bluuebunny/crossref_metadata_2025 huggingface dataset:
SARCOMA OF PERIPHERAL NERVES.
Authors: Dew Harold R.
Published: January 2008

1. Neurogenic sarcoma may occur in the larger peripheral nerve trunks as a primary solitary neoplasm, or secondary to a primary neuro‐fibroma, in which case other manifestations of this disease should be

2. This tumour is a very treacherous one, of varying degrees of malignancy, but extremely prone to recurrence and finally t o cause death from pulmonary metastases. A study of many recorded cases shows that the prognosis after conservative measures is extremely gloomy, the mortality approaching that of bone sarcoma.

3. If operation is undertaken it should be radical; no conservative measures are of any avail, and, if recurrence, which is very common, takes place, amputation holds out the only chance of saving life.

4. Operative interference with slowly growing nerve tumours with few symptoms should not be lightly undertaken, owing t o the risk of inducing sarcomatous change.

5. Deep X ray therapy has a very limited and rather disappointing effect on most of these neoplasms, but the consensus of opinion is that with a view t o limiting recurrence, it should be used intensively as soon after operation as possible.
ACTINOMYCOSIS OF THE FALLOPIAN TUBES, WITH REPORT OF A CASE
Authors: Gardiner S. S.
Published: January 2008

A case of actinomycosis of both Fallopian tubes is reported, the causal organism being a filamentous branched clubbed organism, Grampositive, non‐acid fast, which grows in five to ten days under micro‐aerophilic, but not under aerobic, conditions.

Actinomycosis is not always a suppurative process.

Infection may be conveyed by lymphatic channels.

The probability of the cervix being the point of invasion or the site of a primary focus of infection of the internal genital organs cannot be disregarded.

One must be ever “actinomycosis conscious”, as it is frequently not possible to differentiate clinically between lesions caused by the organism of actinomycosis and those produced by almost any other organism.

The paucity of cases reported is doubtless due to the fact that routine microscopic examination of specimens removed at operation or at autopsy has been neglected.
ACROCEPHALO‐SYNDACTYLISM (ACROBRACHY‐CEPHALO‐SYNDACTYLISM)
Authors: Susman M. P.
Published: January 2008

Here is another example of acrocephalo‐syndactylism, with a brief description of the main features and references to previous records.
DEATHS FROM HYDATID DISEASE.1
Authors: Barnett. Sir Louis
Published: January 2008

In this short paper I have drawn attention to the deaths, numbering 71, that have occurred in the 428 cases of hydatid disease recorded np to the present time in the Hydatid Registry of the Royal Australasian College of Surgeons. I have shown that sepsis from within is responsible for most of them, and I have explained the bearing of lowered intra‐ cystic pressure in this connexion. Haemorrhage, multiple cyst invasion, especially of both lungs, and sotne uncomn˜on causes of death are also mentioned.
HAEMATEMESIS DUE TO GASTRIC AND DUODENAL ULCER.
Authors: Shaw C. Gordon
Published: January 2008

THE treatment of haematemesis due to chronic gastric and duodenal ulcer, like so many questions in gastric surgery, has given rise to views so different and methods of dealing with this emergency so opposed, that one hesitates before he lays down dogmatically what he regards as the correct practice to be pursued. However, I am convinced that time has come, is in fact overdue, when we should state in unmistakable terms what we regard as the proper treatment for these conditions.
OSTEOCHONDRITIS.
Authors: Hoets John
Published: January 2008

It is suggested that endocrine imbalance cannot be dismissed as an aetiological factor in osteocholz &itis deformans juvenilis. Trauma, although not a true stiological factor, will produce and aggravate deformity during the acute stage. Treatment in the present stage of our knowledge consists mainly in providing adequate protection from strain until X ray evidence shows the affected bone capable of performing normal function. Two cases are quoted which appear to bear out the above suggestions.
Hydatid Cysts Ruptured into the Peritoneal Cavity and the Resulting Membranes of Encystment.
Authors: Barnett L. e.
Published: January 2008

Velarde Perez Fontana (Professor of Surgical Pathology, University of Montevideo): “Quistes Hidatidicos rotos en el peritoneo y las membranas consecutivas de enquistamiento”
White Mice and Experimental Echinococcosis.
Authors: Barnett L. E.
Published: January 2008

F. Dévé: “L'echinococcose expérimentale de la Hidatidosis
OBSERVATIONS ON ANÆSTHESIA IN CEREBRAL SURGERY
Authors: Kaye Geoffrey
Published: January 2008

1. The present paper consists of observations made from the anæsthetist's angle in seventy‐seven operations upon the brain or spinal cord.

2. These operations have been classified in terms of the site of the lesion, the anæsthetic technique employed and the operative mortality.

3. Of the sixty‐three patients concerned in the present report, four (6.4%) succumbed during operation and fourteen (22.2%) during the postoperative period. The remaining forty‐five were well when they left hospital, although not necessarily benefited by operation.

4. Details are given of four fatalities on the operating table.

5. The duties of the anæsthetist are discussed in terms of preoperative examination of the patient, administration of the anæsthetic, keeping of the operation record and combating of shock.

6. The anæsthetist's equipment is detailed.

7. The scope of certain anæsthetic methods (local, local with inhalational supplement, endotracheal use of ether, and endotracheal use of nitrous oxide) is discussed, together with notes on pre‐operative sedation in each group.

8. Detailed consideration is given to the apparent causes and to the treatment of shock and respiratory embarrassment during cerebral operations, and in particular to the role of the anæsthetist in aiding such treatment.

