Analysis of ingested foreign bodies according to age, type and location: a retrospective observational study.

OBJECTIVE: This study aimed to analyse the types and locations of ingested foreign bodies according to different age groups, from infants to the elderly. DESIGN: A retrospective chart review. SETTING: Tertiary referral centre. PARTICIPANTS: A total of 4682 patients who ingested foreign bodies from January 2006 through February 2014. METHODS: 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. RESULTS: 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%). CONCLUSION: 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.

Implications of nasopharynx-associated lymphoid tissue (NALT) in the development of allergic responses in an allergic rhinitis mouse model.

BACKGROUND: Nasopharynx-associated lymphoid tissue (NALT) serves as an important inductive site for mucosal immunity in the upper respiratory tract. Despite its importance in the mucosal immune system, little is known regarding the role of NALT in airway allergic immune responses. We aimed to elucidate the role of NALT in the induction of upper airway allergic responses in a mouse model. METHODS: Inhibitor of DNA binding/differentiation 2 (Id2)(-/-) and Id2(+/-) mice was exposed to the ovalbumin (OVA)-induced allergic rhinitis model, because the former resulted in the NALT deficiency. The allergic parameters, such as allergic symptoms, serum OVA-specific immunoglobulin E (IgE) levels, eosinophil infiltration, and cytokine profiles in the nasal mucosa, were compared between Id2(-/-) and Id2(+/-) groups. RESULTS: NALT-null, Id2(-/-) mice displayed significantly lower allergic responses compared with Id2(+/-) mice, as demonstrated by lower levels of allergic symptoms, serum OVA-specific IgE, eosinophilic infiltration, and local Th2 cytokine transcriptions. To determine which of two factors, that is, the absence of NALT or the alteration of immunocompetent cell populations caused by the Id2 deficiency, has a larger effect on the attenuated allergic immune responses in Id2(-/-) mice, lethally irradiated Id2(-/-) mice were engrafted with C57BL/6 wild-type bone marrow cells and showed still significantly lower allergic immune responses compared with equally treated Id2(+/-) mice. In addition, IgE class switch recombination-associated molecules, such as ε immunoglobulin heavy-chain germline gene transcript, ε mRNA, and activation-induced cytidine deaminase mRNA, were detected in NALT from OVA-sensitized wild-type mice. CONCLUSION: These results show the critical role of NALT for the induction of allergic responses in the upper airway at least in part by means of class switching to IgE in situ.