bluuebunny/crossref_metadata_2025 huggingface dataset:
Human immunodeficiency virus and tuberculosis in Argentina: prevalence, genotypes and risk factors
Authors: Pando Maria A. , De Salvo Cristina , Bautista Christian T. , Eyzaguirre Lindsay , Carrion Gladys , Feola Miguel , Lado Isabel , Hoffman Marta , Biglione Mirna M. , Carr Jean K. , Montano Silvia M. , Sanchez José L. , Weissenbacher Mercedes , Avila Maria M.
Published: January 2008

The objective of this study was to determine the prevalence and genetic variability of human immunodeficiency virus type 1 (HIV-1) and other sexually transmitted infections (STIs) among 205 patients with clinical diagnosis of tuberculosis (TB) in Buenos Aires in 2001. Infections with hepatitis B virus (HBV), HIV-1, hepatitis C virus (HCV), Treponema pallidum and human T-cell lymphotropic virus types I/II were diagnosed in 37/187 (19.8 %), 35/205 (17.1 %), 22/187 (11.8 %), 13/187 (7.0 %) and 4/181 (2.2 %) patients, respectively. Almost one in three participants (33.1 %) presented at least one infection in addition to TB. Multiresistance to TB drugs (isoniazid plus rifampicin) was detected in the isolates recovered from three patients. Injecting drug use was detected as the main risk factor for HIV, HBV and HCV infections. Of ten patients who died, eight were infected with HIV. HIV genetic characterization showed the presence of two different subtypes. Env subtype F was found in 13/24 samples (54.2 %) and subtype B in 11/24 samples (45.8 %) by heteroduplex mobility assay. Sequencing of the protease/RT region was performed in ten samples: three were characterized as subtype B and seven as B/F recombinants by bootscanning analysis. Phylogenetic analysis of four full-length sequences showed that three were the circulating recombinant form CRF12_BF. The results of this study suggest an urgent need to detect HIV infection in high-risk groups to prevent future HIV transmission as well as morbidity and mortality associated with TB by providing highly active antiretroviral therapy (HAART) and/or TB treatment. Collaboration between TB and HIV programmes seems to be the best approach to decrease the incidence of these diseases, especially in high-prevalence HIV settings.
Clinical parameters do not predict infection in patients with external ventricular drains: a retrospective observational study of daily cerebrospinal fluid analysis
Authors: Muttaiyah Sharmini , Ritchie Stephen , Upton Arlo , Roberts Sally
Published: January 2008

A retrospective review was conducted of patients with external ventricular drains (EVDs) in situ in order to ascertain the utility of daily cerebrospinal fluid (CSF) analysis in such patients. All laboratory requests for CSF analysis, which were sent to the Microbiology Department, Auckland City Hospital, New Zealand, were reviewed to identify patients with EVDs in situ. The patients' clinical records were reviewed and information was obtained regarding their age, ethnicity, indication for EVD, duration of EVD, CSF analysis results, daily temperatures, Glasgow Coma Scale (GCS) and the presence of other infections. For CSF samples that grew organisms, the patients' notes were reviewed to ascertain whether the organism was a contaminant or was representative of EVD-associated ventriculitis. A total of 454 CSF specimens from 60 patients were reviewed. Of the 56 CSF specimens that were culture-positive, 40 (71 %) were found to reflect clinical infection. Routine CSF analysis identified nine episodes of EVD-associated ventriculitis. Coagulase-negative staphylococci and Staphylococcus epidermidis were the most common isolates and were associated with ventriculitis approximately half of the time. Gram-negative isolates were less frequently isolated, but, when present, were always associated with ventriculitis. This study found that patient temperature and GCS did not allow early prediction of EVD-associated ventriculitis.
Development and evaluation of a novel multiple-primer PCR amplification refractory mutation system for the rapid detection of mutations conferring rifampicin resistance in codon 425 of the rpoB gene of Mycobacterium leprae
Authors: Sapkota Bishwa Raj , Ranjit Chaman , Neupane Kapil Dev , Macdonald Murdo
Published: January 2008

Rifampicin-resistantMycobacterium lepraeis regularly reported and drug resistance is a major threat for the elimination of leprosy. There is an urgent need for a simple method that can detect rifampicin resistance in clinical isolates. This study developed a multiple-primer PCR amplification refractory mutation system, a simple, reliable and economical method for clinical specimens that allowed the rapid detection of mutations in the nucleotides of the codon for Ser425 of theM. leprae rpoBgene, mutation of which to Leu, Met or Phe is associated with rifampicin resistance. The approach involved a multiple-primer PCR in which both mutant-specific and normal sets of primers were included in the reaction. The mutant-specific primer was complementary to the corresponding sequence of the wild-type gene except for one additional deliberate mismatch at the fourth nucleotide from the 3′-OH terminus. A single mismatch has little influence on the yield of PCR products, but if there are two mismatches as a result of mutation at the position being tested, the mutant-specific primer will not function in PCR under appropriate conditions, leading to no yield of PCR product from the mutant allele. The assay was evaluated successfully using a panel of plasmids andM. lepraereference strains carrying the wild-type or knownrpoBmutations. The assay was subsequently applied toM. lepraeDNA extracts from skin biopsies taken from patients. In all biopsy samples, the wild-type allele was detected for Ser425. The PCR results correlated with rifampicin susceptibility, as also measured by the traditionalin vivomouse footpad technique.
A rapid pneumococcal serotyping system based on monoclonal antibodies and PCR
Authors: Yu J. , Carvalho M. da G. S. , Beall B. , Nahm M. H.
Published: January 2008

