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Aspiration of foreign bodies remains a significant clinical problem. Although the majority of objects in the tracheobronchial tree can be removed by rigid bronchoscopy, prompt surgery is required if conventional methods fail. Because the flexible fiberoptic bronchoscope offers greater range and visibility, we investigated its application to the removal of foreign bodies from the airway. A variety of objects were recovered repeatedly from artificial and animal (dog) models using various extraction instruments (forceps, claw, and basket), passed through the channel of the scope. We believe that this study has human application. A skilled fiberoptic bronchoscopist, after a period of training, could use this new technique to augment rigid bronchoscopy in removing foreign bodies from adults and older children. At the present time, the bronchofiberscope is not recommended for pediatric cases because of the small tracheal diameter of infants and young children.

The paper deals with the latest equipment available for the detection of both ferrous and non-ferrous metals in dairy products. The basic principle of the equipment is described and deals with both the metal detector, the conveyor and its associated automatic rejection system. A detection equipment which can sense the presence of ferrous metal in foil-wrapped goods is also described. A summary of the activity on the development of a foreign body detection using ‘soft’ X-rays is also dealt with, and the performance of the system on foreign bodies such as metal, glass and stone is quantified.

So far, iatrogenic foreign bodies were somewhat hesitated to report in medical journals. Recently, following cases of iatrogenic foreign bodies in air passage were seen in our clinic; adenoid mass, a piece of a fractured metal stylet, an injection needle, tooth, a damaged electric bulb for bronchoscopic illumination and a cotton ball. These foreign bodies seem to be unpredictable to occur. Intense precaution during surgery by physicians involved in upper air way (otolaryngologists, anesthesiologists, dentists, chest surgeons etc) and constant inspection of medical instruments by operation room staffs could avoid these unhappy accidents.

When a toothpick or other wooden splinter is embedded in the soft tissues, chronic irritation occurs and secondary infection is commonplace. It is likely that both of these factors lead to the bone and soft tissue changes which result in so-called "pseudotumors" or "osteomyelitis-like lesions." Delay in diagnosis is not uncommon, for the history of foreign body embedment may be nebulous. However, when the roentgenographic findings of: (1) deep soft tissue thickening or swelling; (2) periosteal new bone reaction; on (3) osteolytic or osteoblastic bone change are seen in the presence of prolonged soft tissue infection, with or without a draining sinus, the diagnosis of such a chronically embedded foreign body should be strongly suspected. Surgical exploration and removal of the foreign body is mandatory, for if the foreign body is not removed, inflammation and infection do not resolve. If the foreign body is removed, complete clinical and roentgenographic resolution is the rule.

SUMMARYOutbreaks of epidemic keratoconjunctivitis have occurred among workers in shipyards and other industrial concerns in the West of Scotland in 1956, 1967 and 1971–72. In the most recent episode 220 persons were known to be affected and those mainly involved were shipyard personnel working on the open decks of ships under construction; only a few non-industrial workers were affected. As in previous outbreaks adenovirus type 8 was shown to be the causal organism. It is likely that spread of the virus was probably facilitated in some of the patients by such procedures as first aid measures to remove foreign bodies from the eye. A survey of the family contacts of those affected in 1971–72 revealed that only 2% were secondarily infected. This was probably due to propaganda measures to discourage the use of communal face towels, etc.Despite close virological surveillance over a period of 6 years of patients attending opthalmic clinics in the West of Scotland, there is as yet no clue to the whereabouts of adenovirus type 8 during interepidemic periods. It is suggested that travellers might be responsible for the introduction of the infection into an area.