9. Some technical problems due to the site and character of certain cerebral operations are discussed, and the post‐operative care of patients is considered so far as this lies within the province of the anæsthetist.
SALPINGITIS1
Authors: Greenslade Charles M.
Published: January 2008

I hope I have been able to convince you:

1. Of the close relationship of salpingitis and gonorrhea.

2. Of the value of non‐operative measures in acute salpingitis.

3. Of the scope of the operation in chronic salpingitis.

4. Of the necessity of clearing up the lower genital and urethral infection while dealing with the salpingitis.

5. Of the importance of alterations in the menstrual flow, and of examination of the lower genital tract in the diagnosis of acute abdominal emergencies simulating salpingitis.

6. Of the need of cooperation between gynæcologist, surgeon and venereal specialist i n the management of salpingitis.

In conclusion, the second object for which this College was established reads: “To promote the practice of surgery under proper conditions by securing the improvement of hospitals and hospital methods.” From my remarks you will have gathered, I think, that the surgery of gonorrhea in the female is not up to the standard of surgery in general. I believe that the establishment in each of the public hospitals of this country, and particularly in those outside the four main centres, of a department for the treatment of gonorrhea and its complications, under the charge of a surgeon or gynécologist, and provided with a specially trained nursing staff, would be a great advance in the direction of increasing their efficiency.
THE ANATOMY OF THE BRONCHIAL TREE AND ITS CLINICAL APPLICATION.1
Authors: Neil J. Hardie , Gilmour W. , Gwynne F. J. , Main Wallace , Fairclough. W. A.
Published: January 2008

.Reference is made to the difficulty that exists in describing the bronchial branches in terms used in comparative anatomy.

The apparent inconstancy of the tertiary bronchi is deemed to be a cause of the failure of text‐books to standardize the anatomy of the bronchial tree.

The work of Kramer and Glass is elaborated and a separate area, the snbapical, of the lower lobe of the lung is described. It has a bronchial supply hitherto unrecorded. The bronchi of this area are located, and their homologues shown in mammalia other than the human being. The recognition of this bronchus and its variants allows the anatomy of the bronchial tree to be described with the surety of ordinary anatomical description.

methods are described of making metal casts of the bronchial tree, of showing the distribution of the bronchi by inflation, and of filling single bronchi by means of lipiodol.

A method is described of instilling into the lung antiseptics in isotonic solution in large amounts that are absorbed by the lymphatics.

A plea is made for the recognition of bronchiectasis in early life, and suggestions are offered for its preventive treatment.
THORACOPLASTY IN PULMONARY TUBERCULOSIS: A GENERAL SURVEY OF FORTY‐SEVEN CASES.1
Authors: Hutson A. M.
Published: January 2008

During the eight‐year period 1931–1938 inclusive, forty‐seven patients were subjected to thoracoplasty at the Austin Hospital. Of these, thirty‐four are still living and thirteen have died. Seven deaths were directly attributed to the operation and six to the eventual progression of the disease. The immediate mortality due to the operation was therefore 15%, and the total mortality over the eight‐year period 27‐6%.

Of the surviving patients, twenty‐four have either no sputum or residual sputum microscopically “negative” for tubercle bacilli.

Of these, eighteen are able to carry on their normal, or some suitable, occupation, three have been working and free of symptoms for over five years, and may be classed as “clinically cured”; a further ten have been well for over two years and appear to be maintaining their general health.
THE IMMEDIATE AND REMOTE EFFECTS OF MINOR LESIONS OF THE CERVICAL PORTION OF THE SPINAL CORD FOLLOWING HEAD INJURY
Authors: ALLEN I. M.
Published: January 2008

The effect of head injury upon the cervical portion of the spinal cord has been studied in thirteen cases.

Pour cases of moderate injury to the cervical portion of the spinal cord with fracture‐dislocation of the spine, six cases of minor injury to the cervical portion of the spinal cord without fracture‐dislocation of the spine, and three cases illustrating the remote effects of such injury are described in detail.

The clinical features of the immediate and remote effects of injury to the cervical portion of the spinal cord following head injury are described.

The value of careful examination of the tendon reflexes of the upper limbs in the diagnosis of these cases, when they might otherwise be overlooked, has been confirmed.

On the evidence available it seems that disease of the spinal cord which has followed injury, may be actually a remote effect of injury simulating disease.
SLIPPED UPPER FEMORAL EPIPHYSIS, WITH A REPORT ON A CASE TREATED BY SKELETAL TRACTION.
Authors: Dunlop E. E.
Published: January 2008

1. A report is presented of a case of slipped upper femoral epiphysis successfully treated by skeletal traction.

2. Some opinions as to the aetiology of the condition are reviewed.

3. Methods of treatment in the early acute case are briefly outlined and discussed.
CONGENITAL CYSTIC DILATATION OF THE COMMON BILE DUCT
Authors: Poate Hugh R. G.
Published: January 2008

Summary

1. A case of congenital cystic dilatation of the common bile duct is recorded.

2. The article by Zinniger and Cash has been used as a basis for the present discussion. Most of their recorded cases have been reviewed, corrections have been made and material information has been added.

3. A short presentation of the salient features of the condition has been made.

4. A check review of the literature has been made in all cases in which it has been available, and the bibliography has been extended to include any articles met with since 1930.

