners' beliefs toward computer-assisted language learning (CALL) in general. To narrow this gap, we investigated the constructs that compose a system of…
Inferior Vena Cava Filter Limb Fracture with Embolization to the Right Ventricle.
Jackson, Bradley S; Sepula, Mykel; Marx, Jared T; Cannon, Chad M
2017-08-01
Inferior vena cava (IVC) filter and filter limb embolization is a known phenomenon, with a prevalence of up to 25% for certain filter types. Most commonly, the site of embolization is to the heart. Point-of-care ultrasound is an easily accessible imaging modality that should be utilized when considering IVC filter complications. A 28-year-old woman with a history of metastatic sarcoma and IVC filter placement for deep venous thrombosis presented to the Emergency Department (ED) for chest pain. Chest radiography was reviewed and originally thought to have no abnormalities. Chest computed tomography angiography was negative for filling defects or foreign bodies. A possible foreign body in the heart was noted by a radiologist's over-read of the original chest radiograph. An echocardiogram done by Cardiology was negative for foreign bodies or other abnormalities. Next, an emergency physician performed a bedside echocardiogram, with focused attention to the right side of the heart. An echogenic foreign body was visualized in the right ventricle. The patient was subsequently taken to the cardiac catheterization laboratory, where fluoroscopic visualization of a limb wire of an IVC filter within the right ventricle was obtained. That foreign body was subsequently removed successfully, along with removal of the broken IVC filter. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case report highlights the utility of point-of-care ultrasound in the work-up of a patient with an embolized IVC filter wire. Chest pain patients frequently receive point-of-care echocardiography in the ED, and these ultrasound findings should be recognized and used to guide further treatment and consultation. Copyright © 2017 Elsevier Inc. All rights reserved.
Ramp, Kristina; Skiba, Martin; Karger, Axel; Mettenleiter, Thomas C; Römer-Oberdörfer, Angela
2011-02-01
Members of the order Mononegavirales express their genes in a transcription gradient from 3' to 5'. To assess how this impacts on expression of a foreign transgene, the haemagglutinin (HA) of highly pathogenic avian influenza virus (HPAIV) A/chicken/Vietnam/P41/05 (subtype H5N1) was inserted between the phosphoprotein (P) and matrix protein (M), M and fusion protein (F), or F and haemagglutinin-neuraminidase protein (HN) genes of attenuated Newcastle disease virus (NDV) Clone 30. In addition, the gene encoding the neuraminidase of HPAIV A/duck/Vietnam/TG24-01/05 (subtype H5N1) was inserted into the NDV genome either alone or in combination with the HA gene. All recombinants replicated well in embryonated chicken eggs. The expression levels of HA-specific mRNA and protein were quantified by Northern blot analysis and mass spectrometry, with good correlation. HA expression levels differed only moderately and were highest in the recombinant carrying the HA insertion between the F and HN genes of NDV.
[Recommendations for the prevention of foreign body aspiration].
Lluna, Javier; Olabarri, Mikel; Domènech, Anna; Rubio, Bárbara; Yagüe, Francisca; Benítez, María T; Esparza, María J; Mintegi, Santiago
2017-01-01
The aspiration of a foreign body remains a common paediatric problem, with serious consequences that can produce both acute and chronic disease. Aspiration usually causes a medical emergency that requires a prompt diagnosis and an urgent therapeutic approach as it may result in the death of the child or severe brain injury. It typically involves organic foreign bodies (mainly food or nuts) aspirated by children under 5 years old, and usually at home. In this statement, the Committee on Safety and Prevention of Non-Intentional Injury in Childhood of the Spanish Paediatrics Association provides a series of recommendations, both educational (while eating and playing), as well as legal, to prevent such episodes. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.
Under pressure: progressively enlarging facial mass following high-pressure paint injection injury.
Mushtaq, Jameel; Walker, Abigail; Hunter, Ben
2016-01-19
High-pressure paint injection injuries are relatively rare industrial accidents and almost exclusively occur on the non-dominant hand. A rarely documented complication of these injuries is the formation of a foreign body granuloma. We report a case of a 33-year-old man presenting with extensive facial scarring and progressive right paranasal swelling 7 years after a high-pressure paint injury. After imaging investigations, an excision of the mass and revision of scarring was performed. Access to the mass was gained indirectly through existing scarring over the nose to ensure an aesthetic result. Histological analysis revealed a florid granulomatous foreign body reaction to retained paint. To the best of our knowledge, this is the first reported case of a facial high-pressure paint injury with consequent formation of a foreign body granuloma. 2016 BMJ Publishing Group Ltd.
Apparatus and method of inserting a microelectrode in body tissue or the like using vibration means
NASA Technical Reports Server (NTRS)
Feldstein, C.; Crawford, D. W.; Kanabus, E. W. (Inventor)
1979-01-01
An arrangement for and method of inserting a glass microelectrode having a tip in the micron range into body tissue is presented. The arrangement includes a microelectrode. The top of the microelectrode is attached to the diaphragm center of a first speaker. The microelectrode tip is brought into contact with the tissue by controlling a micromanipulator. Thereafter, an audio signal is applied to the speaker to cause the microelectrode to vibrate and thereby pierce the tissue surface without breaking the microelectrode tip. Thereafter, the tip is inserted into the tissue to the desired depth by operating the micromanipulator with the microelectrode in a vibratory or non-vibratory state.
[The ideal body: media pedagogy].
Ribeiro, Rubia Guimarães; da Silva, Karen Schein; Kruse, Maria Henriqueta Luce
2009-03-01
We present enunciations that circulate in the media regarding the body, discussing the ways in which the speeches related with the maintenance of health and aesthetics invest in its improvement. Therefore, we used the Caderno Vida, a weekly insert of Zero Hora, for we understand it as owner of a proper speech that has the power of subjectivate people The analysis is part of Cultural Studies and it is based on the ideas of Michel Foucault. The methodological strategy used was the speech analysis of subjects about body care. The periodical questions its readers using speeches that point to beauty health and success The constructed categories were: how is the ideal body, what to do to have such body and why we must have this body Balanced feeding, practice of regular physical activities and the accomplishment of plastic surgeries are recommendations recurrently found in weekly inserts.
Septic arthritis due to Cellulosimicrobium cellulans.
Magro-Checa, César; Chaves-Chaparro, Lara; Parra-Ruiz, Jorge; Peña-Monje, Alejandro; Rosales-Alexander, José Luis; Salvatierra, Juan; Raya, Enrique
2011-12-01
Cellulosimicrobium cellulans has been reported as a rare cause of human pathogenesis. Infections mainly occur in immunocompromised patients and very often are associated with a foreign body. We report the first case of septic arthritis caused by C. cellulans in an immunocompetent patient. Our patient suffered a penetrating palm tree thorn injury to his left knee 8 weeks before admission. Although no foreign objects were found, they were suspected because previous reports suggest a frequent association with this microorganism, and open debridament was performed. Removal of foreign bodies related to this organism must be considered a high-priority treatment in these patients to achieve a complete recovery.