18 experimental contraceptives (13 for women 5 for men) which have progressed to the level of actual clinical trial are described. A biodegradable androgen implant lasting 1 year or longer (supplemented by a weekly pill or semiannual injection) has been found to suppress male sperm production while maintaining normal levels of plasma testosterone and is readily reversible. Trials of testoterone propionate testosterone enanthate and medroxyprogesterone acetate successfully suppressed spermatogenesis but potential complications include libido loss or gynecomastia when progestins are used and medical concern over metabolic disorders or cardiovascular hazards when potent androgens are used. Several removable clips which can be attached to the vas deferens through a small scrotal incision and 2 versions of a device (plug and a microvalve) which can be placed within the vas are under study but a satisfactory design has deferens through a small scrotal in with devices which cause sperm necrosis or immotility include: 1) surgical silk suspended within the lumen of the vas and fixed lossely to the perivasal surface to permit subsequent removal; 2) copper or zinc filaments which immobilize sperm or cause head-tail separation. The concept of partial sperm damage is attended by difficult issues of teratology. Heading the list for women are 2 progestin compounds medroxyprogesterone acetate and norethindrone enanthate which have been marketed in some countries as trimonthly contraceptive injections. Ovulation is prevented by suppression of the luteinizing hormone release but the safety and reversibility of the compounds has yet to be proven. The first biodegradable implants for women have been developed and may be clinically tested before the end of 1974. Evidence that ovulation can be suppressed by the absorption of progestins through the vaginal mucosa has led to the creation of 3 compounds incorporated into Silastic intravaginal rings. Similar to the shape and size of a diaphragm rim the rings can be inserted by the wearer and left in place for 1 month or longer. Steroid absorption through the skin has also been established and preliminary tests are being performed on Silastic arm braclets; contraceptive feasibility requires a design which provides a constant rate of absorption. The development of a monthly pill or suppository which induces menstruation could erradicate the risks of long term hormonal contraception but an effective compound has yet to be determined. Trials are in progress with at least 7 new types of IUD including 1 which is designed to remain within the cervix and others which release an antifertility agent into the uterine lumen. Copper carrying devices are the most advanced in testing and should be available in the near future. Ovulation supression tests with a compound of quinestrol and quingestanol have proven unsatisfactory. Identification and synthesis of the luteinizing hormone-releasing factor (LRF) has led to the potential use of this polypeptide for regulating ovulation in normally cycling women; a precisely timed ovulation could improve the effectiveness of the rhythm method. Although diethylstilbestrol is now available to minimize the risk of pregnancy following isolated midcycle exposure the side effects and disruption of the ovarian cycle render the compound unacceptable for regular postcoital contraception.

A total of 57 male, 3-month old rats each received 6 implants in the subcutis of the back, each implant consisting of a PVC tube with two polyester-polyurethane sponges. After 1, 2, 3, 4, 6, 8, 12 and 16 weeks, the tubes were removed and the sponges were subjected to morphological, morphometric, chemical (DNA and collagen) autoradiographical and radiochemical examination.On the basis of the test results, it was established that in the particular form of induced tissue growth chosen three phases can bs distinguished: in the first phase which lasts till the end of the first week after implantation, an exudative inflammation arises. This is measurable by the high percental proportion of neutrophile granulocytes and the 3H-thymidine indices of the proliferating cells. The second phase, which lasts from the 2nd to the 4th week, was defined as the reparative phase. After the 4th week, we had a model of a chronic proliferative inflammation. At this time, and continuing until the end of the test period, the label...

An unusual case of bladder injury due to ingestion of alcohol and LSD is described. The signs and symptoms, and radiologic findings are discussed.

Aufgaben in der Orbita erwachsen der Rhinochirurgie durch die engen topographisch-anatomischen und pathogenetischen Beziehungen zwischen der Augenhohle und dem Nasenhaupt- und -nebenhohlenbereich, und der Rhinochirurg ubernimmt diese Aufgaben in Ubereinstimmung mit dem Ophthalmologen. Die rhinochirurgischen Aufgabenstellungen in der Orbita konnen in Diagnostik und Therapie nur bei engster Zusammenarbeit mit der Ophthalmologie optimal gelost werden, eine sachlich begrundete Abgrenzung gegen die Fachgebiete Neurochirurgie und Mund-Kieferchirurgie ist dabei notig und ohne weiteres gegeben; die Moglichkeiten zu verstandnisvollem interdisziplinarem Teamwork sollten in Zukunft noch mehr genutzt werden.

