bluuebunny/crossref_metadata_2025 huggingface dataset:
G CELLS AND GASTRIN RELEASE FROM HUMAN ANTRAL MUCOSA IN VITRO
Authors: Askew A. R. , Grant B. J. , Vinik A. I.
Published: January 2008

Using an in vitro perfusion technique, the release of immunoreactive gastrin (IRG) from human antral mucosa has been investigated, and comparisons made between the release of IRG and the G cell numbers within the tissue. Serosal stimulation with acetyle choline(5·504 × 10‐12M conc.)resulted in a significantly greater release of IRG from the tissue when compared with release from unstimulated tissue from the same patient (4666 ± 1656 fM/ml. stimulated; 274 ± 130 fM/ml. unstimulated (T = 2·64; P (0·02). A wide variation in G cell numbers was found between tissues and within tissue, and there was no significant correlation between the gastrin secreted and the G cell population. Stimulation with acetyl choline resulted in a 68·8% reduction in G cell numbers compared with a 56·7% reduction in unstimulated tissue, but these were not significantly different (T = 1·68; P) 0·1). No significant correlation was found between the reduction in G cell numbers detected by immunohistology and the IRG secreted by the tissues.
THE HISTOPATHOLOGY OF MICROLYMPHATICOVENOUS ANASTOMOSIS
Authors: Baxter Thelma J. , Gilbert A. , O'Brien B.Mc.C. , Sykes P. J. , Vorrath J. W. , Bennett R. C.
Published: January 2008

Histopathological studies are described on 30 biopsy specimens of lymphaticovenous anastomoses ranging from two days to eight months following operation. Sixteen were patent and 14 were occluded. It was observed that in the non‐patent specimens occlusion stemmed from the venous component. The prime determining factor in the success of the anastomosis was the achievement of correct apposition of the cut edges of the vessels, and this was directly dependent on the number and spacing of the sutures as well as the tension applied at their insertion. Correct apposition is more easily achieved with these delicate thin‐walled vessels by better visualization afforded by the use of the operating microscope and appropriate instrumentation. The slow rate of repair in this situation is emphasized.
OPHTHALMIC MICROSURGERY: ADJUSTMENT PROBLEMS
Authors: Lim A. S. M.
Published: January 2008

More ophthalmic surgeons should be encouraged to use the operating microscope, one of the most important and spectacular advances in surgery in this century. Its advantages are established. This paper discusses practical recommendations based on observations made from a decade of personal experience and from the problems encountered by students at microsurgical courses. The recommendations are as follows: (i) Instrumentation. Surgeons must understand the structure and limitations of the microscopes and the microinstruments; (ii) Inherent disadvantages. There are several disadvantages inherent in performing surgery under the operating microscope, e.g., the ophthalmic surgeon becomes “immobile”, and the operating field of vision is narrow. All these disadvantages require adjustment. With an understanding of these problems, more surgeons will eventually be able to overcome the difficulties.
MICROSURGERY IN OTOLARYNGOLOGY: THE FUTURE
Authors: Edwards William
Published: January 2008

Five areas of active clinical research development in otolaryngology have been selected to illustrate the specific applications of microsurgical principles and the potential future of associated bioengineering research. These are: (i) biocompatible microelectronic circuitry and cochlear electrode implant in total cochlear deafness, with preservation of auditory nerve function; (ii) microneural surgery of the facial nerve in hemifacial spasm and the techniques available for reinnervation of the paralysed larynx; (iii) laser microsurgery of the larynx — a new surgical modality dependent on high‐precision control through the operating microscope; (iv) microvascular free tissue transfer in head and neck reconstruction and its potential value following combined irradiation therapy for carcinoma; and (v) human laryngeal transplantation — its current status.
MICROSURGICAL RECONSTRUCTION FOR CONGENITAL ATRESIA OF THE EAR
Authors: Edwards William
Published: January 2008

Stapedectomy is not an innocuous procedure even under ideal conditions in otosclerosis. In Congenital anomalies it may be hazardous. Victor Goodhill, 1979. Hearing improvement is poor, meatuses tend to stenose and frequently become wet and infected with the final answer still being awaited. Lund and Phelps, 1978.
THE VALUE OF PREDNISONE IN THE PREVENTION OF SCARRING AFTER VASOVASOSTOMY
Authors: Urquhart‐Hay D.
Published: January 2008

A trial, comparing 20 patients undergoing reanastomosis of their vasa following bilateral vasectomy, with 20 patients undergoing the same procedure but in whom prednisone, 40 mg daily for six weeks, had been given to prevent postoperative fibrosis at the anastomotic site, has been conducted. The results suggest that there is a slight increase in the number of successful pregnancies (45% to 55%), and a significant increase in the number of patients in whom sperms have reappeared within the semen (70% to 95%) in the group in whom prednisone has been used.
AN EXPERIMENTAL STUDY ON TRAUMATIC CHANGES IN MICROVESSELS PRODUCED BY PRESSURE CLAMPING
Authors: Yanase Yoshiaki , Ueba Yasuo , Sudo Yasuakl , Yamamuro Takao
Published: January 2008

Acute and chronic changes produced in microvessesls by clamping with serial clips were investigated by macroscopic observation and by light and scanning electron microscopy. The degree of damage of the artery was well correlated with the clamping pressure. The results of the present study revealed that a pressure of 131 g or less did not produce damage to the endothelium, while a pressure of 250 g or more brought about complete fracture or disruption of the intima and
THE PREVENTION OF POST‐APPENDICECTOMY SEPSIS BY METRONIDAZOLE AND CEFAZOLIN: A CONTROLLED DOUBLE BLIND TRIAL6
Authors: Morris William T. , Innes David B. , Richardson Ralph A. , Lee Alan J. , Ellis‐Pegler Roderick B.
Published: January 2008

