bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Intrauterine Phrenic Nerve Division on the Development of the Lungs and Diaphragm in Fetal Rabbits
Authors: Somasundaram K. , Prathap K.
Published: January 2008

Intrauterine division of the left phrenic nerve has been successfully performed in rabbit fetuses as early as the 21st day of gestation, prior to alveolar differentiation. This procedure results in intrauterine atrophy of the ipsilateral hemidiaphragm and hypertrophy of the contralateral side. Light and electron microscopic studies have shown no interference with the subsequent maturation of the lung.
Survival after Regional Perfusion for Limb Melanoma
Authors: Cox Kenneth R.
Published: January 2008

Regional perfusion has been carried out in the limbs of a group of patients with recurrent melanoma, and has achieved disappearance of visible disease in the affected limb in JO patients out of 28 (36%), prevention of local recurrence in five, and no effect on the disease in nine. This control of recurrent melanoma cost no mortality, but did carry a definite but acceptable morbidity
Primary Malignant Tumours of the Mediastinum and Their Management
Authors: Das P. B. , Bhaktaviziam A. , Gupta R. P. , Kanhere M. H. , Jairaj P. S. , Ray D. , John S.
Published: January 2008

Primary malignant tumours of the mediastinum are difficult clinical problems in thoracic surgery from both diagnostic and therapeutic points of view. Three cases of malignant seminoma of the mediastinum have been documented, thus bringing the total number of cases reported in the literature to 78. A case of metastasis to the subcutaneous tissue in malignant thymoma has been documented. Because of the multiple‐cell types of these tumours and their ill‐defined extent due to involvement of adjacent structures,^ surgery is often difficult. Radiotherapy along with chemotherapy has a definite place in their management, either as a primary treatment in inoperable cases or as a supplement to surgery if the condition is operable
Tropical Pyomyositis
Authors: Owen‐Smith M. S.
Published: January 2008

Six cases of tropical pyomyositis occurring in Australian, New Zealand and British soldiers in Malaysia and Singapore are described
Colloid Carcinoma Arising in an Anal Fistula: Case Report with a Brief Review of the Literature
Authors: Raghavaiah N. V.
Published: January 2008

Malignant change in an anal fistula is an extremely rare but an important and dangerous complication. Less than 75 cases have been described in the English, and Scandinavian literature. We now report a case of colloid carcinoma arising in an anal fistula because of its rarity and other interesting features
Carcinoma of the Œsophagus: Preoperative Irradiation Followed by Planned Resection for Lesions in the Middle and Lower Thirds—An Interim Report
Authors: Smith F. S. , Gibson P. , Nicholls T. T.
Published: January 2008

Since 1968, at the Thoracic Surgery Unit in the Royal Perth Hospital, a combined approach of preoperative deep X‐ray therapy and excisional surgery has been adopted for patients with potentially operable carcinoma of the œsophagus. This has produced an improvement in the survival time for middle third lesions when compared with the result previously obtained following unaided surgical excision. The method is described, and the early results are indicated
Synchronous Combined Abdomino‐Thoraco‐Cervical (Esophagectomy1
Authors: Nanson Eric M.
Published: January 2008

A synchronous combined abdomino‐thoraco‐cervical œsophagectomy, with an abdominal and a thoracic team working simultaneously, is advocated. The method is described. The necessity for wide excision of the oesophagus is stressed, and the routine use of the stomach for reconstruction is advised. This approach may be used for both benign and malignant conditions.
Early Gastric Carcinoma
Authors: Rowland R. , Hecker R. , Fitch R. J. , Gibson G. E. , Willing R. , Jennings W. L.
Published: January 2008

Seven cases of early gastric carcinoma are reported. This condition by definition refers to a carcinoma confined to the mucosa and submucosa only. The definition depends upon the depth of spread and not the surface area covered by tumour or the period over which it is believed to have been present. Each patient had a history indistinguishable from one of benign ulceration. All seven patients had barium meal studies, and in only two was the possibility of malignancy raised. In the other five patients the ulcers demonstrated radiologically were considered benign. Fibreoptic endoscopy was done in six cases; in three the appearances were suspicious of malignancy, and in the remaining three the lesions appeared benign. Biopsy specimens taken at endoscopy contained carcinomatous tissue in all six cases. The patients all had partial gastrectomy, and no recurrence has yet been found. The longest follow‐up period is 36 months.
Omental Transfer for the Treatment of Radionecrosis of the Chest Wall
Authors: Gue S.
Published: January 2008

A technique is described for the treatment of non‐healing deep ulcers of the chest wall following radiotherapy. These ulcers are avascular and may involve the costal cartilages. The skin around them is stretched and fixed, so that covering and healing them has been a challenging problem to surgeons. The method used in this patient utilizes the transfer of the whole of the greater omentum attached, to the greater curve of the stomach, which provides a clean, vascular bed for the skin graft, and has been nature's best help to surgeons.
Ovarian Cysts in Childhood1
Authors: Ahmed Saeed
Published: January 2008

This is a review of cases of ovarian cyst encountered in childhood in the Manchester children's hospitals. The patients presented with acute or recurrent abdominal pain or an abdominal or pelvic mass. The commonest cyst found was a teratoma, which was discovered because of its size or because of a complication. All but one of the girls with teratomas had not reached puberty. After puberty the cysts were follicular or luteal in type, although there was one case of cystadenoma. Complications in the form of torsion, rupture with hamoperitoneum or haemorrhage into the cyst were common. Treatment consisted of ovarian cystectomy, oophorectomy or salpingo‐oophorectomy, and the results were satisfactory.
Benign Osteoblastoma
Authors: Davis N. A. , Dooley B. J. , Bardsley A.
Published: January 2008

