bluuebunny/crossref_metadata_2025 huggingface dataset:
SOME RECENT STUDIES ON THE PHYSIOLOGY OF SMOOTH MUSCLE, AND THE MECHANICAL ASPECTS OF GASTROINTESTINAL FUNCTION, AND SOME POSSIBLE IMPLICATIONS TO SURGICAL PROBLEMS
Authors: MILTOX G. W.
Published: January 2008

Recent work on the physiology of gastrointestinal smooth muscle has been reviewed, it is concluded that:–

The smooth muscle of the bowel wall is probably co‐ordinated by a slowly spreading electrical wave, which spreads from cell to cell.

The nerve plexuses in the bowel wall are not intimately related to the co‐ordination of the gut musculature in the small intestine.

The co‐ordination of the smooth muscle is disturbed by an anastomosis, and may be damaged for months, at Jeast, by the injudicious use of bowel clamps.

The different electropotential waves which may be recorded from the small intestine have been reviewed.

The mechanism of gastric emptying, and the possible methods of adaptation available to the gut following gastrectomy, are outlined.

The manner in which post‐gastrectomy dumping syndromes may be either initiated, or augmented, by vasomotor reflexes initiated from hyperactive bowel wall has been discussed.

The different mechanical characteristics of different parts of the small intestine have been discussed in connection with the use of small intestine transplants in urology.
GALL‐STONE ILEUS
Authors: MCCARTHY J. J.
Published: January 2008

In these three cases that I have had the privilege of attending the outstanding features and conclusions are:

1. Three cases of gall‐stone obstruction occurred in a period of less than ten months accounting approximately for 3 per cent, of all cases of obstruction in this period.

2. The operative mortality was nil, due possibly to X‐ray diagnosis being made early in each case.

3. Gall‐bladder dyspepsia was noted in two of the three cases and wound infection was severe in a similar number.

4. Unusual method of removal of stone in Case 3.

5. Although it is suggested that air in the bile ducts is a most important sign, occurring in two out of these three cases, it cannot be said that it occurs in 66 per cent, of cases. Brockis and Gilbert had only one such case in the twelve he reports (a percentage of 8.5). No one has a large enough series to say what the actual percentage is but it probably lies some where between these two figures. With a knowledge of what to look for it may be noted more often.
RHEUMATOID ARTHRITIS, LEG ULCERATION AND POSITIVE LUPUS ERYTHEMATOSUS CELL TEST
Authors: Benjamin M. K. , Hueston J. T.
Published: January 2008

A report is given of an elderly male with rheumatoid arthritis, chronic ulceration of the leg and positive L.E. cell test, as described by Allison and Bettley (1957). In addition the auto‐immune complement fixation (AICF) test was positive.

Split skin autografts to the ulcer failed, to survive. When repeated during continuing cortisone administration they survived.

This experience favours an immunological I pathogenesis both for the original ulcer and for the non‐survival of the initial autograft.

A plan is submitted for the investigation of cases with rheumatoid arthritis and leg ulceration including an L.E. cell test. Treatment of such cases is suggested based on the use of cortisone if an initial graft fails to survive.
SMALL BOWEL OBSTRUCTION FOLLOWING ABDOMINOPERINEAL EXCISION OF THE RECTUM
Authors: HUGHES E. S. R.
Published: January 2008

1. A series of 6 cases subjected to abdominoperineal excision of the rectum and com‐, plicated in the immediate post‐operative period by herniation of a knuckle of small intestine through the pelvic peritoneal suture line is recorded.

2. The complication is due to a defect appearing immediately after operation because symptoms appeared on the first or second post‐operative day.

3. The most important symptom was pain on the second post‐operative day. This was often associated with a rise in temperature which was misleading.

4. The complication is likely to be overlooked because symptoms are not typical of obstruction until relatively late.

5. The complication can be prevented by attention to suturing of the pelvic peritoneum. A continuous interlocking suture reinforced with interrupted sutures is recommended.
A MODIFIED TECHNIQUE OF LOWER LIMB VENOGRAPHY
Authors: PATON R.
Published: January 2008

Two modifications are suggested for the accepted method of performing an intravenous ascending venogram. The first modification is the injection of the contrast medium through a fine polythene cannula inserted into a small vein of the “ankle flare” below the medial malleolus, in a distal direction, the use of a tourniquet being unnecessary. Secondly, it is suggested that the Valsalva manoeuvre is of value in demonstrating reversal of blood flow through communicating veins which have an incompetent valve. A technique is described incorporating the modifications with illustrations of their use.
TRAUMATIC INTRAPERITONEAL RUPTURE OF THE URINARY BLADDER
Authors: HARTLEY B.
Published: January 2008

The prognosis of intraperitoneal rupture of the bladder is known to be improved by early operation. Early diagnosis is therefore essential. A clinical triad of injury, inability to void, and lower abdominal pain will always suggest it, but is not always found. Radiographic methods are a great help, both in the localization of the lesion and in the demonstration of other accompanying injuries. These methods also have their limitations; however, the use of a carefully planned routine will give a great deal of valuable information. Treatment is both local and general. Supra‐pubic drainage of the bladder should be used whenever possible.

A typical case has been presented.
PRIMARY DUODENAL DIVERTICULA AND THEIR PROBLEMS
Authors: Lane Daniel
Published: January 2008

A series of 28 cases of duodenal diverticula requiring admission to hospital has beenreviewed from various sources in Brisbane. Eight of these cases were subjected to excision of the diverticula with a mortality of one due to pancreatitis.

