bluuebunny/crossref_metadata_2025 huggingface dataset:
INTESTINAL ATRESIA AND STENOSIS IN THE NEWBORN†
Authors: Maclaurin Campbell
Published: January 2008

Summary

Seventeen cases of intestinal atresia and stenosis are reviewed. The lesion was in the jejuno‐ileum in 12 and the duodenum in the remaining five.

In the jejuno‐ileal group, 5 infants died of causes unrelated to the method of surgical treatment. Five of the remainder were treated by direct anastomosis of the blind ends and one by wide resection and end‐to‐end union.

Of the 5 treated without resection, only one had no further trouble. Two patients showed persisting functional obstruction, one dying and the other requiring resection before recovery, while 2 more developed late complications in which persisting functional inefficiency of the proximal blind end was felt to be an important factor.

The pathogenesis of the condition is discussed, with particular reference to the work of Louw (1959) and current concepts of treatment are reviewed.

The experience recorded in this paper supports the view of Nixon (1955) and Louw (1959) that the blind ends, especially the dilated proximal one, are liable to be functionally and mechanically inefficient and should therefore be resected before anastomosis which itself should be end‐to‐end, rather than side‐to‐side.
GIANT CELL REPARATIVE GRANULOMA
Authors: Farrar D. A. T.
Published: January 2008

Summary

1. A case of giant cell reparative granuloma of the maxilla of a female child is described.

2. The condition is discussed and its differentiation from osteoclastoma described.
FAT EMBOLISM†
Authors: Watts J. McK.
Published: January 2008

An attempt has been made to assess the problem of fat embolism, a condition certain to become more common because of the increasing amount of trauma occurring today.

Seven case records of this condition are presented and are used as illustrations in a discussion of the clinical features, diagnosis and treatment. The importance of chest X‐rays in the diagnosis of pulmonary fat embolism is stressed. Treatment has been discussed with emphasis on the means of prophylaxis and the recent use of heparin. Hypothermia is suggested as a possible advance in the treatment of cerebral fat embolism.

Despite the accumulated knowledge of many investigators, we seem little closer to solving the problem of the true aetiology of fat embolism. It has been established quite convincingly that mechanical embolization of fat does occur after trauma. hut what part this plays in the ultimate disease is not certain. The finding of fat emboli in non‐traumatic conditions and recent work in the composition of the emboli have lent weight to the theory that at least some of the emboli ate derived from circulating blood lipids.
EOSINOPHILIC INFILTRATION OF THE STOMACH
Authors: Blackwell J. B. , Gild A.
Published: January 2008

Two types of lesion may result when there is eosinophilic infiltration of the deeper layers of the stomach. The first is diffuse eosinophilic infiltration which may involve also the duodenum and jejunum and is five cases of an intermediate nature are compared with both the diffuse and localized types and it is concluded that they are probably a variant of the diffuse form.
PRIMARY RESECTION WITHOUT ANASTOMOSIS FOR CARCINOMA OF THE SIGMOID COLON WITH OBSTRUCTION
Authors: Nayman Jack
Published: January 2008

The total overall five‐year survival for carcinoma of the colon still leaves a lot tobe desired.

In obstruction due to carcinoma of the sigmoid colon, preliminary decompression may facilitate the spread of the carcinoma.

For tumours of the sigmoid colon with obstruction a technique of primary resection with proximal terminal colostomy and invagination of the distal stump performed in 2 cases is described. Continuity being re‐established at a later date.
A LATERAL DUODENAL DIVERTICULUM
Authors: Holmes A. B. , Woodward W. W.
Published: January 2008

A diverticulum excised f rom the outer border of the second part of the duodenum is illustrated and described with a commentary.
RENAL HAMARTOMA
Authors: Blackwell J. B. , Saunders J. M. , Vaughan B. F.
Published: January 2008

This paper deals with a patient with tuberous sclerosis but no mental defect who presented with haemorrhage into a large renal hamartoma. The radiological features including those found on a renal arteriogram have been described. Multiple hamartomata were demonstrated by abnormal vascular channels within them and this was confirmed by pathological examination of the nephrectomy specimen.
SOME ASPECTS OF ANAESTHETIC MANAGEMENT OF NEONATAL SURGICAL PATIENTS
Authors: McDonald I. H.
Published: January 2008

This paper reviews some aspects of neonatal anaesthetic methods developed at the Royal Children's Hospital, Melbourne. Urgency, technique, humidification, warmth blood replacement and ventilation are dealt with in a general context, whilst specific problems relating to thoracotomies and laparotomies are discussed.
TRANS‐SPHENOIDAL HYPOPHYSECTOMY IN CARCINOMA OF THE BREAST
Authors: Gray George
Published: January 2008

Summary

1. The operation of trans‐sphenoidal hypophysectomy is described and the complications discussed.

2. Attention is directed to the advantages of this procedure when compared with trans‐frontal hypophysectomy, pituitary stalk section and yttrium implantation in cases of breast cancer.

3. The advantages of hypophysectomy over adrenalectorny are described briefly.

4. Factors for consideration when cases are selected for hypophysectomy are enumerated.
VASCULAR COMPLICATIONS OF CERVICAL RIBS
Authors: Harris James D. , Jepson R. P.
Published: January 2008

Summary

1. Six cases of subclavian artery aneurysms associated with cervical ribs are reported.

2. The natural history of progression from a fusiform dilatation to a grossly abnormal vessel liable to massive or mural thrombosis with embolization is described.