[Chalcosis bulbi recognized 22 years after trauma].
Yagihashi, Tomoyuki; Wakabayashi, Yoshihiro; Fujita, Satoshi; Fujita, Yasushi; Usui, Masahiko
2006-12-01
To report a case of chalcosis bulbi diagnosed 22 years after accidental entry of a foreign object into the eye. A 57 year-old woman underwent surgery for vitreous opacity and cataract of unknown cause. During the operation, an intraocular foreign body was found in the vitreous at the pars plana, and was removed. The object was a coated copper wire, 3.5 mm in length and 0.2 mm in thickness. She recalled that such a wire had accidentally entered her eye 22 years previously. Copper particles were detected by copper staining of the anterior lens capsule. Fine, sharp metal fragments may penetrate the eye with little resistance. When the injury results in minimal subjective symptoms, the person may not seek examination by an ophthalmologist. In the present case, the foreign body was a fragment of coated copper wire. The exposed metal surface was limited and the copper probably dissolved very slowly. This may account for the lack of significant symptoms. In the Japanese literature, there are many reports of coated copper wire as foreign body in the eye, but few lead to characteristic chalcosis bulbi.
Development of a Moldable, Biodegradable Polymeric Bone Repair Material
1994-03-30
minimally encapsulated by fibrous tissue. Histomorphometric analysis of day 14 specimens showed a very mild foreign body response in terms of area. This...significant visual evidence of foreign body response seen for any Atrix test article. A mass of dense fibrotic tissue was found near the defect site...article in the defect and medullary cavity. The test article was minimally encapsulated by fibrotic tissue. Histomorphometric analysis showed this
Yip, L W; Goh, F S; Sim, R S
1998-03-01
This is a case report of an elderly lady with odynophagia because she accidentally swallowed a tablet which was still wrapped in its blister pack. A discussion of foreign body ingestion, particularly in the elderly, is included. To the authors' knowledge, this is the first paper that includes a lateral cervical radiograph of an ingested blister pack.
Crawford, Nigel W
2007-08-01
Foreign-body aspiration remains a leading cause of mortality in children under 3 years despite child-safety initiatives. This case report describes a classic history of peanut aspiration in a young child. Unfortunately, the diagnosis was delayed and only detected the next day through radiology review. The clinical history is paramount and this case highlights how emergency radiology reporting can minimize morbidity.
High-Throughput Analysis of T-DNA Location and Structure Using Sequence Capture.
Inagaki, Soichi; Henry, Isabelle M; Lieberman, Meric C; Comai, Luca
2015-01-01
Agrobacterium-mediated transformation of plants with T-DNA is used both to introduce transgenes and for mutagenesis. Conventional approaches used to identify the genomic location and the structure of the inserted T-DNA are laborious and high-throughput methods using next-generation sequencing are being developed to address these problems. Here, we present a cost-effective approach that uses sequence capture targeted to the T-DNA borders to select genomic DNA fragments containing T-DNA-genome junctions, followed by Illumina sequencing to determine the location and junction structure of T-DNA insertions. Multiple probes can be mixed so that transgenic lines transformed with different T-DNA types can be processed simultaneously, using a simple, index-based pooling approach. We also developed a simple bioinformatic tool to find sequence read pairs that span the junction between the genome and T-DNA or any foreign DNA. We analyzed 29 transgenic lines of Arabidopsis thaliana, each containing inserts from 4 different T-DNA vectors. We determined the location of T-DNA insertions in 22 lines, 4 of which carried multiple insertion sites. Additionally, our analysis uncovered a high frequency of unconventional and complex T-DNA insertions, highlighting the needs for high-throughput methods for T-DNA localization and structural characterization. Transgene insertion events have to be fully characterized prior to use as commercial products. Our method greatly facilitates the first step of this characterization of transgenic plants by providing an efficient screen for the selection of promising lines.
Demographic and Clinical Findings in Children Undergoing Bronchoscopy for Foreign Body Aspiration
Safari, Mojgan; Manesh, Mohammad Reza Hashemi
2016-01-01
Background: Foreign body aspiration (FBA) is a significant cause of airway distress, mortality, and morbidity in children. Diagnosis of FBA can be challenging and is sometimes delayed for weeks or even months. If not diagnosed and treated promptly, FBA can result in serious consequences. Methods: For this retrospective study, we investigated the medical records of 89 children who underwent bronchoscopy for suspected FBA and recorded relevant demographic, clinical, and treatment data. Results: Of the 89 patients identified for this study, 51 had a definitive diagnosis of FBA. Among these patients, choking, chronic cough and wheezing, cyanosis, and dyspnea were the most frequent symptoms of FBA. The foreign bodies were located in the left bronchus (45.1%), the right bronchus (35.3%), the trachea (15.7%), and in both the right and left bronchi (3.9%). Seeds were the most prevalent foreign body, found in 39.2% of the patients. Conclusion: Lack of complete medical history in patients with suspected FBA is one of the main causes of delayed FBA diagnosis. Bronchoscopy is considered the definitive diagnostic method for FBA and should be conducted in all patients with suspected FBA because of the low risk of complications and reduced probability that FBA diagnosis and treatment will be delayed. PMID:27303219
Yield of chest radiography after removal of esophageal foreign bodies.
Fisher, Jeremy; Mittal, Rohit; Hill, Sarah; Wulkan, Mark L; Clifton, Matthew S
2013-05-01
The aim of this study was to determine the benefit of routine postoperative chest radiography after removal of esophageal foreign bodies in children. Medical records were reviewed of all patients evaluated with an esophageal foreign body at a single children's hospital over 10 years. Operative records and imaging reports were reviewed for evidence of esophageal injury. Of 803 records identified, 690 were included. All underwent rigid esophagoscopy and foreign body removal. The most common items removed were coins (94%), food boluses (3%), and batteries (2%). The rate of esophageal injury was 1.3% (9 patients). No injuries were identified on chest radiographs done as routine or for concern of injury. Patients with operative findings suggestive of an esophageal injury (n = 105) were significantly more likely to have an injury (8.6% vs 0%, P = .0001). Of the 585 children who did not have physical evidence of injury, 40% (n = 235) received a routine chest radiograph. Regardless of the indication, no injuries were identified on chest films. We conclude that intraoperative findings during rigid esophagoscopy suggestive of an injury are predictive of esophageal perforation. Routine chest radiography is not warranted in children who do not meet this criterion. In patients with a concern for injury, we suggest that chest radiography should be deferred in favor of esophagram.
Drawbacks of the use of cotrimoxazole in foreign-body infections.
