Pneumatically deployed net system for endoscopic removal of foreign object

Background/Aim: Delay in diagnosing and treating gastrointestinal (GI) tract foreign bodies may lead to serious complications. In this study, we aimed to retrospectively evaluate the patients who underwent emergency upper GI endoscopy for foreign body ingestion in our clinic. Methods: Between 2015 and 2022, we evaluated 68 patients who underwent emergency upper GI endoscopy with a prediagnosis of foreign body ingestion. The evaluation included factors such as age, gender, presenting complaints, foreign body type, localization, and treatment parameters. Results: Out of the 68 patients included in the study, 21 (30.89%) were female, and the mean age was 54.00 years. Among them, 43 (63.23%) presented with no active complaints, 23 (33.82%) with dysphagia and odynophagia, and two (2.94%) with vomiting. The swallowed objects were classified as follows: coin (n=2), pin (n=5), battery (n=11), drug plaque (n=6), esophageal foreign body (n=7), piece of meat (n=5), chicken bone (n=4), fish bone (n=5), razor (n=7), lighter (n=3), and toothpick (n=1). The foreign bodies were located in the esophagus in 23 cases (33.82%), in the stomach in 32 cases (47.05%), and in the duodenum in one case (1.47%). For 12 patients (17.64%), the foreign body could not be detected endoscopically but was detected using radiologic methods. Among the foreign bodies, 54 (79.41%) were successfully removed. In one patient (1.47%) who could not be removed endoscopically and another patient (1.47%) who developed gastrointestinal perforation due to a foreign body (toothpick), a surgical procedure was performed. Conclusion: Early diagnosis and treatment of foreign body ingestion are crucial in preventing serious complications. Endoscopy, a minimally invasive procedure, can be a safe alternative to surgical procedures, which may carry higher morbidity and mortality risks.

Vinyl glove ingestion: Rare cause of gastrointestinal bleedingA 72-year-old man with a history of Parkinson's disease and dementia was admitted for aspiration pneumonia.He had several prior episodes of pica and aspiration pneumonia.He was treated with antibiotics and nil orally, and was getting better, when melaena was noted.He did not have any abdominal pain.Abdominal computed tomography showed a foreign object filled with air in the stomach (Fig. 1).An emergent upper gastrointestinal endoscopy revealed a stiffened vinyl glove and erosive gastritis (Fig. 2); therefore, endoscopic removal was attempted.Oesophageal injury (Fig. 3) occurred during removal of the rigid glove (Fig. 4).His melaena improved after the procedure, and he was discharged without further complications.Pica and dementia are reported to be risk factors for foreign body ingestion because such patients can eat whatever is around them. 1 The vinyl glove became stiff and sharp after ingestion; thus, causing erosions upon contact with the stomach lining.Although endoscopic removal was successful, the procedure should be done with caution because the vinyl glove hardens.Surgical removal may be required if endoscopic removal fails.

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.

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.

We report the case of a male patient who presented to the Emergency Department with urinary retention secondary to a suspected foreign object in his urethra. We review the diagnosis and management of self-inserted urethral foreign objects in men. Emergent treatment is necessary in patients with urethral foreign objects. Prompt radiologic studies should be obtained because immediate bladder access and drainage is mandatory, especially in patients presenting with urosepsis or urinary retention. Endoscopic removal is the management of choice.