3. For those cases with thrombosis and significant ischaemia, aneurysmal formation of great size or fragility, containing mural thrombosis with embolization, it is recommended that the segment should be resected and a graft inserted.

4. A method of graft insertion without resection of the clavicle is described.
ELECTROLYTE DEPLETION ASSOCIATED WITH VILLOUS TUMOUR OF THE RECTUM
Authors: Battersby Cameron
Published: January 2008

Summary

The case report of a seventy‐four‐year‐old male who presented with severe electrolyte and water depletion as a result of a large villous tumour of the rectum is presented.

Collection of a twenty‐four hour specimen of the mucus discharged from this tumour resulted in 250 C·C. of fluid being obtained. This fluid contained 87 mEq/litre of sodium and 62 mEq/litre of potassium. The liability of the large villous tumour toundergo malignant change or to be associated with a carcinoma elsewhere in the large gut is stressed.
RUPTURED KIDNEY A RETROSPECTIVE STUDY OF 100 CASES
Authors: Wright J. E.
Published: January 2008

Summary

A retrospective study of 100 patients with renal injury has been performed and immediate results assessed. Eighty‐six were males and 14 females. accidents were the commonest causes.

Anterior, lateral or posterioi trauma can cause renal contusion. The pain experienced may be anterior or posterior. Haematuria was present in all except 2 patients. The severity and duration of haematuria bore no relation to the prognosis. Secondary haemorrhage occurred in only 6 patients and presented no clinical problem.

Intravenous pyelography was performed in 49 patients, being normal in 16. Only 1 showed extravasation of dye. Two displaced ureters were detected and 2 pre‐existing lesions (a hydronephrosis and a polycystic kidney) were revealed. A definite calyceal abnormality (dilatation or distortion) was seen in 8 patients.

A conservative policy was followed unless operation was forced by bleeding or deterioration in general condition. The mortality rate was 10 per cent. Only 3 of the deaths were unassociated with multiple severe injuries. These followed pulmonary infarction and tetanus. Sixteen nephrectomies were performed and 4 lacerated kidneys were surgically repaired.

No reason was found from the study of immediate results to abandon the present policy.
THE RATE OF HEALING OF WOUNDS TREATED WITH ULTRA‐VIOLET LIGHT
Authors: Brockis J. G. , Elliott M. , Lissiman M.
Published: January 2008

Ultra‐violet light applied locally to wounds delays healing and in the presence of infection it causes a temporary decrease in the bacterial flora, but this is accompanied by increased tissue destruction and further delay in wound healing.
SPONTANEOUS PERFORATION OF THE CAECUM AND A CARDIAC PACEMAKER
Authors: Hollincs R. M.
Published: January 2008

A case of idiopathic large bowel obstruction with diastatic perforation of the caecum is presented. The possible aetiological role played by a recently implanted cardiac pacemaker is discussed.
DUODENAL LOOP REVERSAL FOLLOWING KOCHER'S MANOEUVRE
Authors: Thomas C. V.
Published: January 2008

A case of reversal of duodenal loop following Kocher's manoeuvre of mobilization of the duodenum is described. This was treated successfully by reattaching the duodenum to the parietal peritoneum.
THE DIAGNOSIS AND MANAGEMENT OF RENAL FAILURE IN SURGICAL PATIENTS
Authors: Marshall Vernon , Yoffa David
Published: January 2008

A group of patients with renal failure due to surgical causes is described, emphasizing the difficulties in diagnosis and the significance of the urinary output after surgery. Difficulties in distinguishing between depletional oliguria and intrinsic renal failure are discussed.

Treatment of established renal failure often requires dialysis, and the relative merits of peritoneal dialysis and haemodialysis are considered. The use of arteriovenous shunts, percutaneous cannulation and regional heparinization as aids to dialysis are discussed.

It is believed that further lowering of the high mortality from renal failure due to surgical causes may be best achieved by earlier diagnosis and referral to a unit experienced in the management of these patients.
MÜLLERIAN DUCT CYST
Authors: Syme Graham
Published: January 2008

A case is described of a large cyst arising in a male pelvis from the vicinity of the prostate and seminal vesicles, and it is considered that the most likely origin of this cyst is from remnants of the Miillerian duct. The literature of this condition is briefly reviewed.
ASSESSMENT OF AUTOGENOUS AND PROSTHETIC MATERIALS IN THE RIGHT VENTRICULAR OUTFLOW TRACT
Authors: Egerton William S. , Windsor Morgan F.
Published: January 2008

In a series of 49 dogs, free atrial appendage grafts, free pericardial grafts, dacron arterial grafts, dacron plus pericardium grafts and 2 types of Teflon graft were each sutured into defects created in the outflow tract of the right ventricle. Twenty‐five six‐month survivors were studied by re‐examination of the graft site at thoracotomy and by histologic section of the implanted materials. Cine‐cardio‐angiography by selective right ventricular injection was performed on one animal in each group. All survivors tolerated the grafts well.