Streptococcus pneumoniae expresses at least 91 different polysaccharide (PS) capsules and the currently available serotyping methods are tedious to perform. We have been developing a rapid pneumococcal serotyping assay (named the ‘multibead assay’) based on the capacity of pneumococcal lysates to inhibit the ability of 24 different anti-capsule antibodies to bind to latex beads coated with 24 different PSs (serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9N, 9V, 14, 18C, 19A, 19F, 23F, 2, 8, 10A, 11A, 12F, 15B, 17F, 20, 22F and 33F). Because the polyclonal antibodies used for 10 serotypes (2, 8, 10A, 11A, 12F, 15B, 17F, 20, 22F and 33F) had limited serotype specificity, we replaced them with monoclonal antibodies for the 10 serotypes. To extend the serotype coverage beyond the 24 serotypes, we have adapted multiplexed PCR for five additional serotypes (15A, 15C, 16F, 35B and 38) to be useful with the pneumococcal lysates prepared for the multibead assay. We then validated the combined assay with 157 clinical isolates from the Centers for Disease Control and Prevention and found that the new combined assay produced results that are concordant with the quellung reaction. The combined assay is robust and could be used to rapidly identify the serotypes of the majority of pneumococci (∼90 %). In addition, the assay validation study suggests the presence of serological subtypes within serotype 11A.
Fatal necrotizing fasciitis caused by Haemophilus influenzae serotype f
Authors: McLellan Elizabeth , Suvarna Kim , Townsend Rob
Published: January 2008

We describe a case of fatal lower limb necrotizing fasciitis in a 65-year-old man who was treated with broad-spectrum antibiotics, limb amputation and tissue debridement. The causative organism was identified by PCR asHaemophilus influenzaeserotype f, which is a highly unusual cause of necrotizing fasciitis.
Helicobacter pylori protein response to human bile stress
Authors: Shao Chunhong , Zhang Qunye , Sun Yundong , Liu Zhifang , Zeng Jiping , Zhou Yabin , Yu Xiuping , Jia Jihui
Published: January 2008

The ability of Helicobacter pylori to tolerate bile is likely to be important for its colonization and survival in the gastrointestinal tract of humans. As bile can be acidified after reflux into the low pH of the human stomach, the inhibitory effect of fresh human bile with normal appearance on H. pylori before and after acidification was tested first. The results showed that acidification of bile attenuated its inhibitory activity towards H. pylori. Next, the protein profiles of H. pylori under human bile and acidified bile stress were obtained by two-dimensional electrophoresis. Protein spots with differential expression were identified using tandem matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The results showed that the changes in proteomic profiles under bile and acidified bile stress were similar when compared with that of normal H. pylori. Expression of 28 proteins was found to be modulated, with the majority being induced during bile or acidified bile exposure. These proteins included molecular chaperones, proteins involved in iron storage, chemotaxis protein, enzymes related to energy metabolism and flagellar protein. These results indicate that H. pylori responds to bile and acidified bile stress through multiple mechanisms involving many signalling pathways.
Accessible reciprocal-space region for non-coplanar Bragg and Laue geometries
Authors: Yefanov Oleksandr
Published: January 2008

Accurate shapes of the accessible reciprocal-space region for non-coplanar Bragg and Laue geometries are given. Vector formulae for finding these regions and for experimental geometry calculations for obtaining diffraction from any accessible (using a given wavelength) reciprocal node are presented. A method for converting these formulae to scalar equations is proposed. Solutions are given and illustrated as three-dimensional figures in reciprocal space.
Automated classification of crystallization experiments using wavelets and statistical texture characterization techniques
Authors: Watts D. , Cowtan K. , Wilson J.
Published: January 2008

A method is presented for the classification of protein crystallization images based on image decomposition using the wavelet transform. The distribution of wavelet coefficient values in each sub-band image is modelled by a generalized Gaussian distribution to provide discriminatory variables. These statistical descriptors, together with second-order statistics obtained from joint probability distributions, are used with learning vector quantization to classify protein crystallization images.
X-ray scattering study of the average polycyclic aromatic unit in Ledo coal
Authors: Boruah Rajani K. , Saikia Binoy K. , Baruah Bimala P. , Dey Nibaran C.
Published: January 2008

This report is an attempt to understand the short-range structural features, to determine the relationship(s) between the aryl/alkyl carbon ratio, and to determine the size of the average polycyclic aromatic unit in Ledo coal from Makum coalfield, Assam, India. An X-ray scattering analysis of the average polycyclic aromatic unit in the coal indicates that the aromatic fraction in this coal is 74% with the aliphatic fraction correspondingly estimated to be 26%. The average carbon atom has 2.3 nearest carbon atom neighbours at an average bond distance of 1.50 (1) Å. The average stacking height of the parallel aromatic layers and the average diameter of the aromatic layers are estimated to be 7.58 Å and 4.86 Å, respectively. For this coal, the average number of stacking layers and the average number of atoms per layer are estimated to be 2 and 8, respectively. In addition, the Gamma band is observed at advalue of 4.42 Å.
Crystal truncation rod X-ray scattering: exact dynamical calculation
Authors: Holý Václav , Fewster Paul F.
Published: January 2008