INTRODUCTION: Foreign body ingestion is a common clinical situation, and most of the ingested foreign bodies (80%) pass spontaneously through the gastrointestinal tract. Though, if an impaction is present, it usually occurs in the anatomic constrictions or angulations of the GI tract. CASE DESCRIPTION/METHODS: We present a 56 y.o. man with PMH of reflux and diverticulosis. The patient presented to the ED complaining of swallowing his dental implants 5 hours prior to admission. He denied having abdominal pain, nausea, vomiting after the accidental ingestion. Physical exam showed a soft, non-tender abdomen and oral examination revealed a 4 cm × 1 cm denture missing that corresponded to the teeth implant. CT abdomen was done showing an ingested denture located at the gastric area (Figure 1: left panel). GI was consulted and an EGD was performed the morning after admission. The EGD was unremarkable and no dentures were found, for this reason a repeated abdominal serial xrays were ordered to monitor the foreign body. The X-Ray (Figure 1: middle panel) displayed the denture at the region of the distal ileum. In light of failure to pass spontaneously, a colonoscopy was performed the next day. At the colonoscopy, the dentures were found in the cecum (Figure 2) and these were retrieved without immediate complications. DISCUSSION: Although dental ingestion is not uncommon, there are several risks factors that were absent in our patient, like edentulism, psychoneurological deficit, and abnormal level of consciousness. Furthermore, this patient was a middle-aged healthy adult, completely alert and able to report any sudden GI symptom. Regarding the management of ingested foreign bodies, timing of the intervention depends on the size, shape, content and anatomic location of these, being the esophagus the most common site for impaction, and if occurs, this warrants an emergent endoscopy. Objects longer than 6 cm are unlikely to pass the duodenum and they need urgent removal. In our case, the foreign body had a maximum diameter of 4 cm; reason why an EGD was not emergent. A colonoscopy was performed in view of the possibility that the dentures were located at the IC valve, which is the most frequent place of perforation. We present this patient in order to elucidate a non-complicated foreign body ingestion, that needed endoscopic removal by means of a colonoscope. Furthermore, we would like to emphasize the safety of monitoring foreign objects with blunt edges and less than 6 cm in diameter.

Foreign body ingestion is a common clinical problem and can be managed by observation, endoscopic removal and surgical retrieval. Multiple, long, pointed and sharp objects are more complicated to manage, and have a higher risk of complications such as obstruction, bleeding and perforation of the alimentary tract. It is sometimes difficult to make a decision regarding the most appropriate management. We report one patient who swallowed multiple foreign bodies, including more than ten nails, two staples, one length of wire and many coins. He refused endoscopic treatment and experienced several episodes of cramping abdominal pain. The ingested objects eventually passed without any complications. We present the clinical course and review papers about the management of foreign body ingestion.

We face a variety of foreign object ingestions. However, we agree that any object longer than 6 cm is not likely to be excreted spontaneously (1). This is the case of a child ingesting a nasal swab accidentally that stayed in the duodenum. The nasal test for coronavirus disease 2019 (COVID-19) using a flock swab with breakpoints was administered to a 4-year-old boy presenting with fever at a clinic. Although his mother held him, he moved during the test, thus breaking the swab. On computed tomography, the ingested swab was in the stomach and advanced to the third portion of the duodenum after 5 days (Fig. 1A); spontaneous passage was expected. Four weeks since the entry, he was referred to our hospital. No gastrointestinal symptoms or food intake issues were noted. On endoscopy, the foreign body remained in the same location (Fig. 1B), with a mildly red mucosa but without ulceration. The 9-cm-long swab was removed (Fig. 2), and he was discharged the next day without complications.FIGURE 1.: Nasal swab retained in the third portion of the duodenum. A) Computed tomography 5 d after the accidental ingestion. B) Endoscopic image. The top of the nasal swab was on the anorectal side. Only mild redness was seen on the contact surface.FIGURE 2.: Top: Unused swab. Bottom: Swab removed from the patient, fractured at the breakpoint (arrow).Adverse events of nasal swab testing, including accidental ingestion even in an infant, have become common due to the increased number of COVID-19–related tests with the widespread use of nasal swabs with a breakpoint at its handle (2–4). In this case, spontaneous excretion was expected due to its flexibility. However, the length of the swab made it difficult. Nasal swabs can even perforate the sigmoid colon of adults (5). If nasal swab with a breakpoint is ingested, endoscopic removal should be attempted. ACKNOWLEDGMENTS We would like to express our sincere appreciation to the parents of the child who gave us their consent of this case report.

This paper presents a flexible type system developed for an axiomatic specification language. The type system can be dynamically adapted to different application areas. In particular, it allows the modelling of different kinds of polymorphism, like type classes or subtyping. The type system is based on the concept of qualified types. It allows one to abstract from concrete types by using type variables and to qualify these type variables by type predicates. The properties of the type predicates are described by a specification language based on Horn clauses. The notion of well-typedness is defined via a type inference calculus. We investigate the implementation of the type inference calculus and present an inference algorithm which splits into two phases. The first phase checks the well-formedness of the given term and computes the necessary type predicate restrictions, The second phase uses resolution to prove the computed restrictions to be correct with respect to the type predicate specification. We show that the inference algorithm is correct and complete with respect to the type inference calculus.