Benign osteoblastoma is a benign bone‐forming lesion, seen most commonly in the first three decades of life and having a predilection for the vertebral column and the short limb bones. It is distinguishable from osteoid osteoma on the bases of size (being more than one centimetre in diameter) and the absence of surrounding sclerosis. The two lesions, however, are probably of the same origin and behave differently because of their different situations. Treatment is by operation, either excision in whole if practicable, or thorough piecemeal excision and curettage, with bone grafting of the defect if indicated.
Melanotic Neuroectodermal Tumour of Infancy: Report of a Case
Authors: Singh Ajmer , Singh Amarjit , Khanna S. D. , Kanta Shashi
Published: January 2008

A case of melanotic neuroectodermal tumour occurring in a seven‐month‐old male infant is reported. The atiopaihogenesis, clinical features, treatment and prognosis of the condition are discussed. Tumours of the join in infancy are extremely rare, and pigmented tumours still rarer. One such case of pigmented tumour of the maxilla is the subject of this report.

A case history of a seven‐month‐old male who had a melanotic neuroectodermal tumour of infancy of the right upper jaw has been presented. The literature on the subject has been reviewed, and its setiohistogenesis has been discussed in detail. It has been widely accepted that the tumour arises from congeni‐tally displaced neural crest tissue. The classic clinical picture and the amenability of the tumour to radical cure by thorough surgical excision are stressed.
FRACTURE OF THE ODONTOID PROCESS
Authors: Marar B. C. , Tay C. K.
Published: January 2008

A review of 26 cases of odontoid fractures has been carried out. Late diagnosis and consequent delay in treatment were found to be important causes of non‐union. Myelopathy in odontoid fractures is of two types. One type is that present immediately after injury, while the other is delayed. In treatment of long‐standing cases, only fusion without posterior decompression should be done. If the latter procedure is carried out, it can produce medullospinal hcemalomyelia with respiratory arrest and tetraplegia. In the performance of atlanto‐axial fusion, the technique of bone grafting and the use of thick wires need emphasis.
URGENT AORTIC VALVE REPLACEMENT IN DISSEMINATED GONOCOCCEMIA ASSOCIATED WITH SINUS OF VALSALVA ANEURYSM and FISTULA FORMATION
Authors: Hllless A. D. , Molloy P. J.
Published: January 2008

A patient with aortic valve disruption due to gonococcal endocarditis and associated with a sinus of Valsalva aneurysm and fistula into the right ventricle is described. The rarity of this combination of conditions and the place of surgery in their management are discussed.
THE ROLE OF BRADYKININ IN ENDOTOXIC SHOCK OF INTESTINAL ORIGIN
Authors: Fink R. L. W. , Mashford M. L. , Caridis D. T.
Published: January 2008

A relationship was looked for between blood levels of bradykinin and endotoxæmia produced by superior mesenteric artery occlusion in the rabbit. The levels of bradykinin were unrelated to and unaltered by the degree of endotoxæmia observed in the systemic and portal circulations. These findings suggest that bradykinin is not responsible for the release of endotoxin from the gut, or for the circulatory collapse which follows.
ALCOHOL, ROAD CRASH CASUALTIES, AND COUNTERMEASURES
Authors: McDermott Francis T.
Published: January 2008

Alcohol is a major contributing factor in over one‐third of all road fatalities in this community. Almost half the fatalities occur in people aged less than 25 years of age. Results of recent compulsory blood test legislation in Australia and New Zealand are presented and provide incontrovertible evidence of the vast extent of the problem of alcohol on the road. The social and drinking profiles of road crash casualties with blood alcohol concentrations greater than. 05 g/100 ml differ from those of other casualties. Countermeasures used in the control of this epidemic include legislation, improved community education, and greater awareness of the need to rehabilitate rather than to penalize.
TRAUMATIC RUPTURE OF THE THORACIC AORTA
Authors: Stafford Greg , O'Brien Mark F.
Published: January 2008

Eleven patients with aortic rupture secondary to non‐penetrating thoracic trauma, recent in four patients and of longer standing in seven, have been operated upon. Every patient with an acute injury had a widened medlastinum in the chest skiagram. The diagnosis of traumatic rupture was made by aortography in each case. The operative procedure involved cardiopulmonary bypass, left heart bypass or aorta to aorta bypass shunt. There was one postoperative death. It is recommended that in the acute stage a rupture of the aorta secondary to trauma should be repaired as soon as possible, while ruptures of long standing should be electively repaired.
OPHTHALMIC MICROSURGERY
Authors: Galbraith J. E. K.
Published: January 2008

The introduction of microsurgical procedures to ophthalmology has resulted in an increased success rate with established operations. New operations which can only be performed with the operating microscope have also been developed. As long as certain basic principles are followed, surgery with the microscope has wide application, and lies within the expertise of all surgeons.
COMPLETE REMISSION OF METASTATIC MALIGNANT MELANOMA FOLLOWING IMMUNOTHERAPY WITH BACILLUS CALMETTE‐GUERIN (BCG): REPORT OF A CASE1
Authors: Coates A. S. , Peters Marion
Published: January 2008

A complete response to BCG is described in a case of recurrent melanoma. In a woman aged 38 years, intracutaneous metastatic deposits confined to the limb of origin had occurred after excision of a malignant melanoma from the ankle, and elective groin dissection had shown two lymph nodes infiltrated with melanoma. BCG vaccine was applied to the buttock, initially by scarification and later by a multiple puncture gun. All metastases slowly regressed, and blopsy of a metastatic site at six months showed no tumour cells. The patient remains free of detectable disease 36 months after the commencement of therapy. It is inferred that BCG may facilitate remission of melanoma, perhaps by reason of antigenic cross‐reactivity between BCG and surface components of human melanoma cells.
TOTAL SCAPULECTOMY FOR HYDATID DISEASE
Authors: Rush Jonathan H.
Published: January 2008