El Haj, Cristina; Ribera, Alba; Lloberas, Nuria; Tubau, Fe; Ariza, Javier; Murillo, Oscar
The anti-staphylococcal efficacy of cotrimoxazole in the setting of difficult-to-treat infections seems to be compromised by large amounts of pus and devitalized tissue, and, therefore, high levels of thymidine. Our objective was to evaluate the activity of cotrimoxazole against a staphylococcal foreign-body infection experimental model, which also yields significant quantities of thymidine. We used a rat tissue-cage model of infection (with high inherent thymidine levels) caused by a strain of methicillin-susceptible Staphylococcus aureus (MSSA; ATCC 29213). MIC values were determined (microdilution method) and compared in the presence or absence of tissue-cage fluid samples. The inefficacy of cotrimoxazole was found to be similar to that of the control group. The MIC of cotrimoxazole was 4-8 fold higher in the presence of rat tissue-cage fluid. The inefficacy of cotrimoxazole in our foreign-body infection model by MSSA, and the probable negative impact of the presence of thymidine on its efficacy, challenge the use of this drug in acute phases of foreign-body infections. It should be reserved as an alternative treatment when the infection is more controlled. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.
Foltran, Francesca; Ballali, Simonetta; Rodriguez, Hugo; Sebastian van As, Arjan B; Passali, Desiderio; Gulati, Achal; Gregori, Dario
2013-04-01
While several articles describe clinical management of foreign bodies injuries in the upper air tract, little epidemiological evidence is available from injury databases. This article aims to understand the burden of airway FB injuries in high-, low-, and middle-income countries as emerging from scientific literature. One thousand six hundred ninety-nine published articles 1978-2008. A free text search on PubMed database ((foreign bodies) or (foreign body)) and ((aspiration) or (airways) or (tracheobronchial) or (nasal) or (inhalation) or (obstruction) or (choking) or (inhaled) or (aspirations) or (nose) or (throat) or (asphyxiation)) and ((children) or (child)). Information on reported injuries according to country, time period, children sex and age, FB type, site of obstruction, symptoms, signs, diagnostic and therapeutic procedures, delay at the diagnosis, complications, number of deaths. Serious complications occur both in high-income and low-middle income countries in a considerable proportion of cases (10% and 20%, respectively). Similarly, death is not infrequent (5-7% of cases). Few countries have good systematic data collection and there's a lack of sensibility in parents and clinicians in terms of acknowledge of the choking risk. On the contrary, international surveillance systems able to collect information in a standardized way need to be implemented. Copyright © 2012 Wiley Periodicals, Inc.
Recombinant Vaccinia Virus: Immunization against Multiple Pathogens
NASA Astrophysics Data System (ADS)
Perkus, Marion E.; Piccini, Antonia; Lipinskas, Bernard R.; Paoletti, Enzo
1985-09-01
The coding sequences for the hepatitis B virus surface antigen, the herpes simplex virus glycoprotein D, and the influenza virus hemagglutinin were inserted into a single vaccinia virus genome. Rabbits inoculated intravenously or intradermally with this polyvalent vaccinia virus recombinant produced antibodies reactive to all three authentic foreign antigens. In addition, the feasibility of multiple rounds of vaccination with recombinant vaccinia virus was demonstrated.
Code of Federal Regulations, 2012 CFR
2012-04-01
.... Any person, institution, or other body may apply to the U.S. Central Authority for assistance in... for use in a foreign country, two additional copies should be provided in the language of the foreign...
Code of Federal Regulations, 2014 CFR
2014-04-01
.... Any person, institution, or other body may apply to the U.S. Central Authority for assistance in... for use in a foreign country, two additional copies should be provided in the language of the foreign...
Code of Federal Regulations, 2013 CFR
2013-04-01
.... Any person, institution, or other body may apply to the U.S. Central Authority for assistance in... for use in a foreign country, two additional copies should be provided in the language of the foreign...
NASA Technical Reports Server (NTRS)
Chaban, Galina M.
2005-01-01
Compounds formed by insertion of rare-gas atoms (Xe, Kr, and Ar) into glycine molecule are investigated using accurate ab initio computational methods. Identification of such insertion compounds may open new frontiers in the field of rare-gas chemistry, such as possible existence of biological molecules that include chemically bound rare gas atoms. The most stable glycine-Rg configuration is found to correspond to insertion of Rg atoms into the 0-H bond of glycine. These NH2CH2COORgH compounds are metastable , but separated by sizable potential barriers from the Rg + glycine dissociation products. Preliminary calculations show that NH2CH2COOXeH compound is energetically stable with respect to another (3-body) dissociation channel (NH2CH2COO + Rg + H), while the corresponding Ar species is not stable in this respect. The compound with the inserted Kr is a borderline case, with the 3-body dissociation products being close in energy to the NH2CH2COOKrH minimum.
NASA Astrophysics Data System (ADS)
Mercuri, F.; Caruso, G.; Orazi, N.; Zammit, U.; Cicero, C.; Colacicchi Alessandri, O.; Ferretti, M.; Paoloni, S.
2018-05-01
In this paper, a new method based on the use of infrared thermography is proposed for the characterization of repairs and inserted parts on ancient bronzes. In particular, the quality of the contact between different kind of insertions and the main body of bronze statues is investigated by analysing the heat conduction process occurring across the interface between them. The thermographic results have been used to establish the nature of these inserted elements and the way they have been coupled to the main body of the statue during and after the manufacturing process. A model for the heat conduction based on the numerical finite elements method has been applied to compare the obtained results to the theoretical predictions. Measurements have been first carried out on test samples and then in the field on the Boxer at Rest (Museo Nazionale Romano in Rome), a masterpiece of the Greek Statuary, which contains a large variety of inserted items and repairs which are typical of the manufacturing process of bronze artefacts in general.
Fostering design for avoiding small parts in commonly used objects.
de Koning, Ton; Foltran, Francesca; Gregori, Dario
2012-05-14
Injuries due to the accidental ingestion or aspiration of small parts have became a matter of interest in the last 30 years, focusing on the relationship between a proper prevention and the diminished frequency of occurrences. Small parts in commonly used objects represent a large sector of potential danger, taking explicit mouthing behavior of children in the first four years of life. In this paper the intent is to show the current situation of design projects and legislation around the world, meant to avoid the casual accidents due to manufacturing reasons. Proposed process and quality control standards seek to eliminate production errors and control materials to avoid deviation from the design. The present study draws its data from the Susy Safe registry, a European Commission co-funded project started in February 2005, whose aim is to establish an international registry of cases of Foreign Bodies (FB) injuries in children aged 0-14 years. Information collected from the data base concern age and gender of the child, location, shape, volume, consistency and elipticity of the foreign body, any complication occurred, hospitalization, and behavioral aspects linked to the injury, like the supervision of the parents or the activity concomitant to the injury. Cases are prospectively collected using the Susy Safe system from 06/2005; moreover, also information regarding past consecutive cases available in each center adhering to the project have been entered in the Susy Safe Registry. Data evidenced that the majority of small parts related injuries are related to stationery. The majority of objects (56.7%), were located in the nose, followed by the ears (31.5%). The distribution on incidence of FB injuries by age class shows that the majority of injuries due to small parts in common objects occurred in children older than >3 years. Male and female were affected with the same frequency when concerning the nose, while all other locations showed a higher frequency in males. Data suggested that hospitalization occurred in 32% of those who compiled the form, resulting in complication just in 16% of injured. Although the most frequent location needing hospitalization was the tracheobronchial tree, the most frequent location showing complication was the nose, 80.3% of the complications, having an infection as most frequent outcome. In children younger than 1 year median volume reached 333.62 mm(3), in children between 1 and 2 years, median volume was 81.12 mm(3), in older children (>3 years) it showed 37.68 mm(3). The same considerations can be seen for the ellipticity, where the median ellipticity was 2.79 in children <1 year, while it was 1.94 in children between 1 and 2 years, and 1.17 in the older ones. Consistency is similar for all age classes, stressing that rigid small parts were those more involved in injuries with foreign bodies. Behavioral aspects pointed out that the 80% of children were playing before the accident, and 65.3% were under adults' supervision. Adult presence resulted associated to the absence of complication, with a p-value of 0.04. The study stresses the importance of primary prevention, seen as the active care of adults toward children manipulating foreign bodies potentially dangerous. This presence may not avoid the event, but in case of FBs aspiration, ingestion, insertion or inhalation, it could be the main factor leading to fewer complications. Copyright © 2012. Published by Elsevier Ireland Ltd.
