Biomedical subjects

W A Shaver

Publications and source records attributed to W A Shaver.

6 recordsLinked to original sources

PubMed1994

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. Recently, a tube made of silicone rubber and thus resistant to gastric secretions was manufactured for us by the Medical Innovations Corporation of Milpitas, Calif. The tip of the tube is long enough to reach to within 3 cm of the fundus. A doughnut-shaped inflatable balloon fits nicely against the gastric mucosa, and a "Secur-Lok" ring external to the abdominal wall slides down to the skin, allowing the tube to be held in position without the use of sutures. We believe that the tube placed using the above technique is effective, comfortable, and reliable. This study was done to evaluate its efficacy. We report a series of 90 patients in whom this new gastrostomy tube was placed. We discuss the lasting qualities of the tube, the function of the doughnut-shaped balloon, the hypothesis we have developed to explain why there has been no esophageal reflux with this tube, and the efficacy of the Secur-Lok ring in holding the tube in position without the use of sutures.

Catheterization↗

PubMed1990

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. A 26% incidence of pulmonary embolus occurred. However patients who had bilateral free-floating thrombi had a 42.8% incidence of pulmonary embolus. Receiving a 7-day course of heparin therapy with a partial thromboplastin time (PTT) at 1.5 times control was 53.2% of patients; 55.4% of the patients underwent follow-up examination, and the mean time to clot attachment was 9.2 days. Patients should receive anticoagulation for 10 days or until clot attachment. Patients with persistent, bilateral free-floating thrombi, or propagation of thrombus are candidates for potential caval interruption. Serial scans should be performed to monitor the thrombus for attachment or alteration.

Aged↗

PubMed1988

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. In addition, only 5% of colons prepared with supplemental simethicone had residual stool noted at the time of colonoscopy, a significant improvement over the 39% prevalence of residual stool in colons prepared with Golytely alone. Addition of simethicone to Golytely lavage decreases the prevalence of colonic foam and residual stool.

Administration, Oral↗

PubMed1988

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. The stomach wall is closed around the tube by the Stamm technique, and the tube is then passed through an adjacent stab wound in the abdominal wall. The gastric serosa is sutured to the peritoneum, and the tube is immobilized by a nonabsorbable suture through the skin and tied around the tube. In our series, 1,072 patients had gastrostomy done by this technique either for postoperative decompression (965) or feeding (107). Fifteen complications occurred in procedures done for decompression and three in those done for feeding. The complications did not alter the surgical result or the hospital stay.

Adolescent↗

PubMed1975

Changes in the male urethra produced by instrumentation for transurethral resection of the prostate.

Radiographic changes produced in the male urethra by instrumentation were studied by pre- and postoperative urethrograms in 50 consecutive men as well as in several hundred selected patients. All 50 patients showed postoperative changes in the urethra. Obvious findings developed in 30% without symptoms while 14% of the men suffered severe symptomatic strictures. In our total operated cases, patients who were entered through the urethral meatus showed a 17.2% rate of stricture formation, while those entered transperineally showed only an 8.5% stricture rate. We conclude that all transurethral instrumentation produces trauma as evidenced by varying degrees of radiographic change.

Aged↗

PubMedDate not supplied

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. Copper added in high concentration to serum in vitro did not have an important effect on serum alkaline phosphatase activity. The mechanism responsible for the decrease in serum alkaline phosphatase activity in patients is uncertain.

Adolescent↗