5. Twenty‐three additional cases have been included in the records.

6. Reasons for the exclusion of Reel and Bun‐ell's case are given.

7. The aetiology has been discussed and additions have been made to the suggested causes.

8. In Table I the results of treatment have been recast and additions have been made.

9. Results of treatment show that a primary eholedocho‐dnodenostomy is the operation of choice, but an adequate stoma must be provided.

10. Drainage with secondary anatomosis may be a life‐saving measure in debilitated patients.

11. The necessity for the administration of bile salts and vitaminKis noted during the period of drainage.

12. A brief summary of 105 cases is listed.

13. A full bibliography is appended.
A MALFORMATION OF THE HIND END OF THE BODY
Authors: Sunderland Sydney
Published: January 2008

Summary

.1. An abnormality of the hind end of the body in a female is described.

2. The various theories relating' to the development of this region and their relative values in explaining the malformations found, are discussed.

3 The suggestion is put forward that fusion of the Müllerian ducts is responsible for the separation of the hind gut from the ventral cloaca, and that further development of the hind end is associated with changes occurring in the distal ends of those ducts. The grounds on which such a suggestion is based are, firstly the conditions found in this specimen, and, secondly, its value in solving certain of the problems connected with the malformations recorded.
CHRONIC LARYNGEAL AND TRACHEAL STENOSES
Authors: SWINBURNE GEORGE
Published: January 2008

. The historical aspect of chronic laryngotracheal stenosis is briefly reviewed and the condition is defined.

. The aetiology, pathology, symptoms and diagnosis are briefly dealt with.

. The methods of treatment are fully discussed.
TWO CASES OF HUNNER'S ULCER OF THE BLADDER OR INTERSTITIAL CYSTITIS IN THE PRESENCE OF IDIOPATHIC HYPOCHROMIC ANÆMIA
Authors: ROBB DOUGLAS
Published: January 2008

Two cabes are described in detail in which Hunner's ulcer or interstitial cystitis occurred in middle‐aged women who also showed marked idiopathic hypochromic anaemia.

It is suggested that this or other similar nutritional deficiencies may be not unrelated to interstitial cystitis and also to certain less striking changes in the bladder wall, and that further observation may place such deficiency as a factor of importance in the cause of the cystitis.

An analogy is drawn between these bladder changes and the bucco‐pharyngeal changes in ansmia.
BLOOD STORAGE ON ACTIVE SERVICE
Authors: OFFICER R.
Published: January 2008

Summary

The changes which occur in blood (hiring storage and which render it dangerous to administer are discussed and illustrated.

The storage of blood in glucose solution is recommended.

A technique for the collection of blood for storage using the standard Australian Army equipment is described.
SCAR DISABILITIES OF WOUNDED HANDS
Authors: Rank Major B. K.
Published: January 2008

Summary

1. The importance of early relief of scar disabilities of the hand is emphasized–that is, before joint changes are established.

2. The part of early wound healing, early function and correct use of physiotherapy in preventing and minimizing scar disabilities of the hand is stated.

3. The “hand grenade” type of injury is described and used as a basis to describe the principles of an effective scar excision and replacement by a full‐thickness skin graft.

4. A “through” type of hand wound is described in so far as scar effects are concerned. The principles of effective treatment by (a) scar excision and rearrangement for small scars and (b) scar excision and direct flap replacement for large scars are set out.

5. Other types of scar disability and their treatment are indicated– namely, web scars, adherent scars of fingers and burn scars.

6. A plea is made for the full application of plastic surgery to obtain better results from all hand wounds.
ABDOMINAL SURGERY IN THE ALAMEIN CAMPAIGN
Authors: GIBLIN THQMAS
Published: January 2008

The experience of 90 abdominal wounds, operated on in forward areas, is used as a basis. Certain cases are quoted.

General management in all stages is reviewed, and standards are laid down under which the mortality was halved.

Benefits of rapid transfusion are shown.

Intraperitoneal injection of sulphadiazine would seem, clinically, to reduce peritoneal infection following bowel perforation.

The necessity is shown for routine early post‐operative gastric suction and continuous intravenous therapy in all cases of perforated bowel.

Lesions of various organs are reviewed in detail and their management is discussed.

Wounds of the colon, if “exteriorized”, are no more fatal than those involving small bowel. A recovery rate of at least 70% is to be expected if patients come to operation within twelve hours.
OCULAR INJURIES OF SOLDIERS IN THE MIDDLE EAST
Authors: Duncan W. J. L.
Published: January 2008

One may summarize the main features of these ocular perforating injuries of war in the following way:

1. In a large percentage the eye was so badly damaged as to demand immediate excision.

2. Frequently penetration occurred without marked external signs.

3. Indirect projectiles of stone and sand frequently complicated the picture.

4. Often the intraocular foreign body was not demonstrable by X rays, and the majority were only feebly magnetic, or non‐magnetic.

5. In about one case in four both eyes were penetrated and frequently the foreign bodies were multiple.

6. In three‐quarters of the cases there were accompanying wounds of the face and/or other parts of the body.

7. Sympathetic ophthalmia did not occur.

8. Early admission to a hospital with adequate equipment is a sine qua non of successful treatment in these distressing war injuries.
A STUDY OF THE SECONDARY INFECTION OF THE LIVER, ILLUSTRATING PORTAL VENOUS ACTINOMYCOTIC EMBOLISM, RESULTING IN EXTENSIVE PYLEPHLEBITIS WITH INFARCTION OF LIVER, GOING ON TO HEPATIC VENOUS ACTINOMYCOTIC EMBOLISM.
Authors: Welsh D. A.
Published: January 2008

Three cases of actinomycosis involving the urinary system are reported and available literature up to the end of 1936 has been reviewed.