A double blind, randomized, controlled trial was carried out at two hospitals to try the effect of metronidazole, which is effective against most anaerobes, and cefazolin, which is effective against many aerobic organisms, singly and in combination, on the incidence of wound sepsis following appendicectomy, Patients were placed at random into one of four groups; to receive metronidazole and placebo, cefazolin and placebo, metronidazole and cefazolin, or double placebo. Patients with generalized peritonitis were excluded for ethical reasons. Treatment was started before operation and continued eight‐hourly for twenty‐four hours. All patients in the trial were followed up at about two weeks after discharge from hospital and their wounds inspected. Two hundred and seventy‐one patients were assessed. Sepsis rates at the two hospitals were similar. On the untreated controls, 30% discharged pus from their wounds, and in the groups receiving one drug only, about 20%. In those receiving both drugs the infection rate was 3%, a highly significant difference from that in the other three groups.
ROUTINE OR INDICATED OPERATIVE CHOLANGIOGRAPHY?
Authors: Cade Richard , Collopy Brian , Ryan Peter
Published: January 2008

An assessment was made both of the reliability of routine operative cholangiography and of the incidence of unsuspected common duct stones identified by this technique. It is suggested that its disadvantages, in particular the incidence of unnecessary bile duct explorations consequent upon false‐positive cholangiograms, make routine operative cholangiography undesirable. If any suspicion of common duct stone exists by virtue of clinical, biochemical or operative findings, an operative cholangiogram should be performed. Following adoption of this policy our findings suggest that the incidence of undetected stone will be negligible.
SUTURE MATERIAL AS A NIDUS FOR FORMATION OF COMMON BILE DUCT STONES
Authors: Orr K. B.
Published: January 2008

Three patients in whom recurrent common bile duct stones formed around suture material used in the region of the biliary tree are reported. Experimental and clinical evidence from the literature is presented to support recommendations that only absorbable ligature and suture materials should be used in the region of the common bile duct.
COMPUTED TOMOGRAPHY IN THE MANAGEMENT OF PAEDIATRIC ABDOMINAL TRAUMA
Authors: Rance Christopher H. , Bear John W.
Published: January 2008

Since the installation of a whole body computed tomography (CT) unit at the Royal Alexandra Hospital for Children in March 1978, it has been shown to play an invaluable role in the management of abdominal trauma in selected cases. Our experience with 16 cases is presented, and the advantages of CT over alternative diagnostic aids are discussed.
EARLY MELBOURNE EYE AND EAR HOSPITALS, AND DR TURNBULL'S HOUSE AT 101 (157) SPRING STREET
Authors: Lowe Ronald F.
Published: January 2008

A description is given of the development of early charitable eye and ear hospitals in Melbourne, and some of the difficulties that had to be overcome. The infirmary founded in 1863 by Andrew Sexton Gray grew in strength to become The Victorian Eye and Ear Hospital. Vicissitudes of accommodation centred around a house at 101 (157) Spring Street, originally built for Dr W. M. Turnbull, an obstetrician.
THE SURGEON AS MEDICAL PRACTITIONER: AN HISTORICAL APPRECIATION OF THE ROLE OF SURGERY IN THE CORPUS MEDICUM
Authors: Richardson J. P.
Published: January 2008

The present‐day division between surgery and medicine, and between surgeons and physicians, is examined in its historical context. It is contended that from the earliest times up to the thirteenth century of the Christian era in Western Europe such a division was not recognized, and that the separation which then occurred was based, not in nature, but in clerical, feudal, and humanistic conceits. Five centuries then elapsed, up to the turn of the eighteenth, before surgery was able to regain public recognition as a grave, honourable, and scholarly profession.
THE HENRY JOSEPH WINDSOR LECTURE: SURGERY FOR THE ALCOHOLIC ‐ NO EASY DECISION
Authors: Little J. M.
Published: January 2008

Henry Joseph Windsor, who died the year before last at the age of 91, endowed this annual Lecture in 1972. His son, Harry, gave the first lecture. Its title was “How far that little candle throws his beams,” and he quoted Portia's words from The Merchant of Venice“How far that little candle throws his beams. So shines a good deed in a naughty world.” That text seemed fitting for his father, whose deep religious convictions shone so clearly in cynical and pragmatic times.
CATTLE HORN INJURIES
Authors: Singh Harjinder , Mahant T. S. , Narula I. M. S. , Dhaliwal R. s. , Suri R. K. , Gujral J. S.
Published: January 2008

The successful management of a patient with potentially lethal intrathoracic trauma resulting from bull horn injury and involving the intrapericardial and extrapericardial portions of the right inferior pulmonary vein is described. To the best of our knowledge this particular injury has not previously been reported. Irrespective of the external appearance of the wound, hospitalization and close observation are essential. Exploration if required should be under optimal operative conditions. Popularization of disbudding and dehorning will prove an effective preventive measure.
COLORECTAL CANCER: THE NATURAL HISTORY OF DISSEMINATED DISEASE ‐ A REVIEW
Authors: Gray Bruce Nathaniel
Published: January 2008

The natural history of disseminated colorectal cancer has been reviewed with reference to its dissemination to the liver. The overall median survival rate of patients with hepatic metastases from colorectal primary cancer has been shown to vary from three to 11 months, with an average median survival of 7 months. Many patients survive for three years and some patients for more than ten years without any specific treatment. This may therefore form a basis for comparison of uncontrolled reports of prolongation of survival due to treatment.
SURGICAL TREATMENT OF CERVICAL LYMPH NODES IN CARCINOMA OF THE TONGUE
Authors: Lam K. H. , Wong John , Lim S. T. K. , Ong G. B.
Published: January 2008

