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At least 127 records · Page 7Linked to original sources

Walter Moxon and his thoughts about language and the brain.

Walter Moxon wrote a well-timed paper in 1866 on aphemia with accompanying right sided hemiplegia. Like many other investigators of this apparent lopsidedness of the articulatory system for human speech. Moxon had to reconcile left hemisphere specialization for this function with the overriding law of symmetry, which for a large sector of the scientific community was a sine qua non of the anatomy and function of high level animal cognition. His reasoning was essentially that since the right dominant hand (and hence the left hemisphere) in some sense led overall bilateral limb movement patterns, that the right side of the tongue would lead whole tongue movement for articulation, the left side following in some mechanical sense. Thus, Moxon could link left hemisphere dominance for handedness as well as for speech. His theory was that "attention" was focused on the left hemisphere during limb movement development, under his assumption that the articulators were limbs as well as the arms and hands. The present paper will examine the professional life of Moxon and his 1866 paper, as well as the scant commentary that it has elicited in the literature on the history of left hemisphere dominance for the human articulatory function.

Aphasia, Broca↗

Zinc toxicity following massive coin ingestion.

This is the first reported case of human fatality associated with zinc intoxication following a massive ingestion of coins. Four hundred and sixty-one coins were removed form the gastrointestinal tract of a schizophrenic patient during the course of hospitalization. Many of the post-1981 pennies, which consist primarily of zinc, showed severe corrosion due to their prolonged contact with acidic gastric juice. The patient presented with clinical manifestations consistent with the local corrosive as well as systemic effects of zinc intoxication and died 40 days after admission with multi-system organ failure. Tissue samples of the kidneys, pancreas, and liver obtained at autopsy revealed acute tubular necrosis, mild fibrosis, and acute massive necrosis, respectively, and contained high levels of zinc. The overall effects of zinc intoxication on the various organ systems, possible hematological derangement, and the impairment of copper absorption as well as the outcome with treatment are discussed.

Bilirubin↗

Esophagoaortic perforation by foreign body (coin) causing sudden death in a 3-year-old child.

We report an extremely unusual consequence to foreign body ingestion in a case of a 3-year-old boy who died suddenly and at autopsy was found to have an esophagoaortic fistula. This fistula was caused by a coin which lodged posteriorly and eroded through the esophagus into the aorta. Serious complications following foreign body ingestion are rare and include stricture formation, intramural abscess, and the formation of fistula tracts. This case illustrates the potentially unpredictable behavior of impacted foreign bodies. The child's parents were initially suspected of child abuse based on the terminal hemoptysis.

Aorta↗

Unexpected second foreign bodies in pediatric esophageal coin ingestions.

OBJECTIVE: To determine the frequency of unexpected second foreign bodies in children who present to the pediatric emergency department with esophageal coin impaction. DESIGN/METHODS: A retrospective chart review pediatric patients with esophageal coin impaction who underwent esophagoscopy/laryngoscopy for coin removal in a 16-year period at a tertiary referral center. Data analysis consists of descriptive statistics. RESULTS: Eighty three of 85 (95%) eligible charts were reviewed. Three children (3.6%) had unsuspected second foreign bodies: an adherent penny, a second penny low in the esophagus, and pieces of paper and lint. No significant esophageal injury occurred. CONCLUSIONS: Unexpected second foreign bodies in pediatric esophageal coin ingestions with adequate radiographic studies are rare and generally do not cause significant esophageal injury.

Catheterization↗

Swallowed penny.

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Aorta, Thoracic↗

Witnessed and unwitnessed esophageal foreign bodies in children.

OBJECTIVE: The purpose of this study was to describe the clinical presentation of children with either an unwitnessed or witnessed esophageal foreign body. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Adolescent↗

Esophageal coin with an unusual radiographic appearance.

Esophageal coins are typically seen as radiopaque disks on anteroposterior chest radiographs. This radiographic finding is generally considered classic for identifying "swallowed" coins as being in the esophagus. We report the case of an 11-year-old girl with an esophageal coin seen end-on on an anteroposterior chest radiograph and as a disk consistent with a coin in the lateral view. These findings are typically associated with coin aspiration. Clinicians should be wary of making the diagnosis of foreign body aspiration of coins by relying on single-view radiographic findings alone. When clinically reasonable, we suggest additional imaging to help further localize swallowed coins.

Child↗

Case report: esophageal foreign body mistaken for impacted button battery.

Foreign body ingestion is a common complaint in the pediatric emergency department. Here, we report an interesting case of a coin ingestion in which the radiographic findings were alarming and inconsistent with the history provided by our patient. A brief review of the diagnosis and management of gastrointestinal foreign bodies is presented, with particular focus on ingested coins and button batteries.

Child↗