bluuebunny/crossref_metadata_2025 huggingface dataset:
TRAUMATIC RUPTURE OF THE DIAPHRAGM REPORT OF TWO CASES
Authors: Hardy K. J.
Published: January 2008

Summary

1. Two patients with rupture of the diaphragm due to non‐penetrating trauma have beendescribed.

2. In the first patient there was displacement of the liver in toto into the chest, the problem being complicated by fat embolism.

3. The second patient developed a delayed rupture of the left hemidiaphragm with the complications of renal failure, delirium tremens and severe bronchopneumonia. Both patients suffered fractures of the tibia and fibula.
LIVER INJURIES
Authors: Little J. M.
Published: January 2008

1. Patterns of liver injury, their causes, anatomy and mortality are reviewed.

2. Twenty‐nine cases managed at Royal Prince Alfred Hospital between 1958 and 1963 are analysed. The predominance of blunt trauma is noted. The overall mortality of 48 per cent. and the 62 per cent. mortality for blunt trauma are presented as being capable of improvement.

3. A regime of management is presented.

4. Several cases from the literature and two recent cases from this hospital are cited as examples of the application of this regime.
OESOPHAGEAL REPLACEMENT*
Authors: Nicks Rowan
Published: January 2008

Experience with 22 segmental replacements on 21 cases is presented and discussed.

Certain safeguards for the operation using colonic and jejunal grafts are made.
AN EXPERIMENTAL STUDY ON BILIARY STRICTURES WITH EMPHASIS ON THEIR RELATIONSHIP TO THE COMMON CHANNEL
Authors: Orlay George , Liddelow Aubrey G.
Published: January 2008

The dog's common bile duct was subjected to various injuries and shown to be relatively immune from severe stricture formation after simple crushing or simple incisional injuries. The construction of a pancreatico‐biliary common channel, however, with similar trauma commonly caused severe strictures. The likelihood that pancreatic juice is responsible for this difference and the literature relevant to this subject are discussed.
ANAL RETRACTORS*
Authors: Nayman J. , Breen D.
Published: January 2008

A brief historical sketch of the history of anal retractors is given, and a new single multi‐purpose instrument described.
MECKEL'S DIVERTICULUM: INVAGINATION CAUSING RECURRENT ILEAL OBSTRUCTION
Authors: McKenzie By Graham , Gault Edward W. , Wood Ian J.
Published: January 2008

Invaginated Meckel's diverticulum with lipoma at apex, beginning to produce an intussuception.
THE LIMITED ROLE OF ATTENUATED SMALLPOX VIRUS IN THE MANAGEMENT OF ADVANCED MALIGNANT MELANOMA*
Authors: Milton G. W. , Brown M. M. Lane
Published: January 2008

Four cases of incurable malignant melanoma treated with attenuated smallpox (B.P.) virus inoculation are reported. The findings suggest that occasionally a worthwhile remission of the disease can be achieved by this means provided the dose of virus used is large, the patient is not immune and there are no gross visceral metastases.
SIGMOIDORECTAL INTUSSUSCEPTION: A REPORT OF TWO CASES
Authors: Davidson J. R. M.
Published: January 2008

Two cases of sigmoido‐rectal intussusception are reported, with notes on their management. The feasibility of other procedures and possible prophylactic measures against distant spread are discussed.
A CASE OF RUPTURED ANEURYSM OF THE RENAL ARTERY
Authors: Thomas David
Published: January 2008

A case of ruptured aneurysm of the renal artery which was successfully treated by nephrectomy is presented.

It appears to be the first recorded case of rupture in which calcification of the aneurysm has been seen on a pre‐operative X‐ray of the abdomen, and the fifth reported case to have survived the complication of rupture.

The subject of aneurysm of the renal artery is briefly reviewed.
TORSION OF THE GALL‐BLADDER
Authors: Gillett D. J.
Published: January 2008

Summary

Strangulating torsion of the gall‐bladder is a rare acute abdominal emergency that occurs typically in elderly visceroptotic female patients, but can occur in either sex at any age. The presenting symptom is midline epigastric pain that resembles biliary colic. In about twenty‐four hours it passes to the right hypochondrium and signs of very localized tenderness and peritoneal irritation develop. The differentiation from acute cholecystitis is the absence of toxicity at the time of presentation.
DUODENAL INJURIES
Authors: Thevathasan C. G.
Published: January 2008

1. Nine cases of duodenal injury were encountered in six years in the Professorial Surgical Unit, General Hospital, Singapore.

2. Four were stab wounds and five were closed injuries with a mortality of 22 per cent.

3. Case summaries are reported.

4. Experience suggests that stab wounds are more easily diagnosed, treated and managed post‐operatively. Blunt injuries on the other hand are seldom diagnosed pre‐operatively; their more varied course and treatment is discussed, and management of some complications noted.
BLOOD OXYGEN SATURATION AND DYE‐DILUTION STUDIES IN THE INVESTIGATION OF THE AETIOLOGY OF VARICOSE VEINS
Authors: Schraibman I. G.
Published: January 2008

Measurements of blood oxygen saturation and dye‐dilution studies in patients with varicose veins have failed to support the standard theories of the aetiology of this condition. No real evidence has been obtained to indicate that this condition may be due to the presence of abnormal arteriovenous communications. By a process of exclusion, it has been indicated that the primary pathology may lie in the vein wall.
URIC ACID STONE FORMATION FOLLOWING ILEOSTOMY*
Authors: Bennett R. C. , Jepson R. P.
Published: January 2008

1. Seventy‐two members of the Ileostomy Association of South Australia were reviewed and 9 (12.5 per cent) found to have associated urolithiasis. The majority of stones (5 out of 7 chemically analyzed) proved to be uric acid in nature.