A series of 56 cases of carcinoma of the anterior two‐thirds of the tongue treated surgically was reviewed. Lymph node metastasis occurred in 50% of cases. There was 22% false‐negative clinical assessments of lymph node status for the ipsilateral side of the neck. Because of these and the difficulty in ensuring early treatment of subsequent node metastasis, concurrent ipsilateral radical neck dissection is recommended. When the ipsilateral side of the neck was involved the contralateral side had 22% false‐negative assessments. Elective radical neck dissection for the contralateral side is recommended in this situation. The overall five‐year survival was 50·6%, and was greatly affected by the status of the neck lymph nodes.
SURGICAL RESEARCH IN AUSTRALASIA
Authors: Gough Ian R. , Balderson Glenda A.
Published: January 2008

An analysis has been made of the 642 papers presented to the Surgical Research Society of Australasia between 1962 and 1978. Most areas of research have maintained a relatively stable level of productivity over the period examined. However, while tumour immunology, education, and microsurgery have attracted increasing interest, that of transplantation immunology and cardiovascular research appeared to be decreasing in recent years. The most commonly investigated body systems were gastrointestinal (27%), cardiovascular (21%), and genitourinary (17%). The most commonly studied scientific disciplines were metabolism/biochemistry (22%), physiological measurement (17%), immunology (10%), oncology (9%), and transplantation (8%). Less than 3% of papers related to controlled clinical trials.
CONCEALED RECTAL PROLAPSE
Authors: Cuthbertson A. M.
Published: January 2008

In a series of 97 patients with rectal prolapse 36 were unaware that the prolapse was occurring. Failure to recognize the prolapse may cause delay in diagnosis and inappropriate treatment. In most instances the prolapse was considered to be primary and responded well to surgical repair; however, in a few patients the prolapse seemed to follow prolonged straining, and in these surgical repair is not so successful.
ULCERATIVE PROCTITIS
Authors: Buls John
Published: January 2008

Ulcerative proctitis is a non‐specific inflammatory condition of a diffuse nature involving the mucosa of the rectum. It commences at the dentate line and extends proximally for a variable distance. By definition, the upper extent of the disease must be able to be seen at sigmoidoscopy. This is usually at a distance of 5 to 15 cm from the anal verge. The natural history of the condition is one of spontaneous remission after varying periods. This makes scientific assessment of therapy very difficult if not impossible. In a small proportion of patients (10% or less) the disease will extend to involve the colon. It is difficult to be certain whether this is true progression or inaccurate assessment of extent at the time of presentation. The treatment of the condition is non‐specific. Reassurance of the patient with emphasis on the excellent prognosis is essential. Response to drug therapy is unpredictable and in many instances disappointing. Dietary manipulation is usually not required. Operative treatment is never indicated for proctitis. If extension of the disease occurs, operation may be required.
LYMPHATIC CYST OF THE DESCENDING COLON: A REPORT OF A CASE
Authors: Stuart Malcolm , Bursle George
Published: January 2008

A patient with a lymphatic cyst of the descending colon, treated by segmental colon resection, is reported. Lymphatic cysts of the colon are extremely rare, and there have been only fourteen previously reported cases. In no case has the diagnosis of lymphatic cyst of the colon been made prior to the excision of the lesion.
THE GLUTAEUS MAXIMUS MUSCLE FLAP IN THE MANAGEMENT OF PERSISTENT PERINEAL SINUS
Authors: Sproles G. J. , Gough I. R.
Published: January 2008

Delayed healing of the perineal wound is a common complication following proctectomy for inflammatory bowel disease. A persistent sinus requires wide and adequate drainage, but the resulting large cavity with rigid walls may take more than a year to heal. Mobilization of a viable flap of glutaeus maximus muscle to fill the cavity allows healing within a few weeks.t
VASCULAR TRAUMA
Authors: FLETCHER J. P. , LITTLE J. M.
Published: January 2008

Experience with vascular trauma over a nine month period is presented. Not all cases of arterial injury are obvious on initial presentation. Preoperative arteriography may be helpful but should not delay arterial reconstruction. Fractures should be stabilised prior to arterial repair. Intra‐operative arteriography may be useful, and fasciotomy should be used liberally in all cases of established ischaemia. Serious associated injuries are common and may determine the ultimate outcome.
TREATMENT OF GRANULATING WOUNDS WITH SILASTIC FOAM DRESSINGS
Authors: SMITH R. C. , FLYNN P. W. , GILLETT D. J. , GUINNESS M. D. , LEVEY J. M.
Published: January 2008

We have examined the usefulness of a Silastic foam dressing in the management of open granulating wounds in 55 outpatients. It is an acceptable and comfortable dressing, which allows earlier discharge from hospital. The method of making the dressing, and the daily care of the wound are described. Improved wound care is achieved by providing two dressings, so that when one is in place the other is being thoroughly cleaned. This technique has been shown to reduce bacterial contamination of the wounds and to improve wound healing (p 0.02).
A CASE OF GASTRIC DUPLICATION IN AN ADULT
Authors: O'REILLY KEVIN , GREEN ANTHONY
Published: January 2008

A case of extensive gastric duplication in an adult is presented, illustrating one of the two common symptoms, and emphasising that surgical excision, where possible, Is the treatment of choice.
DUODENAL POLYP OR ANEURYSM? POSSIBLE HAZARD OF ENDOSCOPIC POLYPECTOMY
Authors: MACDOUGALL C. N. , CASTLEDEN W. M.
Published: January 2008

