Presentation of the Kober medal to Richard Shope.
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Coin impaction of the esophagus is infrequently seen in adults, and multiple coin impaction has not been described. The patient was an 85-year-old blind female who presented with 2 days of dysphagia and odynophagia following an attempt to take her medications at bedtime. She reported an esophageal injury from endotracheal intubation during a surgery 6 months earlier. Radiographs showed a radiopaque circular mass in the midesophagus. Endoscopy showed 3 US coins--a nickel, a dime, and a penny--stacked together and impacted on a stricture at 27 cm from the gums. An overtube was planned, but preplacement evaluation showed the lumen was smaller than the coin diameters. An attempt with a retrieval net was unsuccessful. The patient then underwent endotracheal intubation and the coins were removed individually with rat-tooth foreign body forceps. She recovered and underwent successful endoscopic dilation 3 weeks later. She remains asymptomatic since dilation. A brief review of coin impaction and endoscopic management is discussed. Endotracheal intubation for airway protection during endoscopy is recommended for these patients.
A short survey is presented of academic and medical medals, with specimens dating from the 17th century onward, in the collection of the Society 'Nederlands Tijdschrift voor Geneeskunde'. With respect to the old medals, the existing clusters of interest (academical and medical medals) are served by selective acquisition rather than by the quest for completeness. The evolution of medical science, medical institutes and practice in and after World War II merits documentation by extending the collection to the present days. The motives to commemorate, to celebrate and to honour facts or persons still stand, and Dutch artists are clearly interested and able to express these sentiments in medals.
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