A new method is presented for a calculation of the reciprocal-space distribution of X-ray diffracted intensity along a crystal truncation rod. In contrast to usual kinematical or dynamical approaches, the method is correct both in the reciprocal-lattice points and between them. In the method, the crystal is divided into a sequence of very thin slabs parallel to the surface; in contrast to the well known Darwin dynamical theory, the electron density in the slabs is constant along the surface normal. The diffracted intensity is calculated by a matrix formalism based on the Fresnel reflection and transmission coefficients. The method is applicable for any polarization of the primary beam and also in a non-coplanar scattering geometry.
Application of a single-reflection collimating multilayer optic for X-ray diffraction experiments employing parallel-beam geometry
Authors: Wohlschlögel M. , Schülli T. U. , Lantz B. , Welzel U.
Published: January 2008

Instrumental aberrations of a parallel-beam diffractometer equipped with a rotating anode X-ray source, a single-reflection collimating multilayer optic and a parallel-plate collimator in front of the detector have been investigated on the basis of standard measurements (i.e.employing stress- and texture-free isotropic powder specimens exhibiting small or negligible structural diffraction line broadening). It has been shown that a defocusing correction, which is a major instrumental aberration for diffraction patterns collected with divergent-beam (focusing) geometries, is unnecessary for this diffractometer. The performance of the diffractometer equipped with the single-reflection collimating multilayer optic (single-reflection mirror) is compared with the performance of the diffractometer equipped with a Kirkpatrick–Baez optic (cross-coupled Göbel mirror) on the basis of experimental standard measurements and ray-tracing calculations. The results indicate that the use of the single-reflection mirror provides a significant gain in photon flux and brilliance. A high photon flux, high brilliance and minimal divergence of the incident beam make the setup based on the single-reflection mirror particularly suitable for grazing-incidence diffraction, and thus for the investigation of very thin films (yielding low diffracted intensities) and of stress and texture (requiring the acquisition of large measured data sets, corresponding to the variation of the orientation of the diffraction vector with respect to the specimen frame of reference). A comparative discussion of primary optics which can be used to realise parallel-beam geometry shows the range of possible applications of parallel-beam diffractometers and indicates the virtues and disadvantages of the different optics.
Structural characterization using the multiple scattering effects in grazing-incidence small-angle X-ray scattering
Authors: Lee Byeongdu , Lo Chieh-Tsung , Thiyagarajan P. , Lee Dong R. , Niu Zhongwei , Wang Qian
Published: January 2008

The multiple scattering effects present in grazing-incidence small-angle X-ray scattering (GISAXS) data and interference between them are addressed theoretically as well as experimentally with measurement of a series of patterns at different incident angles, referred to as `incident-angle-resolved GISAXS' (IAR-GISAXS). X-ray reflectivity (XR), GISAXS and IAR-GISAXS of virus particles on Si-substrate supported-polystyrene films have been measured and all the data have been analyzed with appropriate formalisms. It was found that under certain conditions it is possible to extract the correct structural features of the materials from the GISAXS/IAR-GISAXS data using the kinematic SAXS formalisms, without the need to use the distorted-wave Born approximation. Furthermore, the Kiessig fringes in GISAXS enable the measurement of the average distance between the particle and the substrate, similar to the measurement of film thickness using the fringes in the XR data. It is believed that the methods developed here will expand the application of GISAXS as they enable the application of model-independent and kinematic SAXS theories to nanostructured two-dimensional ordered films.
Reproducibility in X-ray reflectometry: results from the first world-wide round-robin experiment
Authors: Colombi P. , Agnihotri D. K. , Asadchikov V. E. , Bontempi E. , Bowen D. K. , Chang C. H. , Depero L. E. , Farnworth M. , Fujimoto T. , Gibaud A. , Jergel M. , Krumrey M. , Lafford T. A. , Lamperti A. , Ma T. , Matyi R. J. , Meduna M. , Milita S. , Sakurai K. , Shabel'nikov L. , Ulyanenkov A. , Van der Lee A. , Wiemer C.
Published: January 2008

X-ray reflectometry (XRR) is a well established technique to evaluate quantitatively electron density, thickness and roughness of thin layers. In this paper, results of the first world-wide XRR round-robin experiment, involving 20 laboratories, are presented and discussed. The round-robin experiment was performed within the framework of the VAMAS Project `X-ray reflectivity measurements for evaluation of thin films and multilayers', the aim of which is to produce a `good practice' manual for XRR. The reproducibility of measurements obtained using different equipment has been investigated. The influence of the fitting of the experimental data was shown to be non-negligible compared with the experimental factors. The dynamic intensity range proves to be an important parameter for obtaining a good quality measurement. A simpler test sample which does not develop a surface oxide layer over time is now the subject of a follow-up study.
Phased rotation, conformation and translation function: performance with mononucleotides
Authors: Pavelcik Frantisek
Published: January 2008

A phased rotation, conformation and translation function (PRCTF) is a novel and promising tool for automatic model building in protein crystallography. Its performance has been tested on nucleic acid structures. A mononucleotide fragment of phosphate-to-phosphate type with seven conformation degrees of freedom was used as a search fragment. The position, orientation and internal torsion angles of all localized fragments are refined by a phased flexible refinement. In general, 50 to 93% of the fragments can be found by the PRCTF. Results depend on resolution and phase quality. The ability of the PRCTF to locate bases is significantly lower (3–30%), owing to the lack of heavy atoms. Individual localized fragments can be connected into polynucleotide chains.
Two-dimensional focusing of high-energy X-rays by thermal-gradient crystals for small-angle X-ray scattering
Authors: Stockmeier Matthias , Petermair Matthias , Magerl Andreas
Published: January 2008