Actinomycosis of not. always a suppurative process.

The possibility of urethritis being caused by the organism of actinomycosis cannot be disregarded.

The clinical picture of actinomycotic lesions in the kidney and bladder and also autopsy revelations are not characteristic.

More cases will be diagnosed correctly if the surgeon or clinician is “a cti nomycosis‐mi nded”.

The paucity of cases reported is doubtless due to the fact that routine microscopic examination of specimens of urine of patients suffering from actinomycosis in other regions of the body has been omitted and also to the fact that routine microscopic examination of specimens removed at operation or obtained at autopsy has been neglected.

The medico‐legal aspect of the disease is mentioned.
PLASTIC PRINCIPLES IN COMMON SURGICAL PROCEDURES.1
Authors: Rank B. K.
Published: January 2008

Summary of Indications for the Grafting of Wounds with Skin Loss

We can summarize then how the main indications arise for primary skin grafting of wounds with skin. loss.

l. The traumatic wounds which, by their nature or by surgical débridement, can be rendered clean surgical wounds. These would include: (a) Certain wounds from mechanical trauma, mostly industrial or transport accidents (Figures IIIA, IIIB, IIIC and IIID). (b) Certain burns suited to primary excision–that is, localized burns of third degree, typically electrical or chemical burns which can be well excised early (Figures IVA, IVB, IVC, IVD, IVE).

2. The surgical wounds with skin loss, made at diverse operations. These operations would include: (a) Excisions of skin lesions, mostly neoplasms, innocent or malignant. (b) Operations in which skin excisions are necessary in relation to deeper lesions. For example: (i) in fasciectomy for Dupuytren's contracture when there is extensive skin involvement, (ii) in radical operations for carcinoma of the breast with skin involvement, (iii) excision of certain pilonidal cyst lesions, (c) Excision of “chronic” unhealed wounds or unstable wounds in which secondary intention healing may have failed by the increasing ischaemia of local fibrosis, (d) Adjuncts to various other plastic procedures, as we shall see later, in relation to the donor areas of certain flaps or whole skin grafts.
TRAUMATIC RUPTURE OF THE URETHRA AND BLADDER
Authors: Barry Hugh C.
Published: January 2008

Traumatic rupture of the lower portion of the urinary tract has been discussed under three groups: the anterior or extrapelvic section of the urethra, the posterior or intrapelvic section of the urethra, the urinary bladder.

The essential points in diagnosis and a simple method of emergency treatment have been described for each group,

The importance of immediate suprapubic drainage, the pitfalls of an indwelling catheter, and the need for early restoration of the soft parts in intrapelvic rupture have been stressed.

Personal cases illustrating each type are reported.
CYST OF AN EPIPLOICAL APPENDAGE OF THE PELVIC COLON
Authors: Rose Thomas F.
Published: January 2008

Summary

The history of a patient with a multiloculated cyst in an epiploical appendage of the pelvic colon is presented. Its macroscopic pathology is described.

The aetiology of the condition is quite unknown and the case is presented for its interest and its rarity.
ACUTE PANCREATITIS
Authors: Nanson Eric M.
Published: January 2008

Four cases of acute pancreatitis are recorded.

The symptoms and signs of these cases are compared.

The value of various features in each case is discussed as an aid to diagnosis.

Conservative treatment with recovery is recorded.
PENICILLIN TREATMENT OF EXPERIMENTAL OSTEOMYELITIS IN RABBITS1
Authors: NAGLER F. P. O.
Published: January 2008

Experimental osteomyelitis resembling that in human beings can be produced in nearly 100% of rabbits by infection with a suitable strain of Staphylococcus aureus according to the method of Scheman, Janot and Lewin.

Penicillin given in the form of a suspension in peanut oil and beeswax has a beneficial effect on acute osteomyelitis in rabbits when given within forty‐eight hours after the infection, but fails to prevent extension of the disease in all cases.

Treatment with penicillin delayed for six days had no significant effect on experimental acute osteomyelitis in rabbits.
CARCINOMA OF OESOPHAGUS AND CARDIAC END OF STOMACH
Authors: Doyle Leo
Published: January 2008

Summary

The patient with a carcinoma of the oesophagus or the cardiac end of the stomach presents no longer the hopeless problem that he had previously. It may be said that this paper presents no argument to prove this, as of the six patients whose histories are presented, but one is still living. This one, however, presented the most difficult operative problem. The other case of oesophageal carcinoma was probably a hopeless surgical problem from the beginning. The patient, however, elected to take his chances. The experience gained from these two cases would lead me to advise any patient with such a lesion to submit to radical operation. The statement made that oesophageal carcinoma is inoperable before it presents symptoms is not the experience met with in these two cases, as these lesions were readily resectable. However, I believe that all cases of oesophageal obstruction occurring in patients of the cancer age should be diagnosed by active means at the earliest moment and if a positive diagnosis cannot be made immediately, the patient should be subjected to an exploratory thoracotomy. Should a carcinoma be found, it can be resected immediately.

Carcinoma of the cardiac end of the stomach will always present a difficult problem, as its situation, with consequent lack of mechanical interference with alimentary function, will be responsible for an advanced state of growth before the production of symptoms. Again, unless the radiologist has the possibility of the lesion in mind and looks for it, he may quite easily overlook it. However, when once the diagnosis is made, an exploration is justified, as the lesion may be removable.