2. The main aetiological factor would seem to be the loss of alkaline fluid and electrolytes from the ileostomy, resulting in the passage of persistently acid urine of low volume and high specific gravity.

3. Prevention may prove difficult and the importance of a properly functioning ileostomy without stenosis is stressed.
INFARCTION OF THE OMENTUM MASQUERADING AS LARGE BOWEL OBSTRUCTION
Authors: Annetts D. L.
Published: January 2008

A case of omental infarction is reported. As the clinical picture presents no specific signs it enters into the differential diagnosis of the acute abdomen. Laparotomy is usually resorted to but the lesion may be easily overlooked unless the surgeon is aware of the existence of this condition.
THE VALUE AND LIMITATIONS OF BIOPSY EXAMINATIONS
Authors: Gault Edward W.
Published: January 2008

A biopsy involves close co‐operation between a surgeon and a pathologist if a representative piece of tissue is to be obtained, and diagnosed.

The surgeon must appreciate the limitations placed on the pathologist as he examines many tissues at an early stage of disease.

The pathologist must seize every opportunity of correlating his histological evidence with the clinical history, X‐ray appearance, other laboratory investigations, and the ultimate course of the disease.

Only in these ways can the patient benefit to the full from a biopsy.
CARCINOMA OF THE UPPER LEFT COLON
Authors: Hughes By E. S. R.
Published: January 2008

1. Carcinoma occurs in the upper left colon a little less frequently than in other segments of the bowel.

2. Chronic ulcerative colitis is an important predisposing cause.

3. There is a high incidence of obstruction and of perforation in carcinoma in this segment. 34/96 had large bowel obstruction, and 6/96 had perforations of the tumour.

4. The resectability rate was 87.5 per cent. Palliative resection was performed in about a third of the cases, curative resection in just over half.

5. Segmental resection with end‐to‐end anastomosis, whether palliative or curative, had a very high incidence of suture line separation. Twelve out of 53 had suture line disruption, and 2/53 had suture line recurrence.

6. A total of 23 patients had subtotal colectomy with ileosigmoid anastomosis. There was one death, and one possible suture line leak. The bowel function has been excellent.

7. The treatment of large bowel obstruction caused by carcinoma of the upper left colon has been mostly by one of two methods — preliminary caecostomy or by subtotal colectomy. Both give good results. If a transverse colostomy has been performed in a subsequent subtotal colectomy, it is best to excise it.
AN UNUSUAL CASE OF SYNOVIAL SARCOMA
Authors: Meadows Robert , Sage Robert E.
Published: January 2008

A case of synovial sarcoma with an unusual presentation occurring in a 77 years old man is described. The primary tumour was a groin nodule, present for thirty years.

Two uncommon associated features were a positive hydatid complement fixation test and a neutrophil polymorphonuclear leucocytosis of 100,000 per cubic millimetre.
The Practice and Implications of Contralateral Exploration in Children with Unilateral Inguinal Hernia
Authors: Solomon John R.
Published: January 2008

Contralateral exploration was performed in 100 children with a unilateral inguinal hernia, and 40 were found to have a virginal sac. The highest yields occurred in girls (77%) and in boys under the age of two years (44%), the latter figure increasing if the original hernia was on the left side and/or was a complete sac. The type of sac discovered and its relationship to closure of the processus vaginalis are discussed, and evidence is given in favour of the congenital theory in the ætiology of indirect inguinal hernias. The advantages and disadvantages of bilateral exploration are also discussed, and recommendations are made that experienced pædiatric surgeons should undertake Contralateral exploration (i) in uncomplicated hernias in boys in the first years of life, and (ii) in girls.
Hæmodilution in Clinical Extracorporeal Circulation: Some Effects of Human Serum Albumin
Authors: Fisk G. C. , Steedman D. M.
Published: January 2008

Two groups of seven patients with uncomplicated septal defects or pulmonary valve stenosis were perfused by the use of “Travenol” bag oxygenators and a heat‐exchanger for open heart surgery. A dilute perfusate was used, to which human serum albumin was added in one group for comparison with the other group. No clinical differences were found between the two groups, but hæmatocrit values suggested that the albumin prolonged the duration of hæmodilution into the postoperative period. The probable advantages of maintaining hæmodilution in this way are discussed.
Perforated Peptic Ulcer in Dunedin and Oxford
Authors: Fraenkel G. J. , Clarke A. M.
Published: January 2008

The incidence of perforated peptic ulcer has been found to be significantly lower in Dunedin, New Zealand, than in Oxford, England. The size and composition of the population in these two cities are very similar. The findings provide evidence in support of a long‐standing impression that peptic ulcer disease is either less common or less likely to lead to perforation in New Zealand than it is in England. The reasons for the observed difference are obscure.
The Use of Arteriography in the Diagnosis of Obscure Upper Abdominal Swellings, with Report of Two Cases
Authors: Ting I. K.
Published: January 2008

Cases of splenic cyst and pancreatic tumour are reported. On both occasions pre‐operative arteriography proved to be of major practical value.
An Assessment of the Efficacy of Hydatid Scolicidal Agents Used Locally in Surgery
Authors: Heslop J. H.
Published: January 2008