Health in All (Foreign) Policy: challenges in achieving coherence.
Labonté, Ronald
2014-06-01
Health in All Policies (HiAP) approach is generally perceived as an intersectoral approach to national or sub-national public policy development, such that health outcomes are given full consideration by non-health sectors. Globalization, however, has created numerous 'inherently global health issues' with cross-border causes and consequences, requiring new forms of global governance for health. Although such governance often includes both state and non-state (private, civil society) actors in agenda setting and influence, different actors have differing degrees of power and authority and, ultimately, it is states that ratify intergovernmental covenants or normative declarations that directly or indirectly affect health. This requires public health and health promotion practitioners working within countries to give increased attention to the foreign policies of their national governments. These foreign policies include those governing national security, foreign aid, trade and investment as well as the traditional forms of diplomacy. A new term has been coined to describe how health is coming to be positioned in governments' foreign policies: global health diplomacy. To become adept at this nuanced diplomatic practice requires familiarity with the different policy frames by which health might be inserted into the foreign policy deliberations, and thence intergovernmental/global governance negotiations. This article discusses six such frames (security, trade, development, global public goods, human rights, ethical/moral reasoning) that have been analytically useful in assessing the potential for greater and more health-promoting foreign policy coherence: a 'Health in All (Foreign) Policies' approach. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
A shot to the heart: a rare case of cardiac embolization
Elsisi, Islam Fathi Hussein Ali; Kidambi, Ananth
2018-01-01
Summary This is a case report of intracardiac foreign bodies that gained access to the heart by migration from a peripheral vein. The case report describes the diagnostic findings on cardiac imaging and summarizes different approaches to management. Learning points: Appearance of embolized cardiac missiles with reverberation and acoustic shadowing. Role of different imaging modalities in the diagnosis of intracardiac foreign bodies. Indications for surgical or transcatheter retrieval. PMID:29440229
ERIC Educational Resources Information Center
Terreros, I. Gomez de; And Others
1996-01-01
An unusual case of Munchausen syndrome by proxy is reported. A mother with a psychiatric record of behavior disorders and family dysfunction perpetrated the ingestion of foreign bodies (for example, earrings, a screw, sewing needles) on a 10-month-old infant with a history of prematurity, repeated visits to emergency rooms, and nonjustified…
Terrorist bombings: foreign bodies from the Boston Marathon bombing.
Brunner, John; Singh, Ajay K; Rocha, Tatiana; Havens, Joaquim; Goralnick, Eric; Sodickson, Aaron
2015-02-01
On April 15, 2013, 2 improvised explosive devices detonated at the 117th Boston Marathon, killing 3 people and injuring 264 others. In this article, the foreign bodies and injuries that presented at 2 of the responding level 1 trauma hospitals in Boston-Brigham and Women׳s Hospital and Massachusetts General Hospital--are reviewed with a broader discussion of blast injuries and imaging strategies. Copyright © 2014 Elsevier Inc. All rights reserved.
Management of a patient with autism following ingestion of a foreign body.
McCain, Stephen; Tan, Samantha; Mark, David
2014-06-25
Patients with autism often find admission to hospital an anxious time. Awareness of the condition, a speedy diagnosis and flexibility in adapting treatment plans will facilitate early discharge and return to their familiar environment. We describe a patient with severe autism who presented with an acute abdomen secondary to ingestion of a foreign body which required laparotomy. Communication directly to medical staff was greatly limited due to severe autism and close liaison with family members was essential in interpreting scant clinical signs. At the time of surgery a rubber bottle teat was found causing transection of small bowel due to erosion of the foreign body. The postoperative course was fraught with challenges and ensuring side room nursing care with family members present throughout his admission minimised postoperative stress and confusion. We recommend awareness of management strategies for patients with autism to ensure rapid recovery and early discharge home. 2014 BMJ Publishing Group Ltd.
YANG, Seung-Il; KIM, Jung-Hyun; JEONG, Soon-Wuk; HAN, Hyun-Jung
2018-01-01
A one-year-old male Golden Retriever presented with acute onset of vomiting and hemorrhagic diarrhea since 2 days. The dog was depressed, showing abdominal pain, 12% dehydration, tachycardia, and a bounding pulse. Diagnostic imaging showed severe dilatation and fluid retention of the entire gastrointestinal tract with decreased motility. A foreign body was found in the gastroduodenal region, but there was no obstruction or plication. The dog was tentatively diagnosed with acute hemorrhagic diarrhea syndrome and rapidly recovered after supportive treatment. However, on the morning of day 4, anorexia and vomiting recurred, and diagnostic imaging revealed intestinal plication with free peritoneal fluid, not found on the previous image. An emergency laparotomy revealed the foreign body to be two used feminine hygiene products. These contaminated products were suspected to induce acute hemorrhagic diarrhea syndrome, and led to subsequent complication in this large dog. PMID:29459505
Yang, Seung-Il; Kim, Jung-Hyun; Jeong, Soon-Wuk; Han, Hyun-Jung
2018-04-18
A one-year-old male Golden Retriever presented with acute onset of vomiting and hemorrhagic diarrhea since 2 days. The dog was depressed, showing abdominal pain, 12% dehydration, tachycardia, and a bounding pulse. Diagnostic imaging showed severe dilatation and fluid retention of the entire gastrointestinal tract with decreased motility. A foreign body was found in the gastroduodenal region, but there was no obstruction or plication. The dog was tentatively diagnosed with acute hemorrhagic diarrhea syndrome and rapidly recovered after supportive treatment. However, on the morning of day 4, anorexia and vomiting recurred, and diagnostic imaging revealed intestinal plication with free peritoneal fluid, not found on the previous image. An emergency laparotomy revealed the foreign body to be two used feminine hygiene products. These contaminated products were suspected to induce acute hemorrhagic diarrhea syndrome, and led to subsequent complication in this large dog.