Ease of surgical handling, ready attainment of haemostasis and excellent incorporation into the hosts' tissues favoured the use of a double‐layer patch of dacron and pericardium for the repair of defects in the outflow tract of dogs.
HODGKIN'S DISEASE OF THE COLON PRESENTING AS DISSEMINATED SCLEROSIS WITH ASSOCIATED ULCERATIVE COLITIS
Authors: Meadows Robert
Published: January 2008

A case of Hodgkin's disease of the colon with associated demyelination is described which presented with neurological disturbances and was initially considered to be suffering from disseminated sclerosis. Persistent diarrhoea led to her admission to hospital where perforation of her sigmoid colon occurred. A colectomy was performed and her clinical features and the macroscopical appearances of the specimen suggested ulcerative colitis.
CAUDA EQUINA COMPRESSION RESULTING FROM MASSIVE LUMBAR DISC EXTRUSION
Authors: Schaeffer H. R.
Published: January 2008

Massive rupture of lumbar intervertebral discs is discussed with particular emphasis on the clinical presentation of this important and to a large degree remediable condition. The varying modes of onset of symptoms are described, and the significance and prognosis of associated motor, sensory and sphincteric abnormalities is discussed.

This condition is a grave clinical emergency, and no delay in diagnosis is permissible. Operative decompression of the nerve roots is always essential and the sooner it is done the better will be the result.
THE EFFECT OF LARGE DOSES OF CYTOTOXIC DRUGS ON THE BLOOD VOLUME OF THE RAT*
Authors: Reeve T. S. , Vincent P. C. , Brittle Nea , Nicholls Annette
Published: January 2008

Studies of blood volume in the rat following treatment with large doses of cytotoxic drugs revealed that significant depletion of red cell volume followed the use of cyclophos‐phamide and nitrogen mustard and, to a lesser extent, methotrexate. The anaemia in the case of nitrogen mustard is not revealed by haemoglobin or haematocrit studies, it being masked by hypovolemia following use of the drug. The results indicate that red cells as well as white cells are at risk in cancer chemotherapy.
REGIONAL PERFUSION FOR PERIPHERAL MELANOMA
Authors: Cox Kenneth R.
Published: January 2008

The rationale, technique, and results of 34 regional perfusions of cytotoxic drugs for peripheral melanoma are described.

While individuals have benefited dramatically, it is not easy to demonstrate a real effect on the group as a whole.

The place of regional perfusion in an orderly plan of management of recurrent melanoma is discussed.

Whether prophylactic perfusion at the time of node dissection can compensate for a discontinuous operation between primary site and nodes, is not yet clear.
A CASE OF CARDIAC ARREST ASSOCIATED WITH BRONCHOSPASM AND D‐TUBOCURARINE
Authors: Harrison G. A.
Published: January 2008

A case is reported of cardiac arrest following respiratory obstruction in a 58‐year‐old woman. The obstruction appeared to be bronchospasm precipitated by the administration of d‐tubocurarine. Because of the nature of anaesthetic technique it was possible to exclude many of the causes which mimic true bronchospasm. It is possible that the patient was sensitive to histamine released by d‐tubocurarine as she had a minor past history of bronchial asthma.
A NEW EXPERIMENTAL PREPARATION FOR THE STUDY OF SKIN TRANSPLANTATION
Authors: Ross Harry
Published: January 2008

An experimental preparation for the study of skin transplantation is described. It involves the construction of an explant of the ileum of the dog with restoration of the continuity of the bowel. The submucosa of die explant provides a site for implantation of skin, which has several advantages compared with the more usual techniques.
THE FATE OF SKIN HOMOTRANSPLANTS IN THE SUBMUCOSA OF THE ILEUM
Authors: Ross Harry
Published: January 2008

A technique using ileal explants has been applied to the investigation of the fate of skin homotransplants in the ileal submucosa of the dog. The results indicate that the ileal submucosa is not a “privileged” recipient site.

The preponderance of polymorphonuclear leucocytes in the cellular infiltrate associated with rejection is noted.
PRIMARY SUTURE OF THE OPERATIVE WOUNDS AFTER HAEMORRHOIDECTOMY*
Authors: Failes David
Published: January 2008

1. A small series of 24 patients is presentee in whom haemorrhoidectomy was followec by primary suture of the operatior wounds.

2. The chief advantage of the technique was quicker healing of the wounds and shortened convalescence.

3. The only disadvantage was an increased incidence of skin tags.

4. No difference in post‐operative pain was noted in patients in this series compared to patients undergoing the “standard” Milligan‐Morgan operation.
SEVERE SODIUM DEPLETION WITH RENAL FAILURE FOLLOWING COMMON BILE DUCT DRAINAGE
Authors: Basten A. , Opit L. J.
Published: January 2008

A case of severe sodium deficit following drainage of the common bile duct is described with oliguric renal failure. It is emphasized that despite extensive studies of sodium metabolism in man, clinical recognition of depletion of this cation in surgical patients is difficult, and may not be appreciated until late. Methods of early diagnosis, the mechanism of development of acute renal failure in such subjects, and the existence of “susceptible” groups of patients are discussed. Finally, a number of recommendations for the management of sodium depletion are made.
THE DEVELOPMENT OF A TECHNIQUE FOR EXPERIMENTAL HEART‐LUNG BY‐PASS
Authors: O'Donovan T. G.
Published: January 2008

Experimental heart‐lung by‐pass surgery presents some problems not generally encountered in human open‐heart surgery, not the least of these being the additional burden this essential surgery places on an already hard‐pressed by‐pass unit.

In evolving a simpler and more satisfactory technique for use in the experimental laboratory various modifications were made to the technique generally employed at Green Lane Hospital. These modifications, and the underlying reasons for making them are outlined.
SMITH'S FRACTURE: A REVIEW
Authors: Paterson Dennis C.
Published: January 2008

Although an uncommon injury, Smith's fracture is a fracture around a wrist joint which must be remembered in all injuries in this vicinity. Its diagnosis was missed in 75 per cent of cases in this series.