The mortality, immediate and late, is high. It will be high, as the mortality of any new procedure designed to help very sick people is always high until, with increasing experience, surgeons make fewer mistakes. This is no justification, however, for failing to make the attempt. Without operation the disease is fatal and we now have a way out. The way is hard, but it is possible and should be undertaken.
SOME ASPECTS OF THE SURGICAL PATHOLOGY OF THE TESTIS1
Authors: Wyndham Norman
Published: January 2008

Summary

1. An outline of our present knowledge of testicular descent is given, showing the relationship of the gonad to the caudal end of the intermediate cell mass and its early position near the groin. ISTo explanation of the mechanics of descent is attempted. The description is based on work a summary of which has already been published (1943).

2. Some of the salient features of cryptorchidism are outlined–its comparative anatomy, its resultant structural and functional changes. The predisposition of such testes to malignant change is assessed. The incidence and spontaneous rectification of the abnormality lead to a consideration of the necessity of treatment.

3. Changes in hormone production consequent upon various testicular conditions are discussed. Gonadotropic hormone of the pituitary is necessary for testicular development. Abnormally high amounts of androgen are elaborated by interstitial cell tumours. Seminomata produce no hormone, but teratomata produce a luteinizing hormone. In both the last mentioned the pituitary gland produces an increased amount of follicularizing hormone. The relationship of urinary hormone assays to diagnosis and prognosis is outlined.

4. Some features of testicular tumours are mentioned–the age periods, the ease with which such tumours are overlooked, some distinguishing characteristics of seminomata and teratomata, and the difficulties associated with adenocarcinomata.
ADVANCED CARDIOPASM: THREE CASES IN WHICH OPERATION BY THE THORACIC ROUTE WAS PERFORMED
Authors: Robb Douglas , Nicks Rowan
Published: January 2008

Three further patients with advanced cardiospasm have been operated on, making five in Auckland in the past seventeen years, the only ones known to the writers.

Though the abdominal route has proved quite adequate, the thoracic is now favoured, on account of the excellent access and the greater facility and accuracy possible in suturing the new opening.

Pre‐operative preparation of the gullet by lavage and emptying is facilitated by the use of the rocking stretcher.

Post‐operative management has been simplified by abandoning the use of inlying tubes in the gullet. Ordinary post‐thoracotomy management must be carefully applied.
CARCINOMA ARISING IN A DIVERTICULUM OF THE URINARY BLADDER
Authors: Howarth V. S.
Published: January 2008

An example of carcinoma arising in a diverticulum of the bladder is recorded.

The condition is rare and its incidenceis variously estimated as occurring in 1.6 per cent. to 2.3 per cent of all bladder diverticula.

Diagnosis is difficult and the haematuria which commonly occurs is usually attributed to associated prostatism or to concomitant infections.

Visual inspection of the interior of the diverticulum at operation did not, in the case reported, disclose the presence of the neoplasm.
THE OPERATION FOR UNDESCENDED TESTES IN THE SUPERFICIAL INGUINAL POUCH
Authors: Craic C.
Published: January 2008

In describing the operation for ectopic special attention has been drawn to the special attention has been drawn to the properly following points:

1 The serous sac that surrounds the testis should be preserved as a vaginal sheath.

2 The anatomy of the cord need not be disturbed except to dissect out the hernial sac or attached peritoneum.

3 The statement that a hernial sac is always present is denied and the relationship of the peritoneum to the internal ring in the absence of a sac is described. All that is necessary to cure the hernia is removal of the sac. Plastic procedures are unnecessary.

4 The method of separating the testicular vessels and the vas far into the pelvis is described.

5 The method of keeping the testis in the scrotum without performing Torek's manoeuvre is described.

6 The results in 10 cases are given.
MEGALOCORNEA AND ITS SURGICAL COMPLICATIONS
Authors: Hamilton J. Bruce
Published: January 2008

Megalocornea is undoubtedly a definite clinical entity, but like buphthalmos is subject to raised intra‐ocular tension.

Only 25 per cent. of cases of megalocornea are so involved, whereas in 100 per cent. of buphthalmos the intra‐ocular tension is raised.

This increase in intra‐ocular tension is a very important complication and must be watched for in megalocornea in adult life.

In one case it occurred at the age of 30 years, but in the oldest case it did not appear until about 60 years of age.

This complication appears 3 times as com‐ monly in females as in males.

Senile cataract is a further complication and the extraction of this type of cataract appears to be followed frequently by spontaneous retinal detachment.
PANCREATIC TISSUE IN THE WALL OF THE SMALL INTESTINE
Authors: Ogilvy I. H.
Published: January 2008

1. A case of pancreatic tissue in the wall of the small intestine, complicated by intestinal obstruction, and 4 additional cases discovered during routine post‐mortem examination are reported.

2. Observations made on these cases support the hypothesis that the pancreatic tissue arises from the overlying intestinal epithelium.

3. The condition is more common than the number of cases reported in the literature would suggest.

4. Complications are uncommon, but it is important to recognise the nature of the tissue when it is found at operation, and the appearance is such that this is pos‐ sible in the majority of cases.

5. The management of the condition is briefly discussed.
OBSERVATIONS ON THE SURGICAL ANATOMY OF THE THORACO‐LUMBAR SYMPATHETIC SYSTEM.
Authors: Bradley K. C.
Published: January 2008

A description has been given of some anatomical variations in the lower thoracic and lumbar sympathetic chains.

The ganglia have been analysed according to their segmental origin.

Some of the relationships of the sympathetic chain and splanchnic nerves to the crura of the diaphragm have been described.

