bluuebunny/crossref_metadata_2025 huggingface dataset:
FUNCTIONAL RESULTS FROM REPLANTATION SURGERY: A FIVE YEAR REPORT FROM THE VIENNESE REPLANTATION TEAM
Authors: Berger A. , Millesi H.
Published: January 2008

We present the results of treatment of completely and incompletely severed digits achieved by the Viennese Replantation Team. These results are regarded as comparable with other internationally reported series. Our extended use of vein and nerve grafts has effected an improvement in functional results and has made possible a more radical approach to severe hand injuries. We have also used composite and compound grafts for fingertip restoration, and utilized joint transplantation or transposition when necessary.
LOCAL RECURRENCE OF CARCINOMA OF THE BREAST
Authors: Leggett C. A. C.
Published: January 2008

The following consideration of the forms and significance of local recurrence after mastectomy Is based on the experience gained during the follow‐up study of approximately one thousand cases of carcinoma of the breast treated in the private service of the author. Detailed description of locally recurrent disease Is rare and appears to justify the recording of the following observations.
MICROSURGICAL RECONSTRUCTION OF DESTROYED CANALICULI LACRIMALES
Authors: Busse H. , Küchle H. J. , Greul G.
Published: January 2008

The authors describe the microsurgical technique applied for the primary and secondary reconstruction of destroyed lacrimal canaliculi. In the event of fresh injuries, they recommend the immediate repair of the mucosal tissue and the reconstruction of the muscle tissue after direct or retrograde intubation of the lumina canaliculi. For secondary reopening of a stenosis, depending on the localization and the extent of the injury, various methods can be used, such as retrograde probing, the opening of the canaliculus in the area of the punctum papilla as described by Ark, retrograde opening from the tear sac in the manner used by Sattler or from the canaliculus communis following the method of Busse and colleagues. In the event that a substitute is necessary, then the authors recommend the implantation of a hydrophilic tear duct prosthesis in combination with a conjunctivodacryocystostomy in the manner described by Stallard.
EARLY INTRACARDIAC REPAIR OF LARGE VENTRICULAR SEPTAL DEFECTS WITH CONVENTIONAL CARDIOPULMONARY BYPASS AND MODERATE HYPOTHERMIA
Authors: Mok C. K. , Chan M. C. , Cheung K. L. , Lee Jan W. T. , And P. Nandi , Ong G. B.
Published: January 2008

With the use a conventional cardiopulmonary bypass and moderate hypothermia, primary intracardiac repair of large ventricular septal defects was performed in 30 children below the age of two years. All babies were falling to thrive and suffered from cardiac failure resistant to medical therapy, or had evidence of early pulmonary vascular disease. Two patients died after the operation, giving an operative mortality of 6.7%. Twenty‐eight survivors have been followed for periods of one month to two and a half years. All are thriving and have normal or mildly enlarged hearts on their chest skiagrams. Primary intracardiac repair of large Ventricular septal defects can be performed in infants and small children with a low operative risk when the standard cardiopulmonary bypass technique is being used.
INTRAARTERIAL INFUSION CHEMOTHERAPY IN SALVAGE OF LIMBS INVOLVED WITH ADVANCED NEOPLASMS
Authors: Stephens Frederick O. , Crea Paul , Harker Garry J. S. , Lonergan Denise M.
Published: January 2008

Partial or complete limb salvage has been achieved in seven patients by the use of basal intraarterial infusion chemotherapy. All had either refused amputation or had been considered unsuitable for it. Results in all cases showed marked tumour regression to a size where local measures were then successful in controlling the disease. Six of the patients are alive and well with no sign of recurrence at periods ranging from four months to six years.
PREMATURE INCOMPLETE FUSION OF THE GROWTH PLATE: CAUSES AND TREATMENT BY RESECTION(PHYSOLYSIS)IN FIFTEEN CASES
Authors: Vickers D. W.
Published: January 2008