Five cases have been selected from private records to illustrate some of the problemsof duodenal diverticula.

There are many pitfalls involved in both diagnosis and treatment. The incidence of bleeding in this series was surprisingly high.

It has been difficult to ascertain the effect of excision of the uncomplicated diverticulum. Many of these patients have proved very vaguein their symptomatology.

Cases for operation must be selected with great care. Many barium meals may be required to establish the correct diagnosis. Cholecystectomy should be performed only if the gall‐bladder is the seat of some pathological process. It was performed much too readily inthis series.

Operations on duodenal diverticula are rarely justified unless complications arise. It is important to assess not only the type of diverticulum but also the type of patient in whom it is found.
INTRACRANIAL CHONDROMA
Authors: Gorman R. F.
Published: January 2008

1. Solitary intracranial chondroma is a very rare condition.

2. Herein we have reported this condition in a 17‐year‐old female.

3. Theories of pathogenesis are briefly discussed.
A FATAL CASE OF CANCER OF THE GALL‐BLADDER: SOME AETIOLOGICAL AND SURGICAL OBSERVATIONS
Authors: Reeve T. S. , Rundle F. F.
Published: January 2008

A patient who underwent cholecystostomy and removal of multiple gall‐stones, developed, twenty‐eight years later, an empyema of the gall‐bladder, an abdominal wall abscess and fistulous track. The underlying condition was a cancer in the gall‐bladder. Note worthyfeatures were the long latent period of twenty‐eight years between cholecystostomy and her presenting with cancer, the subsequent development of a massive recurrence in the abdominal wall three and one‐third years after cholecystectomy, and the probability that this recurrence resulted from extension of the growth to the fistulous track. Failure to excise the track completely may have determined the eventually fatal outcome five years after cholecystectomy.
ANTERIOR TIBIAL ARTERY OCCLUSION AND RELATED SYNDROMES
Authors: Venner B.
Published: January 2008

The condition of occlusiorl of the anteriot tibial artery is described and illustrated by a case of embolism resulting in gangrene of the tissues of the anterior compartment, infection and ultimately in amputation. The related condition of the anterior tibial syndrome is mentioned. The early reccgnition of the condition is necessary, to employ a minorsurgical procedure which may offer some prospect of mitigating the effects of the ischaemia.
FLUID AND ELECTROLYTE BALANCE IN SURGERY*
Authors: Nanson Eric M.
Published: January 2008

The distribution of fluid and electrolytes in the three body compartments has been stated.

The regulation of fluid and electrolyte intake and output has been discussed, and the way this regulation may be upset has been pointed out.

The calculation of the various fluid and electrolyte deficits is described. The value of the Scribner method of calculating the twenty‐four hour loss is stressed.

The various repair solutions and their appropriate applications are described.

The importance of early restoration of normal renal function is stressed.

Potassium metabolism is discussed in a tabulated form.

The effects of operation per se on fluid and electrolyte regulation are discussed.
THE USE OF THE YEENEMA TROCAR IN PERINEAL PROSTATIC BIOPSY
Authors: Maddern J.
Published: January 2008

As the digital diagnosis of carcinoma of the prostate is open to a significant error, oestrogen therapy or radical surgery should not be begun on this evidence alone. Some confirmatory evidence should be obtained.

Trocar perineal biopsy is a useful method of confirming the diagnosis in:

(a) Cases in within carcinoma is suspected clinically.

(b) Hard nodules in the prostate.

(c) Cases with extensive osteosclerotic lesions in which the prostate is not unduly hard.

The Veenema trocar gives a simple and effective method of performing this with a good degree of accuracy and a minimum of complications.
ARTHRODESIS OF THE HIP
Authors: Williams Peter
Published: January 2008

Summary

1. One hundred and twenty‐two operations for arthrodesis of the hip have been studied to determine the efficiency of the various techniques in obtaining bony fusion.

2. It is suggested that the age of the patient, the shape of the upper end of the femur and the degree of stiffness in the hip should all be taken into account before choosing the method of fusion to be used. Some techniques have such a high failure rate that their continued use can no longer be justified. Others have such a low failure rate that if certain criteria are satisfied they can be used with almost certain success in a given case.
TUBERCULOUS ARTERITIS PRESENTING AS A POPLITEAL ANEURYSM
Authors: Jepson R. P. , Meadows R.
Published: January 2008

Summary

A case of tuberculous arteritis, with false aneurysmal formation in the popliteal artery is described.

Certain arteriographic features are stressed which may help to differentiate a tuberculous lesion from the more common arteriosclerotic aneurysm.

Why a tuberculous arteritis should occur at this site is discussed.
HEAD INJURIES IN CHILDHOOD
Authors: Hooper Reginald
Published: January 2008

Aetiological and structural factors which result in some specific peculiarities as a result of head injuries in children are discussed.

The importance of local changes at the point of impact is stressed.

Difficulties in diagnosis and management of simple and compound depressed fractures are described.

Severe focal brain injury may result in considerable neurological defect and in the later development of epilepsy.

Extradural haemorrhages are similar in the clinical characteristics to those observed in adults, but the picture obtained in subdural haemorrhage is different. Subarachnoid haemorrhage may produce a confusing picture which can only be resolved by lumbar puncture.
TRAUMATIC INTRAMURAL HAEMATOMA OF THE DUODENUM
Authors: Shannon R.
Published: January 2008

1. Three cases of traumatic intramural haematoma of the duodenum are presented.

2. A review of reported cases shows a remarkable constancy of clinical features, namely, delayed onset of pain and recurrent vomiting following relatively minor trauma to the upper abdomen, the absence of shock and sometimes the finding of an abdominal mass.