Ravani, Raghav; Chawla, Rohan; Azad, Shorya Vardhan; Gupta, Yogita; Kumar, Vinod; Kumar, Atul
2018-01-01
Purpose: The objective of this study is to describe the removal of retained intraocular foreign body (RIOFB) by bimanual pars plana vitrectomy through midline sclerotomy in phakic patients. Technique: Four eyes with RIOFB and clear lens underwent microincision vitrectomy surgery. A chandelier illumination was placed through one of the existing ports. The foreign body (FB) was localized by direct visualization (intravitreal) or indentation (pars plana), stabilized using an intraocular magnet/FB forceps introduced through a midline sclerotomy and freed of vitreous from all sides using a vitrectomy cutter through the other port bimanually, reoriented along their long axis and extracted through the midline sclerotomy. Results: All four FBs were removed successfully without slippage or damage to the clear lens. Conclusion: Chandelier illumination-assisted removal of FB through midline sclerotomy helps in easier localization, stabilization and removal, avoiding lens touch even in anteriorly located FBs such as at pars plana. PMID:29676316
Pediatric airway foreign bodies.
Fitzpatrick, P C; Guarisco, J L
1998-04-01
Foreign body aspiration (FBA) is a leading cause of accidental death in children less than one year old and is the cause of death in 7% of children less than four. Food items, especially peanuts, are the most common items aspirated in infants and toddlers, whereas older children are more likely to aspirate non-food items such as pen caps, pins, and paper clips. A high degree of suspicion is required to diagnose FBA. A history of a witnessed choking episode is most important in early diagnosis. An asymptomatic period is common after aspiration and contributes to a delay in diagnosis of greater than one week in 12% to 26% of patients. This delay in diagnosis causes increased morbidity from bronchial inflammation, obstruction, and pneumonia which is resistant to treatment. Prompt endoscopic removal of the foreign body with an open rigid bronchoscope under general anesthesia is the mainstay of therapy.
Foreign bodies and caustic lesions.
Dray, Xavier; Cattan, Pierre
2013-10-01
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. Endoscopic treatment is successful in about 95% of patients. Severe complications (including oesophageal perforations) are rare. Underlying diseases (including eosinophilic oesophagitis) must be investigated after food bolus impaction. Accidental or suicidal ingestion of corrosive agents may result in severe upper gastrointestinal tract injuries requiring a multidisciplinary approach including gastroenterologists, surgeons, otorhynolaryngologists, anaesthesiologists and psychiatrists. Treatment includes conservative management of patients with mild injuries, while patients with severe injuries undergo emergency surgical exploration. At distance of the ingestion episode, oesophageal reconstruction is required in patients who underwent oesophageal resection and in patients who developed oesophageal strictures that failed dilatation. Copyright © 2013. Published by Elsevier Ltd.
Garlipp, B; Schulz, H-U; Böttcher, S; Lemke, A; Meyer, F; Lippert, H
2012-11-01
Obstruction of bile flow following pancreatoduodenectomy can be caused by stenosis of the hepaticojejunostomy created at the time of surgery, obstruction of the bile-draining jejunal loop, stones or, very rarely, ingested foreign bodies in the common hepatic duct. In analogy with endoscopic sphincterotomy or the once popular side-to-side-choledochduodenostomy, the creation of a hepaticojejunostomy eliminates the barrier of the sphincter Oddi, enabling intestinal content such as ingested foreign bodies or food fibers to migrate into the bile duct. We report on the case of a patient developing biliary tract obstruction due to fibrous material in the common hepatic duct 15 years after pancreatoduodenectomy. In addition, an overview of the literature on the rare phenomenon of foreign body-associated obstructive jaundice is given. © Georg Thieme Verlag KG Stuttgart · New York.
Stable fixation with absorbable sutures in craniofacial surgery.
Linz, C; Kunz, F; Krauß, J; Böhm, H; Wirth, C; Hartmann, S; Wirbelauer, J; Schweitzer, T
2016-05-01
The present study analyses the exclusive use of absorbable suture material (Vicryl(®), Ethicon, Germany) in the fixation of transposed bone segments in craniofacial surgery without modification of the osteotomy design. Among 129 children up to 24 months of age, osteosynthesis was conducted exclusively with Vicryl(®) sutures. The stability of postoperative results was evaluated and possible foreign body reactions were examined within the framework of clinical and radiological routine checks. All examined children exhibited stable postoperative conditions while the length of hospital stay was not affected. X-ray examinations of the skull in two planes demonstrated good bony union in all cases. Relevant foreign body reactions were not observed. The exclusive application of absorbable suture material enables stable and cost effective osteosynthesis. Significant foreign body reactions were not observed. The exclusive use of absorbable sutures did not alter the osteotomy design. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Office Removal of a Subglottic Bread Clip
Rosow, David E.; Chen, Si
2013-01-01
Objective. The presence of an upper airway foreign body is an emergent, potentially life-threatening situation that requires careful but rapid evaluation and management. Organic or nonorganic material may typically be found in the pyriform sinuses or tongue base or may be aspirated directly into the tracheobronchial tree. We present here an unusual case report of a patient who accidentally ingested a plastic bread clip that was lodged in his subglottis for 15 months and report successful removal in the office under local anesthesia. Methods. Mucosal anesthesia was achieved with inhaled 4% lidocaine spray. Flexible laryngoscopic removal of the foreign body was then successfully accomplished. Results. The patient's symptoms resolved completely following removal, with no sequelae. Conclusions. Office removal of airway foreign bodies is feasible and can be safely done with adequate topical anesthesia, but great caution and emergency planning must be exercised. PMID:24379980
Endovascular retrieval of dental needle retained in the internal carotid artery.
Moore, Kenneth; Khan, Nickalus R; Michael, L Madison; Arthur, Adam S; Hoit, Daniel
2017-07-01
Intravascular foreign bodies are a known complication of medical and dental procedures. Dental anesthetic needles may be broken off and retained in the oropharynx. These needles have occasionally been reported to migrate through the oral mucosa in to deeper structures. Here we present the case of a 57-year-old man who had a retained dental needle that had migrated into his internal carotid artery. The needle was removed using endovascular techniques. To our knowledge, this is the first report of a retained dental needle being retrieved using this method. We review the literature on intravascular foreign bodies, retained dental needles, and endovascular techniques for retrieval of such foreign bodies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Sen, Emine; Elgin, Ufuk; Koç, Fatih; Oztürk, Faruk
2011-01-01
Foreign bodies are usually detected at the first visit. However, they may be overlooked sometimes, especially in children, and may cause some clinical conditions including unilateral relapsing conjunctivitis. A five-year-old girl was presented to the emergency clinic of our hospital with epiphora, purulent discharge, eyelid swelling, and a foreign body feeling in her right eye. The symptoms had been present for one year, and the patient was treated for relapsing conjunctivitis. In slit lamp examination performed with difficulty because of the patient's lack of cooperation, a localized edema and erythema were observed under the right eyelid. An exploration under general anesthesia was planned, and a 1.5 cm-long subconjunctival grass inflorescence was removed. An unknown subconjunctival foreign body should be considered in each patient with relapsing conjunctivitis, especially in children, even in the absence of ocular trauma.