Smith's fractures fall into 4 distinct types as determined by the patient's age and X‐ray appearances.

It is suggested that all Smith's fractures should be reduced with the hand in maximum supination, in an above‐elbow plaster cast, for six weeks.

Even when adequately treated, all patients are left with some disability, but this is very much less than in those where the diagnosis is missed or the fracture treated as a Colles' fracture, or treated by open reduction.
A COMBINATION EXTRACTOR FOR DIFFERENT TYPES OF SMITH PETERSEN PIN
Authors: Hodgkinson Richard
Published: January 2008

The variable types of apparatus used to fix fractures about the hip joint are listed. A combination tool is described which aims at simplifying the problem of extracting some of these pins despite variable thread sizes and shapes.
CARCINOMA OF THE SIGMOID COLON
Authors: Hughes E. S. R.
Published: January 2008

1. Carcinoma of the sigmoid colon occurred mostly between 40 and 80 years of age, with the highest incidence between 60–70 years. The disease affected 3 patients in their twenties. Females are slightly more commonly involved.

2. Two‐thirds of the patients had a typical non‐urgent mode of presentation. The barium enema occasionally produced a false negative result. The remaining one‐third presented either with acute large bowel obstruction or with perforation of the tumour. When perforation occurs, it causes an abscess (or intense inflammatory reaction) which may remain localized, burst into the peritoneal cavity, or discharge into the bladder and produce a vesico‐colic fistula.

3. Sixteen per cent, of cases were not resected. Multiple peritoneal metastases, a large fixed mass (sometimes partly inflammatory) and poor condition of the patient were responsible.

4. Palliative resection was performed in about 25 per cent, of cases. There were 3 deaths after resection. Two survived unexpectedly. One had a large sub‐serosal plaque of malignant tissue in relation to the primary tumour and associated with peritoneal free fluid; the other had small nodules on the surface of the small bowel, thought to be secondary deposits, but later shown to be carcinoid tissue.

5. Curative resections were performed in 59 per cent, of the patients. Two of the 86 patients so treated died in the post‐operative period. A further patient developed a faecal fistula and required a colostomy to close it. A total of 51 patients were treated five years or more ago, and 44 (86 per cent.) survived. Five of the 7 failures had curative excisions after earlier treatment for acute large bowel obstruction. There have been 3 late deaths from recurrence, all intra‐abdominal.

6. Large bowel obstruction complicated 36 of the patients. Caecostomy proved a satisfactory method of overcoming the obstruction, and was performed on 16 occasions. Resection was performed in 14 of the 16 patients, and an anastomosis in 13. Colostomy was an alternative method of decompressing the bowel, but did not appear to have any advantage over caecostomy. Immediate resection was used on occasions, but its place appeared limited. The long term prognosis of obstructed patients is only fair with 5 of 21 patients treated five years or more ago surviving.

7. Perforation with abscess formation is a formidable complication because it complicates subsequent removal. If the abscess should discharge into the bladder, one‐stage resection is not only a satisfactory operation but is followed by good 5‐year survivals.

8. A total of 80 patients were referred 5 years or more ago and 46 survived at least that period, an absolute five‐year survival rate of 57.5 per cent. Of 22 patients seen ten years or more ago, 8 survived, an absolute ten‐year survival of 36 per cent.

9. It is concluded that one‐stage partial sigmoid colectomy with end‐to‐end anastomosis, without mobilization of the splenic flexure or rectum, and completed. without drainage or post‐operative antibiotics is the treatment of choice for carcinoma of the sigmoid colon.
CHRONIC ULCERATION AND MALIGNANCY*
Authors: Manchanda R. L. , Khanna S. D.
Published: January 2008

1. The history and histology of 114 chronic ulcers which were excised in the surgical unit, Government Medical College, Patiala, have been presented.

2. Twenty cases showed definite malignancy, 6 were diagnosed as carcinoma‐in‐situ and in 2 cases features were suspicious of early malignancy.

3. The histological details of chronic ulcer cases have been discussed in detail and some conclusions have been arrived at.
MENISCECTOMY IN CHILDREN
Authors: Ritchie Douglas M.
Published: January 2008

A review has been made of the reasons for meniscectomy in children in a series from the Royal Children's Hospital, Melbourne. The findings are analysed according to the lesion found.
Multiple Colonic Polyposis in Hirschsprung's Disease
Authors: Shannon R. , Vickers T. H.
Published: January 2008

Three cases of mucosal polyposis of the colon in Hirschsprung's disease are presented. It is suggested that continuing inflammation due to colonic dysfunction was responsible for the lesions. The possibility of neoplasia complicating this evidence of sustained increased cell multiplication is raised.
Necrotizing Colitis: Report of a Successful Case
Authors: Wright J. E.
Published: January 2008

The case of a patient who survived necrotizing colitis is described in detail. The view is expressed that this condition is a distinct entity of obscure ætiology. Radical surgery, in the form of subtotal colectomy with double colostomy or ileostomy and sigmoidostomy, is advocated as offering the only hope of survival. Clinical features which should lead to suspicion of the diagnosis before operation are outlined, and the need for vigorous preoperative and intraoperative resuscitation is stressed.
Vagotomy and Pyloroplasty in the Surgical Treatment of Hiatus Hernia in Children
Authors: Coupland G. A. E. , Rickham P. P.
Published: January 2008