3. Characteristic radiological signs may confirm the diagnosis, a large gas bubble and fluid level in the stomach and also at times in the first part of duodenum in a plain X‐ray and a rounded filling defect in the second part of the duodenum on barium meal examination.

4. Simple evacuation of the haematoma leads to prompt recovery.
THE SURVIVAL OF RED BLOOD CELLS INJECTED INTO THE PERITONEUM
Authors: Allcock E. A.
Published: January 2008

It has been shown that autogenous red blood cells injected into the peritoneum are absorbed intact via the lymphatic plexus under the diaphragm.

Cells so absorbed enjoy a normal survival time for red blood corpuscles of the species investigated.
LYMPHANGIOGRAPHY AS A DIAGNOSTIC AID REPORT OF A CASE
Authors: Gibson G. R.
Published: January 2008

A technique of lymphangiography is described and a case reported in which lymphangioprams proved to be of diaqnostic assistance in obstructive disease of the urinarytract. Further possible applications of lym‐phangiography and some of the complications and difficulties associated with it are discussed.
RECURRENT VOLVULUS OF THE SIGMOID COLON IN A YOUNG PATIENT
Authors: Myers N. A.
Published: January 2008

A case of recurrent volvulus of the sigmoid colon in a young patient has been reported.

Attention has been drawn to the relative rarity of this condition and the absolutrarity in young patients.

A plea has been made for a uniform terminology in describing volvulus of the sigmoid colon.

Radiological examination is diagnostic;. at the same time it has been pointed out that redundancy of the sigmoid colon as an isolated feature is in no way related to the condition discussed and does not warrant operative treatment.

The treatment of recurrent volvulus of the sigmoid colon is sigmoid colectomy.
APOCRINE GLAND CARCINOMA (SWEAT GLAND CARCINOMA) OF THE BREAST
Authors: Wald M. , Kakulas B. A.
Published: January 2008

An apocrine gland carcinoma of the breast occurring in a woman aged 71 years is reported, in which the pathological features, while being in general similar to those which have been described in the literature, presept the unique features of areas of squamous metaplasia and abundant iron pigment.
COMPLETE RUPTURE OF THE STOMACH IN CLOSED ABDOMINAL INJURY: A REPORT OF 3 CASES
Authors: Greig M. T.
Published: January 2008

Three case reports of rupture of the stomach in closed abdominal injury following external trauma are presented.

The discussion is concerned chiefly with the causes of the high mortality of the condition.
LARSEN‐JOHANSSON DISEASE
Authors: Pirotta T.
Published: January 2008

A brief discussion of Larsen‐Johansson disease, its history, aetiology, clinical findings and treatment is given.

A plea is made to restrict the term “Larsen‐Johansson Disease” to cases presenting clinically with the typical features. A normal accessory ossific centre discovered accidentally on X‐rays should not be called a disease.

Two new cases are presented.
ILEO‐CUTANEOUS URETEROSTOMY IN CHILDREN:OPERATIVE TECHNIQUE AND COMPLICATIONS
Authors: Smith E. Durham
Published: January 2008

(1) Modifications in the technique of the operation of ileo‐cutaneous ureterostomy in paediatric conditions are described to emphasize.

(a)the value of performing the operationin two stages‐the first to establish the ileal segment and ileostomy stoma, the second to complete the ureteric anastomosis. The post‐operative course has been smoother than hitherto, following the 2‐stage procedure, and free of any operative complications.

(b)the importance of making the ileal segment no longer than 9 centimetres in order to reduce the absorptive area and thus avoid post‐operative hyperchloraemic acidosis.

(c)that the actual ureteric anastomosis remains in an extraperitoneal plane.

(d)that the site of the stoma must be higher in the lordotic child in order to avoid slipping of the ileostomy ring.

(e)that the nipple of the stoma is kept small, only about 0.5 centimetre above the skin, to avoid its being trauma‐tised.

(f)that the stoma is fashioned in an eversion technique which has eliminated the risk of stenosis by the use of protective skin flaps.

(2) The operative complications are reviewed, and attention is drawn to the high incidence of stoma1 complications; purulent discharge from the disconnected bladder still presents a problem in management.
RENAL HOMOTRANSPLANTATION FROM THE CADAVER USING A MODIFIED TECHNIQUE
Authors: Johnson Neil , Marshall Vernon , Myers Kenneth A.
Published: January 2008

Summary

A method of cadaver renal grafting is dexribed based on the patch technique of arterial anastomosis of Carrel and Guthrie (1906). It is fell that the method offers advantagesin potential shortening of ischaemic time and in the ease of anastomosis, particularly when multiple arteries are found.
CARCINOMA OF THE GALL‐BLADDER
Authors: Bennett R. C. , Jepson R. P.
Published: January 2008

Summary

Fifty‐six cases of carcinoma of the gall‐bladder occurring in two Adelaide teaching hospitals over a five‐year period have been reviewed. Eighty‐four per cent. of patients were over the age of 60 years at the time of diagnosis, and the majority of cases occurred in women. Gall‐stones were present in all except one patient in whom this could be verified. The prognosis, as in other series, proved to be very gloomy, and 61 per cent. of all cases were dead within three months of presentation. The three patients who survived longer than eighteen months, had lesions which were diagnosed as carcinoma only when the specimens were opened after operation.