Mention has been made of some facts of importance in performing sympathectomy.
TECHNICAL ASPECTS OF THE SURGERY OF HYPERTENSION WITH A FOLLOW‐UP OF FIFTY CASES
Authors: Miller Douglas
Published: January 2008

A description of Fey's renal incision modified for thoraco‐lumbar sympathectomy given.

A follow‐up of 50 patients up to five years, reported.

The results are classified as symptomatic and objective.
THE ADENOLYMPHOMATA.
Authors: Heinz Ian
Published: January 2008

Twelve adenolymphomata are described and also what appears to be the first reported case of this tumour in the false vocal cord.

Some theories of origin are discussed and it is stressed that the problem of their genesis belongs to a group of neoplasms.

The tumour from the larynx serves to pin point the issue as it tends to focus one's mind in considering the plasticity of tissues.

Excision is eminently satisfactory as recurrence is rare and radiotherapy seems to play no part in the treatment.
FIVE UNUSUAL THORACIC CASES*
Authors: MacMahon John S.
Published: January 2008

Some interesting cases met with in the surgery of the chest are reported which in‐clude:‐

1.Torulosis of the lung.

2.Massive pulmonary haemorrhage treated by pneumonectomy.

3.Posterior mediastinal goitre.

4.Pulmonary adenomatosis.

A short description has been given of the above clinical conditions. The difficulties of diagnosis and technical problems encoun‐tered at operation have been described.
FACIAL NEURALGIAS
Authors: Money R. A.
Published: January 2008

The facial neuralgias form a group of symptom ‐ complexes, characterised by pains of various types in one or both sides of the face.

The commonest variety is true trigeminal neuralgia or tic doloureux, and it has certain definite characteristics which distinguish it and without which the diag‐ nosis should be reviewed.

Eight other varieties of facial neuralgia are classified and described. Some of theses have a definite cause and are as‐ sociated with tumours or aneurysms

The treatment of these various conditions is discussed on the following 1ines:

(a) Analgesics.

(b) Anti‐neuritic vitamins.

(c) Injections of alcohol into the branches of the 5th nerve, its roots or the Gasserian ganglion.

(d) Resection of the sensory root of the 5th nerve.

(e) Attack upon the sympathetic nerves or blood vessels supplying the af‐fected area.

(f) Removal or correction of the cause, when known.

(g) Prefrontal leucotomy for intractable pain.

Migraine and neuralgias of nasal and ocular origin are omitted.
NASOPHARYNGEAL CARCINOMA: AN ACCOUNT OF THE CRANIAL NERVE LESIONS FOUND IN 185 CASES
Authors: Lawley Margery
Published: January 2008

Forty‐eight per cent. of 185 cases of nasopharyngeal carcinoma seen over an eight‐year period exhibited evidence of cranial nerve damage. The abducens nerve and trigeminal nerve were the most frequently involved. The lesions fell into two main groups: (a) where one or more of the second, third, fourth, fifth and sixth nerves were involved, and (b)where there was a lesion of one or more of the last four cranial nerves and of the cervical sympathetic chain.

The early onset of cranial nerve lesions and the consequent need for speedy diagnosis is emphasized.
PORTAL HYPERTENSION A CONSEQUENCE OF BILIARY CIRRHOSIS
Authors: Hodge David
Published: January 2008

Two cases are described in which haemorrhage occurred from oesophageal varices due to portal hypertension on the basis of biliary cirrhosis. In each instance the cirrhosis was of the secondary type, being due to surgical damage to the common bile duct, and residual calculi in the extra‐hepatic bile ducts respectively. Brief references are made to the experiences of other authors who have dealt with the same subject within recent years, and an explanation is ventured for the more common occurrence of portal hypertension in portal than in biliary cirrhosis.
TUMOURS OF THE SALIVARY GLANDS
Authors: Eddey Howard H.
Published: January 2008

The diagnosis and treatment of tumours of the salivary glands has been discussed, the conclusions being based on personal experience of 49 cases.

Adequate surgery is necessary to prevent recurrence of mixed salivary tumours. Radical surgery, usually without lymph node dissection, is necessary for carcinoma, but the outlook for cure is poor.
CORTICOID REPLACEMENT AFTER ADRENALECTOMY WITH SPECIAL REFERENCE TO THE USE OF FLUOROHYDROCORTISONE
Authors: Woodruff M. F. A. , Llaurado J. G. , Pearse V. T.
Published: January 2008

Neither cortisone nor 9α‐fluorohydrocorti‐sone acetate alone provides adequate steroid replacement in adrenalectomised patients: cortisone because its mineralocorticoid action is insufficient in comparison with its glucocorticoid action, and 9α‐fluorohydrocortisone acetate because the converse is true. By using both these steroids a proper balance can be achieved. One patient, who has been studied in detail for a year following bilateral adrenalectomy, is being satisfactorily maintained with 0.1 mg. 9α‐fluorohydrocortisone acetate and 20 mg. cortisone twice daily by mouth.
THROMBOSIS OF THE INTERNAL CAROTID ARTERY
Authors: CONNELI JOHN
Published: January 2008

Attention is drawn to the “little stroke” syndrome produced by atheromatous occlusion of the internal carotid artery. The clinical features and diagnosis of the condition are discussed. Three cases are presented and the important technical details in the operative procedures are stressed.
SPONTANEOUS PERFORATION OF THE OESOPHAGUS
Authors: ALLCOCK EDWARD A.
Published: January 2008

A successful case of spontaneous rupture of the oesophagus pointing to the right side 9 cm. from the hiatus is recorded.