A case of hydatid disease (Echinococcus granulosa) involving the left scapula is reported. The reasons for performing a total scapulectomy in this patient are discussed, and the technique of the operation is described.
CURRENT PRACTICE OF PERIPHERAL ARTERIAL SURGERY
Authors: Lord Reginald S. A.
Published: January 2008

Current methods of assessing and treating common problems in peripheral arterial surgery are reviewed. Topics specifically excluded are extracranial arterial disease, renovascular reconstruction, the thoracic aorta, and the upper limb arteries.
ASPECTS OF THE MICROCIRCULATION
Authors: McCaffrey John
Published: January 2008

The microcirculation is an important but little understood part of the cardiovascular system. As new techniques have been developed, more accurate information has become available concerning the changes in the microcirculation in both health and disease. A review has been made of some of the more important facets of the microcirculation of particular interest to surgeons. Reference is made to basic physiology, especially the mechanisms controlling flow in the microcirculation. The significance of changes in small blood vessels in hypovolæmic, septic, and progressive shock is also discussed, and the role of platelet aggregation in shock states is explored.
GUIDELINES FOR PLANNING CLINICAL TRIALS
Authors: Forbes John F.
Published: January 2008

This paper outlines the necessary steps involved in setting up and administering a clinical trial. The importance of adequate preparation, with careful definition of priorities and objectives, is emphasized. Guidelines for writing a clinical protocol are discussed in detail, as well as aids to deal with the running of the study, statistical planning, and presentation of results. The principle of different types of study, methods of patient assessment, and an overall plan of study, have already been introduced in the preceding paper.
SEQUENTIAL ANTITUMOUR IMMUNOREACTIVITY AND CARCINOEMBRYONIC ANTIGEN LEVELS AS A GUIDE TO PROGNOSIS IN COLORECTAL CARCINOMA
Authors: Nairn R. C. , Nind A. P. P. , Pihl E. , Ceredig R. , Jablonka I. M. , Cuthbertson A. M. , Hughes E. S. R. , Rollo A. J.
Published: January 2008

Twenty‐five patients with colorectal carcinoma were tested for blood‐lymphocyte antitumour cytotoxicity and carcinoembryonic antigen (CEA) levels at three‐monthly intervals for eighteen months or more after resection, and examined clinically every three to six months. Twelve of the patients were followed for two years and one for four years. The six patients whose tumours recurred showed positive blood lymphocyte antitumour cytotoxicity and elevated plasma CEA levels at some time from six months after operation, usually well before the recurrence was clinically detectable.
THE MODULATION OF TUMOUR‐VERSUS‐HOST RESPONSE IN LUNG, COLON, AND BREAST, CANCER PATIENTS: IMPLICATIONS FOR ADJUVANT IMMUNOCHEMOTHERAPY1
Authors: Steward A. M.
Published: January 2008

Major advances in the understanding of clinical tumour biology occurred with the appreciation that tumour‐associated substances circulated in the blood of cancer patients. In this study their origin and immunogenic function have been investigated. Whole tumour cells (WTC) and cancer cell membrane fractions (CMF) of 24 patients with lung, colon, and breast cancer were investigated for their antigenic effect upon the patients' own lymphocytes and upon healthy allogeneic ones. The antigenicity of whole lung and breast cancer cells to stimulate lymphocyte DNA synthesis, and the ineffectiveness of colon cells were confirmed. CMF had little stimulating effect upon autologous lymphocytes; however, they were able to augment lymphocyte response to PPD and PHA in high dilution and to sppress it in high concentration. The serum of cancer patients exerted similar biphasic activity upon PPD and PHA stimulated lymphocytes (“lymphosppressive‐stimulatory factors”, or LSSF). Sephadex studies confirmed that LSSF activity in cancer serum correlated with circulating CMF. These substances modulate lymphocyte nucleic acid synthesis in vitro; it is likely that they similarly modulate the patient tumour‐host cell relationship.
THE MONITORING OF SERUM FACTORS IN PATIENTS WITH CANCER
Authors: Gray Bruce Nathaniel , Walker Colin , Bennett Richard C.
Published: January 2008

Numerous changes occur in the sera of patients bearing malignant neoplasms. These changes may take the form of appearance of oncofetal proteins that are normally not detectable in non‐cancer‐bearing patients, or an alteration in the normally present serum constituents such as the serum proteins. Monitoring of these serum factors may be of considerable value in assessing the progress of cancer patients following treatment of their primary tumour. This paper reviews progress in this area to date and documents our early results with six non‐specific serum factors (total protein, total protein hexose, total protein hexosamine, ceruloplasmin, alpha‐1‐antitrypsin, and haptoglobin), in 64 patients bearing a variety of malignant neoplasms in various stages of the disease. Present methods of postoperative assessment of cancer patients are inadequate for detecting early recurrence. Preliminary results indicate that the nonspecific serum factors that we are studying may be of considerable value for monitoring of cancer patients, and may also possibly serve as a diagnostic screen in high‐risk groups.
DOUBLE PATHOLOGY IN ACUTE CHOLECYSTITIS
Authors: Black R. B.
Published: January 2008

