Anterior segmental distraction for a Class III maxillary prosthetic defect in a cleft palate patient.

Reconstruction of a partially dentate skeletal Class III patient who has had repair of a bilateral cleft lip and palate can be challenging. In this article we present our results with a segmental maxillary distraction to esthetically restore the support of the upper lip and functionally reconstruct the anterior maxillary dentition with implants. Prosthetic considerations were critical to determine the vector of distraction to achieve ideal results.

Pancreatic autotransplantation.

Segmental pancreatic autotransplantation is successful in our hands if blood flow through the splenic artery is enhanced by either a jump graft or a distal fistula, and if these technical manoeuvres are supplemented by anticoagulation. We found the jump method of arterial anastomosis was the most successful. Perfusion of the isolated graft is not necessary, and may even be harmful.

Randomized sequential trial of parenteral nutrition in healing of colonic anastomoses in man.

Adults who underwent elective colonic resection with anastomosis for both benign and malignant disease were randomly assigned to control or treated groups. Treated patients received daily 50 ml/kg of amino acid solution containing either 10 or 25 g/dl glucose by central or peripheral vein plus 500 ml of commercial soybean emulsion for 24 hours before operation and for 5 consecutive days after. Patients in both groups were examined by roentgenography after a water-soluble contrast enema, between 10 and 14 days after operation, and the integrity of the anastomosis was assessed radiologically without knowledge of the treatment given.