A novel method for focusing X-rays in two dimensions by thermal-gradient crystals in symmetrical Laue geometry is described. A 225 kV stationary tungsten tube delivers an X-ray beam with a source diameter of about 1.0 mm (full width at half-maximum). The focal point at the detector at a distance up to 16 m from the source is of the same size. The beam at the focusing crystals at half the distance between the source and the detector has typical dimensions of 30 × 30 mm. The intensity of the focal point can be increased by more than 200 times by applying a thermal gradient of about 2.2 K mm−1on the focusing crystals. The described method and apparatus are designed for small-angle X-ray scattering at high photon energies up to 60 keV, where the high penetration power allows experiments on strongly absorbing materials in transmission mode. Particle sizes up to 3000 Å can be detected. First measurements on nanocrystalline tungsten carbide and Teflon yield radii of gyration of 540 Å and 815 Å, respectively.
A simple method for analyzing peak broadening due to tilt and twist distributions in X-ray diffraction measurements of materials of arbitrary type
Authors: Nakashima Kiichi , Matsuoka Takashi
Published: January 2008

A method for simply identifying the X-ray diffraction peak broadening caused by tilt and twist distributions through analysis of theirhkldependence is proposed. The development of a new general formulation for thehkl-dependence analysis is presented. This makes thehkl-dependence analysis generally applicable to any material with any type of crystal structure. It also makes it possible to analyze thehkldependence of broadening in terms of whole profile shapes, which improves the reliability of the analysis. Another advantage of the formulation is that the analysis procedures for broadening due to both tilt and twist distributions can be derived in a straightforward manner from the same general version. Owing to these advantages, the method is applicable to GaN-based epitaxial films. The method for twist distributions is experimentally demonstrated using GaN epitaxial films on sapphire substrates.
Metalloproteins: metal binding predicted on the basis of the amino acid sequence
Authors: Carugo Oliviero
Published: January 2008

A protein sequence is often insufficient for knowledge of the chemical formula and the properties of the mature molecule that perform its function. Post-translational modifications are very common and most of them cannot be predicted on the basis of the protein sequence alone. A very common chemical modification of proteins that is not directly encoded by a single gene is the complexation with metal cations. Here it is shown that the uptake of metal ions (calcium, cobalt, copper, iron, magnesium, manganese, nickel or zinc) by proteins can be predicted on the basis of the amino acid composition, by using a mixture of several simplified amino acid alphabets and by employing machine learning methods, with 70–90% accuracy, depending on the type of metal. Not only is it possible to predict if a protein requires a certain metal ion but it is also possible to discriminate amongst various metal species. These results are likely to be useful in structural proteomics, by improving the experiment success rate, and in comparative genomics, where it is interesting to compare metal-ion contents in different organisms. It is particularly important that these predictions can be made when homology-based annotations are impossible.
EXPERIMENTAL TRANSPLANTATION OF URETERS INTO THE INTESTINE.
Authors: Taylor P. N. Walker‐
Published: January 2008

1. A brief history of the operation is given up to the present date. 2. General surgical opinion judges that the principle of submucous transplantation described by Coffey offers best hope of success.

3. A new technique is described which is truly aseptic. The sub‐mucous principle is employed, but the necessity of incision and resuture of the muscle and peritoneum of the bowel wall is obviated.

4. Operations have been carried out on 77 dogs, with the implanta‐tion of 106 ureters. 1

5. Peritonitis as a complication is not serious; none occurred while using the completed technique; that is, 34 operations (one case originating from a gangrenous wound is not considered).

6. Pyelonephritis is not frequent and is always accompanied by some evidence of ureteral obstruction.

7. Hydronephrosis following on contracture of the cut end of the ureter still remains the greatest problem.

8. The use of ureteral catheters, though particularly well suited to the technique, produced bad results in these experiments because they blocked so easily on account of the small bore. I n animals in which large catheters could be used, it is considered the objection to their use would be removed.
ABDOMINAL INCISIONS IN THE LIGHT OF RECENT WORK ON THE INTERCOSTAL NERVES.
Authors: Davies Francis , Wakeley Cecil P. G.
Published: January 2008

Conclusion and Summary

1. The course and divisions of the intercostal nerves in the thoracic and abdominal walls are described in the light of recent work on this subject.

2. The estensive inter‐communications between neighbouring nerves, both in the thoracic and especially in the abdominal walls, are noted.

3. Although, owing to these inter‐communications, post‐operative hernia (zipart from sepsis) is not a common sequel even of the wide and variable incisions that are commonly practised, yet' the endeavour should always be made t o inflict the minimal damage to the nerves and musculature of the abdominal wall. From this point of view certain abdominal incisions are reviewed.
ULCERATIVE COLITIS IN NEW ZEALAND, WITH SPECIAL REFERENCE TO THE ACUTE TYPE
Authors: Bell F. Gordon
Published: January 2008

.1. A series of 40 cases of idiopathic ulcerative colitis of purely New Zealand origin is analysed.

2. The high percentage of acute cases forms the striking feature, and chief attention has been devoted to the problems arising in this severe and often rapidly fatal type.