Three cases are described In which there was concurrent development of acute cholecystitis and a second acute abdominal Illness. Acute cholecystitis occurred In patients with acute appendicitis, small‐bowel obstruction, and acute colonic diverticulitis. Experience with three such cases over the course of eight years by a single surgeon suggests a possible aetiological link between the two diseases. It is suggested that, under some circumstances, exploration of an acute abdomen may need to be more than cursory.
A CASE OF SPONTANEOUS THROMBOSIS OF THE PAMPINIFORM PLEXUS OF THE TESTIS
Authors: Anseline P.
Published: January 2008

A case of spontaneous thrombosis of the pampiniform plexus of the testis in a young man is presented. The literature is briefly reviewed.
BURNS IN CHILDHOOD: AN EPIDEMIOLOGICAL SURVEY
Authors: P. PEGG STUART , GREGORY J. J. , HOGAN P. G. , MOTTARELLY I. W. , WALKER L. F.
Published: January 2008

The epidemiology of 382 burns admitted to the Royal Children's Hospital, Brisbane, is reviewed. Accidents due to burn trauma are disproportionately common among children when compared with adults, and during childhood years make up a sizable proportion of all injuries, in addition to the immediate physical trauma, there can be severe psychological consequences as well as severe disturbances to family life. Seventy per cent of the children In this series were normal active children less than four years of age, who were too young to learn that certain things are dangerous, and for this group preventative measures must be directed towards the parents. Possible methods of prevention of burns In children are discussed, and It Is tragic that the very traits that make young children so engaging also lead them to accidental burn injuries. Their only hope of prevention lies In increased parental concern.

A survey has been done of 382 burns admitted to the Burns Unit, Royal Children's Hospital, over a five and a half year period, there being 250 males and 132 females. The cause of these burns is described, particularly the common causes such as kitchen scalds, bath scalds, petrol burns and clothes burns, as well as predisposing causes. These are discussed to give an overall picture of the epidemiology of childhood burns. The comparison is made with other series from Australia, and possible methods of preventing these injuries are discussed.

It is tragic that the very traits that make young children so engaging also lead them to accidental burn injury. The only hope of prevention lies in an increased parental concern.
BUERGER'S DISEASE – A REVIEW OF 105 PATIENTS
Authors: WONG JOHN , LAM S. T.K. , ONG G. B.
Published: January 2008

One hundred and five cases (101 males and four females) of Buerger's disease occurring In Hong Kong have been reviewed. In the foot the digits affected were predominantly the big, second and little toes, whereas in the hand the index and middle fingers were most commonly involved. There was no selective involvement of the left or right side In the upper or lower extremities. The majority of patients were operated on and had amputation, sympathectomy, or both procedures performed. Major lower limb amputation was carried out in 22.6% of patients with lower limb involvement. Reconstructive arterial surgery was possible In only four patients, and early failure of grafts In three patients resulted in major amputation.
PITFALLS IN CARPAL TUNNEL DECOMPRESSION
Authors: CONOLLY W. BRUCE
Published: January 2008

In the period 1972 to 1977, 35 patients with persistent pain and other disabilities after carpal tunnel decompression were referred for treatment. The pitfalls included: (i) wrong diagnosis – 5 patients; (ii) inadequate decompression – 9 patients; (iii) recurrent compression – 4 patients; (iv) iatrogenic nerve injury – 7 patients; and (v) postoperative complications – 10 patients. The patients in Groups 1 and 5 were treated by non‐operative measures. Most of the patients in Groups 2, 3, and 4 were treated by reoperation. This paper outlines the causes and prevention of pitfalls in carpal tunnel decompression.
PAPILLARY ADENOCARCINOMA ARISING IN A THYROGLOSSAL CYST
Authors: TURNER PETER L. , HILL HILIARY F. , ABERDEEN JOHN B.
Published: January 2008

Carcinoma arising In a thyroglossal cyst is a rare but well‐recognized condition. In this paper we present a further case of papillary adenocarcinoma arising in a thyroglossal cyst, and review the published experience of this condition.
MYXOMA OF THE TRICUSPID VALVE
Authors: SURI R. K. , PATTANKAR V. L. , SINGH HARJINDER , AlKAT B. K. , GUJRAL J. S.
Published: January 2008

Myxomas of the intraventricular cavity are extremely rare, and those of right ventricular origin are the least frequent. Only three cases of myxoma of the tricuspid valve have so far been reported. In this communication a myxoma of the tricuspid valve in a 23‐year‐old woman is reported because of its unusual and interesting clinical presentation and the extreme rarity of this lesion.
THE XEROGRAPHIC ASSESSMENT OF CRANIOFACIAL DEFORMITIES
Authors: MAYNE L H.
Published: January 2008

An improved method of assessment of craniofacial deformities is described.
DE‐EPITHELIALIZATION AND OVER‐FLAPPING IN PLASTIC SURGERY
Authors: MEHROTRA O. N.
Published: January 2008

Contour defects resulting from trauma, from the excision of a neoplasm, or present at birth, may be restored in a number of ways, and the material used may be autogenous, homogenous, heterogenous, or synthetic in nature. The use of Silastic implants is currently fashionable, but despite the manufacturer's claims, there is no foreign material which the body will accept permanently as Its own. Implants are easy to procure and to shape, and their use can sometimes simplify a surgical procedure, but there is no doubt that where autogenous material is available, it will almost always give the best and most permanent result. This paper illustrates the versatility of simple de‐epithelialization and over‐flapping procedures in restoring contour defects, and is also a plea for the use of living tissue where it is readily available.
SURGICAL MANPOWER IN NEW SOUTH WALES
Authors: MORGAN BRIAN P.
Published: January 2008