Methods are described for evaluating the scolicidal efficacy of different substances which may be useful in human surgery. Forty‐two substances were thus investigated, and four of these are recommended for clinical use.
A Percutaneous Laryngotome for Acute Upper Airway Obstruction
Authors: Watts J. McK.
Published: January 2008

In adults with acute upper airway obstruction and in whom endotracheal, intubation is impossible, temporary laryngotomy is a simpler and safer alternative to emergency tracheostomy. A new instrument is described which permits temporary laryngotomy to be performed with speed and safety in such an emergency.
VERTEBRAL HYDATIDOSIS
Authors: Stewart GeorgeR. , Loewenthal John
Published: January 2008

five cases of hydatid disease involving vertebrae have been presented and a brief review of the incidence, pathology, and current treatment of this condition included. it appears that until more effective antiparasitic agents are developed, early, radical and if necessary repeated surgery provides the best prognosis in the management of vertebral hydatidosis.
PLASTIC AND RECONSTRUCTIVE CONSIDERATIONS IN SELECTING INCISIONS USED FOR RADICAL NECK DISSECTION
Authors: Bakamjian V. Y. , Marshall Donald
Published: January 2008

1. The radical excision of a head and neck cancer can often be accompanied by the first major step towards acceptable reconstruction in a reasonable time.

2. A convenient donor site for skin flaps to be used in such reconstruction is the neck but this area is frequently compromised by the incisions commonly used for neck dissections.

3. Each case should be approached on its own merits and a decision should be made as to whether a cervical flap is desirable for closing the anticipated defect.

4. If no such flap is needed, then 2 parallel transverse incisions provide sufficient exposure for neck dissection and have appreciable advantages over other approaches.

5. On the other hand, if a flap is considered necessary, the incisions appropriate for the case should be planned initially to allow the most efficient repair.

6. Possible methods for attaining these goals have been shown with examples.

7. A clear plan of reconstruction should be available before proceeding to the excision, as failure to have one may prevent the use of the most convenient and satisfactory method of repair.
HOST RESISTANCE TO CANCER*
Authors: Goldstein G.
Published: January 2008

1. Experimental studies on immunity to tumours in animals show that tumour growth is modified by an immunological reaction provided that the immunological system of the host is intact and the tumour carries antigens which are different to those of the host and therefore recognizably “foreign.”

2. Human cancers show deletions of normal antigens and also contain new antigens. Human patients with cancer may show reactivity in vitro against their own tumours, and immunological reactivity in vivo is evidenced by infiltration with lymphocytic and plasma cells; this is associated with a slower growth for certain human tumours.

3. Human patients with cancer have a general impairment of immunological reactivity and it is suggested that this permits the emergence of cancer.

4. The thymus plays an important role in regulating the development and maintenance of immunological reactivity. The declining size of the thymus with age was correlated with the rising cancer incidence with age. Declining thymic activity may lead to impaired immunological function and this may allow the development of human cancer.
A CASE OF MALIGNANT TRANSFORMATION IN FIBROUS DYSPLASIA
Authors: Brownbill David , Snell John A.
Published: January 2008

A girl of 7 years developed fibrous dysplasia and subsequent to surgical treatment and deep X‐ray therapy fibro‐sarcomatous change appeared after eleven years. The treatment and time intervals are compared with recorded cases of malignant change in fibrous dysplasia.
RUPTURE OF ABDOMINAL ANEURYSM INTO INFERIOR VENA CAVA
Authors: Jepson R. P. , Miller J. H.
Published: January 2008

1. two cases, one successfully treated, of aorto‐caval fistulae, due to rupture of an abdominal aneurysm are reported.

2. it is re‐emphasized that such a lesion is compatible with life and the duration of symptoms and survival is in major part dependent on the size of the communication.

3. the syndrome of pain, abdominal mass, bruit and thrill, and high caval pressure leading to collapse, venous congestion and renal failure is described.

4. it is suggested that such cases are surgical emergencies: that infusions may be dangerous and the presence of cardiac failure should not automatically eliminate the possibility of surgical care. the fistula, which may be several centimetres in length can be managed with or without caval control.
A BIZARRE SMOOTH MUSCLE TUMOUR OF THE STOMACH
Authors: AND L. J. H. Butterfield , Casey T. P.
Published: January 2008

a case is reported of a female patient, aged 68 years, who presented with swollen legs. this common symptom had an uncommon cause, a leiomyosarcoma of the stomach. the tumour itself was also unusual in that it was large and cystic and showed pseudoepithelial features.
Pilonidal Sinus Treated by Z‐Plasty1
Authors: McDermott F. T.
Published: January 2008

The rationale and technique of Z‐plasty treatment for sacro‐coccygeal pilonidal sinus are presented. Z‐plasty achieves healing by primary intention, and by modification of the local environment prevents recurrence.
Corrosive Strictures of the Œsophagus and Stomach
Authors: Cohen Douglas
Published: January 2008

Alkali tends to cause œsophageal strictures, while acid has its main effect on the stomach. The reasons for this are briefly discussed. The presentation and management of acid gastric strictures are described. The management of œsophageal strictures is discussed in detail, under the headings of (a) early management, (b) management of the established stricture, (c) treatment of the impassable stricture. Reference is made to the technique of colon replacement of the œsophagus and to the excision of local residual strictures.
Gastrostomy in the Treatment of Advanced Sepsis: A Suggestion
Authors: Milton G. W. , Conrad P. , Claffey T. J.
Published: January 2008