The clinical picture and management are discussed.

Immediate exploration and suture of the oesophageal rupture is advocated.
CIRSOID ANEURYSM OF THE PELVIS A CASE REPORT WITH A BRIEF REVIEW OF THE LITERATURE
Authors: MCDONALD IAN A. , MCLEISH G. R.
Published: January 2008

The eighth recorded case of cirsoid aneurysm involving the uterus is reported.

Laparotomy was performed twenty‐seven years before for monorrhagia. The abdomen was closed when the aneurysm was found and radium was inserted into the uterus.

Hysterectomy became necessary on the present occasion when excessive haemorrhage followed diagnostic curettage of the uterus for post‐menopausal bleeding.

The authors conclude that surgical excision of these lesions should be undertaken only as a life‐saving procedure.

A brief review of ‐the literature is made.
A SIMPLE METHOD FOR THE OXYGENATION OF HEPARINIZED VENOUS BLOOD
Authors: COHEN DOUGLAS
Published: January 2008

The use of coronary perfusion of fresh oxygenated heparinized blood as an adjunct to hypothermia during intracardiac surgery is discussed and a simple method for the preparation of the fresh heparinized, oxygenated blood is described.
FIBROSARCOMA OF THE SCROTUM
Authors: LANE DANIEL
Published: January 2008

A case of fibrosarcoma of the scrotum is described. This would seem extremely rare as it has not been possible to find any report of a similar case.
PERCUTANEOUS PROSTATIC BIOPSY
Authors: MACLEISH D. G.
Published: January 2008

A series of 35 percutaneous needle biopsies of the prostate is reported. The technique is described, and its indications and limitations are briefly discussed.
THERAPEUTIC APPLICATIONS OF HYPOTHERMIA
Authors: Wilson Patricia
Published: January 2008

Hypothermia is not a therapeutic measure per se–it merely lowers metabolism and permits the vital organs to withstand prolonged hypoxia. Therefore, the prime indication for therapeutic hypothermia must be reversible hypoxia of vital organs.

At present the greatest application is in disorders of the central nervous svstem. To be effective the temperature must be lowered to a point where metabolism is appreciably diminished. The highest useful temperature for central nervous system disorders is 30%C and probably much lower temperatures are more effective, especially if a major blood

supply to a portion of the brain or spinal cord is to be interrupted.

In cases of hyperthermia and in acute infections it is probably not necessary to coolbelow 3244%C.

The technique involves surface cooling with sedation to control restlessness and shivering; so far chlorpromazine appears to be the best agent for this purpose. Initial hypertension is controlled by vegolysen.

The procedure does not appear to be particularly hazardous provided detailed precautions are observed. The chief danger is ventricular fibrillation which is not a common complication in this type of patient who usually has a normal cardiovascular and respiratory system.

There is much conflicting experimental evidence on the metabolic effects of prolonged hypothermia.

It is important that we determine in human beings the significance of these alterations in metabolism and particularly whether these changes are normal physiological phenomena for the lower temperatures. It must also be ascertained whether the complex changes associated with hypothermia can be reversed after prolonged periods of low temperatures.

With greater knowledge of the physiology, better sedatives and drugs to control shivering and more careful monitoring of the patient, we should be able to achieve even lower temperatures.

There is every indication that, under these conditions, hypothermia will have a definite place as an adjunct to modern therapy.
THE REINFORCED GRAHAM‐COLE TEST
Authors: Ryan James
Published: January 2008

Biligrafin reinforcement is a valuable adjunct to the Graham‐Cole test. Indications for the additional test are given.

Results of a series of 60 cases suggest that radiological methods can be further improved, and that more pre‐opcrative information can be obtained in patients with gallbladder disease.
STUDIES ON RENAL TRANSPLANTATION IN SHEEP
Authors: MITCHELL R. M.
Published: January 2008

Transplants of the kidney were performed in 34 sheep using the “iliac” position. The function of autografts, homografts and normal host kidneys was studied together with the histological changes. To reduce ischaemic damage during transplantation, the kidneys were cooled. Cooling by perfusion was unsuccessful but a useful technique of local renal cooling was evolved. Iliac autografts functioned normally up to two and one‐half years but homografts were rejected in five to nine days. The function of a grafted kidney‐was affected by the presence of normal kidneys. The concept of renal loading in relation to graft function is discussed. Bacteriological study showed that an anuric homograft, if not quickly removed, became secondarily infected with CI. welchii. This led to toxic damage to the animal's own kidneys. Injection of spleen cells into embryonic lambs was followed six months after birth by kidney homotransplantation from the same donor. There was no increased tolerance to such renal homografts.
THE GENETIC APPROACH TO HEREDITARY CONGENITAL PTOSIS
Authors: RANK B. K. , THOMSON J. A.
Published: January 2008

1. It is considered that ptosis and ptosis with epicanthus are probably manifestations of the same dominant autosomal gene with high penetrance.

2. There is no significant difference in the proportion of affected males and females in sibships with one parent affected. The apparent difference in sex incidence of the condition is due to the high sex ratio observed in such sibships.

3. An appeal is made for the collection of unselected pedigree material for use in genetic studies.
MICRODISSECTION STUDY OF LATE RENAL DISEASE
Authors: BAXTER THELMA J.
Published: January 2008

“There are challenges of a salutary severity that stimulate the human subject of the ordeal to a creative response; but there are also challenges of an overwhelming severity to which the human victim succumbs”. Arnold J. Toynbee, “A Study of History”, Vol. 2, Part H, D, vii.