A series of surveys of general surgeons in the State of New South Wales is reported. Each five years the number of general surgeons entering practice has been proportionately greater than population growth, and has also been proportionally greater than that of other surgical specialities. The speciality is not growing and is so saturated that almost half the general surgeons are engaged in general practice. It is suggested that the number of training posts be reduced to a level near that required to satisfy the requirement of our community for replacement of those leaving practice.
ULTRASONIC VISUALIZATION OF BREAST CANCER
Authors: REEVE T.S. , JELLINS J. , KOSSOFF G. , BARRACLOUGH B.H.
Published: January 2008

Ultrasonic examination of the breast with grey scale echography gives considerable information about the composition of the constituent tissues. This information alone is sometimes of major assistance in the management of the individual patient, particularly in young women with nodular breasts due to dysplastic changes. The method is complementary to the more commonly used visualization techniques and should be considered, particularly in young women, as the first imaging technique to examine palpable masses in the breast, prior to the utilization of ionizing radiation.
A NEW ZEALAND EXPERIENCE OF STAGHORN CALCULUS SURGERY
Authors: WALTON J.K.
Published: January 2008

Sixty‐one patients with staghorn calculi who have undergone surgery at the Auckland Department of Urology since 1972 have been reviewed. Maoris have been shown to have a higher disease incidence than Europeans. In those cases followed longer than one year true stone recurrence was 14%. A significant number of patients have developed obstruction in the periureteric region, and the reasons for this and possible preventive measures are discussed.
DOUBLE DUODENAL DIAPHRAGM: REPORT OF A CASE
Authors: REINER R.G. , ALP M.H. , O'BRIEN J.A. , JONES G.H.
Published: January 2008

The clinical, radiographic, endoscopic, and operative findings of double duodenal diaphragm In an adult with symptoms suggesting gastric outlet obstruction are presented.
THE USE OF THE URETERIC STENT
Authors: RUSSELL JOHN M. , CLARKE STEPHEN J‐ , BOYCE WILLIAM H.
Published: January 2008

The use and placement of ureteric stents either endoscopically or as part of an open procedure are outlined. The ureteric stent can replace the pyelostomy or nephrostomy tube and significantly reduce the postoperative morbidity.

We feel that ureteric stents do permit primary healing following procedures such as pyelotomy, ureterotomy, and nephrotomy. Stents are well tolerated by the patient, help to improve the comfort of the convalescent period, and decrease the incidence of wound infection, stricture, and fistula. Problems with ureteric stents are rare and are easily managed.

The extra effort required to insert a ureteric stent is insignificant compared with its advantages, and we recommend its adoption. We believe that for too long surgeons have tolerated postoperative urine leakage as inevitable, but it need not be. With adequate internal drainage associated with meticulous surgical repair, urine leakage and proximal urinary diversion should be phenomena of the past.
MELANOMA OF THE CENTRAL NERVOUS SYSTEM
Authors: ATKINSON LEIGH
Published: January 2008

The neurological manifestations of melanoma are analysed in this review of 1,500 patients in the Queensland Melanoma Project from 1963 to 1969. Three hundred and fifty patients have died, and 113 were recognized as having central nervous system metastases. The natural history of these metastases was examined, together with the results of a limited number of autopsies. The results of treatment are discussed.
THE TOURNIQUET
Authors: LOVE BRUCE R. T.
Published: January 2008

The morbidity of the tourniquet is not well documented. The “post‐tourniquet syndrome” is the most common side effect, but is usually unrecognized. The causation of nerve palsy. although this sequela is uncommon, has been documented. Other problems associated with tourniquet use are discussed.
FRACTURE AND RETROSTERNAL DISLOCATION OF THE CLAVICLE
Authors: Kanoksikarin Som , Wearne W. M.
Published: January 2008

A case of posterior fracture‐dislocation of the sternoclavicular joint is described. This injury was successfully treated by open reduction and internal fixation. This rare injury is discussed and an alternative method of treatment is described.
A RECENT DEVELOPMENT IN THE TREATMENT OF SEVERE COMPOUND FRACTURES
Authors: LOVE BRUCE R. T. , KING K. F.
Published: January 2008

The Wagner leg lengthening device has recently been used successfully as an external fixation device in the stabilization of severe compound fractures. Fixation is rigid, yet adjustable, it does not interfere with the fracture site, and it allows clear access to wounds.
A COMPARISON BETWEEN SAPHENOUS VEIN AND DACRON VELOUR GRAFTS FOR FEMOROPOPLITEAL BYPASS
Authors: HARRIS JOHN , MAY JAMES
Published: January 2008

One hundred and thirty‐eight femoropopliteal grafts were performed for arteriosclerotic occlusive disease of the femoral artery in a five‐year period. One group of patients who had 81 saphenous vein grafts was compared with a similar group who had 57 Dacron Velour grafts. At three years 90% of the vein grafts were patent, compared to 45% of the Dacron Velour grafts. Twenty‐seven per cent of all patients presented with threatened limb loss. Amputation was averted in all but 5%. Intraoperative flow measurement did not prove to be a reliable indicator of long‐term patency.
PROXIMAL TUBULAR ADENOMA OF THE KIDNEY
Authors: WEEDON D. , SPLATT A. J. , MOORE A. W. E.
Published: January 2008

A case of proximal tubular adenoma of the kidney (renal “oncocytoma”), confirmed by electron microscopy, is reported. This benign tumour has been mistaken for renal adenocarcinoma in the past by both surgeons and pathologists.
THE STRUCTURE AND FUNCTION OF THE BURNS UNIT AT THE ROYAL PERTH HOSPITAL
Authors: MCCOMB HAROLD
Published: January 2008