The incidence of carcinoma of the gall‐bladder in 0·5 per cent. of consecutiveroutine autopsies and 3·7 per cent. of patients undergoing surgery for gall‐bladder disease, is greater than in most reported series.

The question of cholecystectomy for symptomless gall‐stones is discussed, and it is concluded that in otherwise fit patients this should be recommended, not only because of the risk of carcinoma, but also because of the numerous other troubles and hazards to which these patients are exposed.

The more radical surgical approach to established disease by means of right hepatic lobectomy must have a very limited place in view of the age and poor general condition of the majority of patients.
SEVERE CHRONIC RELAPSING PANCREATITIS*
Authors: Wood IAN J. , Goldstein Gideon
Published: January 2008

1. Seven patients complaining of severe pain suggestive of chronic relapsing pancreatitis were not controlled by medical means and a laparotomy was performed.

2. Case I had normal findings at laparotomy and serves as a “contrast case.” In the 6 remaining cases chronic pancreatitis was confirmed. In one, wedge biopsy was performed distal to stenosis of the pancreatic duct with subsequent pancreatic leakage. Three cases were treated by distal pancreatectomy and Roux‐en‐Y pancreaticojejunal anastomosis 2 were rendered pain free and one succumbed 4 months after operation with pancreatic leakage. One case was treated by distal pancreatectomy and pancreatico‐gastrostomy, with moderate relief of pain for six months. One case was treated by distal pancreatectomy and oversewing of the stump as the duct was not patent there was relief of pain but she died seven months later from an unrelated cause.

3. A regime is suggested by one of us (I.J.W.) for the management of patients with severe chronic relapsing pancreatitis unresponsive to medical treatment. This includes meticulous medical care both pre‐ and post‐operatively and an operative pancreaticogram to reveal the state of the pancreatic duct system, thus enabling a rational operative approach to be planned. Needle biopsy of the pancreas may be of value and our experience indicates that this is hazardous only if performed distal to obstruction of the pancreatic duct.

4. Improved results in the treatment of this challenging disease will accrue from close co‐operation between surgeon, physician, radiologist and pathologist.
RETROCAVAL URETER
Authors: Campbell G. D. , Anderson J. C.
Published: January 2008

Retrocaval ureter is due to an abnormality in development of the inferior vena cava. The incidence has been estimated at one in 1,000 but the number of documented cases in the world literature is still far from high. This paper gives a follow up on the case published in 1949 by Anderson and Hynes in which they described their plastic operation on the pelvi‐ureteric junction. Two further cases are reported, both treated in a similar fashion together with 2 other asymptomatic cases. The methods of diagnosis are reviewed together with treatment.
BILATERAL TRAUMATIC DISLOCATION OF THE HIP JOINT CASE REPORT
Authors: Nelson P. G. B.
Published: January 2008

1. A case of bilateral traumatic hip dislocation is presented and the mechanism of the injury suggested.

2. A survey of the larger series in the literature has shown this to be an uncommon injury.

3. The treatment principles in relation to functional results are outlined.
HYDATID DISEASE OF THE LIVER ASSOCIATED WITH THE BUDD‐CHIARI SYNDROME
Authors: Cox John S. T. , Seymour A. E. , Clarkson A. R.
Published: January 2008

The case presented is that of a young male railway worker who presented with diarrhoea and abdominal distension. His history included an attack of jaundice two years prior to admission.

Difficulty in diagnosis was due to ascites, an enlarged irregular liver, a 4 plus hydatid complement fixation test and a positive Casoni test. In view of the latter two investigations, it was almost certain that hydatid disease existed but the presence of malignancy and cirrhosis was not so certain. This was resolved at operation.

An attempt was made to relieve the portal hypertension and hepatic vein occlusion by anastomosis of the inferior vena cava to the superior mesenteric vein.

Autopsy confirmed the presence of cirrhosis with hydatid cysts in the liver and occlusion of the hepatic veins by one of them and the resultant Budd‐Chiari syndrome.
EXTRACORPOREAL CIRCULATION USING A DISPOSABLE BUBBLE OXYGENATOR FOR OPEN HEART SURGERY IN CHILDREN*
Authors: Fisk G. C. , Cohen D. H. , Gengos D. C. , Steedman D. M.
Published: January 2008

Disposable “Travenol” oxygenators are used for high flow perfusions using diluted blood with moderate hypothermia.

A heat‐exchanger is placed in the venous line from the patient.

Blood is collected on the afternoon prior to surgery.

Clinical and laboratory data from fifty patients are presented and discussed.

This technique has proved to be simple, flexible and satisfactory.
SPONTANEOUS RUPTURE OF THE RECTUM WITH EVISCERATION OF SMALL INTESTINE THROUGH THE ANUS
Authors: Hennessy E.
Published: January 2008

A case of spontaneous rupture of the rectum with prolapse of small intestine through the anus is described.