Duodenal polyps rarely cause acute gastrointestinal haemorrhage. We report a patient with a pancreaticoduodenal artery aneurysm which presented at endoscopy as a duodenal polyp.
TORULOPSIS GLABRATA OSTEOMYELITIS OF THE SPINE: A CASE REPORT AND REVIEW OF THE LITERATURE
Authors: THURSTON ALAN J. , GILLESPIE WILLIAM J.
Published: January 2008

Until recent years, infective lesions of the spine have almost always been due to Mycobacterium tuberculosis or pyogenic bacteria. Recently, however, a number of infections by other types of organisms have been reported. Torulopsis glabrata, normally a well‐distributed saprophyte in man, has not, to the best of our knowledge, been among these. We now report a case of spinal osteomyelitis due to this organism, and discuss the management of infections for which it can be responsible.
POLYTETRAFLUOROETHYLENE (PTFE) GRAFTS FOR HAEMODIALYSIS IN CHRONIC RENAL FAILURE: ASSESSMENT OF DURABILITY AND FUNCTION AT THREE YEARS
Authors: RAPAPORT ADAM , NOON GEORGE P. , MCCOLLUM CHARLES H.
Published: January 2008

The utilization of 162 PTFE grafts for anglo access in 131 patients over a three year period is reported. One hundred and three new PTFE arterlo‐venous flstulae were constructed in addition to 59 patch and tube incorporations Into pre‐existing graft flstulae. At three years, the cumulative patency of newly constructed grafts was 85%. Seventy four per cent of the grafts have had no thrombosis and are functioning up to 38 months following insertion. An aggressive approach was adopted towards the 15% of grafts that had at least one episode of thrombosis prior to flow being successfully restored. Graft occlusion which occurred up to 18 months following Insertion, represented 11% of the group In this series. PTFE has provided an important advance In angio access for chronic renal failure with high patency and excellent durability after three years.
AN AID TO THE INSERTION OF ARTERIOVENOUS SHUNTS
Authors: McCULLOUGH K. G.
Published: January 2008

A description Is given of a simple Introducer to facilitate the Introduction of etched Teflon vessel tips Into silicone rubber tubing In the construction of extracorporeal arteriovenous shunts.
BASAL CELL CARCINOMA IN QUEENSLAND
Authors: EMMETT ANTHONY J. J. , BROADBENT GEOFFREY G.
Published: January 2008

An analysis Is presented of a referred series of 1411 basal cell carcinomas treated by surgical excision and plastic surgical repair In which 259 were recurrent after previous other treatments. Of the 1,411 BCCs treated there were 10 BCCs which recurred (0.7% recurrence rate). A further 10 BCCs were primarily re‐excised because of Inadequate clearance around the tumour found on histological examination. (0.7% primary re‐exclslon.) The cases recurrent after previous treatment did not behave badly In terms of subsequent recurrence as they were widely excised and carefully observed In the postoperative years. Surgery must aim to be curative. We clearly define the tumour margin using magnification and mark an adequate clearance of surrounding normal tissue. This Is then excised In width and depth. Repair of the defect Is carried out to restore the area to as near normal as possible. Surgical repair Is able to bring new tissue Into the area to further enable it to withstand the rigours of the climate and not leave behind a premallgnant scarred area.
EMERGENCY SURGERY FOR THE COMPLICATIONS OF PEPTIC ULCER IN THE ELDERLY
Authors: PILLAY S. P. , HARDIE I. R. , BURNETT W.
Published: January 2008

An analysis of 37 patients over the age of 65 years who underwent emergency surgery for complications of peptic ulcer Is presented. A major predisposing factor to these complications was the use of ulcerogenic drugs that were prescribed for chronic musculo‐skeletal aliments. The overall mortality was 23.5%, and was mainly related to pre‐existing cardlo‐pulmonary disease.
INFORMATION FLOW IN THE CONDUCT OF MULTICENTRED COLLABORATIVE CONTROLLED CLINICAL TRIALS OF CANCER THERAPY
Authors: COATES ALAN
Published: January 2008

Prospective randomized controlled clinical trials are a powerful tool for unbiased comparative evaluation of alternative treatment policies. Such trials must include relatively large numbers of patients, usually beyond the resources of any one clinical centre. Collaboration between centres is usually necessary and inevitably causes problems of communication at all stages of trial design and execution. Trial design demands agreement on the prior data base, and the writing of a trial protocol. The protocol must include precise depiction of trial objectivsa, eligibility criteria, randomization procedures, treatment policies, the end points by which effectiveness will be measured, and the records to be kept. It will also contain sections describing the scientific background and rationale of the trial, and statistical and ethical considerations. Once the trial is in progress, information must flow from the participating clinical institutions to a coordinating data centre; this will usually require the use of specially designed data collection forms. Most trials will require separate forms for initial registration, pre‐therapy baseline information, sequential evaluation (flow sheet), and summaries when the patient reaches defined end‐points. Additional forms may document specific treatment details, evaluation by a reviewer, and patient self‐assessment scores or autopsy details. Attention to these aspects of study design will avoid later problems of misinterpretation, and will facilitate accurate and timely acquisition of data. Information flow from the coordinating centre to trial participants is also important, in order to maintain interest and patient accrual.
THE EVALUATION OF THE RESULTS OF CANCER THERAPY TREATMENT UTILITY1
Authors: LANGLANDS ALLAN O.
Published: January 2008