This article describes the design of the Burns Unit at the Royal Perth Hospital, and emphasizes the importance of flexibility, while at the same time providing opportunities for isolation and the control of infection. The manner in which the Unit functions is described, with special reference to a modified hospital bed which facilitates bathing of the patient. Control of infection and early replacement of full thickness skin loss have been regarded as essential. The facilities and the treatment regime adopted have been shown to produce excellent results.
DELAYED DIAGNOSIS OF CARCINOMA OF THE RECTUM AND SIGMOID
Authors: HUGHES E. S. R. , MCDERMOTT F. T. , MASTERTON J. P.
Published: January 2008

In a large series of patients with carcinoma of the sigmoid colon and rectum there was a delay in diagnosis due to misinterpretation of the physical signs in 36 cases (2.3%). The causes of the misdiagnosis were haemorrhoids, radiological misinterpretation, and chronic inflammatory disease. A miscellaneous variety completed the series. A study of the survival of those patients in whom there was a delay in diagnosis shows that it is most unlikely that it actually affected adversely the prognosis of these patients.
CEPHALORIDINE PROPHYLAXIS IN RESECTION OF THE LARGE INTESTINE
Authors: HUGHES E. S. R. , MCDERMOTT F. T. , WHITE A. , MASTERTON J. P.
Published: January 2008

A controlled prospective clinical trial of cephaloridine chemoprophylaxis in resection of the large intestine was undertaken between 1974 and 1978. Data were available on 159 of 177 unselected patients. All were operated on by one surgeon. Three groups were studied: intraabdominal resection and anastomosis (102 patients); pullthrough resection and anastomosis (30 patients): and resection, with colostomy or ileostomy, without anastomosis (27 patients).

In the total patient series cephaloridine reduced wound infection from 38.3% to 15.4% (P< 0.003). There was no significant decrease in intraabdominal infection. In the group of patients undergoing intraabdominal resection and anastomosis the wound infection rate was reduced from 40.0% to 14.9% (P< 0.01). Cephaloridine reduced wound infection from 50.0% to 21.4% (P = 0.05) in those patients in whom drainage tubes were inserted. A decrease in the incidence of faecal fistula from 10.9% to 4.3% was not significant. Wound infections were not reduced significantly after pullthrough excisions or resections without anastomosis.

The results support the routine prophylactic use of cephalosporins in patients undergoing

intraabdominal resection of the large intestine with anastomosis.
URINARY CALCULUS FORMATION ON BLOOD CLOT: REPORT ON A CASE
Authors: FLETCHER D. R. , MCGREGOR B. W.
Published: January 2008

A case of urinary calculus formation on a nucleus of blood clot is described. The literature is reviewed and prevention is briefly discussed.
Y INCISION FOR MEDIAN STERNOTOMY
Authors: NANDI P. , MOK C. K. , ONG G. B.
Published: January 2008

Between July 1968 and June 1977, in the University of Hong Kong Department of Surgery, 1,083 patients underwent operations via a median sternotomy using a Y incision. Of these patients, 1,070 had open heart surgery, eight had total thymectomy and in five patients pericardectomy was carried out. The overall wound complication rate was 2.31%, with a wound infection rate of 1.24%. The main advantage of a Y incision is that it leaves a better cosmetic appearance than the usual vertical incision because the upper end of the scar is at a much lower level. The incidence of subcutaneous haematoma and subsequent wound infection is much lower with the Y incision, whereas the T incision is associated with a high rate of both these complications due to the large upper flap that one has to create and mobilize to expose the suprasternal area. While using the Y incision, one only requires a small V‐shaped upper flap to obtain access to the suprasternal space.
RUPTURE OF SUBPECTORAL PROSTHESES DURING CLOSED COMPRESSION CAPSULOTOMY
Authors: HUESTON J. T. , HARE W. S. C.
Published: January 2008

The radiological findings of extrusion of silicone gel from bilateral ruptures of subpectoral mammary prostheses are reported. A warning is given that closed manual compression of prostheses in the subpectoral plane may rupture the prosthesis as well as the scar capsule.
COLORECTAL CANCER: EXPLICIT CRITERIA AUDITING
Authors: GOULSTON K. J. , BASSETT M. L. , DENT O.
Published: January 2008

The explicit criteria method for quality assurance programmes consists ol drawing up criteria for management of specific conditions, either by consensus of experts (normative criteria) or by adopting practice norms (empiric criteria). These are then applied to medical record reviews. Opinions were sought from 36 physician gastroenterologists, 12 trainee gastroenterologists and 219 N.S.W. interns regarding which investigations were considered essential for a patient admitted to hospital for surgery for colorectal cancer. A haemoglobin estimation and chest X‐ray examination were considered to be almost universally necessary by all groups; barium enema/colonoscopy necessary by 95% interns; 92% trainees, 84% surgeons and 75% physicians; liver function tests by 84% interns, 83% trainees, 52% surgeons and 72% physicians; liver scan by 57% interns 50% trainees, 16% surgeons, 53% physicians. Average percentages for the five investigations were 86% interns, 83% trainees, 77% physicians, 68% surgeons. A retrospective medical record review of 230 consecutive patients admitted to A.C.T. hospitals with colorectal cancer showed that the following investigations were recorded; preoperative haemoglobin level 92%; preoperative chest X‐ray 74%; liver function tests/liver scan 66%; barium enema/colonoscopy 58%. This study highlights the difficulties of retrospective record reviews; shows no real difference in opinion between interns and trainee gastroenterologists regarding these explicit criteria; and suggests that normative criteria set up for quality assurance programmes must be formed by involvement of all medical personnel concerned. This, in itself, could be a rewarding education process.
ORTHOPAEDIC PROBLEMS OF RENAL TRANSPLANTATION
Authors: HULBERT J. , BROCKIS J. G. , GlLMOUR W. N. , GOLINGER D. , HOUSE A. K. , van MERWYK A.
Published: January 2008