Pre‐existence of prolapse of the rectum is an important causative factor.
Acute Necrotizing Colitis
Authors: Ehrlich F.
Published: January 2008

The condition of acute necrotising colitis is described after experience of 10 cases. This entity is characterised by sudden onset of abdominal pain and bloody diarrhæa, progressing rapidly to produce grave illness with general peritonitis and shock. The pathology is that of intense inflammation of the colonic wall affecting the mucosa first, and leading to the appearance of gangrenous patches. The histological changes include necrosis of the gut wall with inflammatory cell collections and the presence of clostridium‐like organisms in the intestinal wall. Periportal infiltrations of inflammatory cells have been noted in the liver. The ætiological factors may include the action of clostridial toxins and perhaps the ingestion of alkali. The disease is highly lethal.
Intracranial Neurinoma of the Hypoglossal Nerve
Authors: Strang R. R.
Published: January 2008

The tenth case of a neurinoma affecting the intracranial part of the hypoglossal nerve is reported. The clinical course was characterized by the progressive unilateral involvement of the lower cranial nerves, primarily the twelfth, in combination with symptoms of cerebellar compression. Histologically, the encapsulated tumour presented the typical picture of an eighth‐nerve neurinoma.
A PUMP TECHNIQUE FOR RADIAL‐CAROTID BY‐PASS
Authors: Harris J. D. , Rees V. E. , Jepson R. P.
Published: January 2008

1. a technique using a radial‐carotid by‐pass is described, involving a rotary pump designed to have a variable, but predetermined, volume output.

2. its use in 14 cases is described and it is suggested that it is most clearly indicated where advanced major cerebro‐vascular disease exists or where occlusion of the carotid has been shown to be deleterious.

3. other methods of shunting are reviewed and some of their disadvantages outlined.
A LIGHT and ELECTRON MICROSCOPICAL STUDY OF COLLAGEN DEGENERATION
Authors: Mitchell R. E.
Published: January 2008

1. an electron microscopical study of skin with severe collagen degeneration showed that there are changes in elastic, collagen and reticular fibres which lead to a great reduction in the amount of organized fibrous tissue present in the dermis.

2. the collagen fibrils, which are normally formed by tightly packed, strictly aligned filaments, were degraded with the release of the filaments to form disorientated masses.

3. it is suggested that the material which stains like elastin in the dermis is derived from both elastin and collagen. there is hypertrophy and dispersion of elastic fibres, which have degraded collagen added to their surface. there is also a change of narrow bands of the degraded collagen masses to a material looking like elastin.

4. the walls of the small blood‐vessels are profoundly altered, and it is considered that these changes would alter their permeability and therefore affect the nutrition of the overlying epidermis.
TERATOMA OF THE NECK IN THE ADULT
Authors: Kemp Donald R.
Published: January 2008

a case of malignant teratoma of the neck in an 85‐year‐old female is reported. successful surgical removal has resulted in no sign of recurrence after seven months.

a review of the literature reveals 7 other similar cases, 4 of which were malignant, and of the 3 benign lesions, one was a recurrent tumour appearing 23 years after neonatal excision.

although the age of presentation ranges from 23 to 85 years, the onset of growth as seen by the patient occurs in young adulthood.

operation was performed on 7 of the patients without mortality. of the 4 patients whose tumours were malignant, at least 2 died of metastatic spread within ten months of operation.

at least 4 of the tumours were examples of teratoma of the thyroid gland, and one case bore no relation to it whatsoever.

malignant features are common, occurring in 5 cases. these are often of an anaplastic nature, the sarcomatous element appearing to predominate. on the other hand, 3 of the growths were benign and another (author's case) almost certainly so for many years.
Volume and Histology of the Human Pharyngeal Hypophysis
Authors: McGrath Philomena
Published: January 2008

The pharyngeal hypophysis and the pars distalis of the hypophysis cerebri were examined in each of 52 cadavers of a mean age of 75 years. Comparative studies were made of volume and histology. The pharyngeal hypophysis was found to be of appreciable volume and to represent up to 0.5% of the total adenohypophysial tissue in the cadaver. The pars distalis in the female was significantly larger than that in the male, but no significant sex difference in size was noted in the pharyngeal hypophysis. In the majority of subjects, the histological appearance of the pharyngeal hypophysis closely resembled that of the pars distalis. The findings of this investigation demonstrate that, on the basis of size and cytology, the pharyngeal hypophysis is of functional significance in the presence of an aged, normal pars distalis. The suggestion is made that the functional significance of the pharyngeal hypophysis may increase with age, particularly in the male.
A Pattern of Acute Pancreatitis1
Authors: Elmslie R. G.
Published: January 2008

This is a report on acute pancreatitis from two hospitals in South Sydney. A profile of the local disease is built up and compared with profiles from other parts of Australia and overseas.
An Experimental Study of the Influence of Selected Suture Materials on Healing in Aponeurotic Tissue
Authors: Gray F. J. , Herbert Christopher
Published: January 2008

Experimental studies have been made of the effects of certain selected suture materials on the short‐term and long‐term healing of wounds in the lumbo‐dorsal aponeurosis of the rabbit. The results, subjected to statistical analysis, suggest that the polyester “Mersilene” produces stronger wounds than silicone‐proofed braided silk and chromicized catgut in the first two weeks of healing. From about six weeks to one year, stronger wounds are produced by the use of chromicized catgut sterilized by conventional methods than by its counterpart sterilised by 60Co irradiation, and by silk or “Mersilene”. Between two and six weeks there is no significant difference, in the gain of wound strength, between any of the above‐mentioned materials. These conclusions are discussed.
The Tensile Strength of Small Bowel Anastomoses in the Dog
Authors: Nelson P. G. , Dudley H. A. F.
Published: January 2008

The results of tensile strength studies on conventional two‐layer anastomoses suggest that at all times they are of sufficient strength to withstand normal physiological demands.
A Case of Mutiple Duodenal Diverticula
Authors: Parkinson S. W.
Published: January 2008

