Operations on large arteries; application of recent advances

With the use of anticoagulants to prevent recurrence of thrombosis it is now possible to open a major artery which has been occluded by a thrombus, remove the thickened lining with the clot and restore the continuity of the vessel. Free vein grafts have been used successfully to replace arterial segments in the extremities. Vein inlay grafts are preferred in dealing with aneurysms of the abdominal aorta. The aneurysmal wall can be used to support the venous segments. It has been possible to by-pass aneurysms of the abdominal aorta by anastomosing the splenic artery to the left iliac artery. The use of the left superficial femoral artery as a by-pass to supply blood to the right leg is described.     

Lethal Temperatures in Ammocoetes of Four Species of Lampreys

Abstract An investigation has been made of the resistance time and upper lethal temperature of ammocoetes of four species of lampreys provided with a substrate into which they could readily burrow. In general, ammocoetes burrowed after transfer from the acclimation to the experimental temperature baths and later came out of the substrate only in lethal temperatures. A relationship was observed between the resistance time and the time taken to emerge, with the resistance time increasing exponentially with decreasing experimental temperature. In Ichthyomyzon fossor, landlocked Petromyzon marinus, Lampetra (Lethenteron) Lamottenii and in Lampetra (Lampetra) planeri from two different times of the year, the incipient lethal levels over a two week experimental period for larvae acclimated to 15° G were respectively 30.5, 30, 29.5, 28.5 and 28° C. Values for P. marinus acclimated to 5 and 25° C were respectively 29.5 and 31° C, whereas in L. planeri they were 28 and 29° C in April/May and 27 and 29° C in July/August. Extrapolation of the results for the three acclimation temperatures yielded ultimate incipient lethal levels of 31.4° G in P. marinus and 29.2 and 29.4° C for L. planeri examined in the spring and summer respectively.     

The pedicled transposition of the digastric and stylohyoid muscles in the treatment of velopharyngeal incompetence. Anatomic basis and clinical application]

The anatomical basis for the application of neurovascular pedicled muscle transfers of the digastric and stylohyoid muscles in the treatment of velopharynx incompetence is described. The fact that the neurovascular pedicle is located in the cranial third of the muscle bellies provides the safety of the operative procedure. The muscles have to be dissected with respect to that. The direction in which the transferred muscles pull is described. The muscle transposition is combined with the classic Wardill-Kilner operation to lengthen the soft palate. The transferred muscles have to avoid scar contraction and shortening of the soft palate and to gain a muscular function of the soft palate. The clinical use is justified in rare cases as demonstrated in one case.