Complications of cystography include infections, especially those associated with intrarenal reflux; complications related to bladder filling; allergic reactions; catheter problems; inflammatory response of the bladder to contrast media; peritoneal spillage of contrast medium via the vagina; transurethral reflux of organisms from cleansing procedures; pain from reflux or incorrect catheter placement; radiation effects; temporary anuria; and intrarenal foreign body reaction to contrast media. Fourteen cases are presented, including two patients who died from sepsis. Some considerations for reduction of the complications are discussed.

In order to embolize the coronary arteries a closed-chest technique was employed using fluoroscopically-positioned catheters introduced selectively into the coronary arteries. Plugs made of catheter material were extruded directly into the coronary lumen. Small alterations in the coaxial catheter system permitted the use of either hollow or solid plugs, with production of delayed or immediate coronary artery occlusions, respectively. With hollow plugs the mortality rate was 11 per cent. An average of 4 ± 2 per cent of the left ventricular cross-sectional area was infarcted. Solid plugs were associated with a mortality rate of 15 per cent and infarction of 20 ± 2 per cent of the left ventricle. Using this method it is therefore possible to create reproducible, controlled infarct sizes in dogs enabling a careful study of collaterals, ischemic myocardium, and therapeutic interventions.

A modified technique for the removal of endodontic instrument fragments from root canals involves the use of trepan burs and fiber optics. The use of trepan burs and fiber optics permits a practitioner to remove fragments of broken endodontic instruments from any location in the root canal. After the canal has been enlarged, the trepan burs are used to free the tip of the instrument fragment. Fiber optics illuminate the fragment in the canal while the burs are being used. The fragment is extracted with use of a hollow tube inserted over the free tip of the broken instrument.

Children with esophageal foreign bodies may present with a variety of respiratory symptoms and few, if any, symptoms of esophageal obstruction.Awareness of this presentation by the clinician and radiologist should lead to early diagnosis. This is most important, for if the diagnosis is not secured at an early stage, complications such as esophageal ulceration, esophageal perforation, chronic aspiration pneumonia, and failure to thrive can develop.Early roentgenographic examination of the neck (lateral view with extension and inspiration) and chest is essential and usually all that is needed for the diagnosis.Barium swallow examination may be required in some cases, but potentially hazardous diagnostic procedures such as tracheoscopy and bronchoscopy should be avoided.

The United States Mint may begin producing an aluminum alloy one-cent coin. Aluminum, unlike copper, is not radiodense and an ingested aluminum coin is difficult to distinguish on radiographs. Since children often swallow coins, this is of particular interest to pediatricians. Should the proposed aluminum coin be minted, pediatricians and radiologists will have to exercise special care in assessing children who may have swallowed such a coin.

Tissues from around surgical implants have been examined by optical microscopy and electron microscopy and by electron diffraction and x-ray spectrographic techniques. The presence of small alloy fragments and carbides worn from cobalt-chromium total joint replacements was confirmed. These foreign bodies had been phagocytosed by macrophages and there were no indications that the tissues were damaged by their presence. In 13 of 44 specimens there were granulomatous foci related apparently to the presence of numerous minute particles of unknown composition which had elicited vigorous macrophage reactions. In tissues near stainless steel joints too there were particles of the naked alloy taken up by macrophages and again the fibrous tissue appeared unaffected. Typically the tissues near to stainless steel implants are affected by cytosiderosis. It is deduced that the iron released by corrosion from stainless steel is processed by macrophages locally and there is formed a mixture of hydrated ferric oxides similar to hemosiderin. This may be looked upon as a detoxication mechanism. There is evidence that in some specimens the limit of tissue tolerance for stored iron has been exceeded locally with consequent pathological changes. Another common deposit around stainless steel implants occurs in large plaques. It attracts giant cells and there is evidence that it is fibrotic and cytotoxic.

Granulomas of the foreign-body type were discovered incidentally in tissue removed from the nasal cavity for various indications. All of the patients had received preoperative intranasal injections of a steroid preparation to decompress the obstructing mucous membrane. The granulomas have a distinctive appearance and should be recognized in order to obviate erroneous diagnoses of infections or collagen diseases. The granulomas are apparently innocuous.