3. The high incidence in young people is demonstrated.

4. The bacteriological findings were as disappointingly negative as they are commonly found to be.

5. The total mortality was 32‐5%.

6. Surgical treatment is discussed and the value of a timely ileostomy is emphasized.
TREATMENT OF ILEUS, WITH SPECIAL REFERENCE TO CONTINUOUS STOMACH ASPIRATION AND MASSIVE INTRAVENOUS INFUSION1
Authors: Wood Ian J.
Published: January 2008

1. The signs and symptoms of ileus are recorded.

2. The normal distribution and movement of water in the body are discussed with special reference to the gastro‐intestinal circulation.

3. The treatment of ileus by aspiration with the indwelling stomach tube and by fluid replacement by the continuous intravenous drip method is discussed.

4. The necessity of maintaining a positive fluid balance is emphasized.
EXPERIMENTAL TESTICULAR ASCENT AS PRODUCED IN A MARSUPIAL (TRICHOSURUS VULPECULA)1
Authors: Bolliger Adolph , Carrodus Arthur
Published: January 2008

.If œstrogenic material is administered to sexually immature possums (Trichosurus vulpecula), testes and epididymes show a tendency to leave the scrotum and to become situated under the skin near the abdominal ring. This process, which is called testicular ascent, was rapidly completed in a young animal of about Ave and a half months of age. In older but still immature animals, the process is slower and requires larger or lethal doses of cestrogenic material. In mature adult animals the testicles were confined to the scrotum, even after large doses of œstrin.
THE RADICAL OPERATIVE TREATMENT OF THE POSTERIOR GROUP OF THE UPPERNASAL ACCESSORY SINUSES1
Authors: Brown R. Graham
Published: January 2008

1. The author emphasizes the importance of the work done by Onodi and later more extensively by Óickworth in giving us a comprehensive pathology of sinus disease and its frequently associated changes in the surrounding bone, meninges, pituitary body and stalk and the adjacent vessels, the cerebral vessels and the brain tissue itself.

2. The logical outcome of such important, findings is that more radical operative work should be performed in chronic nasal accessory sinus disease.

3. Two operations have been described that offer a satisfactory means of approach to the cells in question, that is, the Ferris Smith and the transantral radical operations.

4. It is essential that the operator be sound in his anatomy and thoroughly efficient in his technique before undertaking such operations.
THE SIGNIFICANCE OF HYPOTHENAR ELEVATION IN MOVEMENTS OF OPPOSITION OF THE THUMB
Authors: SUNDERLAND SYDNEY
Published: January 2008

Attention has been drawn to the significance of hypothenar elevation in movements of opposition of the thumb and little finger.

An additional test for ulnar nerve lesions involving the supply to the hypothenar musculature is described–namely, persistent flatness of the dorsum of the hand on the affected side when opposition of the thumb and little finger is attempted.
VOLUNTARY MOVEMENTS AND THE DECEPTIVE ACTION OF MUSCLES IN PERIPHERAL NERVE LESIONS
Authors: SUNDERLAND SYDNEY
Published: January 2008

The trick or supplementary movements which have been observed in 170 cases of peripheral nerve injuries have been described. These are voluntary movements which can still be effectively carried out even when those muscles customarily held to be responsible for their execution have been deprived of their nerve supply.

Trick movements have been recorded in isolated and combined lesions of all the main peripheral nerves.

The immediate recognition of such movements in peripheral nerve injuries is of considerable importance since the failure to detect them will lead to false estimates of the extent of the nerve lesion and the progress of regeneration. This will in turn result in incorrect diagnoses and in unjustified optimism concerning either the progress of spontaneous regeneration or the efficacy of a surgical procedure designed and undertaken to facilitate regeneration.

Attention has been directed to the care which must be exercised in testing voluntary movements and in estimating, solely on the basis of the derangement of movement, the condition of any muscle or muscles.
THE REMOVAL OF BLOOD FROM TRAUMATIC HÆMOTHORACES
Authors: Hayward John I.
Published: January 2008

Summary

1. The reasons for removing the blood from a hemothorax are given.

2. The strange ways in which hemothorax blood may clot are described, and the theo'ries to explain the clotting are discussed.

3. The various ways in which heahorax blood may be removed are discussed.

4. A brief outline of how hemothorax patients have been treated in New Guinea is given.

5. Important practical points concerned in the aspiration of hemo‐thoraces are described.
CARCINOMA OF THE RECTUM
Authors: Turner John
Published: January 2008

Summary

1. An analysis of the records of carcinoma of the rectum in three teaching hospitals in Melbourne is presented.

2. The means whereby the operability rate and the mortality rate could be improved are suggested.

3. The use of colostomy in cases regarded as inoperable is discussed.

4. Combined perineo‐abdominal excision without preliminary colostomy is recommended as the method of choice in the majority of cases.

5. The importance of the preoperative and post‐operative treatment is stressed.

6. The post‐operative complications are discussed, with particular reference to bladder dysfunction and to complications arising from the colostomy.

7. The care of the colostomy is described in detail.
PYLORIC STENOSIS WITH AZOTÆMIA
Authors: Dunn R. M.
Published: January 2008

1. Four cases of azotazmia following severe fluid loss from the upper gastro‐ intestinal tract are reported. Three cases followed pyloric stenosis ahd the other case followed gastro‐enterostomy and vagotomy for a similar condition.