Foreign objects lodged in the mandibular bone often result from trauma or dental procedures. Accurate localization of these foreign objects is crucial for guided surgical removal, especially when patients present with persistent pain. Conventional imaging modalities like periapical and panoramic radiographs may not provide sufficient detail for precise localization. Cone beam computed tomography (CBCT) has emerged as a valuable tool for guided surgical interventions owing to its superior imaging capabilities. We present two cases of foreign objects lodged in the mandible, where patients complained of prolonged pain, soreness, and numbness in the right mandible extending to the head and behind the ear. Both patients had undergone previous right mandibular tooth extractions and received treatment from a neurologist without resolution of symptoms. Both cases showed the control improvement in complaints, and no paresthesia or postoperative complications were found. CBCT-guided surgical removal was performed in both cases, revealing a metal specimen measuring 6 × 3 × 1 mm3 in the first patient and a remaining root measuring 5 × 3 × 2 mm3 in the second patient. Diagnosing foreign objects in the mandible poses challenges due to their varied size, composition, and proximity to vital structures. CBCT offers superior imaging resolution, enabling precise localization and assessment of anatomical relationships, such as the distance to the inferior alveolar nerve and surrounding boundaries. CBCT emerges as the preferred imaging modality for diagnosing and guiding the surgical removal of foreign objects in the mandible. Its advantages include accurate localization, low radiation exposure, and cost-effectiveness. Compared with CT scans, CBCT also offers faster scanning times, making it a valuable tool in clinical practice for managing such cases

The space debris problem poses a huge threat to operational satellites and has to be addressed. Multiple removal methods have been proposed to keep Earth’s orbit stable. Flexible connection capturing methods, such as the harpoon system, tether–gripper system and the net system, are potential candidate methods for space debris removal in the future. However, the tethered system is usually assumed as a dumbbell model where two end masses are connected by a rigid bar. This traditional model is not accurate enough to predict the motion of the target, neither the whole system. In this paper, three models, namely the modified dumbbell model, lumped-mass model and the ANCF model, to describe a tethered post-capture system for space debris removal are described and compared. Moreover, modal analysis of the tethered system is performed, and an analytical solution of the system’s natural frequency is derived. In addition, two configurations of the tethered system, namely the single tether configuration and the sub-tether configuration are simulated and compared based on three models, respectively. Finally, the influence on the chaser satellite by the initial angular velocity of the target is analyzed.

A new system for endoscopic removal of a gastric prosthesis for treatment of obesity is presented. This technique permits rapid deflation of intragastric balloons as well as safe endoscopic removal of the gastric remnant. The method has been successfully employed in 26 patients, i.e. 74 events of balloon extraction.

ABSTRACTIntroductionSelf-insertion of foreign objects in teeth is a common occurrence in children facing dental problems in an attempt to alleviate irritation, drainage, or other symptoms from teeth. However, this could lead to the development of infection and may worsen the condition if not intervened at an early stage. The removal of such objects and the preservation of involved teeth pose a challenge and, in some cases, the tooth must be extracted to resolve the infection.Aims and objectivesThe aim of this article is to report cases of foreign object insertion and discuss the related consequences, thereby, stressing the importance of regular dental visits and maintenance of oral hygiene so as to minimize dental neglect.Case StudiesThe article discusses four case reports of children in the age group 2–14 year old who reported with self- inserted foreign objects in their teeth.DiscussionRegular dental visits and timely dental management can help reduce the complications associated with such incidents. Ultrasonic instruments, the Masserann kit, periapical surgery and various other techniques have been recommended by the authors for successful removal of foreign objects from the pulp chamber and the canal.How to cite this articleLakhani B, Garg S, et al. Self-insertion of Foreign Objects in Teeth. Int J Clin Pediatr Dent 2019;12(2):145–149.

Dynamics analysis and GNC design of flexible systems for space debris active removal

Associative processing techniques have been suggested for numerous application areas and have been proven to be superior to more conventional procedures for a number of specialized applications. Recent advances in computer technology and development of new architectural concepts for associative devices have made the design of larger and more flexible systems possible. Such systems are extremely complex and must be adequately protected against failures. This paper reports on the results of a study which has indicated the techniques that are applicable and difficulties that may be encountered in the design of fault-tolerant associative processors.