The place of vagotomy and pyloroplasty in the treatment of 18 children with severe complications of hiatus hernia is discussed. Vagotomy with pyloroplasty was performed in four groups of cases: (a) as a primary procedure with concurrent repair of the hiatus hernia; (b) without repair of the hiatus hernia; (c) after failure of transthoracic repair of hiatus hernia; (d) accompanying excision of a stricture and æsophago‐gastric anastomosis or colon transplant. The importance is stressed of early operation to reduce the acid gastric reflux when marked æsophagitis or stricture is present. The results were good in 16 cases and fair in one, and there was one death.
Adrenalectomy for Lesions of the Adrenal Gland1
Authors: Wilson Edward
Published: January 2008

Adrenalectomy for lesions of the adrenal gland is discussed on the basis of an experience with 24 cases, which included eight of Cushing's syndrome, three of phæochromocytoma, one of an adrenal adenoma, one of an adrenal carcinoma and one of an aldosteronoma. Details of these cases are given. It is stressed that Cushing's syndrome and the syndromes produced by adrenal tumours such as a phæochromocytoma or an aldosteronoma may be overlooked when early or atypical. Adrenalectomy does not now carry an appreciable risk, and indeed it has much to offer these patients.
Use of the Heimlich Flutter Valve for Chest Drainage in Battle Casualties
Authors: Fox Bruce
Published: January 2008

In military surgery, the Heimlich flutter valve has the following advantages over underwater drainage that make it a valuable device in forward surgical units: I. The patient is ambulatory very quickly, because the valve functions in any position and the tubing drains into a plastic bag. Thus, the patient can walk while the chest drainage is still functioning and attend his own toilet, etc. Chest X‐ray films can be taken in the X‐ray department, and the tubing need not be clamped. 2. The technique is easily understood by the staff, and less frequent nursing attention is required. This is a very important point for a tired surgical team. 3. The apparatus is sterile as packaged, and is disposable.
Cardiac Tamponade Resulting from Non‐Penetrating Chest Injury, with Reports of Two Cases
Authors: McDermott F. T. , Douglas M. C.
Published: January 2008

Two cases are described in which cardiac tamponade resulted from blunt chest injury. The significance of various clinical features and the value of special investigations are discussed. It is emphasized that early diagnosis is facilitated by an awareness that this complication may be caused by such injury. Management is detailed, and the relevance of early and late follow up is indicated.
Bone Grafting of Fractures of the Tibial Shaft with Special Reference to the Use of the Phemister Principle1
Authors: Anderson Graham
Published: January 2008

This is a report of the follow‐up investigation of 205 cases of bone graft of the tibial shaft, in which three different techniques were used—cortical sliding graft, canccllous graft and Phemister‐type graft. The three methods are compared, with special reference to the rates of healing and the problem of sepsis. The results show that Phemister grafting was the most reliable method used.
Ureteric Reflux and Renal Damage
Authors: Penn I. A. , Breidahl P. D.
Published: January 2008

The management of primary ureteric reflux in children in some centres in the United Kingdom is more radical than the management usually employed in Australia. In a proportion of cases of this condition at the Princess Margaret Hospital over a period of five years, conservative treatment has been associated with progressive renal damage, as evidenced by repeated radiological assessment. The results of a conservative policy do not appear entirely satisfactory, and the place of early surgery may warrant serious consideration.
Insulin‐Secreting Islet‐Cell Tumours of the Pancreas
Authors: Smith Mervyn
Published: January 2008

Some current thoughts on the subject of insulin‐secreting islet‐cell tumours of the pancreas are presented, and a typical case is reported. On the diagnostic side, mention is made of newer aids to diagnosis in the form of tolbutamide and leucine tests and possibly insulin assays. Diagnosis can still be quite confidently made without these aids, and if Whipple's triad is met, surgery is indicated. With regard to surgical treatment, the changing, or changed, distribution picture is presented, and the unlikely occurrence of hyperplasia of islet tissue is mentioned. Management of the case when exploration gives negative results is discussed, emphasis being laid on the possible place for partial pancreaticoduodenectomy rather than blind body‐and‐tail excision. Finally, to indicate that we by no means yet have the answer to the full function of the various components of islet tissue, mention is made of the possible later development of ulcerogenic lesions in a pancreas which has already harboured a beta‐cell tumour.
Necrosis of the Abdominal Wall following Operations
Authors: Masterton J. P.
Published: January 2008

Patients who have had several abdominal operations through separate incisions closely related anatomically, but not temporally, develop occasionally necrosis of the intervening skin and superficial tissues. Four cases are presented, to illustrate this. A contributing factor may be the relatively poor blood supply of the abdominal wall, as well as inappropriate siting of second or subsequent incisions. The blood supply of the abdominal wall is described, and some suggestions are made on how to avoid what can be a serious complication.
Experimental Studies on the Use of Diaphragmatic Flaps for Myocardial Revascularization: Preliminary Report
Authors: Clarke C. Peter
Published: January 2008

Animal experiments were performed to evaluate the use of a diaphragmatic flap, based on a major branch of the phrenic artery, for myocardial revascularization. Even without the stimulus of ischæmia, a significant cross‐anastomosis of blood vessels between the myocardium and flap was demonstrated.