One in six patients receiving renal transplants has orthopaedic problems. Osteoporosis with accompanying fractures is common, as is avascular necrosis of the hips, knees, and other bones. Immunosuppressive therapy with steroids is implicated and its mode of action discussed. No means of prophylaxis is known. If treated conservatively, aseptic necrosis of bone is much more disabling than is commonly believed as judged by the critical assessment technique of Charnley. The authors therefore recommend that a surgical approach should be adopted whenever possible.
HYPERCALCAEMIA IN PAGET'S DISEASE OF BONE
Authors: GILLESPIE W. J.
Published: January 2008

Albright in 1944 described a syndrome of hypercalcaemia in patients immobilized following fractures through bones affected with Paget's disease. This paper reports a further two cases in which this syndrome was con‐. sidered the cause of hypercalcaemia with fatal outcome. Both patients had parathyroid adenomata. The literature is reviewed, and it is argued that no firm evidence for the existence of this syndrome has ever been put forward. The finding of hypercalcaemia in Paget's disease of bone should prompt an exhaustive search for its cause.
PORTAL HYPERTENSION DUE TO ARTERIOVENOUS FISTULA OF THE GASTRODUODENAL ARTERY
Authors: MEAH FREDA , YAHAYA OSMAN
Published: January 2008

The record is presented of a patient with severe recurrent bleeding due to portal hypertension. Surgical control of the feeding vessels of a fistulous communication between the gasHoduodenal artery and its companion vein arrested the haemorrhage and controlled the portal hypertension.
INTRARECTAL DERMOID: REPORT OF A CASE
Authors: RAO P. L. N. G. , CHARY K. S. N. , KATARIYA R. N.
Published: January 2008

Intrarectal dermoid Is a rare clinical problem, mostly occurring in women. Though it is presumed that anterior rectal dermoids arise in the ovary and erode into the rectum, up to date there has been no substantial evidence for this. A 26‐year‐old woman is described who presented to us with an intrarectal dermoid wherein the stalk connecting the rectal dermoid and the left ovary was clearly demonstrated.
TRANSPLANT RENAL ARTERY STENOSIS
Authors: WOO K. T. , YEUNG C. K. , D'APICE A. J. F. , KINCAID‐SMITH PRISCILLA
Published: January 2008

Renal artery stenosis occurred in 13.5% of 229 consecutive cadaver renal transplants performed at the Royal Melbourne Hospital over an eight and a half year period. Clinical and laboratory indices which suggested the diagnosis were examined. The presence and severity of hypertension were of little predictive value, while deterioration of renal function for which other causes had been excluded and the histological appearance of renal biopsy specimens were valuable in suggesting the diagnosis. A selective approach in both investigation and attempted surgical repair is recommended.
A VASCULAR SURGEON'S APPROACH TO RENAL TRANSPLANTATION
Authors: FIELD PETER L.
Published: January 2008

The blood vessels and blood supply are of first importance in organ transplantation, and the use of established vascular surgical principles and techniques can simplify renal grafting and reduce its risks and complications. This paper describes a vascular surgeon's approach to the problems of donor nephrectomy, kidney insertion, and the avoidance and management of complications, based on the surgical experience in the Royal Melbourne Hospital of

some 350 transplants.
A PATTERN OF LOCAL RECURRENCE FOLLOWING RESECTION OF COLORECTAL CANCER
Authors: PHEILS M. T. , CHAPUIS P. H. , THOMSON A. A. G. , PAYNE J. E. , MACPHERSON J. Gu , NEWLAND R. C.
Published: January 2008

Twenty patients (10%) developed a local recurrence following 200 consecutive curative resections for colorectal carcinoma. Analysis of the pathology of the primary tumours suggests that invasion of adjacent tissues, and lymph node involvement, were more important predisposing factors for the development of local recurrence than the margin of resection on the mucosa. The average time interval between resection and diagnosis of local recurrence was 17 months. The average survival time following diagnosis was 10 months. Nineteen out of 20 of these patients developed evidence of disseminated disease subsequent to the diagnosis of local recurrence. The most effective palliation occurred in patients in whom the local recurrence could be resected.
TRANSPLANTATION OF ORGAN CULTURED RAT PARATHYROIDS
Authors: GOUGH IAN R. , FlNNIMORE MARGARET
Published: January 2008

The hypothesis that tissue culture alters the immunogenicity of grafts by removal or inactiva‐tion of passenger leucocytes has been investigated in an inbred rat parathyroid allograft model. DA rat (Ag‐B4) parathyroid glands cultured for up to three weeks in Eagle's minimal essential medium (MEM) alone, or MEM with added donor‐specific antilymphocyte serum, did not survive longer than fresh glands when allografted into Lewis rat (Ag‐B1) recipients. Subsequent in vitro comparisons of three different culture media established that RPM11640 was superior to MEM and Medium 199 for rat parathyroids. However, further series of transplants after culture in RPM11640 alone also failed to produce prolongation of allograft survival.
THE CARCINOID TUMOUR
Authors: Thompson J. F. , Gee D. C. , Little J. M.
Published: January 2008