Premature incomplete fusion of the growth plate results in shortening and progressive deformity of bone and joint. A preliminary report is presented of encouraging results following a new operation aimed at a surgical cure by direct attack on the pathological bony bridge. Growth has been reestablished in all of the cases treated in this way, and progressive spontaneous correction of deformity has been observed. Injuries involving high energy dissipation were mostly responsible. A small number of cases followed burns or were of spontaneous onset.
OPERATIVE REPAIR OF NEGLECTED RUPTURE OF THE TENDO ACHILLIS
Authors: Rush Jonathan H.
Published: January 2008

An operation to reconstruct a neglected rupture of the tendo achillis is described using the aponeurosis of the gastrocnemius‐soleus muscle fashioned into a tube. The repair is strong and effective and has given good results in five patients.
THE RESULTS OF SURGERY FOR CARCINOMA OF THE PANCREAS
Authors: Ross Harry , Jonas Richard A.
Published: January 2008

A retrospective analysis was performed on 104 consecutive patients with carcinoma of the pancreas treated between 1970 and 1974 inclusive. Fifty‐three per cent underwent palliative bypass, 13% laparotomy only, 6% had a Whipple operation, 7% various miscellaneous operations, and 21% did not undergo operation. The operative mortality of palliative bypass and diagnostic laparotomy was 13% and 71% respectively. The mean survival of patients after biliary bypass was 6·7 months. Seven patients undergoing bypass had tumours of the pancreatic head, five centimetres or less in diameter, and apparently localized disease, and their mean survival was 15·9 months. The mean survival of the four patients surviving radical surgery was 15·5 months. There were no cures. It was concluded that cholecystojejunostomy without enteroenterostomy was an appropriate biliary bypass operation and that diagnostic laparotomy should be avoided in patients without obstructive jaundice and with disseminated disease.
THE OBJECTIVES OF PALLIATIVE SURGERY IN PANCREAS CANCER: A RETROSPECTIVE STUDY OF 73 CASES
Authors: Eastman M. C. , Kune G. A.
Published: January 2008

In 73 cases of pancreas cancer, histological diagnosis was not obtained in 43 (59%). Relief of obstructive jaundice was not satisfactorily achieved in 14 of 39 patients at risk (36%), while gastric outflow obstruction developed subsequent to surgery in eight of 31 patients at risk (26%). Fine needle aspiration cytology is advocated to improve the rate of positive peroperative tissue diagnosis. To relieve bile duct obstruction, cholecystojejunostomy is advocated only in patients with pancreas cancer who have a very short life expectancy, and only when the cystic duct is patent. Choledochojejunostomy and gastrojejunostomy “double bypass” Is advocated for cancers which are macroscopically localized to the pancreatic area. The selective use of this double bypass will improve surgical palliation and minimize reoperations in cancer of the pancreas.
NON‐CHROMAFFIN, NON‐FUNCTIONING RETROPERITONEAL PARAGANGLIOMAS: A REPORT OF THREE ADDITIONAL CASES WITH A REVIEW OF THE LITERATURE.
Authors: Chandrashekar V. , Ananthakrishnan N. , Mehta R. B. , Sankaran Vanaja , Parkash Satya
Published: January 2008

A review of the literature has revealed only 24 cases of retroperitoneal non‐functional paraganglioma recorded up to the present date. This report presents three additional cases, in two of which metastasis had occurred at the time of surgery. The clinical presentation and the biological behaviour of these tumours are reviewed in detail, as also are recommendations regarding therapy.
RECTUS SHEATH HAEMATOMA CAUSING MUSCLE NECROSIS
Authors: Askew A. R.
Published: January 2008

Rectus sheath haematomas are unusual, and it is very rare to find associated rectus muscle necrosis. The aetiological factors are discussed. Non‐surgical treatment is preferred, but if surgery is indicated, evacuation of the haematoma with ligation of the feeding vessels is an effective method of treatment.
THE MANAGEMENT OF BLEEDING GASTRIC ULCER: A PROSPECTIVE STUDY
Authors: Hunt P. S. , Hansky J. , Korman M. G. , Francis J. K. , Marshall R. D. , Mccann W.
Published: January 2008