Complications in transorbital penetrating injury by bamboo branch: A case report.
Feng, Lei; He, Xiaojun; Chen, Jie; Ni, Shuang; Jiang, Biao; Hua, Jian-Ming
2018-05-01
Wooden transorbital penetrating injury is an uncommon and serious trauma that may cause multiply complications. Here we describe a 62-year-old Chinese woman with a transorbital penetrating injury caused by a long bamboo branch. Computed tomography scan and magnetic resonance imaging showed the presence of a wooden foreign body. Cerebrovascular digital subtraction angiography and temporary balloon occlusion were performed with general anesthesia. Anti-inflammatory therapy was subsequently administered. Retention of wooden foreign body, orbital cellulitis, and traumatic aneurysm at the right internal carotid artery were diagnosed 1 month later. Coil embolization of the right internal carotid artery aneurysm and endoscopic sinus surgery were then performed, and postoperative condition was monitored and recorded. Penetrating transorbital injury complications may occur because of retained wooden foreign bodies near the intracranial arteries. Reasonable surgical intervention and special attention should be performed in this kind of trauma.
Similarities and differences in coatings for magnesium-based stents and orthopaedic implants
Ma, Jun; Thompson, Marc; Zhao, Nan; Zhu, Donghui
2016-01-01
Magnesium (Mg)-based biodegradable materials are promising candidates for the new generation of implantable medical devices, particularly cardiovascular stents and orthopaedic implants. Mg-based cardiovascular stents represent the most innovative stent technology to date. However, these products still do not fully meet clinical requirements with regards to fast degradation rates, late restenosis, and thrombosis. Thus various surface coatings have been introduced to protect Mg-based stents from rapid corrosion and to improve biocompatibility. Similarly, different coatings have been used for orthopaedic implants, e.g., plates and pins for bone fracture fixation or as an interference screw for tendon-bone or ligament-bone insertion, to improve biocompatibility and corrosion resistance. Metal coatings, nanoporous inorganic coatings and permanent polymers have been proved to enhance corrosion resistance; however, inflammation and foreign body reactions have also been reported. By contrast, biodegradable polymers are more biocompatible in general and are favoured over permanent materials. Drugs are also loaded with biodegradable polymers to improve their performance. The key similarities and differences in coatings for Mg-based stents and orthopaedic implants are summarized. PMID:27695671
Bone scanning in the adductor insertion avulsion syndrome.
Mahajan, Madhuri Shimpi
2013-05-01
A thigh splint (adductor insertion avulsion syndrome) is a relatively uncommon diagnosis analogous to shin splints. This article reports a 19-year-old female patient NOT a regular athlete who presented with groin pain. Physical examination was non-specific; magnetic resonance imaging pelvis did not reveal any abnormality. Patient referred for whole body bone scan, especially to locate any abnormality in the spine. This study highlights the role of whole body bone scan in the evaluation of groin pain and importance of evaluation of whole lower extremity.
Ohlinger, L.A.
1958-10-01
A device is presented for loading or charging bodies of fissionable material into a reactor. This device consists of a car, mounted on tracks, into which the fissionable materials may be placed at a remote area, transported to the reactor, and inserted without danger to the operating personnel. The car has mounted on it a heavily shielded magazine for holding a number of the radioactive bodies. The magazine is of a U-shaped configuration and is inclined to the horizontal plane, with a cap covering the elevated open end, and a remotely operated plunger at the lower, closed end. After the fissionable bodies are loaded in the magazine and transported to the reactor, the plunger inserts the body at the lower end of the magazine into the reactor, then is withdrawn, thereby allowing gravity to roll the remaining bodies into position for successive loading in a similar manner.
... causes, such as infection. You may also undergo flexible sigmoidoscopy, colonoscopy, body CT, body MRI, MR enterography, upper GI, small ... Flexible sigmoidoscopy , performed by inserting a sigmoidoscope (a flexible tube ... can also sometimes be seen. Body CT scan , a special type of x-ray ...
Morishita, Kota; Tatsukawa, Eri; Shibata, Yasuaki; Suehiro, Fumio; Kamitakahara, Masanobu; Yokoi, Taishi; Ioku, Koji; Umeda, Masahiro; Nishimura, Masahiro; Ikeda, Tohru
2016-07-15
Foreign body giant cells (FBGCs) and osteoclasts are multinucleated giant cells (MNGCs), both of which are formed by the fusion of macrophage-derived mononuclear cells. Osteoclasts are distinct from FBGCs due to their bone resorption ability; however, not only morphological, but also functional similarities may exist between these cells. The characterization and diversity of FBGCs that appear in an in vivo foreign body reaction currently remain incomplete. In the present study, we investigated an in vivo foreign body reaction using an extraskeletal implantation model of hydroxyapatite (HA) with different microstructures. The implantation of HA granules in rat subcutaneous tissue induced a foreign body reaction that was accompanied by various MNGCs. HA granules composed of rod-shaped particles predominantly induced cathepsin K (CTSK)-positive FBGCs, whereas HA granules composed of globular-shaped particles predominantly induced CTSK-negative FBGCs. Plasma, which was used as the binder of ceramic granules, stimulated the induction of CTSK-positive FBGCs more strongly than purified fibrin. Furthermore, the implantation of HA composed of rod-shaped particles with plasma induced tartrate-resistant acid phosphatase (TRAP)-positive MNGCs in contrast to HA composed of globular-shaped particles with purified fibrin, which predominantly induced CTSK-negative and TRAP-negative typical FBGCs. These results suggest that CTSK-positive, TRAP-positive, and CTSK- and TRAP-negative MNGCs are induced in this subcutaneous implantation model in a manner that is dependent on the microstructure of HA and presence or absence of plasma. We attempted to elucidate the mechanisms responsible for the foreign body reaction induced by the implantation of hydroxyapatite granules with different microstructures in rat subcutaneous tissue with or without plasma components as the binder of ceramic granules. By analyzing the expression of two reliable osteoclast markers, we detected tartrate-resistant acid phosphatase-positive multinucleated giant cells, cathepsin K-positive multinucleated giant cells, and tartrate-resistant acid phosphatase- and cathepsin K-negative multinucleated giant cells. The induction of tartrate-resistant acid phosphatase-positive multinucleated giant cells was plasma component-dependent while the induction of cathepsin K-positive multinucleated giant cells was influenced by the microstructure of hydroxyapatite. This is the first study to show the conditions dividing the three kinds of multinucleated giant cells in the foreign body reaction. Copyright © 2016 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.
NASA Astrophysics Data System (ADS)
Derevianko, Andrei; Porsev, Sergey G.