There may be a useful place for such a flap for myocardial revascularization as an alternative or additional procedure to internal mammary artery implantation.
REVIEW OF 280 TRACHEOSTOMIES
Authors: LORD REGINALD
Published: January 2008

1. A series of 280 tracheostomies from St. Vincent's Hospital, Sydney, is reported.

2. Indications for operation are classified and figures presented to show that the operation is more common than formerly.

3. Operative techniques are described.

4. Complications, in particular those relating to cuffed tubes, are tabulated.

5. A case report of tracheo‐arterial fistula is added to the literature.

6. Overall mortality was 40 per cent.
MYCOTIC ANEURYSM OF THE HEPATIC ARTERY RECOVERY AFTER RESECTION
Authors: Nash Thomas
Published: January 2008

A case of mycotic aneurysm of the hepatic artery is presented in which recovery of the patient occurred after excision of the aneurysm. The literature of hepatic aneurysm is reviewed and this appears to be the first mycotic aneurysm of the hepatic artery recorded with recovery of the patient after excision of the aneurysm. The diagnosis, clinical features and treatment are discussed together with the significance of the blood supply to the liver. The use of operative angiography is advocated as a possible means of demonstrating the actual alternative blood supply of the liver when ligation of the hepatic artery seems necessary.
ANEURYSMAL BONE CYST
Authors: Bridger Patrick
Published: January 2008

Five cases of aneurysmal bone cyst are presented.

The aetiology, clinical signs, radiology and pathology are outlined. They illustrate the typical features of this lesion: a short history of a painful bony swelling which radiologically is eccentric, ballooned out and honeycombed. They also emphasize the protean clinical and radiological manifestations which present diagnostic difficulties. The lesion has masqueraded as a benign bone cyst, giant cell tumour, osteogenic sarcoma and even hydatid.

The pathologist must have an adequate biopsy, for without this he may find it difficult to distinguish the cyst from other giant cell bone lesion.

Complete resection or curettage is a satisfactory form of treatment.
HASHIMOTO'S DISEASE
Authors: Jepson R. P. , Miller J. H.
Published: January 2008

1. Thirty‐four cases of Hashimoto's disease are presented, in some instances in association with Sjogren's syndrome, rheumatoid arthritis, and adrenal‐pituitary atrophy.

2. The difficulties in diagnosis are stressed by reason of the frequent nodular nature of the enlargement and the lack of precision in pre‐operative tests.

3. It is advocated that all patients prior to thyroidectomy should have antibody tests performed, and where the index of suspicion is high a surgical biopsy performed before a major ablation is proceeded with.

4. The place for surgery is well defined: pressure symptoms, cosmetic reasons, or pain, and this should be restricted to a limited subtotal resection without risk to the parathyroid glands or recurrent laryngeal nerves.
MIXED SALIVARY TUMOUR OF THE NASAL SEPTUM
Authors: Millar Hugh
Published: January 2008

a mixed salivary tumour of the nasal septum is reported.

excision via lateral rhinotomy is described.

recurrence of the same tumour occurred in a separate situation, presumably the result of cell seeding at the original operation.
PRIMARY AND SECONDARY REPAIR OF THE POSTERIOR URETHRA
Authors: Carswell W. R.
Published: January 2008

the follow‐up of a patient who sustained a rupture of the deep urethra and ensuing multiple fistulae, first seen eighteen months after injury in 1957, shows eight years after reconstruction, and nine and one half years after the original injury, a result which should encourage all surgeons to attempt this reconstruction. at least nothing is to be lost and all is to be regained, except perhaps fertility.

the injuries involve, often, good quality lives.

reconstruction operation should be chosen in preference to recto‐vesicostomy, in the writer's opinion.

primary repair results are encouraging and no strictures have so far been seen in four primary and one major secondary reconstruction.

all patients so treated will be followed up, including comparatively recent repairs, not here included.

retropubic primary and secondary repair is again recommended in this serious injury.
AN OPERATIVE TECHNIQUE FOR THE TREATMENT OF PILONIDAL SINUS
Authors: Hobbs Alan F.
Published: January 2008

an account is given of the use of an operative technique for the treatment of pilonidal sinus, which was described by ziegler et alii in 1946, and which has been employed by me 42 times in 41 patients over a period of seventeen years. the technique is described and an account given of the results obtained recently by examination or response to a questionnaire in 24 of the operations. in three further cases, details up to the time of resuming work are given. the method is considered to have given satisfactory results.
Surgery for Chronic Relapsing Pancreatitis
Authors: Bennett R. C. , Harris J. D. , Jepson R. P. , McKenna K. , Opit L. J. , Proudman W. D.
Published: January 2008

Eight cases of chronic relapsing pancreatitis are reviewed. It is re‐emphasized that at this stage of the disease the major duct is involved in multiple strictures and cannot be drained by terminal anastomosis. The advantages of longitudinal pancreatico‐jejunostomy are outlined, particularly in regard to the preservation of pancreatic function. The outstanding result in this series has been the relief of pain and the considerable gain in weight and well‐being, even though no patient has apparently stopped drinking.
Diallyl‐Nortoxiferine (“Alloferin”): A Clinical Appraisal
Authors: Dwyer B. E. , Gunner B. W. , Walker W. D.
Published: January 2008

The clinical use of the muscle relaxant diallyl‐nortoxiferine (“Alloferin”) is discussed. The following features of the drug were studied: dosage, duration of action, effect on blood pressure and pulse rate and reversibility with neostigmine.
Fractures and Dislocations of the Cervical Part of the Spine1
Authors: King D. M.
Published: January 2008