Two cases of advanced inanition due to prolonged sepsis are reported. In both cases, a life‐saving change in the patients' general condition was produced by forced feeding carried out through a gastrostomy.
Intramural Hæmatoma of the Duodenum
Authors: Schneider O. H.
Published: January 2008

The literature dealing with intramural duodenal hæmatoma is reviewed briefly. The history of an injury followed by upper abdominal pain and signs of high small bowel obstruction is highly suggestive. A lag period between injury and onset of symptoms is typical, and X‐ray contrast studies are diagnostic. A personal case is described in detail.
Congenital Arterio‐Venous Fistulas of the Extremities
Authors: Flanc Charles
Published: January 2008

A case of congenital arterio‐venous fistula of the shoulder region is presented. The literature pertaining to congenital arterio‐venous fistula is reviewed, with particular emphasis on pathogenesis, clinical features and treatment. The pathology reported in our study of this' patient matches well the modern concept of the basic pathology of congenital arterio‐venous fistula. The difficulties of the management of recurrent spontaneous hæmorrhages and of chronic ulceration are very evident. The ætiology of these complications is also discussed.
Ectopic Adrenal Cyst
Authors: Casey T. P.
Published: January 2008

A case report is presented of an elderly male patient with a large retroperitoneal cyst which is considered to have arisen in ectopic adrenal tissue. Clinical and histological diagnostic problems were posed by this adrenal cyst.
Reconstructive Surgery in Postgastrectomy States
Authors: Kenny P. J.
Published: January 2008

The various types of Postgastrectomy phenomena are discussed. Journal interposition and gastric replacement are described, and a method of double jejunal loop pouch formation is advanced.
Applied Histology of the Cartilage of the Human Nasal Septum
Authors: Fry H. J. H.
Published: January 2008

The histological features of nasal septal cartilage have some direct relevance for the surgeon, both for comprehension and for the execution of some surgical techniques. These features and their application are described.
Exploration of the Common Bile Duct
Authors: Pheils Murray T. , Andersen Peter T.
Published: January 2008

One hundred and fifty patients have had cholecystectomy and there have been 62 common duct explorations during the last four years carried out by the members of the Professorial Surgical Unit, Repatriation General Hospital, Concord. Thirty‐eight patients had duct exploration at cholecystectomy, an exploration rate of 24%. Negative exploration occurred in four patients. The indications for duct exploration, the use of cholangiography and the technique of duct exploration are discussed.
Results of Surgical Treatment of Carcinoma of the Penis
Authors: Kuruvilla J. T. , Garlick F. H. , Mammen K. E.
Published: January 2008

A five‐year follow‐up of 133 patients treated surgically for carcinoma of the penis shows a 69% survival if the lymph nodes are not involved, and 33% survival if the lymph nodes arc involved. Clinically, in patients with operable disease, it is not possible to determine with accuracy whether the lymph nodes are invaded by tumour. The prognosis is not affected significantly by anaplasia of the growth, but is related to clinico‐pathological spread. Local complications are recurrence, urethral stenosis, delayed wound healing of the groin dissection and lymphœdema.
Skin Arthroplasty of the Elbow
Authors: Mills Kingsley , Rush Jonathan
Published: January 2008

Despite the increasing use of metal prostheses in the treatment of severe rheumatoid arthritis of the elbow joint, soft‐tissue arthroplasty still has a definite place. This paper reviews the indications, technique and results of skin arthroplasty of the elbow.
Early Function in Renal Allografts from Cadaver Donors
Authors: Gibson G. R. , Storey B. G. , Rogers J. H. , May J. , Sheil A. G. R.
Published: January 2008

A low incidence of non‐function in a series of 67 cadaveric renal transplants is reported. Methods of preservation of function in kidneys from cadaver donors are discussed. Of particular importance are the avoidance of prolonged ischemia, and the avoidance of transplantation in the presence of antibodies toxic to the donor's leucocytes.
Avascular Necrosis in Cadaveric Renal Allografts1
Authors: Eremin Jennifer , Swaney W. E. , Marshall V. C. , Kincaid‐Smith Priscilla
Published: January 2008

While it has been known for many years that avascular necrosis of the femoral head can occur in the absence of any obvious æetiological factor, the proportion of patients receiving steroid therapy who develop this lesion, while low, is much higher than that in the adult population in general. This is a report of 6 such cases, occurring in a series of 34 patients with functioning renal grafts. The reasons for the development of the lesion are discussed, with special consideration of the possible role of infection in the ætiology.
The Production, Preparation, Testing and Use of Antilymphocyte Globulin1
Authors: Rogers John H. , Sheil A. G. R.
Published: January 2008

Antilymphocyte serum and its globulin derivative are powerful immune depressant substances in experimental animals. It is probable that antilymphocyte globulin will prove to be immune depressant in man also. Since 1967 it has been used by a number of clinicians in over 200 transplant cases. Side‐effects have been observed, but they have not been prohibitive in the short term. However, enhanced tumour growth and unusual infections must be watched for. Methods of production, preparation and testing are briefly reviewed. It is suggested that further careful clinical trials in wan should continue.
Malabsorption and Gastro‐Intestinal Surgery1
Authors: Sorrell V. F.
Published: January 2008