2005-03-01
We consider evaluation of matrix elements with the coupled-cluster method. Such calculations formally involve infinite number of terms and we devise a method of partial summation (dressing) of the resulting series. Our formalism is built upon an expansion of the product C†C of cluster amplitudes C into a sum of n -body insertions. We consider two types of insertions: particle (hole) line insertion and two-particle (two-hole) random-phase-approximation-like insertion. We demonstrate how to “dress” these insertions and formulate iterative equations. We illustrate the dressing equations in the case when the cluster operator is truncated at single and double excitations. Using univalent systems as an example, we upgrade coupled-cluster diagrams for matrix elements with the dressed insertions and highlight a relation to pertinent fourth-order diagrams. We illustrate our formalism with relativistic calculations of the hyperfine constant A(6s) and the 6s1/2-6p1/2 electric-dipole transition amplitude for the Cs atom. Finally, we augment the truncated coupled-cluster calculations with otherwise omitted fourth order diagrams. The resulting analysis for Cs is complete through the fourth order of many-body perturbation theory and reveals an important role of triple and disconnected quadruple excitations.
Bedke, Jens; Kruck, Stephan; Schilling, David; Matter, Anton; Horstmann, Marcus; Sievert, Karl-Dietrich; Stenzl, Arnulf; Nagele, Udo
2010-04-01
Foreign bodies of the urinary tract represent a urologic emergency. First-line treatment is endoscopic removal, but this is often impeded by restricted space, especially in the urethra. We postulated that foreign objects could be fragmented by Holmium:YAG laser and investigated its effect on objects of varying composition. In a specially designed stage flushed with physiologic saline, medical and non-medical objects of differing composition and diameter were subjected to fragmentation by Holmium:YAG at powers of 18 and 30 W. In additional thermal experiments, 5,000 J was applied to differing volumes of 0.9% sodium chloride. Experiments were repeated ten times. With one exception (16 Ch silicon catheter) all medical objects were fragmented (latex urinary catheter, ureteral stents, and guidewires). Of non-medical objects (wood, steel, copper, graphite, and nylon) only copper wire was not amenable to laser dissection. These in vitro results were applied in two patients who presented with a pencil (wood and graphite) in the urethra or bladder. After Holmium:YAG laser fragmentation, the pencil could be removed by forceps each. Foreign objects in the urinary tract can be fragmented with a Holmium:YAG laser. When foreign bodies are too big for initial endoscopic extraction, the clinician should consider this technique as a reasonable and atraumatic option to avoid open surgery.
Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War Fighters
2012-10-01
surgeon noted that the 3 foreign bodies implanted in the third thigh with the traditional surgical removal were placed in the subcutaneous fat and...Conference Chicago, IL 16-17 April, 2005 235. Unique Aspects of Pediatric Fractures Course Moderator/Speaker AOCR Mid Year Conference Chicago...Otolaryngol Head Neck Surg. 2003; Mar;129(3):305-9 38. Jones GP, Seguin J, Shiels WE II: Salter-Harris II Fracture of the Proximal Humerus in a Preterm
Vaginal foreign body causing recurrent discharge and vaginal stenosis--a case report.
Gurung, Geeta; Rana, Ashma; Amatya, Archana
2007-06-01
Chronic vaginal discharge in children and adolescents is a common gynaecological complaint which is often resistant to antibiotic treatment. We present a 14 years old, premenarcheal girl who presented to us with the complaints of recurrent, foul smelling purulent occasionally blood stained vaginal discharge for eight years, where a foreign body in the upper vagina was found after releasing a dense adhesion of the lower vagina which was unable to detect by pelvic ultrasound.
Modeling the risk: innovative approaches to understand and quantify the risk of severe FB injury.
Berchialla, Paola; Bellussi, Luisa; Castella, Annalisa; Snidero, Silvia; Passali, Desiderio; Gregori, Dario
2012-05-14
The entry of a small item into the respiratory or digestive tract is still one of the leading causes of injuries in children up to 14 years old. The aim of the paper is to provide a quantitative risk assessment analysis for identifying consumer product features which contribute to increase the risk of sustaining a severe injury. Data on foreign body injuries were collected in 28 European countries and one Pakistani hospital. A total of 7296 cases were classified according to ICD-9CM 931-935. Information about injuries included age and gender of the injured child, circumstances of the accident and foreign body features. A classification tree was set up in order to analyze the impact of the item features like volume shape and rigidity on the severity of the injury. Males are involved in severe injuries more often than females. Most severe injuries when the foreign body is localized in the ears were due to objects with volume lesser than 49 mm(3). Volume cut-off is slightly higher for foreign bodies that have been found in the nose (55 mm(3)). Objects with conforming rigidity pose children to higher risk of severe injury. The presence and supervision of an adult is crucial in reducing the risk for severe injuries both in pharynx and laryhnx and in mouth. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Intravascular foreign bodies: danger of unretrieved fragmented medical devices.
Tateishi, Minori; Tomizawa, Yasuko
2009-01-01
A warning on the danger of unretrieved device fragments and recommendations to mitigate the danger were issued by the Food and Drug Administration in January 2008. The causes of intravascular foreign bodies are classified into three main categories: improper manipulation and usage, device defects, and others, such as patient and anatomical factors. Device failure after long-term use is rarely predicted at the time of approval, since device abnormality is rarely experienced in animal studies and clinical trials conducted during development of the device. Stent fracture due to metal fatigue is one example. Complex complications could occur from simultaneous use of two or more devices with diverse characteristics. The success rate of percutaneous retrieval of intravascular foreign bodies has improved with the advances in commercially available devices. However, the procedure is not always successful and sometimes surgical removal becomes necessary. Appropriate device selection and acquisition of experience in using the device are important. When an intravascular foreign body cannot be retrieved, the risk of complication could be high. Magnetic resonance imaging examination sometimes causes adverse events, including burns due to the heat generated by metal movement. Such information should be correctly recorded. Furthermore, it is necessary to provide patients with adequate information about the characteristics of implanted devices and unretrieved fragments. We reviewed the literature on unretrieved medical device fragments and include articles that describe the Japanese experience.