The results of cancer management are frequently presented in a way such that the only comparison that can be made between treatments is that of fixed term survival. Very few reports attempt to include an analysis of the effect of second line therapy or a comparison of the different morbidities of different treatments. Techniques now exist (one of these is the concept of treatment utility) which take into account not only the probability of the outcome of a treatment but also the quality of that outcome. To expand this concept requires research in cancer management to be directed to the production of numerical values for treatment toxicity, pain, disability and mutilation, in addition to the conventional survival rates. This paper examines the concept of treatment utility when a comparison is made between two treatments which produce differences in surivval but only one of which is associated with significant permanent disability.
PULMONARY COIN LESIONS: A TEN‐YEAR REVIEW OF 239 CASES
Authors: NANDI P. L. , TANG S. C. , MOK C. K. , LEE W. T. , ONG G. B.
Published: January 2008

The results of a study of 239 resected solitary pulmonary nodules are presented; 66.5% of the resected nodules were malignant, and there were three patients with malignant coin lesions who were under 30 years of age. These findings confirm the generally accepted fact that most solitary pulmonary nodules must be resected if the presence of cancer is to be excluded. Transbronchial biopsy under biplane fluoroscopic guidance through a flexible bronchoscope may provide an effective alternative to early thoracotomy in the future, so that malignant nodules can be diagnosed before operation and patients with benign lesions are spared a thoracotomy.
CYSTS AND “PSEUDOCYSTS” OF THE MENISCI OF THE KNEE JOINT
Authors: CROSS MERVYN J. , WATSON A. STUART
Published: January 2008

A series of 636 consecutive knee arthrotomies was subjected to a prospective study, including the incidence, clinical presentation, and operative findings of meniscal cysts and associated pathological conditions. The clinical differential diagnosis was studied in detail, and from this, the importance of a specific clinical sign indicating a torn lateral meniscus was realized. This sign was termed a “pseudocyst”. It was concluded that meniscectomy was the operation of choice and not simple cyst removal, and that the high incidence of associated meniscal tears and of her less frequent joint pathological conditions justified a standardized approach designed to assess the meniscus and of her intraarticular structures, rather than a simple incision over the joint‐line swelling.
THE ORDERING OF BLOOD FOR ELECTIVE GENERAL SURGICAL OPERATIONS
Authors: FARMER E. , HAM J. M.
Published: January 2008

The current practice in ordering blood for common elective general surgical operations in the Prince of Wales Hospital has been studied. The numbers of patients having serum grouped and held and those having blood cross‐matched were determined, together with the number of units cross‐matched. The percentage of patients transfused and the number of units of blood given were then assessed for each procedure. The results demonstrated that blood was often ordered for patients who were most unlikely to require it. In addition, the amounts of blood ordered were frequently excessive, so that the cross‐match‐to‐transfusion ratio (C/T ratio) for some procedures was high. We suggest that relatively simple changes in the current practice of ordering blood for operations should result in savings in costs, and most importantly, in a reduction in the wastage of blood.
MECKEL STONE ILEUS: A CASE REPORT
Authors: GRANT ALEXANDER B. F.
Published: January 2008

Calculus formation is a rare complication of a Meckel's diverticulum. These calculi may cause a mechanical small‐bowel obstruction ‐ Meckel stone ileus ‐ an extremely rare mode of presentation of a Meckel's diverticulum. A case in which this has occurred is reported – only the fifth such occasion that this has happened.
ANGIOSARCOMA OF THE BREAST: A CASE REPORT
Authors: HART S. A. , SISELY L. V. , TANNENBERG A. E. G.
Published: January 2008

Angiosarcoma is a rare tumour in the breast and long‐term survival is unusual. A case is presented with a three‐year‐follow up to date and with comments on the pathology and management of this disease.
T. AUBREY BOWEN AND HIS HOUSE AT 167 COLLINS STREET EAST, MELBOURNE
Authors: LOWE RONALD F.
Published: January 2008

in 1874, Dr. Aubrey Bowen, one of Melbourne's earliest ophthalmic surgeons, took possession of a new and elegant house in Collins Street East. Here he lived and practised for sixteen years, and after him the house had further medical associations. Almost all similar doctors' homes have disappeared from the area, but this building persists, offering a reminder of a style of practice now gone. Fortunately, it and the buildings nearby have been classified by the National Trust of Australia (Victoria).
CHANGING SURVIVAL PROSPECTS IN RECTAL AND COLONIC CANCER
Authors: MCDERMOTT F. T. , HUGHES E. S. R. , PIHL E. , PRICE A. B.
Published: January 2008

Cancer specific survival analysis in a series of 2204 patients managed by one of the authors for large‐intestinal cancer shows a worsened outcome for patients treated operatively for rectal cancer from 1970 to 1979 in comparison with the two previous decades (p > 0.05). Cancer specific survival after curative resection has also worsened (p > 0.001). These changes are partly explained by an increase in Dukes' stage C tumours (p = 0.01). Paradoxically, the deterioration has been paralleled by earlier diagnosis (p > 0.01). The worsened outcome cannot be accounted for by changes in sex or age distribution, tumour site, patient referral pattern or by an increase in sphincter‐saving operations. The hypothesis advanced that a real change has occurred in the behaviour of rectal cancer in the Australian community requires further testing. There has been no significant change in survival prospects between the last two decades for colonic cancer patients treated operatively. A national cancer registry should be established to monitor changes in the epidemiology and survival prospects of large‐intestinal cancer and of her malignancies.
KNOWLEDGE OF COLORECTAL CANCER AND ATTITUDE TO OCCULT BLOOD TESTING AMONG RECENT MEDICAL GRADUATES IN NEW SOUTH WALES
Authors: DENT OWEN , GOULSTON KERRY
Published: January 2008