A case of multiple duodenal diverticula (including one lateral diverticulum) is described, with which were associated hœmatemesis, melœna and a partial “blind loop” syndrome.
Heminephrectomy: A Simplified Technique
Authors: Watts H. G.
Published: January 2008

A technique of hemincphrectomy is described, in which stress is laid on division of the renal mass through the pelvis or calyces of the segment to be removed. It is particularly applicable when one of the renal elements shows poor function. Three illustrative cases are presented.
Elective Surgery for Duodenal Ulcer
Authors: Burnett William , Baillik Hugh D.
Published: January 2008

A study has been made of the value of the augmented histamine test with medical vagotomy in pre‐selecting the most appropriate operation for any individual patient requiring elective surgery for duodenal ulcer. One hundred consecutive patients were studied. The selection procedure altered the otherwise preferred operation of vagotomy and gastro‐jejunostomy in only eight cases—five patients being treated by vagotomy and anirectomy and three by partial gastrectomy. The results are discussed, and it is concluded that the use of these tests as a preoperative selective procedure is unjustified.
Early Post‐Cibal Symptoms after Surgery for Duodenal Ulcer
Authors: Nelson P. G.
Published: January 2008

Factors related to the incidence and severity of early post‐cabal symptoms after four standard operations for duodenal ulcer are discussed. These factors, together with the clinical evidence of the present survey of 277 cases over six years, point to the conclusion that the type of operation in itself has little, if any, influence on the incidence and severity of dumping or bilious vomiting. Evidence is presented to suggest that the factor which is common to all operations, and which is probably of most significance, in the cause of poetical symptoms is the destruction or by‐pass of the functional integrity of the pylorus.
The Complications of Primary Duodenal Diverticula
Authors: Nall Robert
Published: January 2008

Symptoms referable to primary duodenal diverticula are unusual and complications are rare. The complications which may arise in duodenal diverticula from mechanical causes or from stasis and infection, and which may follow opcrative removal, are discussed with reference to illustrative cases. The management of selected complications is outlined.
The Assessment of Acute Injuries of the Knee, with the Results of Early Ligament Repair
Authors: McNeur J. Clarke
Published: January 2008

Accurate assessment of the degree of damage sustained in an acute injury to the knee joint is of importance in determining treatment, and therefore to the future function of that joint. Adequate investigation, including examination of the joint under a general anesthetic with “strain” radiographs, is necessary. The results of surgical repair of ruptured ligaments in 22 knees arc reported, these results confirming the value of early ligament repair.
Postoperative Stasis after Vagotomy and Pyloroplasty
Authors: Hunt D. R.
Published: January 2008

Thirty‐two patients who had vagotomy and pyloroplasty performed for duodenal ulcer or its complications have been assessed after operation by the use of a simple radiological test of gastric emptying. Twenty‐seven showed emptying at 24 hours after operation, and this finding was used as a guide to beginning the administration of oral fluids and tube withdrawal. Eight cases of stasis are discussed.
Xeroderma Pigmentosum
Authors: Khanna N. N. , Thakur V. , Pant G. C.
Published: January 2008

Five cases of xeroderma pigmentosum have been presented, three of the patients belonging to one family. There was no history of consanguineous marriages in this series. All five patients had advanced ocular complications. Three presented with multiple basal cell carcinomata, which were treated by radiotherapy in two cases and surgery in one. One patient presented with a dermatofibroma, which does not seem to have been reported earlier in association with this disease. Reconstructive techniques such as the use of flaps and grafts arc safe, and the healing response is quite satisfactory.
Nephrocolic Fistula: Report of a Case
Authors: Vlahakis Emmanuel , J. Bucchiere John , Leary Frank J.
Published: January 2008

A case of nephrocolic fistula due to non‐specific pyelonephritis is described. The (Etiology, symptomatology, and treatment of this malady are briefly discussed.
Deviation of the Ureters due to Giant Bladder Diverticula
Authors: Syme Rodney R. A.
Published: January 2008

Vesical diverticula may on occasion reach very large size, containing more urine than the bladder proper. Depending on its position, a diverticulum may cause displacement of the lower ureter. Medial deviation of the pelvic ureter, by which a non‐visualized diverticulum may be diagnosed, is not rare. The case to be described is exceptional in that both medial and lateral deviation of the ureters was present in the same patient, due to giant bilateral diverticula.
Total Reduplication of the Stomach: A Rare Anomaly
Authors: Gray D. H.
Published: January 2008

The fourth recorded case of total reduplication of the stomach, illustrating the problems created by this anomaly, particularly hemorrhage, is presented. Management by duodeno‐duodenostomy is discussed in the light of previous reports.
Spontaneous Intraabdominal Hæmorrhage
Authors: Faris Irwin
Published: January 2008

Three cases of this rare emergency are presented. The pathological basis, clinical features and treatment are discussed, and the importance of precisely locating the bleeding site is emphasized. Two of these patients were diabetic, an association which has not previously been described.
The Significance of a Single Injury in the Causation of Basal‐Cell Carcinoma of the Skin
Authors: Ewing M. R.
Published: January 2008