ENT Foreign Bodies: An Experience
Awad, Al Hussein; ElTaher, Mostafa
2018-01-01
Introduction Ear, nose and throat (ENT) foreign bodies (FBs) are common occurrences, particularly among children. The proper recognition, study, and management of FBs are required to prevent complications. Their consequences are greatly variable, from mild disturbances that may not require hospitalization up to life-threatening complications. Objective To analyze the clinical spectrum of ENT FBs, the methods of removal, the outcomes and complications as seen in a tertiary referral hospital. Methods This hospital-based cross-sectional retrospective study was performed from July 2014 to June 2016. Patients with any type of ENT FBs, regardless of age, were included in the study; data was collected from 1,013 patients (572 males and 440 females) with a mean age of 12.5 years. Results Foreign bodies represented a large category among ENT emergencies (30%). Children were affected more frequently, particularly ≤ 6 years old. Swallowed FBs were the most common (53.6%), followed by aural FBs (24.68%), nasal FBs (19%), and inhaled FBs (2.6%). A total of 54.69% of ENT s were removed under general anesthesia (GA). Conclusion Foreign bodies (FB) in the ears, nose or throat are a common occurrence in otorhinolaryngology (ENT) emergency services. Children are the most affected age group. The commonest site of FB lodgment is in the throat. Ear, nose and throat FBs need to be properly managed to avoid complications. PMID:29619103
Kuklin, Nelly A; Pancari, Gregory D; Tobery, Timothy W; Cope, Leslie; Jackson, Jesse; Gill, Charles; Overbye, Karen; Francis, Kevin P; Yu, Jun; Montgomery, Donna; Anderson, Annaliesa S; McClements, William; Jansen, Kathrin U
2003-09-01
Staphylococcal infections associated with catheter and prosthetic implants are difficult to eradicate and often lead to chronic infections. Development of novel antibacterial therapies requires simple, reliable, and relevant models for infection. Using bioluminescent Staphylococcus aureus, we have adapted the existing foreign-body and deep-wound mouse models of staphylococcal infection to allow real-time monitoring of the bacterial colonization of catheters or tissues. This approach also enables kinetic measurements of bacterial growth and clearance in each infected animal. Persistence of infection was observed throughout the course of the study until termination of the experiment at day 16 in a deep-wound model and day 21 in the foreign-body model, providing sufficient time to test the effects of antibacterial compounds. The usefulness of both animal models was assessed by using linezolid as a test compound and comparing bioluminescent measurements to bacterial counts. In the foreign-body model, a three-dose antibiotic regimen (2, 5, and 24 h after infection) resulted in a decrease in both luminescence and bacterial counts recovered from the implant compared to those of the mock-treated infected mice. In addition, linezolid treatment prevented the formation of subcutaneous abscesses, although it did not completely resolve the infection. In the thigh model, the same treatment regimen resulted in complete resolution of the luminescent signal, which correlated with clearance of the bacteria from the thighs.
Preclinical x-ray dark-field imaging: foreign body detection
NASA Astrophysics Data System (ADS)
Braig, Eva-Maria; Muenzel, Daniela; Fingerle, Alexander; Herzen, Julia; Rummeny, Ernst; Pfeiffer, Franz; Noel, Peter
2017-03-01
The purpose of this study was to evaluate the performance of X-ray dark-field imaging for detection of retained foreign bodies in ex-vivo hands and feet. X-ray dark-field imaging, acquired with a three-grating Talbot-Lau interferometer, has proven to provide access to sub-resolution structures due to small-angle scattering. The study was institutional review board (IRB) approved. Foreign body parts included pieces of wood and metal which were placed in a formalin fixated human ex-vivo hand. The samples were imaged with a grating-based interferometer consisting of a standard microfocus X-ray tube (60 kVp, 100 W) and a Varian 2520-DX detector (pixel size: 127 μm). The attenuation and the dark-field signals provide complementary diagnostic information for this clinical task. With regard to detecting of wooden objects, which are clinically the most relevant, only the dark-field image revealed the locations. The signal is especially strong for dry wood which in comparison is poorly to non-visible in computed tomography. The detection of high atomic-number or dense material and wood-like or porous materials in a single X-ray scan is enabled by the simultaneous acquisition of the conventional attenuation and dark-field signal. Our results reveal that with this approach one can reach a significantly improved sensitivity for detection of foreign bodies, while an easy implementation into the clinical arena is becoming feasible.
TVT-S in the U position--anatomical study.
Hubka, Petr; Nanka, Ondrej; Martan, Alois; Grim, Milos; Zvarova, Jana; Masata, Jaromir
2011-02-01
The objective is to describe the anatomical position of tension-free vaginal tape Secur (TVT-S) in the U position regarding possible injury and fixation site. We placed TVT-S inserters bilaterally in 13 embalmed and five fresh frozen female bodies. After dissection, we measured distances from the obturator bundle. In embalmed bodies, the mean distance of TVT-S from the obturator bundle was 2.83 cm (standard deviation (SD) 0.87 cm) on the left, 2.92 cm (SD 1.24 cm) on the right. Perforation of the fascia of obturator internus muscle occurred in 38.5%. In fresh frozen bodies, results were fundamentally similar (p > 0.05). There is a risk of injury to the obturator bundle and urinary bladder during TVT-S; however, there is a significant risk of inserting the TVT-S inserter outside the obturator internus muscle (into the lesser pelvis). The position of TVT-S does not change significantly after legs mal-positioning.
Sutherland-Smith, James; Tilley, Brenda
2012-01-01
Magnetic resonance imaging (MRI) artifacts secondary to metallic implants and foreign bodies are well described. Herein, we provide quantitative data from veterinary implants including total hip arthroplasty implants, cranial cruciate repair implants, surgical screws, a skin staple, ligation clips, an identification microchip, ameroid constrictor, and potential foreign bodies including air gun and BB projectiles and a sewing needle. The objects were scanned in a gelatin phantom with plastic grid using standardized T2-weighted turbo-spin echo (TSE), T1-weighted spin echo, and T2*-weighted gradient recalled echo (GRE) image acquisitions at 1.5 T. Maximum linear dimensions and areas of signal voiding and grid distortion were calculated using a DICOM workstation for each sequence and object. Artifact severity was similar between the T2-weighted TSE and T1-weighted images, while the T2*-weighted images were most susceptible to artifact. Metal type influenced artifact size with the largest artifacts arising from steel objects followed by surgical stainless steel, titanium, and lead. For animals with metallic surgical implants or foreign bodies, the quantification of the artifact size will help guide clinicians on the viability of MRI. © 2012 Veterinary Radiology & Ultrasound.
Barker, Thomas H; Framson, Paul; Puolakkainen, Pauli A; Reed, May; Funk, Sarah E; Sage, E Helene
2005-03-01
Implanted foreign materials, used to restore or assist tissue function, elicit an initial acute inflammatory response followed by chronic fibrosis that leads to the entrapment of the biomaterial in a thick, poorly vascularized collagenous capsule. Matricellular proteins, secreted macromolecules that interact with extracellular matrix proteins but do not in themselves serve structural roles, have been identified as important mediators of the foreign body response that includes inflammation, angiogenesis, and collagen synthesis and assembly. In this report we delineate functions of hevin and SPARC, two homologs of the SPARC family of matricellular proteins, in the foreign body response. Despite their sequence similarity, hevin and SPARC mediate different aspects of this fibrotic response. Using mice with targeted gene deletions, we show that hevin is central to the progression of biomaterial-induced inflammation whereas SPARC regulates the formation of the collagenous capsule. Although vascular density within the capsule is unaltered in the absence of either protein, SPARC-hevin double-null capsules show substantially increased numbers of vessels, indicating compensatory functions for these two proteins in the inhibition of angiogenesis. These results provide important information for further development of implant technology.
... such as marbles), crayon pieces, erasers, paper wads, cotton, beads, button batteries, and disc magnets. A foreign ... DO NOT search the nose with cotton swabs or other tools. This may ... into the nose. DO NOT use tweezers or other tools to remove ...