Carcinold tumours afr by bo means rare. The wide range of sites in which they occur is explained by their origin from APUD cells of the neural crest. These cells migrate to all parts of the allmentary tract during embryonic life, and ultimately are found as well in various gut derivatives such as the respiratory, pancreatic and billary systems. On the blast of a series of 31 carcinold tumours seen at the Royal Prince Alfrad Hospital in a five‐year period, the distincitve clinical and histological features of carcinoids of foregut, midgut and hindgut origin and reviewed. Diagnoisis, treatement and results are discussed, and recommendations regarding management of the patient with a cercinoid tumour are given.
THE CURRENT STATUS OF SURGERY FOR ENDOMETRIAL CARCINOMA: FACTS AND FANTASY
Authors: Kneale B. L. G.
Published: January 2008

Surgery is the prime method of therapy for endometrial carcinoma. However. in nearly all cases radiotherapy is combined with it either before or after operation. High risk facotors include hyperoestrinism, cervical spread, myometrial invasion, cellular anaplasia, and metastatic spread to adnexa, vagina and the pelvic lymph nodes. The latter involvement of the last factor is analysed in some deatail. on the base of 216 dissecsitons with an incidence of 8%. Analysis of other authors' findings are reviewed on the basis of autopsy and slection. The place for Wertheim hysterectomy is discussed, also vaginal hysterectomy and the timing of surgery when irradiation is discussed, also vaginal hysterctomy and the timing of surgery when irradiation is given preoperatively. The author's statistics are derived from a previous stuyd of 468 patients treated between 1956 and 1971.
COLOSTOMY CLOSURE: TECHNIQUE AND MORBIDITY
Authors: Chapius Pierre , Killingback Mark
Published: January 2008

A personal retrospective series of 100 consecutive colostomy closures performed between 1968 and 1978 is reviewed. Serious intraabdominal complications occurred in three patients. The total complication rate in this series was 29%. There were no deaths and no faecal fistulae. However, wound infection occurred in 22 patients.
THE TREATMENT OF BREAST CANCER IN A FRENCH ANTICANCER CENTRE
Authors: Renwick Stuart , Contesso Genevieve , Lacour Jean , May‐Levin Francosie , SARRAZ DANIELL
Published: January 2008

The comple protocol for the treatment of breast cancer at the Institute Gulslave Rousssy, Villejutit, France, is presented. Treatment is carried out by a multidisciplinary committee dealing with nearly one thousand new breast cancer annually. The protocol is based on initial classification by the T.N. M. system and by characteristics indicating “aggressive biological behaviour”. Patients are seprated into three broad groups for which the mainstays of treatment are surgery, radiotherpy, and chemotherapy. The retionals and results of the protocol are presented.
SENSORY REHABILITATION OF THE HAND
Authors: Parry C. B. Wynn
Published: January 2008

The experience of our institution is presented to support the proposition that formal sensory retraining procedures are well worthwhile in adult patients after median nerve lesions. The retraining programme is described and the results achieved in our series of patients are discussed, with particular emphasis on the roles of the patients' relatives, occupational therapists and physiotherapists.
CHANGING TRENDS IN BREAST CARCINOMA1,*,5
Authors: Braithwaite Peter A. , Bolton Paul M. , Shugg Dace
Published: January 2008

In view of the more open medical and public discussion of breast cancer, and considering the general dissatisfaction with radical forms of surgery and radiotherapy, we examined computer records of 1,014 patients with carcinoma documented by the Tasmanian Breast Survey between 1956 and 1976. In the two epochs, 1956 to 1966 and 1967 to 1976, there was a 14% increase in the proportion of patients presenting with Stage I carcinoma, and a 9% decrease in the proportion of patients with Stage II (P = 0·0075), but there was no change in the proportion of patients presenting with Stages III or IV. The utlization of radical mastectomy decreased markedly, irrespective of stage (P = 0·0000). as did the utilization of radiotherapy (P = 0·0000). The mean age at presentation did not change significantly.
PERFORATED LEIOMYOSARCOMA OF MECKEL'S DIVERTICULUM
Authors: Jonas R. A. , Fraser R. N. , Bhathal P. S.
Published: January 2008

A case is reported of perforated leiomyosarcoma of Meckel's diverticulum. The patient presented with localized peritonitis which responded to antibiotic therapy, and diagnosis was not made until elective resection of a tubulovllious adenoma of the rectum which was found in the course of investigation. Although rare, leiomyosarcoma is the commonest malignant tumour of Meckel's diverticulum.
TECHNICAL ADVANCES IN CORNEAL MICROSURGERY
Authors: Draeger J.
Published: January 2008

Barraquer was the first ophthalmic surgeon who consistently took into account modern technology when planning the details of his operating theatre. Since then, ceiling suspension of a microsurgical unit, with remote control for all functions in ophthalmic surgery, has been taken for granted. During the recent decade the microscopes and instruments used have been remarkably improved. This is true for the microscope itself and its accessories, but even more so for many of our remote‐controlled instruments, such as rotortrephines for perforating grafts, rotorkeratomes and rotorknives, and recently for the new automatic lamellarkeratom. Better cutting quality leads to more precise wound edges, to better coaptation, and to better optical results. These systems also can be useful in cataract surgery, especially in the implantation of new intraocular lenses.
IMMEDIATE PROSTHETIC REPLACEMENT FOLLOWING MAJOR MAXILLARY SURGERY
Authors: Heggie Andrew A. C. , MacFarlane W. Ian , Warneke Sydney C.
Published: January 2008

Treatment of the maxillectomy patient must embrace maxillofacial prosthetics at all stages of the patient's treatment, including the preoperative phase. Success can only be assured when full cooperation exists between the specialists concerned. Three case reports are offered as examples in which immediate prosthetic replacement was of considerable benefit, and the advantages of this service are discussed.