The extent to which new information on colorectal cancer (C.C.) is being transmitted to medical undergraduates was assessed in a repeated survey of new interns' knowledge of and attitudes on C.C. A probability sample of 214 graduates of the two Sydney medical schools was drawn as they commenced their internships in 1978. A comparable sample of 186 was drawn in 1980. Interns in each sub‐sample completed a questionnaire of 54 pre‐coded items of knowledge of C.C. epidemiology, early diagnosis, and followup, and on their attitudes towards C.C. On most topics knowledge was not well developed, and 1980 graduates were not significantly better informed than those of 1978. Almost three‐quarters of 1980 interns intend using faecal occult blood testing.
HISTIOCYTIC LYMPHOMA PRESENTING WITH EXTRAHEPATIC BILIARY OBSTRUCTION: A REPORT OF THREE CASES
Authors: YOUNG IAN F. , ROBERTS‐THOMSON IAN C. , SULLIVAN JOHN R.
Published: January 2008

Three patients with histiocytic lymphoma presented with jaundice due to extrahepatic biliary obstruction. Two had widespread disease, but one had a primary lymphoma of the head of the pancreas simulating pancreatic cancer. Biliary bypass surgery was avoided in two patients, both of whom showed resolution of jaundice following treatment with cytotoxic chemotherapeutic drugs.
BENIGN THYROID INCLUSIONS WITHIN CERVICAL LYMPH NODES: AN ALARMING INCIDENTAL FINDING
Authors: IBRAHIM N. B. N. , MILEWSKI P. J. , GILLETT R. , TEMPLE J. G.
Published: January 2008

Small clusters of microscopically normal thyroid follicles within cervical lymph nodes are very occasionally encountered during histological examination. We support the view that provided the thyroid gland is not palpable and a technetium thyroid scan is normal, these should be regarded as benign thyroid inclusions and do not represent small metastatic lesions from thyroid carcinoma. We report an example of these inclusions in a cervical lymph node which was removed incidentally during the excision of a branchial cyst in a 25‐year‐old woman. The inclusion was too small to be noticed macroscopically and consisted of a small aggregation of histologically normal thyroid follicles situated in the subcapsular region of the lymph node.
BILATERAL INCOMPLETE URETERIC DUPLICATION WITH A URETERIC DIVERTICULUM
Authors: SHARMA S. K. , MALIK N. , KUMAR S. , BAPNA B. C.
Published: January 2008

A case of bilateral incomplete ureteric duplication with a ureteric diverticulum is presented. The aetiology of the latter and the possibility that the pain may be based on peristaltic dysfunction are discussed.
LIVER RESECTION FOR NEOPLASM
Authors: THOMPSON JOHN F. , LITTLE J. MILES
Published: January 2008

Major hepatic resections can now be performed with much greater safety than formerly. This is largely a consequence of improved surgical and anaesthetic techniques, which have in turn resulted from better understanding of the anatomy, physiology and biochemistry of the liver. The treatment of liver tumours by resection must be reappraised in the light of these advances. This paper reports twelve patients who have undergone major hepatic resection for neoplasm at the Royal Prince Alfred Hospital over a ten‐year period. The current indications for such surgery in the treatment of benign and malignant liver tumours are reviewed, and the results discussed.
VOLVULUS OF THE KOCK POUCH WITH OBSTRUCTION AND PERFORATION: A CASE REPORT
Authors: AGREZ M. V. , Dozois R. R. , BEAHRS O. H.
Published: January 2008

A case of volvulus of a continent ileostomy reservoir with secondary obstruction and perforation of the efferent limb is presented. This unusual complication may be avoided by securely anchoring the pouch to the undersurface of the abdominal wall and closing the para‐ileal gutter.
AN AETIOLOGICAL STUDY OF DIVERTICULOSIS OF THE RIGHT COLON
Authors: MURAYAMA NORIHISA , BABA SHOZO , KODAIRA SUSUMU , ABE OSAHIKO
Published: January 2008

Right‐sided diverticular disease is commoner in Japan than elsewhere. Measurements ot the thickness of the right colon muscle in such cases, together with counts of the number of haustra in the right colon, suggest that the aetiology of right‐sided diverticular disease is the same as that of left‐sided diverticular disease, namely, abnormal thickening of the muscle in the wall of the colon.
SERUM IMMUNOGLOBULINS IN COLORECTAL CANCER
Authors: GOUGH IAN
Published: January 2008

Serum immunoglobulins (IgG, IgA and IgM) were measured in 75 patients with colorectal carcinoma. The levels of all three immunoglobulins were significantly higher in patients with recurrent colorectal carcinoma compared to those with resectable Duke's B or C colorectal carcinoma, particularly for IgM which was elevated above the normal range in 23 of 55 patients (41.8%). In recurrent disease there was no difference in serum immunoglobulin levels for multiple compared to single metastatic sites, or for patients with hepatic metastases compared to those with non‐hepatic metastases. In recurrent colorectal carcinoma, serum alkaline phosphatase was normal in 23 of 55 patients, and serum IgM was elevated in 12 of these 23 patients. Serum carcinoembryonic antigen was normal in 3 of 18 patients, and serum IgM was elevated in two of these three patients. In patients who have had a colorectal cancer resected, measurement of serum immunoglobulins, in combination with other screening tests, may be of value in the diagnosis of recurrent disease.
SINGLE‐LAYER CONTINUOUS COLORECTAL ANASTOMOSIS
Authors: BAILEY H. RANDOLPH , VOO JOHN W. LA , ERNEST  , MAX  , SMITH KENNETH W. , HAMPTON JAMES M.
Published: January 2008

Since the first successdul resection of a colonic neoplasm was carried out in 1823, many attempts have been made to find the ideal technique for bowel anastomosis, in respect both of the surgical technique employed and the suture material used. We have finally adopted a single layer anastomosis with a continuous polypropylene suture. To our knowledge, no series of such anastomoses has so far been reported, and we now review our technique, first described by Allen in 1979, and our very satisfactory experiences following our adoption of it for virtually all colorectal anastomoses above the peritoneal reflection.
THE IMMUNE RESPONSE TO CARCINOMA OF THE COLON IN A RAT MODEL: A TEMPORAL STUDY
Authors: HOUSE A. K.
Published: January 2008

Carcinoma of the colon was induced in rats by treatment with 1,2‐dimethylhydrazine (DMH). Macroscopic tumours were observed from eight weeks after commencing DMH injections and rapidly increased in mass to cause death of the animals between 20 and 27 weeks later

Tumour immunity was assessed by the gross parameters of body, spleen and mesenteric lymph node weight and by in vitro tests of lymphocyte antitumour cytotoxicity and leucocyte migration inhibition by tumour and normal colon homogenates. Immune responses were recorded in control (saline treated) and in tumour (DMH treated) rats.

