Experimental vascularized total joint autografts--a primate study

Autogenous vascularized and nonvascularized total joint transfers were studied in the hands of Macaca fascicularis monkeys. Nine second toe proximal interphalangeal joints were transferred as a vascularized free graft to the hand, and the excised finger joints were transferred to the foot as a nonvascularized free graft. The grafts were examined clinically and histopathologically at 16 weeks to 10 months. Two of the nonvascularized free grafts were amputated because of infection and necrosis. Three had chronic infections. The four surviving nonvascularized grafts demonstrated necrosis of the hyaline cartilage and degenerative changes. Of the nine vascularized joints, one developed a wound infection that required amputation, another failed at 2 weeks because of wound dehiscence, and the remaining seven survived with preservation of the hyaline articular surfaces. The experimental technique was designed to be easily applied to clinical use. A skin island is provided as a "patency/viability monitor." The extensor mechanism is included in the graft for early function.     

Effect of a topical adrenergic agent on gastric blood flow

Irrigation of the stomach with saline containing levarterenol has only a small additive effect on the reduction of gastric blood flow, regardless of the temperature of the saline.     

Perforation of Meckel's diverticulum in infancy

Nine infants underwent operations for perforation of a Meckel's diverticulum over a 21-yr period. All of the infants were acutely ill when initially seen by the surgical service. Lethargy, irritability, anorexia, fever, abdominal tenderness, and passage of blood in the stools were common clinical manifestations. The preoperative diagnosis of perforated Meckel's diverticulum was not made in any of the cases. Skilled preoperative and postoperative management is important for the survival of these infants. There was no mortality and minimal morbidity. In retrospect, the peptic etiology of perforation in this age group is a key to early recognition. The past history of most of the patients includes previous episodes of blood in the stools and episodic abdominal complaints.     

Surgical techniques for long-term study of thoracic duct lymph circulation in dogs

Two new surgical techniques for cannulation of the thoracic duct in dogs are presented. Both allow the study of the thoracic duct circulation under physiological conditions in awake and unrestrained animals.     

Technic of chronic thoracic duct “side fistula” for immunologic evaluation of patients with cancer

A technic suitable for long-term study of the human thoracic duct circulation under physiological conditions is described. The results and observations obtained in ten patients studied for three to twenty-one days are presented.