Malabsorption may result from various operations on the gastro‐intestinal tract. In some circumstances malabsorption caused by disease or by a previous operation may be abolished or improved by gastro‐intestinal surgery. This relationship between malabsorption, disease and gastro‐intestinal surgery is reviewed.
The Effect of Oral Framycetin upon Colon Flora and upon Abscess Formation about Colon Wounds in Dogs
Authors: Ryan Peter , Stratford Bryan , Dixson Shirley
Published: January 2008

During experiments designed to test the effect of bacterial contamination and infection upon the healing of colon wounds, fecal specimens removed directly from the dog's colon at colotomy have been examined microbiologically in one (“treated”) group after, and in another (“control”) group without, framycetin medication. The bacterial flora of the dog's colon were found to resemble those in the human colon, and as previously shown in human cases, framycetin completely eliminated coliform organisms from the feces. After closure of such a colotomy wound, an abscess almost always developed in the subcutaneous pouch in which it had been fixed, whether or not the dog had been “prepared” with framycetin, but fewer colonies of organisms grew from the abscesses found in the “prepared” cases, and pus from none of these latter abscesses grew Escherichia coli on culture.
Arterial Embolism of the Lower Limbs: Experience with the Use of the Fogarty Embolectomy Balloon Catheter
Authors: Buxton Brian , Morris Peter
Published: January 2008

Since the introduction of the Fogarty embolectomy catheter for the removal of arterial emboli, an increase in the ease and speed of embolectomy has occurred, but the mortality and morbidity associated with arterial embolism of the lower limbs has not altered appreciably. This conclusion results from a study of treatment of arterial emboli in vessels of the lower limbs between 1960 and 1968 at the Royal Melbourne Hospital.
Carcinoma of the Palm of the Hand: Case Report and Review of the Literature and Alfred Hospital Records
Authors: Elliott Barry , Snell John A.
Published: January 2008

A case of squamous carcinoma of the palm of the hand is reported, it being the only case on record at the Alfred Hospital. In an extensive review of the literature the authors could find only 12 other cases reported.
Prostatectomy after 23 Years of Catheter Life
Authors: Singh Sarinder Man , Datta N. S. , Bapna B. C.
Published: January 2008

A case is reported in which transvesical prostatectomy was performed 23 years after a 76‐year‐old physician had started self‐catheterizatnon, and a trilobed prostate gland. weighing 185 grammes was removed. The patient passed urine normally after operatton.
Enzyme‐Treated Bovine Arterial Heterografts, II: In Vivo Assessment in the Dog
Authors: Buxton Brian , Myers Kenneth
Published: January 2008

An assessment of bovine carotid arterial heterografts was made following their implantation into the thorocic aorta of the dog. Untreated arteries and enzyme‐treated arteries obtained from two sources were studied. Macroscopic, microscopic and tensiometric studies of the grafts were made after their removal from the dogs. Untreated arteries showed a high incidence of rupture and aneurysm formation. However, enzyme‐treated heterografts prepared in our laboratory also showed an unsatisfactory high incidence of degenerative rhanges. In contrast, enzyme‐treated vessels prepared commercially showed no macroscopic evidence of degenerative changes over an average period of five and a half months. Microscopic examination showed that both treated and untreated grafts became encased in dense fibrous tissue, but that the inflammatory response in the wall was considerably less in the treated grafts. Tensiometry revealed a marked increase in the strength of all grafts after implantation when compared with the strength of similar ungrafted vessels.
Urine Cytology and Primary Carcinoma of the Renal Pelvis and Ureter
Authors: Cullen T. H. , Popham R. R. , Voss H. J.
Published: January 2008

This is a report of a small series of cases of primary carcinoma of the renal pelvis and ureter, with particular reference to diagnosis of these conditions by cytological examination of the urine. The causes of failure of detection and the advantages of using this method are discussed, and the cytological and histological diagnoses are compared.
Vesico‐Colic Fistula due to Diverticulitis1
Authors: Pheils MurrayT.
Published: January 2008

Last year we reported a retrospective review of 25 patients treated for vcsico‐colic fistula due to diverticulitis. Further cases occurring during the last two years have now been added, and the symptomology, investigation, treatment and results have been consolidated. As a result of this additional experience a classification for the condition is proposed, which it is hoped will provide a guide to the surgical management.
Neuromuscular Reflexes of Rectal Continence
Authors: Varma K. K. , Stephens Douglas
Published: January 2008

The purpose of this paper is to describe the nerve pathways, reflex arcs and sphincter muscles responsible for the sensory and motor mechanisms of rectal continence. The data from which the reflex arcs were deduced were obtained from anal and rectal pressure profiles in children with normal and malformed rectums, and in children with injuries and deformities of the spinal cord which affect the neuromuscular control. These profiles were correlated with the clinical state of continence and with the known anatomy of both normal and abnormal states.
The Management of Closed Liver Trauma Treated by Hemihepatectomy
Authors: Gillett David J.
Published: January 2008

A case of closed liver trauma treated by hemihepatectomy is described, and the management of the metabolic derangements following this operation are discussed.
Anterior Tibial Syndrome following Restoration of Arterial Flow
Authors: Coupland G. A. E.
Published: January 2008

Sudden revascularization of an ischemic limb may be followed by the onset of the anterior tibial syndrome. Five cases are reported in which this syndrome occurred following successful revascularization, four of them requiring fasciotomy. The “reopening syndrome” may on rare occasions follow revascularization, and the causes and treatment of this phenomenon are discussed.
Massive Ascites Due to Pancreatic Stones
Authors: Nambiar R.
Published: January 2008

