Gastrostomy: evaluation of a new tube using an old technique.

Formerly, for gastrostomy, we passed a No. 18 French red rubber catheter through the antrum of the stomach with the tip directed toward the fundus. We used this method with great success, both for decompression and feeding.

Free-floating deep venous thrombosis. A retrospective analysis.

Duplex scan to diagnose deep venous thrombosis is an established technique. As experience accumulated, patients with free-floating thrombi were identified. A retrospective review of 65 patients was performed to study these thrombi, to evaluate treatment regimens, and to analyze patient outcome.

Gastrostomy: a simple and effective technique.

To provide a comfortable and effective method for gastrointestinal decompression of feeding, we developed an alternate technique for gastrostomy. Under local or general anesthesia a No. 18 red rubber catheter with multiple openings cut into the distal 8 to 10 cm is passed through a stab wound in the antrum of the stomach and directed cephalad to a point 5 cm from the wall of the fundus.

Improvement of oral colonic lavage with supplemental simethicone.

We have noted that colons of patients prepared for colonoscopy with Golytely, a nonabsorbable electrolyte lavage solution, frequently contain foam which may obscure small mucosal lesions. Therefore, a randomized, blinded controlled trial was performed to determine the prevalence of Golytely-induced foam and the effect of supplemental simethicone in decreasing the prevalence of foam. Foam was present in 32% of colons prepared with Golytely alone but in none of the colons prepared with Golytely supplemented with simethicone.

Low serum alkaline phosphatase activity in Wilson's disease.

Low values for serum alkaline phosphatase activity were observed early in the course of two patients with Wilson's disease presenting with the combination of severe liver disease and Coombs' negative acute hemolytic anemia. A review of other cases of Wilson's disease revealed that 11 of 12 patients presenting with hemolytic anemia had values for serum alkaline phosphatase less than their respective sex- and age-adjusted mean values; in eight, serum alkaline phosphatase activity was less than the lower value for the normal range of the test. Low values for serum alkaline phosphatase were much less common in Wilson's disease patients with more chronic forms of presentation.