Body weight of the tumour rats paralleled that of control animals until tumours were well advanced. At this time tumour animal body weight was significantly less than that of control animals. Spleen weight and in vitro lymphocyte antitumour cytotoxicity were significantly greater in tumour than in control rats and were so found soon after macroscopic tumours were observed. Mesenteric lymph node weight and leucocyte migration inhibition did not change until late in tumour development, but at this time there was an immune response in tumour animals. The study showed that carcinoma of the colon induced in rats was associated with an antitumour immune response and that this change occurred soon after macroscopic tumours were present. In spite of this the animals die'd of their neoplasms.
INTRAPANCREATIC PSEUDOCYST FORMATION: A COMPLICATION OF ACRYLATE PANCREATIC DUCT OBLITERATION
Authors: WARD WILLIAM F.
Published: January 2008

The case of a young woman is presented who, at the age of 33 years, had surgical occlusion of the pancreatic duct by instillation of acrylate glue for chronic relapsing pancreatitis. She presented in mid‐1979, after a period of increasing frequency and severity of pain, with intractable narcotic dependency, and was shown to have a pseudocyst in the head of the pancreas. Distal pancreatic resection and cystoenterostomy have resulted in loss of narcotic dependency and a return to reasonably good health, in spite of a late development of insulin‐dependent diabetes mellitus which is well controlled. Histological examination of the excised body and tail of the pancreas showed that exocrine atrophy, though advanced, was incomplete. It is suggested that in chronic pancreatitis, complete obliteration of the duct system may not be possible because of preexisting duct lesions. This may allow persistence of exocrine pancreatic tissue and lead to the complications of continuing pancreatitis and pseudocyst formation.
CARCINOMA OF RECTUM: RESULTS FOLLOWING SURGICAL RESECTION 1971–19791
Authors: CHAPUIS P. H. , PHEILS M. T. , NEWLAND R. C. , SMYTH E. , DENT O. , BOKEY E. L. , PAYNE J. E.
Published: January 2008

Comparison of 122 patients who have had an abdominoperineal excision of the rectum with 118 patients treated by conventional anterior resection showed no significant difference in patient survival. The grounds were comparable in respect of age, sex, tumour level and pathology. This suggests that conventional restorative resection for rectal cancer may be undertaken without adversely affecting survival.
FAECAL MUTAGENESIS AND COLONIC CANCER
Authors: ASKEW A. R. , GREEN M. K. , REIBELT L. D.
Published: January 2008

The incidence of faecal mutagens has been evaluated using the Ames Test in 16 patients with proven colon cancer and 35 volunteers with no symptoms referable to the colon and a negative haemoccutt test Twenty‐five percent of the cancer patients, and 20% of the volunteers had mutagen positive faeces. These results suggest that the incidence of faecal mutagens In patients with colon cancer Is similar to that found in a population with a high risk of developing colonic neoplasms.
THE PRESENCE OF ONCOFOETAL ANTIGENS IN LARGE BOWEL CARCINOMA
Authors: MA JENG , BOER WILLEM G.R.M. DE , NAYMAN JACOB
Published: January 2008

This paper is an immunohistological study of the occurrence of the oncofoetal antigens, (carcinoembryonic antigen (CEA), small intestine mucin antigen (SIMA), and normal large bowel mucin antigen (LIMA) in 60 surgically resected colons: 10 non‐malignant specimens and 50 colorectal carcinomas. SIMA is a new oncofoetal antigen found in mucinous carcinoma of the large bowel1. In the adult it is normally present only in the duodenum and jejunum. Of the 50 carcinoma specimens, 13 were mucinous, 17 non‐mucinous and 20 mixed mucinous and non‐mucinous. LIMA was the only antigen detected in the mucosa of non‐malignant specimens. In mucinous carcinomas only SIMA was present, whilst in the non‐mucinous specimens CEA was always found and to a lesser extent LIMA. The same relationship was observed in mixed tumours: SIMA in mucinous and CEA‐LIMA in the non‐mucinous parts. In the mucosa adjacent to the cancer In all 50 cases there was evidence of an increase or decrease in LIMA. In 42 cases (84%) both oncofoetal antigens (CEA and SIMA) could also be detected in this transitional or perineoplastic epithelium at varying distances from the tumour. These results provide evidence to suggest that the majority of large bowel carcinomas occur in areas of metaplastic change.
COLORECTAL CARCINOMA AND LYMPHOMA
Authors: JAWORSKI R. C. , DOWTON B. , GRANT A. , GIBSON M. , CHAPUIS P. H. , PHEILS M. T.
Published: January 2008

Examination of the clinical, pathological and follow up data on patients who have had a colorectal carcinoma resected at Concord Hospital between 1971 and 1979 has disclosed five patients with a synchronous or metachronous lymphoma. The literature related to this association is reviewed.
ACUTE SUBDURAL HAEMATOMA ASSOCIATED WITH VON WILLEBRAND'S DISEASE: A CASE REPORT
Authors: RICE M. L.
Published: January 2008