Protection of the spinal cord is the main concern in the management of injuries of the cervical part of the spine, and to enable this, early recognition of the unstable fracture or dislocation is essential. This paper consists of a review of 57 cases of fracture or dislocation of the cervical part of the spine at the Middlemore Hospital during the years 1947 to 1964 inclusive. On the basis of X‐ray appearances, stability and prognosis, they are divided into six main groups. Three groups—burst fractures, bilateral facet dislocations and extension injuries—are found to be associated with a relatively high incidence of cord damage. The importance of certain X‐ray techniques and the indications for operative treatment are discussed.
Composite Reconstruction of the Femoro‐Popliteal Artery
Authors: Doyle John C.
Published: January 2008

A series of cases is reported, in which femoro‐popliteal occlusive vascular disease has been treated by femoro‐popliteal endarterectomy. This technique is particularly applicable to stenoses and short blocks. It may also be considered as an alternative to “Dacron” bypass graft in cases in which the use of the long saphenous vein as a bypass graft is precluded by its absence, unsatisfactory calibre or anomalous branching.
The Management of Perforated Peptic Ulcer
Authors: McKenna K. P.
Published: January 2008

The case histories of 211 patients with perforated peptic ulcer treated by simple suture between the years 1949 and 1954 have been studied, in an attempt to determine whether more definitive ulcer surgery is justified at the time of perforation. Certain features in these histories have been investigated to determine their prognostic value at the time of perforation, and an attempt has been made to show the indications for definitive surgery. Of the patients who left hospital, approximately 70% have been reviewed 10 to 15 years after simple suture. It is concluded that there is no justification for adopting a policy of definitive surgery in all cases, but certain indications for this form of treatment are suggested.
The Management of Acute Cholecystitis
Authors: Burnett William
Published: January 2008

A detailed analysis is presented of 200 consecutive patients suffering from acute cholecystitis who presented at the Surgical Professorial Unit at the Royal Brisbane Hospital between the years 1961 and 1969. Conservative management was initiated and maintained whenever this was considered to be reasonable and safe. Immediate surgery, however, was considered imperative in 22 of the 200 patients, and early surgery was carried out in a further 29, by reason of failure of conservative management in 25, and uncertainty of diagnosis in four. The overall mortality rate in the series of 200 was 0.5%.
Feeding Jejunostomy
Authors: Welch Richard G.
Published: January 2008

This is a review of 32 cases of feeding jejunostomy carried out in the Queen Elisabeth Hospital between the years 1959 and 1968 inclusive. The indications and conditions for which this procedure was used are illustrated. The complications and results of its use are discussed.
Renal Transplantation in the Rat: Details of a Technique1
Authors: Fabre J. , Lim S. H. , Morris P. J.
Published: January 2008

Renal transplantation in the rat is certain to serve as an important experimental model for reviewing principles of transplantation immunology in whole organ grafting. Thus it is likely that many laboratories will attempt to develop this experimental model. However, the available techniques have been described only in the broadest terms and arc inadequate as a guide to its development. For this reason a detailed description of renal transplantation in the rat, using end‐to‐end anastomosis of the renal vessels and a bladder‐to‐bladder anastomosis of the urinary tract, with simultaneous bilateral nephrectomy, is described. This technique has produced a high success rate, and is based on an experience of 226 rat renal transplants.
Traction Injury of the Facial Nerve in the Rabbit
Authors: Hart Peter F.
Published: January 2008

An experimental traction injury of the facial nerve has been produced in the rabbit. The resultant palsy behaves in a manner similar to that of the temporary facial palsy seen as a complication of clinical parotid surgery. This nerve injury in the rabbit is due to the traction rather than the dissection of the nerve from its bed, but it seems likely that the mechanism of the palsy is nevertheless ischemic. There is a wide variation in the magnitude and duration of the traction insult required to produce a postoperative facial palsy.
The Pharmacological Basis of Drug Interactions
Authors: Brown T. C. K. , Cass N. M.
Published: January 2008

Drug interactions become more likely with the increased use of polypharmacy. Some interactions such as those employed by anesthetists are useful, but others can be dangerous. The pharmacological principles involved are discussed with the aid of diagrams and tables, and the mechanisms of drug interactions are outlined. A brief review of interactions related to anesthesia and surgery is included.
Carcinoma of the Rectum Presenting with Ischæmic Colitis
Authors: Hunt David R.
Published: January 2008

A case of carcinoma of the rectum presenting with ischemic colitis is described. The problems arising from the coexistence of these conditions are discussed in terms of the diagnosis of stricture in the presence of ischemic colitis and of the surgery required for the carcinoma.
Suprapubic Catheter Drainage in Gynæcology
Authors: Cope Ian
Published: January 2008

The suprapubic method of bladder drainage has many advantages over transurethral drainage. It has the lowest incidence of urinary infection of all methods of bladder drainage in common use. It allows the area of surgical repair in cases of stress incontinence time for the ædema to subside without urethral mucosal damage and avoids the necessity for urethral catheterization after repair. The complications are few, wound infection and hematuria being the main ones. The method greatly facilitates bladder management after operation, to the delight of the nurses and patients who have had previous experience with urethral drainage.
Preparation of Patients for Cadaveric Renal Transplantation1
Authors: Epstein Joseph , Marshall V. C. , Saker B. , Kincaid‐Smith Priscilla , Eremin Jennifer
Published: January 2008