During last 6 years (1968-1973), 49 cases of foreign bodies in the oesophagus were treated in the author's clinic. As for the kind of the foreign bodies, 26 cases (53%) were coins, 9 cases (18%) of fish bone, 8 cases (16%) of chicken bone, etc..Generally in Japan and Korea coin cases occur most frequently, accounting for 40% to 70% of all cases fo foreign bodies in the oesophagus, while in U.S.A. and European countries they are not so large in number, only reaching 10% to 20%. Such a large number of coin cases in Japan and Korea is presumed to be related with the size of coin.The most circulating coins in Japan and Korea are 10 yen coin (Japan) and 1 whan and 10 won coin (Korea). Their sizes are respectively 23.5mm, 19mm, and 23mm in diameter fittest to stay in the infant's oesophagus.On the other hand in U.S.A. and European countries, for example, 10 cent coin (U.S.A. and the Netherlands) and 1 penny and 10 pence coin (England) are larger or smaller than Japanese and Korean coin. Their sizes are respectively 17mm, 15mm, and 29mm in diameter.For the prevention of the coin case, therefore, it is necsssary to reform the size of Japanese coin into about 15mm or larger than 30mm in diameter.

A consideration of the aetiology of lip plug carcinoma with special reference to local geographical tumour incidence

CONTENTS Meridional Localization : Localization with Respect to Structures of Eye An Improved Chart The Square Root Rule Calculating the Size of a Foreign Body Borderline Localizations Two Scale Plotting Mathematical Localization (Nongraphic) Localization in the Highly Ametropic Eye Application of the Wessely Keratometer Some Modifications of the Vogt (Bone-Free) Method Ophthalmoscopic Localization A Simplified Apparatus A Convenient Drawing Board A Convenient Viewing Box MERIDIONAL LOCALIZATION : LOCALIZATION WITH RESPECT TO STRUCTURES OF EYE When an ocular foreign body is localized from roentgenograms by one of the graphic or mathematical methods, its position is described by giving the horizontal and vertical components of its distance from the optical axis and its horizontal distance from the apex of the cornea. Translated into mathematical terms, the foreign body is localized with reference to a system of rectangular coordinates, the origin of which is at the apex of the cornea. In this system the X

Ocular injuries should receive immediate meticulous care. The majority of such injuries can and should be the responsibility of the physician first seeing the patient. The simplest of ocular trauma may result in loss of eyesight but this can usually be prevented by following a few simple rules of ocular care. Lacerations of the lids cannot be sutured in the same manner as simple lacerations elsewhere on the body surface. The peculiar and complex anatomy of the eyelids must be maintained if function is not to be disturbed.

Amyloid goitre is a rare manifestation of amyloidosis; about 50 cases have been recorded and this paper adds a further six cases, the first to be described from Uganda. The condition has to be distinguished from the more common types of goitre, and histological differentiation from medullary carcinoma may be difficult with small biopsies. Irrespective of an underlying cause, the distribution of amyloidosis in Uganda resembles the classical secondary type, and the findings in 81 cases confirm this. The age of onset of the primary type is earlier than seen elsewhere and it is possible that these variations result from immune depression following malnutrition or endemic infectious diseases.

THE case to be reported is of particular interest because of the following observations: Porosity of the anterior and posterior walls of the left frontal sinus disappeared and acute pansinusitis of the left side cleared up completely except for a cyst in the left antrum when penicillin was injected intramuscularly in a dosage of 100,000 to 200,000 units per day for three weeks. Treatment for an infection of a flat bone, including the frontal bone, is adequate when 200,000 units of penicillin is injected daily for three weeks,1 so far as intramuscular injection of penicillin may aid in lessening the need for surgical intervention in this condition. In other words, an adequate trial of penicillin for the prevention or the treatment of osteomyelitis of a flat bone has been made when 200,000 units has been injected intramuscularly daily for three weeks. Of course, such a trial may be unsuccessful, with