Low-frequency stimulation of STN-DBS reduces aspiration and freezing of gait in patients with PD.

Objectives: To study whether 60-Hz stimulation, compared with routine 130 Hz, improves swallowing function and freezing of gait (FOG) in patients with Parkinson disease (PD) who undergo bilateral subthalamic nucleus (STN) deep brain stimulation (DBS).

Methods: We studied 7 patients with PD who experienced FOG that persisted despite routine 130-Hz stimulation and dopaminergic medication. Each patient received 3 modified barium swallow (MBS) studies in a single day under 3 DBS conditions in the medication-on state: 130 Hz, 60 Hz, or DBS off, in a randomized double-blind manner.

Water flush technique: a noninvasive method of optimizing visualization of the distal esophagus in patients with primary achalasia.

Objective: The purpose of this study was to assess the use of a water flush technique to optimize visualization of the distal esophageal mucosa during barium esophagography of patients with moderate to severe primary achalasia. The water flush consists of having patients drink tap water at end esophagography in an attempt to clear the standing barium column.

Conclusion: The water flush technique is a simple, noninvasive maneuver that improves the extent of diagnostic visualization of the distal esophageal mucosa in patients with moderate to severe primary achalasia.

Gastroesophageal reflux disease and antireflux surgery-what is the proper preoperative work-up?

Background: Many surgeons feel comfortable performing antireflux surgery (ARS) on the basis of symptomatic evaluation, endoscopy, and barium esophagography. While esophageal manometry is often obtained to assess esophageal peristalsis, pH monitoring is rarely considered necessary to confirm the diagnosis of gastroesophageal reflux disease (GERD).

Aims: The aim of this study was to analyze the sensitivity and specificity of symptoms, endoscopy, barium esophagography, and manometry as compared to pH monitoring in the preoperative evaluation of patients for ARS.

Duodenal switch gastric bypass surgery for morbid obesity: imaging of postsurgical anatomy and postoperative gastrointestinal complications.

Objective: The purpose of our study was to evaluate the normal postsurgical findings and appearance of gastrointestinal tract complications in patients who have undergone biliopancreatic diversion with duodenal switch bariatric surgery. We performed a 4-year retrospective review of 218 patients who underwent duodenal switch surgery.

Conclusion: The most common complications of duodenal switch surgery were bowel obstruction, followed by ventral hernias and anastomotic leaks.

Imaging findings in Roux-en-O and other misconstructions: rare but serious complications of Roux-en-Y gastric bypass surgery.

Objective: The purpose of this study was to present the clinical and imaging findings of Roux-en-O and other misconstructions of Roux-en-Y gastric bypass surgery. The more common complications of Roux-en-Y gastric bypass have been described in the literature. Complications secondary to misconstructions are rare and difficult to diagnose.

Superior mesenteric vein thrombosis after colectomy in a patient with Crohn's disease.

Background: An 18-year-old woman with a history of Crohn's disease presented in January 2004 with severe epigastric pain, nausea and vomiting of 4 hours' duration. The patient was diagnosed with inflammatory bowel disease, thought to be consistent with ulcerative colitis, in March 2003, but had no medical history up until this point. Initial treatment with mesalamine was unsuccessful and she subsequently presented with medically resistant fulminant colitis and required an urgent colectomy in June 2003.

Atypical complications of gastric bypass surgery.

Although gastric bypass surgery continues to grow in popularity for weight loss and weight maintenance in the morbidly obese, there has been little attention given to the imaging of complications associated with these surgeries. The purpose of our study is to demonstrate the variety of gastric bypass surgery complications that can be identified radiographically, with attention to the more unusual complications. This study was performed with institutional Internal Review Board approval.

Enteroclysis and computed tomography enteroclysis.

Enteroclysis, the most detailed radiologic examination of the small bowel, can be a challenge for both patient and radiologist. This article broadly outlines the principal technical features of the standard enteroclysis procedure and discusses its diagnostic advantages and indications, as well as its limitations and difficulties. A comparative assessment of computed tomography-enteroclysis and the emerging magnetic resonance adaptation complements the survey of current approaches to radiologic small bowel diagnostics.