A case of massive pancreatic ascites due to stones impacted in the head of the pancreas is described. The problems in differential diagnosis are outlined. Treatment consisting of transduodenal removal of the stones, sphincterotomy and gastrojejunostomy was followed by complete disappearance of symptoms and freedom from farther episodes of pancreatitis.
Carcinoid Tumours of the Rectum1
Authors: O'Reilly Kevin
Published: January 2008

A personal canvass conducted in Queensland revealed but five cases of rectal carcinoid. The nature of these lesions is discussed, and an attitude towards their management is expressed.
The Use of Scalp Flaps Following Resection of Oral Cancer1
Authors: Dhawan I. K. , Aggarwal S. B.
Published: January 2008

This paper describes the use of scalp flaps to provide cover in the defects left after resections for oral cancer. Scalp flaps provide cover and forehead flaps provide lining. Combined scalp and forehead flaps have been carried on subcutaneous vascular pedicles and on carrier skin segments. These have been used even after ligation of the external carotid artery. They have also been brought down like a visor on bilateral subcutaneous vascular pedicles.
Parotid Tumours: A Review of 138 Cases
Authors: Eddey Howard H.
Published: January 2008

A review of 138 patients who have been personally operated upon, and in whom the follow‐up is complete, has been undertaken. The problems of diagnosis and treatment are discussed, and the various complications considered. The frequency and severity of facial nerve injury, particularly in the management of recurrent or malignant tumours, is discussed, and the high frequency of postoperative gustatory sweating pointed out. The indications for radiotherapy, the possibility of postoperative salivary fistula or tumour recurrence and the association of tumour with other diseases of the gland are mentioned.
Simple Parotid Cysts1
Authors: Brennan M. F. , Gwynne J. F. , Macbeth W. A. A. G.
Published: January 2008

The physical features of primary simple cysts of the parotid gland are presented, and comment is made on the œtiology and management of these lesions. Such lesions are undoubtedly more common than indicated by the literature, and must be distinguished from cystic lesions that occur as a consequence of other primary parotid pathology.
Carcinoma of the Larynx in Melbourne, 1956–1965
Authors: Kerr R. C. , Madigan J. P. , Millar H. S.
Published: January 2008

This paper presents the report of a study of carcinoma of the larynx in Melbourne over the period 1956 to 1965, carried out with a view to determining the relative effectiveness of different modalities of treatment of the disease when applied to similar clinical stage groups.
The Kuntschér Rod in the Treatment of Femoral Shaft Fractures: The Question of Early versus Delayed Operation1
Authors: Rush Jonathan
Published: January 2008

A study of the cases of fractured femoral shaft treated by the insertion of a Kuntscher rod over the five‐year period 1963 to 1967 at the Midalemore Hospital, Auckland, is presented. At the time of review all operations had been curried out at least twelve months previously. The results of treatment have been considered an relation to the time of operation. Delayed internal fixation, that is, operation about 10 aays after the initial injury, did not significantly improve the rate of union of the fracture, and was associated with a high incidence of infection.
Axillofemoral Bypass in the Management of Infected Aortic Bifurcation “Dacron” Graft
Authors: Vellar I. D. A. , Doyle J. C.
Published: January 2008

Infection is probably the most serious of all the complications that follow reconstructive arterial surgery, particularly when a plastic prosthesis has been used. Not only may a successful operative procedure be jeopardized by thrombosis of the graft, but the life of the patient is severely threatened by septicœmia and massive hœmorrhage from infected suture lines. We have been unable to find any reference to this particular problem in the Australian literature, and for this reason we report in this paper the managment of an infected aortic bifurcation graft in which both the proximal and distal suture line had undergone disruption.
Articular Cartilage Loss in Long‐standing Flexion Deformity of the Proximal Interphalangeal Joints
Authors: Field P. L. , Hueston J. T.
Published: January 2008

The difficulty in achieving full extension of the proximal interphalangeal joint after some years of fixation in full flexion is here explained by a study of joint surfaces resected after 15 years of full flexion in a hysterical woman. There was loss of articular cartilage and subchondral bone from the proximal phalangeal head where it was not in contact with the base of the middle phalanx. Even more important was the direct adhesion of the extensor tendon to this dorsal unused aspect of the proximal phalangeal head. Metaplasia from articular cartilage to fibrous tissue appeared to occur, and permanently prevented restoration of full extension of these joints.
Granulomatous Orchitis: A Report of Two Cases
Authors: Chang A. R. , Penman H. G.
Published: January 2008

Two cases of granulomatous orchitis seen in Otago, New Zealand, are reported. An attempt is made to assess the incidence of this rare condition. The clinical and histological features are described, and the differential diagnosis is briefly discussed.
Localized Osseous Involvement in Cryptococcosis: Case Report and Review of the Literature
Authors: Ong T. H. , Prathap K.
Published: January 2008

Bony lesions caused by Cryptococcus neoformans in the absence of a disseminated disease are uncommon. A case of a solitary osseous lesion is recorded, and a review of skeletal involvement in cryptococcosis is discussed.
The Relation between Preoperative Stay in Hospital and Postoperative Infection
Authors: McEwin Roderick
Published: January 2008

This investigation demonstrates that postoperative infection increases with the period of time over which the patient has been in hospital before operation, presumably exposed to skin colonization by “hospital” bacteria.
Arterial Injuries in Civilian Practice
Authors: Annetts D. L. , Harris J. D. , Jepson R. P. , Ludbrook J. , Miller J. H. , Tracy G. D.
Published: January 2008