A case of acute subdural haematoma associated with von Willebrand's Disease is described. No other cases are believed to have been reported. The use of factor VIII infusions in the form of cryoprecipitate and fresh frozen plasma undoubtedly influenced the successful outcome of this case.
ADVANCED TRAINING IN ORTHOPAEDIC SURGERY IN AUSTRALIA
Authors: DOOLEY B. J.
Published: January 2008

This paper complements that of Harley Gray of New Zealand, and outlines the programmes and organisation for advanced training in orthopaedic surgery in Australia.
DIURETIC RADIONUCLIDE RENOGRAPHY IN UPPER URINARY TRACT OBSTRUCTION
Authors: LICHTENSTEIN MEIR , FOWLER ROBERT , ANDREWS JOHN , WOOD GRAEME
Published: January 2008

Diuretic renography using radioidine sodium hippurate and a frusemide stimulus was used to differentiate between obstructive and nonobstructive dilatation of the urinary tract. Information was recorded by a gamma camera on line to a computer. Sixty‐seven uretero‐renal units (URU) were studied in 33 patients with an average age of 91/2 years. The diuretic renogram correctly indicated obstructions in 18 URU but gave false positive results in another five. Of these five, four had severely Impaired function. The renogram indicated nonobstruction in 49 URU, and gave false negative results in another two; of these two one patient had a duplex kidney with a poorly functioning ureteric segment and the other patient had gross reflux and megaureters. The diuretic renogram is useful in the investigation of equivocal upper urinary tract obstruction but may be unreliable in situations of inadequate renal function.
THE SCOPE OF SURGICAL ONCOLOGY
Authors: JR WALTER LAWRENCE
Published: January 2008

Surgical oncology, as a subspecialty within general surgery, has slowly evolved as our knowledge of cancer and its treatment has advanced. Determining the proper number and roles of surgical oncologists in cancer management, and defining the preparation of the surgical oncologist for these roles are incomplete projects at present. The heritage of surgical oncology, its current status, and perceived future needs for optimal development are described.
LARGE BOWEL SEGMENT LENGTHS AND THE DISTRIBUTION OF COLORECTAL CANCER
Authors: CHAPUIS P. H. , FAITHFULL G. R. , DENT O. F.
Published: January 2008

Data was obtained on the average length and variability of each anatomical segment and tor the whole of the large bowel from 50 patients examined by air contrast barium enema X‐ray examination. Results were validated by measurements of the colon and rectum removed at autopsy In ten patients. Large bowel segment measurements from barium enema X‐ray examinations were shown to be a valid basis for determining the average in vivo lengths of segments. The use of descriptive terms based on the anatomical location of colorectal carcinoma should be replaced by a more exact method of defining site distribution when recording and reporting the distribution of carcinomas in operative series and for teaching purposes.
ANGIOGRAPHIC FINDINGS IN NORMAL AND DISEASED GALLBLADDERS INCLUDING ISCHAEMIC CHOLECYSTITIS AND INFARCTION OF THE GALLBLADDER
Authors: LAWRENCE‐BROWN M. M. D. , CHAKERA T. M. H. , HARTLEY D. E. , MATZ L. R.
Published: January 2008

Angiographic studies were performed on 60 normal and diseased gallbladders obtained from cholecystectomy specimens and necropsy examinations. The normal macro and microangiographic pattern was confirmed, as was the reduction in the number of blood vessels in chronic cholecystitis and cholelithiasis. Histological correlation however showed that the degree of arteriographic change paralleled the degree of histological disease. The microvascular pattern was directly related to the degree of mucosal villous atrophy, a change which may be important in the pathogenesis of some types of gallbladder disease. The most severe angiographic changes occurred in the case of ischaemic cholecystitis, and contrasted with the normal blood vessel pattern in a case ol thin walled infarction of the gallbladder.
CHOLECYSTECTOMY WITHOUT ROUTINE OPERATIVE CHOLANGIOGRAPHY
Authors: NOTTLE P. D. , HUGHES E. S. R. , MCDERMOTT F. T.
Published: January 2008

A series of 1575 consecutive patients with cholelithiasis managed by cholecystectomy without operative cholangiography is presented. All operations were performed by one of our authors. Exploration of the bile ducts was performed in 185 (12%) patients. During the postoperative period there was evidence of retained calculi in three (1.6%) of the 185 patients. The incidence of remote calculi (those presenting at a time distant from cholecystectomy) was determined for patients undergoing cholecystectomy between 1963 and 1967. Follow up information was available on 258 (80%) of 321 patients. Clinical evidence of remote calculi was found in seven (2.7%) patients. The incidence of both retained and remote calculi was similar to that found in series where operative cholangiography was routine.
ISOLATED GALLBLADDER INJURY SECONDARY TO BLUNT ABDOMINAL TRAUMA: CASE REPORT
Authors: JOHNSON WILLIAM R. , HARRIS PHILLIP
Published: January 2008

A 19 year old youth presented with acute right upper quadrant abdominal pain following a midair collision while playing soccer. At laparotomy extraperitoneal biliary extravasation was found secondary to subserosal perforation of the gall bladder. Isolated gallbladder injury is uncommon following blunt abdominal trauma and this particular injury is rare.
PANCREATICO‐COLIC FISTULA IN PANCREATITIS
Authors: HINDER JANET , BOKEY E. L. , SUMMERHAYS C. F. , PHEILS M. T.
Published: January 2008

A rare case of pancreatico‐colic fistula following pancreatitis is presented. The diagnosis and management of this condition is discussed.