The case records arc reported of 13 patients who gave a history of a well‐remembered injury, which appeared to have resulted, within a comparatively short period of time, in the development of a basal‐cell carcinoma at the same site. Although it is likely that, if such an injury is relevant, it has only accelerated the appearance of a tumour in a precancerous area, it is, none the less, curious that this happening is more commonly recorded in the pathogenesis of a basal‐cell carcinoma than in that of a squamous‐cell carcinoma. In seven of the cases the injury was a thermal one.
Operating under Magnification
Authors: Thomson John R.
Published: January 2008

A brilliantly lit, magnified, stereoscopic view of an operating field is of some advantage when operating on small structures, and is essential with structures that can be resolved only with difficulty. Manual dexterity rapidly improves with practice to meet the needs created by better visualization. The axes, coordinates, and dynamics of equipment are discussed. The Zeiss operating microscope series allow a very wide application. With parts readily interchangeable, there is a maximum flexibility in form. Needless complexity should be avoided. There are many pitfalls (all of which can be overcome) and discussion on sterility, fusion faculty, depth of field, area of field, blind spots, ocular defects in the surgeon, and increased time taken by operations is presented. Photography and teaching objectives are discussed.
Urinary Retention Due to Asymptomatic Protruded Lumbar Disc: Report of a Case
Authors: Vermillion C. Dale , Utley W. L. F. , Liddell W. A.
Published: January 2008

Recently, asymptomatic protruded lumbar discs have been reported in the American literature as causing urinary retention. A 33‐year‐old woman with urinary retention was seen at Christchurch Hospital, and evaluation revealed an asymptomatic central protrusion of her L 4–5 disc. This was removed and a spinal fusion carried out with relief of her symptoms. The literature is briefly reviewed.
In‐Vivo Studies with a Cation Exchange Resin Mixture in the Removal of Excessive Ammonium from the Extracorporeal Circulation System
Authors: Juggi J. S.
Published: January 2008

This paper describes the in‐vivo experience with a mixture (Mixture G) of four forms of the strong cation exchange resin, “Amberlite” IR‐120, in the treatment of ammonia intoxication. This resin mixture, with a total quantity of 750 mEq, when used in the extracorporeal circulation system, was found to be efficient in the correction of hyperammonemia of experimental dogs and to be unaccompanied by any untoward effects.
Human Cardiac Allotransplantation: A Case Report
Authors: Morris K. N. , Stirling G. R. , Cooper Eric
Published: January 2008

This is a full report of the first cardiac allotransplantation carried out at the Alfred Hospital, Melbourne. Operation was followed by acute failure of the transplant, almost certainly due to a major degree of pulmonary hypertension, which at operation was found to be present in the recipient.
Cardiac Valve Replacement with Heterologous Aortic Valves1
Authors: Richardson J. P. , Clarebrough J. K.
Published: January 2008

Eighty‐six formalin‐prepared heterologous aortic valves have been used to replace the human aortic valve over a three‐year period, with encouraging clanical resuts. In a more recent ten‐month pertoct, similarly prepared valves mounted in a suitable frame have been usea as a mitral valve prosthesis tn 11 patients without any operative mortality. Clinical and hæmodynamic follow‐up has shown excellent long‐term function in the aortic valve replacement group, although one‐third of patients have developed some evidence of valve incompetence. Only four patients have had severe incompetence, and in two this was shown to be due to dehiscence of the implanted valve from the host tissues and related to late infection. Pathological studies have shown no evidence of degenerative changes in the valves after implantation, the coliagen and elastic tissue remaining histologically near normal.
Coagulation Changes following Hepatic Circulatory Arrest in Dogs1
Authors: Brockis J. G. , Jackson J. M.
Published: January 2008

This paper reports a series of experiments carried out in order to study the coagulation changes that occur during isolation of the liver from the rest of the circulation and after its subsequent revascularization, a series of 11 dogs being used for the investigation. Changes of any consequence were confined to euglobulin lysis times, which after initial shortening became lengthened again after restoration of the circulation.
Lateral Sphincterotomy: An Appraisal with Special Reference to Sequelae
Authors: Hardy K. J. , Cuthbertson A. M.
Published: January 2008

Lateral sphincterotomy was introduced in the hope that it would give fewer side‐effects than a midline posterior sphincterotomy for anal fissure. This study is a follow‐up of 17 patients who underwent lateral sphincterotomy.
Gastrostomy: A Review of its Uses in a General Surgical Unit1
Authors: Coupland C. A. E. , Reeve T. S.
Published: January 2008

This paper is cancerned with the use of gastrostomy in a general surgisal unit from January, 1967 until December, 1968. Details of the technique regarded as important in ensuring mininral complications are described. The major use for gustrostorny has been for the prevention of postoperative respiratory complications. When a tracheoslomy is to be required for more than several days, gastrostonzy is recommended to enable early alimentations, to reduce inhalation of food, and to prevent the occurrence of tracheoœsophageal fistula.
The Femoral Shaft Re‐Fracture1
Authors: O'Brien John Patrick
Published: January 2008

The purpose of this paper is to draw attention to the usually avoidable complication of re‐fracture of the femoral shaft which has followed treatment by conservative means. The cause, prevention and method of management of re‐fracture are outlined, and the particular susceptibility of the transverse mid‐shaft fracture is discussed.
A Comparison of the Anticoagulant Effects of Heparin and Phenindione on a Standard Experimental Arterial Thrombus1
Authors: Hunt P. S. , Reeve T. S. , Hollings R. M. , Sherwood R. , Kearns R.
Published: January 2008