Experience with renal homotransplantation during the last six years has made it apparent that the path from the terminal stages of chronic renal failure to renal transplantation is not always smooth and can expose the patient to a series of events which have a definite morbidity and mortality. This communication describes the various problems encountered in the period leading up to transplantation. In addition. the factors thought to be significant in their development and management will Be discussed.
The Influence of Technical Factors upon Renal Homograft Function1
Authors: Tracy G. D. , Annetts D. L. , Farnsworth R. H. , Jeremy D. , Murnachan G. F.
Published: January 2008

Though immunological rejection is the chief obstacle to the prolonged survival of renal homografts, a significant number of graft failures can be attributed to complications of surgical technique. The purpose of this paper is to analyse the influence of vascular anomalies in the donor kidney upon graft function. Factors considered include the duration of “warm” and “cold” ischæmia, the technical improvisation of the vascular anastomoses, and the utilization of both kidneys from any cadaver. During the past three and a half years, 43 renal homografts have been transplanted into 40 patients at the Prince Henry Hospital, Sydney. Although there has been a high incidence of vascular anomaly in this series, no donor kidney has been discarded for this reason, and satisfactory graft function has been obtained in 31 of the transplanted kidneys.
Enzyme‐Treated Bovine Arterial Heterografts, I: Preparation and Physical Properties
Authors: Buxton Brian , Myers Kenneth , Mandel Tom
Published: January 2008

In an attempt to render bovine carotid arteries suitable for use as arterial replacement grafts in the human, the vessels have been modified by a technique of preparation which removes the cellular tissue and elastin from the wall of the graft to leave an almost pure collagen tube. Electron microscopy has revealed that the collagen fibrils remain intact after preparation. Tensiometric studies performed in vitro on vessels prepared by this technique have shown that they retain most of their original strength.
Two Complications following Needle Biopsy of the Liver
Authors: Berg D.
Published: January 2008

Two cases of hepatic bleeding following percutaneous needle biopsy of the liver are recorded. Both required laparotomy and both settled on drainage of the entrapped hœmatoma. In the course of the discussion the literature on hœmobilia is briefly reviewed.
The Measurement and Significance of the Urinary Flow Rate1
Authors: Beck A. David , Gaudin Howard J.
Published: January 2008

A simple, portable urinary flowmeter is described. In an attempt to assess its practical significance, the urinary flow rates of 200 male subjects were recorded. In the absence of symptomatic urethral obstruction the flow rate varies with the age of the subject and the voided volume; the latter should exceed 200 ml if the maximum rate is to be determined. The majority of patients with obstructive prostatic disease or urethral stricture will void with rates below 5 ml/sec, the range of normal being 15 to 45 ml per second.
The Anatomical Basis of Liver Surgery
Authors: Kune Gabriel A.
Published: January 2008

The surgical anatomy of the liver has been investigated in 80 cadaveric specimens, the subject being studied with the use of corrosion casts of the liver, by careful anatomical dissection of the porta hepatis and hepatic veins and by dye injection of blood vessels and bile ducts supplying the liver. The results of these findings are now described, with particular attention to the lobar and segmental structure of the liver, and to the distribution of the hepatic artery, bile ducts, portal vein, collapsed umbilical vein and hepatic veins within and outside the liver. The clinical application of these findings in massive liver resection and infusion chemotherapy, in the diagnostic and therapeutic value of the collapsed umbilical vein, the interpretation of cholangiograms, the significance of aberrant bile ducts, and liver transplantation is outlined.
The Anatomy of the Umbilical Vein
Authors: Hardy K. J. , Nye Daryl H.
Published: January 2008

Interest in the umbilical vein has been aroused recently because of its potential in hepatic radiology and hepalic surgery. This paper describes the anatomy of the umbilical vein and its junction with the portal vein.
Crush Syndrome: The Management of Hypovolaemia and Renal Complications
Authors: Mitchell R. M. , Freeman J.
Published: January 2008

Two case histories are reported, the first of which demonstrates the classical features of the crush syndrome, while in the second, the patient received prophylactic treatment and showed only mild evidence of renal failure.
The Early Diagnosis of Carcinoma of the Larynx
Authors: Fagan P. A. , Ryan James
Published: January 2008

The clinical features of 128 patients with carcinoma of the larynx from the Royal Prince Alfred Hospital have been analysed. The œtology and pathology of this disease are discussed. The causes of delay in diagnosis are emphasized, and some of the procedures available to prevent delay are described.
The Effects and Clinical Significance of Heparin and Phenindione on a Standard Experimental Femoral Venous Thrombus1
Authors: Johnson D. C. , Reeve T. S. , Sherwood R. , Kearns R.
Published: January 2008

Experimental studies have been made into the response to anticoagulant therapy of a standard electrically produced thrombus in the femoral veins of sheep. The anticoagulant reginies involved heparin and phenindione and simulated clinical situations. In these studies, heparin administered continrtously for 14 days by the intruvenous route was the superior form of therapy.
Acute Pancreatitis: A Review
Authors: Barraclough B. H. , Coupland G. A. E.
Published: January 2008

A series of 68 patients with acute pancreatitis admitted to the Royal North Shore Hospital of Sydney in a three‐year period is discussed. An ætiological diagnosis was made in 68% of these. There were three cases associated with a parathyroid adenoma and a 10% incidence of hæmorrhagic pancreatitis, and pseudocysts occurred in 6%. There was no mortality in the 22 patients who underwent laparotomy. The ætiological mechanisms, diagnosis and treatment of acute pancreatitis are reviewed.