2. Disturbance of the dynamics of the circulatory system and of the intrarenal circulation appears to account for the outstanding features of the syndrome.

3. Further doubt is cast on the role played by toxins.
TWO UNUSUAL CASES OF INTUSSUSCEPTION OCCURRING IN CHILDREN, WITH A REVIEW OF THE LITERATURE
Authors: Hipsley Donald , Goulston Eric
Published: January 2008

1. Two unusual cases of intussusception in childhood are presented, one illustrating a chronic variety due to polypoidal‐like hyperplasia of the lower part of the ileum, the other an acute intussusception due to polypi of the upper part of the jejunum.

2. It is felt that operative methods of bowel fixation to prevent recurrence of intussusception are unnecessary and unlikely to be successful.

3. It is worth while to make a careful examination of the bowel in all cases of intussusception, especially in children over two years, as small tumours within the intestinal wall in an edematous bowel may be easily overlooked.

4. Xtiology of intussusception is discussed with reference to lymphoid hyperplasia in the terminal part of the ileum.

5. Age incidence is discussed.

6. A review of the relevant literature is given.
THE REVISION OF THE DERMATOMES1
Authors: Young James H.
Published: January 2008

In pursuing the study of this subject it is necessary to divest the mind of all preconceived ideas bearing upon it and to note carefully every individual circumstance, however contrary it may appear to one's expectations and desires. One great difficulty is the unreliability of the patient. Pain of the most excruciating kind leaves in the mind but a very imperfect recollection of its exact site. In all cases the description of the pain prior to examination should be received with great caution, and instructions given to note accurately the exact site during an exacerbation or recurrence. In the latter case trustworthy accounts can generally be received even when the observer is not present.

I must confess I have also found it necessary to put a control on my own observations, by having them verified by a colleague. In making my observations I invariably had the most striking and important cases examined independently. Such phenomena as my colleagues could not verify I rejected, for if these sensory symptoms are to be of value they must be capable of being elicited by observers free from bias. And further, cases should not be recorded based upon recollections alone, for it is wonderful how far from the truth memory may wander, when there is a favourite theory to be advanced.
THE ROLE OF VANGINAL HYSTERECTOMY IN GYNAECOLOGICAL SURGERY
Authors: Chapman Clement
Published: January 2008

A plea has been made for the more frequent use of vaginal hysterectomy.

The class of case in which it should be employed has been set out.

Its advantages have been described.

Reference to the essential points in operative and postoperative detail has been made.
THE GENESIS OF VARICOSE VEINS
Authors: King E. S. J.
Published: January 2008

In review, at the early stage of varicosis there is in an area, a dilatation, sometimes of sudden onset, without valvnlar in competence, with centripetal pulsation and without involvement of the proximal part of the veins. At this stage the veins are capable of contraction, that is, the muscle is not degenerate nor intrinsically weak; yet dilatation does occur.

These phenomena are explained by the action of some chemical factor, possibly a hormone or hormones of the oestrogen group, which have been shown to produce relaxation of smooth muscle in other tubes.

Once the condition has developed, then, just as with other structures such as bones, mechanical factors come into play and produce the various secondary changes which are clearly the effect of hydrostatic stresses. These give rise to the structures which are “ill‐faced”, worse bodied, shapeless everywhere.

The distinction between the two stages is of paramount importance in distinguishing between primary aetiological factors and those responsible for the more obvious and, in some respects, the more important secondary changes.
DESMOID TUMOUR OF THE ABDOMINAL WALL
Authors: Burnell G. H.
Published: January 2008

A case of desmoid tumour of the abdominal wall is described, in which it was necessary to remove all muscular layers of the abdominal wall over an area eight inches by eight inches, reinforcing the gap so caused by the insertion of a large stainless steel wire filigree.
DELAYED SPLENIC HAEMORRHAGE. A CLINICAL STUDY
Authors: Hueston J. T.
Published: January 2008

A case of unusually delayed splenic haemorrhage is reported, and the march of symptoms analysed in detail.

The clinical features have been corre‐ lated with the state of the specimen removed.

Splenic rupture due to delayed intra‐ splenic haemorrhage is distinguished from rupture due to continued initial haemorrhage.
POSTERIOR DISLOCATION OF THE CERVICAL SPINE.
Authors: Hueston J. T.
Published: January 2008

Posterior dislocation of the cervical spine is described, and contrasted with the more common type of anterior dislocation.

The mechanism of injury is hyperextension, with disruption of the anterior longi‐ tudinal ligament.

In all cases quadriplegia was present. The anatomical basis of this is discussed.

The application of these findings to the management of cervical spine injuries is discussed.
TUMOURS OF THE PITUITARY BODY AND ITS ENVIRONS.
Authors: King E. S. J.
Published: January 2008

Tumours and cysts of the pituitary region may be simple or complex in form.

The complex structures, usually para pituitary in position are commonly regarded as having an origin directly from such archaic structures as the hypophyseal duct or less clearly recognizable “cell residues.”

The assumption that such tumours or cysts arise from special tissues is due to the view that only these possess the potentialities for production of several tissues and that such capacity is not present in more adult structures.

This assumption is misleading on two accounts: (i) the cysts and tumours are not in reality as complex as cursory examination would suggest, and (ii) investigation shows that powers of differentiation greater than those previously recognized are, in effect. present in adult tissues.