This paper presents a collaborative survey of 108 instances of serious arterial injury which were seen over the period 1959–68. The commonest cause of injury was iatrogenic. followed by motor vehicle accidents, industrial accidents, and gunshot or knife wounds. The results of repair of iatrogenic injuries and of upper limb accidental injuries were good. The end‐results of treatment of accidental major arterial obstruction in the lower limb were bad. The two major causes of failure of treatment were thought to be failure to recognize the arterial injury, and failure to repair it within six hours.
The Use of Electrocutting and Electrocoagulation in Surgery
Authors: Lawrenson Kevin B. , Stephens Frederick O.
Published: January 2008

Electrocutting and electrocoagulation are convenient aids to surgical technique, but their we is avoided by some surgeons because of a believed risk of increased wound morbidity‐Medical literature contains little information concerning morbidity after the use of electro‐surgery as compared with its occurrence after standard alternative techniques. This paper describes such experiments, which compare tensile strengths of healing wounds and the incidence of intraperitoneal sequelœ following extensive use of electrosurgery and use of other alternative procedures.
Traumatic False Aneurysm of the Right Hepatic Artery: An Unusual Complication of Cholecystectomy
Authors: Andersen Peter T.
Published: January 2008

A case of traumatic false aneurysm of the right hepatic artery causing jaundice three Months after cholecystectomy is reported. A review of the recent literature, and the role of trauma in the etiology of hepatic aneurysms, including their appropriate surgical management, are discussed.
The Natural History of Postoperative Deep Vein Thrombosis
Authors: Rosengarten David S.
Published: January 2008

An account is given of a new method for the early diagnosis of deep vein thrombosis by radioisotope scanning. A much higher incidence of postoperative thrombosis is revealed than has been previously recognized. An analysis of the natural history of these thromboses is attempted.
Malignant Granular Cell Myoblastoma: Report of a Case
Authors: Kubacz G. J.
Published: January 2008

The report of n patient who developed a malignant granular cell myoblastoma of the thigh is presented. The possible histogenesis of these tumours is discussed, the literature is reviewed and treatment is outlined.
The Management of Aorto‐Iliac Disease
Authors: HARRIS J. D. , JEPSON R. P. , MILLER JUSTIN
Published: January 2008

This paper is concerned with the fate of 112 patients with aorto‐iliac disease who underwent surgery from 1959 to 1966. The patency rate for those who underwent endarterectomy was 92%, and for those in whom a prosthesis was placed, 26%. It is stressed that the operation should be designed to suit the special needs of the individual patient, and it is pointed out that provided the proximal occlusions are overcome and the profunda femoris artery is intact, the symptoms of additional femoro‐popliteal disease are usually acceptable in elderly patients.
The Incidence of Benign and Malignant Neoplasms of the Colon and Rectum: A Post‐Mortem Study
Authors: HUGHES L. E.
Published: January 2008

Uncertainty remains about the relationship of benign polypoid lesions to the development of carcinoma of the colon. The normal incidence of polyps is gernzane to this problem, and this incidence has been determied 200 unselected autopsies. Polyps occur in Qucensland more commonly than most textbooks would suggest, but the figures are in keeping with careful studies carried out in other countries. The data suggest that the great majority of benign polyps are not progressive lesions, and the clinical implications of their detection are discussed.
Renal Venous Thrombosis in Children
Authors: BECK A. DAVID , MARSHALL VICTOR F.
Published: January 2008

Thrombosis of the renal venous system, though uncommon, is a potentially serious disorder in childhood. The present paper is a review of the pertinent literature, and two further cases are reported. Gastro‐enteritis does not precede hæmorrhagic infarction in the majority of clinically diagnosed cases. Males appear to be affected more often than females, the peak incidence in both sexes being in the first month of life. With meticulous attention to fluid and electrolyte imbalance, prompt nephrectomy yields excellent results.
Feminizing Adreno‐Cortical Carcinoma: Report of a Case
Authors: SLAVOTINEK A. H. , EDWARDS R. G.
Published: January 2008

A case of feminizing adreno‐cortical carcinoma is reported and features of these tumours are commented on. The differential diagnosis of gynæcomastia and its investigation are discussed. The features of adrenal carcinoma are also discussed, the literature is reviewed and treatment is outlined.
A Congenital Sac Containing Ileum
Authors: LEWIS PETER E.
Published: January 2008

A unique case of intestinal obstruction is reported. The obstruction was due to a food bolus in a loop of ileum present in a peritoneal sac which was associated with a band passing from a Meckel's diverticulum to the caecum and representing an obliterated vitelline artery.
Vagotomy and Anterior Pylorectomy for Uncomplicated Duodenal Ulceration: Results of 38 Cases
Authors: SCOTT PETER R.
Published: January 2008

A review of the results of 38 bilateral truncal vagotomics and anterior pylorectomies performed over the past five years is presented.
The Treatment of Experimentally Induced Acute Pancreatitis1
Authors: KUNE G. A.
Published: January 2008

This paper reports the results of treatment of acute hæmorrhagic pancreatitis produced experimentally in the dog, the agents used being isotonic saline, Dextran, “Trasylol” and antibiotics. Avenues of future inquiry are suggested in the light of these experiments and those of other workers in this field.
A Solid State Pulsed Coagulating Diathermy Instrument:1 Preliminary Report
Authors: PETTY P. G. , LIM A. J. , STAHL R.
Published: January 2008

A solid state pulsed coagulating diathermy instrument is described. The operating parameters of this instrument have been investigated for bipolar coagulation. The advantages of this instrument over spark‐gap instruments are lower power requirement, smaller physical size, lessend fire danger and elimination of E. C. G. interference (when used with bipolar configuration).
Diagnosis by Frozen Section Examination, II: Results in Skin Lesions
Authors: HIRST E. , CAINS G. D. , BALE PATRICIA M.
Published: January 2008

A series of 910 frozen section examination of skin lesions is presented, and the results are analysed in detail and compared with others in the literature. The difficulties in histological diagnosis are discussed and contrasted with those of clinical diagnosis especially of pigmented lesions.

