Jejunum versus colon for free oesophageal reconstruction: an experimental radiological assessment

The reconstruction of the cervical oesophagus and the hypopharynx by revascularised bowel grafts has become a frequently described treatment option. Problems with the standard jejunal grafts have led us to suggest that the colon provides a suitable alternative. Experimental work in dogs demonstrates clear functional differences between colon and jejunum as free oesophageal grafts, and shows how structurally and functionally the colon integrates into the new position in the oesophagus better than the jejunum.

Experimental assessment of free jejunal and colonic grafts of the esophagus

The reconstruction of the cervical esophagus and the hypopharynx by revascularized bowel grafts has become a well-recognized treatment option and often is the method of first choice. Problems described by several protagonists of the standard revascularized jejunal graft have caused us to hypothesize that the colon provides both a suitable alternative and a solution to these problems. Experimental work in dogs demonstrates clear functional differences between colon and jejunum as free esophageal grafts. Video-fluoroscopic and manometric assessment of the two types of graft show that structurally and functionally the colon integrates into the new position in the esophagus better than does the jejunum.

Injury to the upper cervical spine: fracture versus congenital anomaly

As skull and cervical spinal radiographs are being obtained routinely on head and neck injuries, more incidental anomalies of the neck region are being detected. The differentiation of congenital anomaly from fracture can be difficult. The importance of this, however, cannot be underestimated because of the dire consequences of a missed cervical fracture. A case of such an anomaly and its presentation following injury is presented.

Complications of radial forearm flap donor sites

The complications of radial forearm flap donor sites in 15 patients from two centres have been reviewed. The complications included skin graft failure, swelling of the hand, stiffness of joints, reduced strength and sensation, cold-induced symptoms and fractures of the radius. Methods to reduce the incidence of such complications are discussed.

The anatomy of the thoracodorsal artery within the latissimus dorsi muscle

This paper reports the findings of an anatomical study of the primary and secondary muscular branches of the thoracodorsal artery within the latissimus dorsi muscle. Twenty latissimus dorsi muscles were studied, harvested from 13 fresh cadavers and the findings support the hypothesis that it is possible to thin safely a latissimus dorsi muscle flap at the time of flap transfer.

Aspects of mandibular reconstruction

We present in this paper the indications for bony reconstruction following mandibular resection, together with evaluation of the reconstructive techniques available. Case reports illustrate methods we have found satisfactory and are followed by our recommendations for their specific use.

Charcot's oedème bleu des hystériques

A patient with hysterical, "artificial" or factitious oedema of the hand caused by the application of a tourniquet is reported. A high index of suspicion is needed in diagnosing this condition in which surgery should be avoided. Psychotherapy is the ultimate treatment but a pneumatic compression bag was found to be of use and helped confirm the diagnosis.

Benign skin tumors

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Radial forearm flap for floor of mouth reconstruction

Approaches to reconstructing floor of mouth defects are reviewed including methods of bony reconstruction following mandibular resection. The place of the free radial forearm flap, incorporating vascularized hemiradius if necessary, is described together with the anatomy, operative technique and a review of seven cases. It is concluded that this flap is an important addition to current methods of reconstructing substantial intraoral soft tissue defects alone or associated mandibular defects as well, owing to the high quality of results and to its low morbidity.

Perception of life stress events by older and younger women

24 women over 60 yr. and 24 younger women rated the severity of life stress events drawn from a pool of events occurring to elderly people. There were no over-all age differences, but rather strong agreement on which events were most threatening. There was some evidence, however, that the old rated 'severe' death events as less threatening than younger women.

The isolation of glucose tolerance factors from brewer's yeast and their relationship to chromium

Growth of brewer's yeast in the presence of Cr3+ led to increased yields of substances with GTF activity in assays performed with isolated adipocytes. The formation of these substances may be a means of diminishing the toxic effects of Cr on yeast. During fractionation of extracts of brewer's yeast the Cr was easily dissociated from any complexes that may have been present. The GTF activity for both yeast and adipocytes was isolated in cationic and anionic small amino-acid or peptide-like molecules. These substances caused increased glycolysis in yeast and increased glycolysis and fatty acid synthesis in adipocytes. No evidence was found that GTF aided the binding of insulin to its receptor. The GTF activity could only be demonstrated with adipocytes from rats fed a torula yeast-high sucrose diet, which may have caused the rats to have a decreased sensitivity to insulin.

Plastic and reconstructive surgery. Head and neck cancer

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Plastic and reconstructive surgery. Cosmetic surgery II

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Cosmetic surgery I

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Chronic swelling of the leg and stasis ulcer

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Malignant skin conditions

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Benign skin tumours and conditions

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Plastic and reconstructive surgery. Scars, hypertrophic scars, and keloids

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Plastic and reconstructive surgery. Burns

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Plastic and reconstructive surgery. Microvascular surgery

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Skin cover

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