The various tissues that are seen in these complex structures develop by changes in cells previously present; thus, the cyst or tumour does not arise like Minerva, fully panoplied, from the brow of Jove but develops by gradual differentiation of proliferating cells in the same manner as is seen in the formation of normal tissues or organs.

In a cyst, for example, there first appears a simple epithelium which may be in part ciliated; this may become pseudostratified or stratified (the former may be ciliated and the second may show keratin formation). The squamous epithelium may then form a basal‐type epithelium with calcifiable homogeneous secretion. Lymphocytic accumulation and cartilage formation occurs and, in areas of excessive keratinous formation, cholesterol accumulation may be found. When all these various tissues and materials are found together the structure becomes one of considerable macroscopical and histological complexity.

The close relation of such complex tumours and cysts to simple ones is thus clear and it is unnecessary to regard the essential progenitor of such structures as a “totipotent” cell or a cell of some special kind. The complex cyst or tumour is merely a variant of that which, because it closely resembles the tissues commonly observed in the part, is usually regarded as simple.
SCLEROSING PERI‐ANGEITIS OF THE LATERAL THORACIC WALL
Authors: Hughes E. S. R.
Published: January 2008

An unusual lesion affecting the lateral chest wall is described; 5 cases are reportedand the literature on the subject is reviewed. Histological examination indicates gross sclerosis around some vessel or vessels.
TESTICULAR TUMOURS: THE ASSOCIATION OF SEMINOMA AND TERATOMA
Authors: King E. S. J.
Published: January 2008

Twelve cases of tumour of the testis in which there was an association of a seminoma and a “teratoma” are discussed and three of these are described in detail.

The malignant “teratomata” do not usually show a degree of multi‐differen‐ tiation greater than is seen in many carcinomata in other parts of the body but usually show only an epithelial tissue and often only one form of this.

The evidence for the opinion that these are really teratomata is therefore of the slenderest, and the reasons for consider‐ ing that they are not so are discussed.

These tumours (both the “teratoma” and the seminoma) are regarded as arising from the cells of the testicular tubules.

The term teratoma, by definition, should be applied only to such tumours as show considerable multi‐differentiation and the term should cease to be used as applying to those in which this is not true. For this reason it should not be used for those malignant forms of epithelial growth which differ from the seminomata.

Tumours of this kind should be desig‐ nated carcinoma.

The seminoma is a carcinoma but, in view of its characteristic features, this or some comparable term should be re‐ tained at present.

In this way over 95 per cent. of the growths of the testis, which constitute the malignant epithelial tumours, would fall into two sub‐groups, the carcinoma and the seminoma.
CHRONIC SCLEROSING PERI‐SYNOVITIS OF THE DORSUM OF THE HAND
Authors: McKenzie Graham
Published: January 2008

Four cases of fibrosis of the hand are described.

The clinical feature of swelling occurring in the tendon sheaths and in the tissues beyond these, arising usually after an injury, is described.t)

The condition is one of a chronic inflammatory change following the injury; instead of simple resolution, which usually occurs, there is fibrosis and cystic (that is, synovial) development.
GASTRIC MUCOSA WITHIN THE OESOPHAGUS
Authors: Morris Kenneth N.
Published: January 2008

There is a clinical state in which the lower end of the oesophagus is lined by gastric epithelium. The origin of this gastric mucosa is a matter of conjecture. It may be complicated by the development of reflux oesophagitis and high oesophageal stricture or by the formation of typical peptic ulcers which may haemorrhage, perforate or stenose. The correct line of treatment of this condition is a matter of debate but we have been pleased with the results achieved by a conservative approach to the problem.
PRIMARY ONE‐STAGE PROCTOCOLECTOMY IN ULCERATIVE COLITIS
Authors: Hughes E. S. R. , King W. E.
Published: January 2008

1. Six cases of ulcerative colitis treated by ileostomy and primary proctocolectomy are reviewed.

(a)Two cases showed chronic ulcerative colitis, complicated by stricture formation. In one, the stricture was malignant.

(b)Two cases showed a sub‐acute or chronic relapsing ulcerative colitis. In both, the history was long, and in both radiological studies at intervals showed proximal spread of the disease.

(c)Two cases showed an acute or fulminating ulcerative colitis. The history was short, and the patients gravely ill at the time of surgical intervention.
SUBACUTE NODULAR POLYANGEITIS
Authors: King E. S. J.
Published: January 2008

An example of a disseminated nodose form of vascular inflammatory change, characterized by the development of subcutaneous and muscular nodules, is described.

The disease was of limited duration and has not (in a quarter of a century) recurred.

The histological features differed from those of polyarteritis nodosa in that histological changes were found in arteries, veins and capillaries.

The changes also were more chronic in type and in some respects, especially the development of giant cells, resembled those of temporal arteritis.
CERVICAL LYMPH NODE METASTASES FROM EPITHELIOMA OF THE FACE, LIPS AND MOUTH
Authors: EDBEY HOWARD H.
Published: January 2008

The results of treatment of 48 patients with epithelioma of the face, lips or mouth who were referred for surgical treatment of cervical lymph node metastases have been considered.

Some of the problems of management have been discussed with particular reference to the indications for combined neck and mouth disssction and to the treatment of recurrence.

Some indication has been given of the prognosis in this condition.
CHRONIC INFLAMMATORY MASTITIS WITH DUCT ECTASIA
Authors: ACKLAND THOMAS H.
Published: January 2008

Attention is drawn to the occasional occurrence of true chronic inflammation in the breast.