SUMMARY AND CONCLUSIONS

Microdissection of a grossly contracted kidney from a patient aged 25 years showed the remnants of tubules and ducts. No glomerulus was found but there was evidence of tubular hyperplasia, particularly in the form of diverticular formation and localized cellular proliferations. Damage had been too severe and extensive for this regeneration to significantly influence the progress of the renal degeneration and atrophy.

The usual explanation of an abnormally small kidney is that it is due to “dysplasia” or some other “congenital” process. This is based on the fundamental misconception that, in postnatal life, tissues have arrived at an immutable state. Any inflammatory processes are “explained” as to be expected because abnormal tissues are more liable than others to injuries of various kinds. Furthermore, the assumption that structures, which resemble foetal tubules, are in fact the original foetal components which have remained in this form for many years of adult life ignores the essential plasticity of tissues and implies that they are not influenced by the many stimuli which have clearly been acting on the other tissues of the organ. The postulate that such components lack the lability observed elsewhere is unreasonable.

Precise and definite evidence as to the stages and pathways in the pathogenesis of the fibrotic kidney are absent, having been lost in a maze of repeated injuries and the various reactionary and regenerative activities which follow. Conclusions must therefore be speculative. However, if the disease process began early in life and was continuous and progressive, extreme changes are to be expected.

Whatever the time (antenatal or postnatal) at which the process began, the important feature in the present case is that the parenchymal tissues of the kidney, even though practically overwhelmed by recurrent infections, still manifest the capacities of all tissues (whatever their stage in the life of the individual) for regenerative change.
THE DIAGNOSIS OF PORTAL HYPERTENSION
Authors: BKRCI G. , ALLCOCK E. A. , EWING M. R.
Published: January 2008

A review has been made in the light of our experience of the methods used to establish the diagnosis of portal hypertension.

We have had enthusiastic support in our enquiries from Dr. H. A. Luke, Director of Radiology of the Alfred Hospital. We would like to record our thanks to our colleagues in the many hospitals who have allowed us to investigate patients under their care.
CONTRACTION IN WOUNDS MADE AT SHORT TIME INTERVALS
Authors: CIJTHBERTSON A. M.
Published: January 2008

Large skin wounds were made at staged time intervals on the opposite flanks of rats. evidence was found for the presence of substances liberated from the primary wound which influenced the rate of closure of a subsequent wound.
TRAUMATIC RUPTURE OF THE KIDNEY IN CHRISTMAS DISEASE
Authors: SHANNON ROBERT
Published: January 2008

Christmas disease is clinically indistinguishable from haemophilia.

The Christmas factor is more stable than the deficient factor in haemophilia, as a result of which Christmas disease may be treated with stored bank blood, but this should not be used in haemophilia.

A case of traumatic rupture of the kidney in Christmas disease is reported with recovery following nephrectomy.
GUN FOR THE ATTACHMENT OF CLIPS TO SMALL VESSELS IN DEEP PELVIC SURGERY
Authors: FAIRBANKS D. , MANSON A. S. , GODFREY GRAHAM
Published: January 2008

The paper describes a gun suitable for the attachment of clips to small vessels in the course of deep pelvic surgery. It is particularly useful where difficulty is experienced in applying ligatures.
INTACT EXTRUSION OF HYDATID CYSTS
Authors: WOODWARD W. W.
Published: January 2008

(1) Partial extrusions of three hepatic hydatid cysts are reported from Tasmania, thus adding to the existing accounts of these events. Two were downward into the peritoneum and one upward into an expanded subphrenic space. These partial extrusions were all seen at operation.

(2) Total extrusions known to have occurred elsewhere are briefly mentioned. A Tasmanian total extrusion is described in a case report. Total extrusion from this patient's liver was followed by intact transperitoneal migration into the recto‐vesical pouch. Operation happened to be done before rupture occurred and the cyst was delivered intact from the recto‐vesical pouch, an operation to which the writer has not found previous reference in English, though it cannot be said that anything like an exhaustive search has been made.

(3) Because of the risk of rupture of the newly uncovered hydatid it is recommended that surgery should be resorted to as an emergency when intact extrusion is a possibility.

(4) If the cyst is not seen where it was to be expected, then a very gentle exploration of the remainder of the opened serosal cavity is indicated, in case the cyst has migrated intact.

(5) Finally, there is the possibility that intact extrusion may be found to be not so extremely uncommon a phenomenon if operation in a suspected case is done early, i.e. before rupture of the cyst.
AN EXPERIMENTAL METHOD FOR THE PRODUCTION OF MITRAL INCOMPETENCE*
Authors: REEVE THOMAS S. , MONK IAN
Published: January 2008

1. A new method is described for producing mitral incompetence in sheep. It provides a high percentage of survivors for long‐term experiments.

2. The pericardial envelope is not opened during the procedure, and no intrapericardial adhesions are produced. This allows easy access to cardiac structures when surgical correction is attempted subsequently.
TRAUMATIC AVULSION OF THE INSERTION OF FLEXOR DIGITORUM PROFUNDUS*
Authors: Gunter G. S.
Published: January 2008

1. Traumatic avulsion of the insertion of the tendon of flexor digitorum profundus of

2. The probable mechanism responsible for the injury and the subsequent deformity in untreated cases is discussed.

3. Various procedures undertaken at different stages in the progress of the injury, and under varying conditions, are described and discussed.

4. The long term results in eight cases are demonstrated.