A standard experimental thrombus was produced electrically in the femoral arteries of sheep. The resultant clots were attacked with heparin or phenindione. Heparin prevented formation of the thrombus in test animals, and in animals with established thrombi it prevented further propagation. Phenindione was not successful in either of these roles.
Congenital Dislocation of the Hip: A 12‐Year Survey
Authors: McKenzie A. R.
Published: January 2008

A 12‐year review has been made of 114 eases of congenital dislocation of the hip joint in children treated in one institution. The general plan of treatment for all cases was similar and patterned on the practice of Scott and Somerville of Oxford. Ninety‐seven hip joints in 61 patients were re‐examined clinically and radiologically, and the results are analysed.
Mammography: A Surgical Assessment
Authors: Hunter Ronald
Published: January 2008

Perhaps for the first time, a surgeon as distinct from a radiologist makes in this review an assessment of the value of mammography to a surgeon. The experience gained in a review of 300 cases of breast pathology at the Royal Adelaide Hospital is presented. The detection of occult carcinoma is discussed. The limitations and dangers of mammography are emphasized.
Achalasia of the Cardia in a Three‐Month‐Old Infant Treated Successfully by a Modified Heller's Operation
Authors: Eaton Henry
Published: January 2008

A case of achalasia of the cardia in a boy aged three months is described. This is the youngest case on record of a successful result following a modified Heller's operation in an infant. A biopsy specimen of the œsophageal muscle did not show any abnormalities in the myenteric plexus. These findings are discussed in the light of present concepts of the disease. The safety and reliability of surgery in these young infants are emphasised, making it the treatment of choice in pædiatric achalasia.
Subdural Empyema
Authors: Weinman Darrel , Samarasinghe H. H. R.
Published: January 2008

Subdural empyema is a distinct clinical entity not uncommon in Ceylon. Forty‐seven cases have been analysed. The commonest sources of infection are otitis media and frontal sinusitis. These empyemas are often complicated by cortical thrombophlebitis, meningitis and intracerebral abscesses. The symptomatology is difficult to differentiate clinically from that of other forms of intracranial suppuration. Percutaneous carotid angiography is the investigation of choice. The treatment consists of surgical evacuation of pus combined with correct antibiotic therapy and skilled nursing. Our mortality of 25·5% was due to uncontrollable associated infections, usually the result of late referral.
Pseudocyst of the Pancreas
Authors: Kemp Donald R.
Published: January 2008

A review is presented of cases of pseudocyst of the pancreas occurring over a 10‐year period at the Alfred Hospital, Melbourne. There were 14 cases. The clinical presentation, surgical management and biochemical characteristics of these cysts arc described and discussed.
Extramedullary Plasmacytoma of the Gastro‐intestinal Tract
Authors: McCaffrey John , Kingston C. W. , Hasker W. E.
Published: January 2008

A case of plasmacytoma affecting the terminal small bowel is described. This is a rare condition, and its importance lies in its relationship to other myelomatous pathological conditions. In the case reported it would appear that the tumour arose primarily in the small bowel and that the bone marrow remained normal.
The Experimental Application of Microsurgical Techniques to Internal Mammary to Coronary Artery Anastomosis
Authors: Jairaj P. S. , O'Brien B. Mcc. , Richardson J. P. , Clarebrough J. K. , Bennett R. C.
Published: January 2008

Obstructive coronary artery disease is in many patients a disease of the proximal arteries. Saphenous vein bypass grafts have been satisfactorily performed into vessels of diameters of 2.5 mm and above. A certain proportion of patients exist, however, in whom the only vessels available for grafting are of diameters of less than 2 mm. The purpose of this study was to test the feasibility of performing internal mammary to coronary artery anastomosis in the dog in vessels of diameters of 1–2 mm, using the operating microscope The study indicates that it is technically possible to perform these anastomoses with an acceptable immediate patency rate.
The Significance of the Size of the Palatine Tonsil
Authors: Roydhouse Noel
Published: January 2008

Five hundred and seventy‐one pairs of tonsils were weighed after removal from children aged from two to 12 years. The distribution of weights formed a normal distribution curve, with a mean weight of 7.3 gm, 63% being between 5 and 8 grammes. Of one group of 302 children, 60% had been recorded as having large tonsils, whereas only 10% of the excised tonsils were in fact large. The children with large tonsils had less tonsillitis on the average than the 121 children on the waiting list for adenotonsillectomy over a two‐year period. After removal of large tonsils, the health of these children was not as good as it was in the 204 post‐tonsillectomy children observed over a two‐year period. There was no close correlation between histological appearance and size. The increase mean weight by age from two to 12 years was 5.3 to 7.8 gm, and in relation to body weight from 9.5 to 51 kg, 6 to 9.2 gm, such increases being of a barely detectable amount. The evidence presented indicates that the size of the tonsils has no clinical significance.
Perforation of Duodenal Diverticula: A New Hypothesis
Authors: Reilly Peter L. , Kune Gabriel A.
Published: January 2008

Two cases of perforated duodenal diverticula are presented. Each of these followed the ingestion of an aerated soft drink. The importance of a sudden rise in intraluminal pressure as a cause of perforation is discussed. The diverticulum was excised completely in both cases.
Choledochal Cyst and Carcinoma of the Pancreas in a Boy of Fifteen Years
Authors: Binks J. B. , Pauline G. J.
Published: January 2008

The case history is given of a boy of 15 years who suffered both from a choledochal cyst and from a carcinoma of the head of the pancreas. This occurrence appears to have been entirely fortuitous. An identical twin proved to hove a normal biliary tree on radiological investigation.