The term “plasma cell mastitis” does not necessarily describe the changes which occur, so that a more embracing descriptive term is required.

The diagnosis of carcinoma of the breast is very likely to be made in these cases.
FAMILIAL INTESTINAL POLYPOSIS ASSOCIATED WITH FURTHER‘ ABNORMALITIES OF GROWTH
Authors: KENNY P. J. , O'NEILL J.
Published: January 2008

The condition of familial polyposis coli associated with “soft” and “hard” tissue tumours is briefly reviewed. A family group suffering from polyposis coli and multiple epidermoid cysts is reported. As far as we are aware, this is the first time this disease entity has been reported in this country.
ANEURYSM OF THE ABDOMINAL AORTA
Authors: Morris Kenneth N.
Published: January 2008

An account is given of the clinical features and the management of aneurysm of the ab‐dominal aorta. Rupture of the aneurysm is a common terminal event in this condition and it is desirable that operation should be undertaken before rupture occurs. Unfortunately many of these patients are not suitable for major surgery.

The author's personal series comprises 22 operations for aneurysm of the abdominal aorta. Fifteen of these operations were carried out after the aneurysm had ruptured. Details of operative techniques and results are given.
EXPERIMENTAL PANCREATIC NECROSIS
Authors: Graham J. W.
Published: January 2008

A method of inducing pancreatic necrosis in dogs is described. The possible significance of this in regard to pancreatic necrosis in man is discussed.
INTESTINAL DUPLICATION
Authors: Roberts D. I.
Published: January 2008

A case of intestinal duplication which presented as an acute abdominal emergency is reported with the purpose of drawing attention to the condition in its various forms. The embryology and common symptomatology is also discussed.
CHONDROBLASTOMA*
Authors: King Thomas
Published: January 2008

Excision of the head and neck of the femur for a benign chondroblastoma was performed because of a pathological misdiagnosis of osteogenic sarcoma.

2. There was a recurrence after the excision of the tumour because tumour cells had been spilled along the drill hole in the great trochanter during the diagnostic curettage.

3. At the third operation the great trochanter was excised after which there was no recurrence.

4. There is good function, no pain, but 3′shortening at the present time, four years later.
SPORADIC AMOEBIASIS IN VICTORIA
Authors: CUTIIBERTSON A. M. , TANGE J. D.
Published: January 2008

Forty‐four cases of amoebiasis have presented at the Melbourne teaching hospitals between 1935 and 1958.

A high mortality and high incidence of complications were noted. This is clearly‐related to difficulties experienced in diagnosis.

It is suggested that in the absence of distinctive clinical features, an awareness of the condition and perseverance in the face of negative examinations are necessary if the diagnosis is to be established in the early stages of the illness.
CARCINOMA OF THE OESOPHAGUS WITH SURVIVAL
Authors: Dunlop E. E.
Published: January 2008

1. Some modern trends in the treatment of carcinoma of the oesophagus are discussed.

2. A personal case series of 170 patients with carcinoma of the oesophagus during theperiod 1945 to 1959 and a ten year series from the Royal Melbourne Hospital (1949–1958) are presented.

Carcinoma arising in the stomach or gastric cardia are excluded but not those involving both pharynx and oesophagus.

Brief reference is made to 32 cases who received radiotherapy at the Peter MacCallum Clinic over the same period 1949 to 1958.

3. The advanced age and frailty of the patients are evidenced, and sex variations discussed in relationship to site.

4. The intractability of many of the lesions is discussed in terms of local metastasis (63 per cent.), blood stream metastasis (15 per cent.) and advanced spread. Reference is made to double carcinoma and vagaries of spread and recurrence. A wide margin of resection is advised if cure be the objective.

5. Views on the place of palliative and radical procedures are advanced in the light of the pathology, the distress of the patients cnd the grim outlook of the untreated disease.

6. Palliatie measures discussed include intubation (with preference for plastic tubes), gadrostomy and jejunostomy (which are not favoured). short circuits, palliative resection and X‐ray therapy.

7. Major surgical excisions were carried out in 68 of the personal case series; lowerthird 33, middle third 44 and upper third 39 with mortality 29 per cent. (15 per cent. lower third, 32.5 per cent. for the upper two‐thirds).

8. On the basis of results obtained in Melbourne there does not appear to be any well‐established case for abandoning surgery for carcinomata of the upper two‐thirds of the oesophagus.

9. A survey of these results together with others available from other countries suggests that the disease is grim indeed, but that surgery offers comfort and some distinct hope of lasting relief.
CARDIAC OUTPUT UNDER ANAESTHESIA
Authors: B. Dwyer  , George E.
Published: January 2008

The basic physiology of the output of the heart and the total body peripheral resistance and their relation to the blood pressure are reviewed together with their methods of estimation.

The radio‐isotope dilution method of cardiac output determination is described in detail and the effects of thiopentone, “Presuren and halothane on cardiac output and peripheral resistance were studied in a few cases.

The application of this method to the investigation of new anaesthetic agents, the causes of hypotension under anaesthesia and the management of hypotensive states appears Received for publication 15th October, 1959.

In clinical practice, anaesthetists may use Starr's pulse‐pressure formulas to obtaina better indication of the direction and magnitude of the changes in the cardiac output under anaesthesia.