In 910 consecutive frozen section examinations of skin lesions nine false positive reports were submitted, but only two were of major importance. False negative reports occurred with malignant melanomas when the lesion was small or heavily pigmented, and with other malignant lesions when the specimens were large (sampling error). Frozen section examination accurately identifies lesions that tend to be mistaken for malignant melanoma on clinical examination.
Fish‐Bone Impaction of the Throat
Authors: AHMED NAZIR
Published: January 2008

A series of 55 cases of fish‐bone impaction of the pharynx and œsophagus is discussed. Special reference is made to the serious and sometimes fatal complications that may result from delay in treatment, and cases illustrating these complications are reported in detail.

Fifty‐five cases of fish‐bone impaction of the pharynx and the œsophagus are reported. Spontaneous disimpaction can occur. Persistent simple impaction, although distressing for the patient, is easily managed. Delay in treatment or well‐intentioned but inexpert attempts at dislodging the fish bone by the patient or his friends may result in perforation of the pharyngo‐œsophageal wall with retropharyngeal inflammation and suppuration, a condition carrying high morbidity. Perforation of the carotid artery or the aorta is a grave complication, requiring urgent treatment if a high mortality is to be avoided. A brief review is made of the complications of fish‐bone impaction in the abdominal part of the alimentary tract.
The Stress Trajectories in the Femur
Authors: ALLCOCK E. A. , SVENSSON N. L.
Published: January 2008

This article presents a three‐dimensional photoelastic technique for the investigation of the internal stresses in bones and joints.

1. The value of plastic models for the investigation of the distribution of weightbearing forces in bone has been discussed.

2. The development of internal stresses in loaded plastic models has been investigated.

3. The great value of assessment of stress patterns and trajectories by a frozen photoelastic technique using araldite D is reported.

4. The practical application of these models to the design of prostheses and other implants has been investigated.
Squamous Cell Carcinoma of the Anal Canal and Anal Margin
Authors: HARDY K. J. , HUGHES E. S. R. , CUTHBERTSON A. M.
Published: January 2008

This is a study of 41 patients with squamous carcinoma of the anus. There were 23 with a carcinoma situated above the dentate line, the five‐year survival rate being 27%, and 18 with a carcinoma below the dentate line, with a five‐year survival rate of 30%. Advanced local and lymphatic spread at the initial examination was a prominent feature of the series.

The records of 41 patients with squamous cell carcinoma of the anal canal and anal margin are reviewed. An exact follow‐up study was possible in every instance. There were 23 individuals with carcinoma of the anal canal and 18 with carcinoma of the anal margin. Spread to local structures or lymph nodes was observed in nearly half of the patients with anal canal carcinoma, and less frequently in anal margin carcinoma. The preferred method of treatment for anal canal carcinoma was a Miles abdominoperineal resection, and for anal margin carcinoma wide local excision. The combined five‐year survival was 28.6%, being 27% for anal canal carcinoma, and 30.5% for anal margin carcinoma.
Anastomotic Ulceration
Authors: PHEILS MURRAY T. , GILLETT DAVID J.
Published: January 2008

Seventy‐eight operations on 68 patients with suspected anastomotic ulceration have been analysed. The incidence, investigation, diagnosis and management of this condition are discussed.

Seventy‐eight operations on 68 patients with anastomotic ulceration have been assessed. Only 50% of these patients had a completely satisfactory result. Problems of investigations and diagnosis are discussed. It is suggested that better results can be obtained by a careful selection of patients for operation, and choice of the appropriate operation following full investigation.
The Conservative Management of Uveal Malignancies
Authors: GALBRAITH J. E. K.
Published: January 2008

The results of conservative treatment of a series of intraocular malignant melanomas are presented. Tumours of the anterior uvea were excised, while those posteriorly situated were irradiated from a local source containing radon. Details are presented of the construction and use of the radioactive applicator.
An Experimental Preparation Suitable for Studying the Effect of Bacterial Contamination and Infection upon the Healing of Colon Wounds
Authors: RYAN PETER
Published: January 2008

The chief danger of colon operations in the preantibiotic era was thought to be sepsis. Though, no doubt, actual infection of the bowel ends will prevent their healing, it has never been proven that mere contamination with organisms from the fæces or from surrounding peritonitis will produce infection sufficient to cause anastomotic breakdown, provided that the bowel wall is normal and that apposition, blood supply and peritoneal defences are adequate. In order to test specifically the effect of bacterial contamination and infection upon colon wound healing, a dog experimental model has been devised in which other factors affecting colon healing are controlled, and in which concomitant abscess formation is induced adjacent to the healing suture line, peritonitis being avoided by extraperitonealizing the colon in a subcutaneous pouch.