In a prospective study of six years' experience with a haematemesis and melaena unit from 1972 to 1978, there were 98 admissions of patients with bleeding gastric ulcer. There were ten deaths, giving a mortality of 11%. Forty‐one patients were treated by emergency surgery with seven deaths, an operative mortality of 17%. All ten deaths occurred in the first four years; there were no deaths during the final two‐year period (38 admissions), In retrospective studies at Prince Henry's Hospital, Melbourne, it was found that the mortality for bleeding gastric ulcer was 17% to 18% for the period 1951 to 1970. It is concluded that a prospective system of management with an active policy of early endoscopy and surgery and regular audit of results reduces the mortality from bleeding gastric ulcer.
SQUAMOUS CARCINOMA OF THYROGLOSSAL DUCT REMNANTS: A CASE REPORT AND REVIEW OF THE LITERATURE
Authors: Benveniste G. L. , Hunter R. , Cook M. G.
Published: January 2008

The first reported case in Australia of a squamous carcinoma arising in a thyroglossal duct remnant is presented. This case shows the previously unreported feature of associated hyperthyroidism.
EXTRAMAMMARY CYSTOSARCOMA PHYLLODES WITH BILATERAL BREAST INVOLVEMENT
Authors: Singh Jogindar , Singh Bholla , Chander Jagdish
Published: January 2008

A unique case of cystosarcoma phyllodes is present and the Literature is reviewed
ANAEROBIC BACTERIA, THE COLON AND COLITIS
Authors: Roediger W. E. W.
Published: January 2008

Anaerobic bacteria constitute more than 90% of the bacteria in the colon. An anaerobic environment is needed to maintain their growth and the production of short‐chain fatty acids by these bacteria from carbohydrates. Short‐chain fatty acids are rapidly absorbed and essential for metabolic as well as functional welfare of the colonic mucosa. The importance of these acids in water absorption and in the pathogenesis of colitis is discussed in relation to the concept of “energy deficiency diseases” of the colonic mucosa.
RENAL IMPAIRMENT AND ITS REVERSIBILITY FOLLOWING VARIABLE PERIODS OF COMPLETE URETERIC OBSTRUCTION
Authors: Fink R. L. W. , Caridis D. T. , Chmiel R. , Ryan G.
Published: January 2008

There is debate concerning the time course and degree of recover possible after relief of complete unilateral ureteric obstruction. This study in dogs investigates these features. One ureter was occluded for varying periods, and then reimplanted into the bladder. Recovery was monitored by Tc‐Sn‐labelled diethylene triamine penta acetic acid (D.T.P.A.) scans and renograms together with creatinine clearance studies. The morphological changes were also studied. There was found to be a progressive loss of functional recovery with increasing periods of obstruction, though this was dramatically improved by contralateral nephrectomy once recovery had stabilized. Increased radial scarring developed in the kidney following increasing periods of obstruction.
ABDOMINOPERINEAL LEVATOR ANI REPAIR FOR RECTAL PROLAPSE: TECHNIQUE
Authors: Hughes E. S. R. , Johnson W. R.
Published: January 2008

A review some twenty years ago of the then popular rectosigmiodectomy for complete rectal prolapse having shown an excessive recurrence rate and a high incidence of incontinence, it was felt essential to seek for a more satisfactory and reliable surgical procedure for its management. This was achieved in the form of an operation, carried out from above and below, approximating the levator ani anterior to the rectum. This has given very much more satisfactory results, and is described in detail in this paper.
THE VASCULAR COMPLICATIONS OF CERVICAL RIB
Authors: Connell John L. , Doyle John C. , Gurry John F.
Published: January 2008

The consequences of cervical rib do not appear to be widely understood. Whilst most cervical ribs cause little or no trouble, and, at the most, require shoulder raising exercises, some are the cause of serious nerve compression and sometimes arterial compression. Much confusion has existed in the understanding of the vascular manifestations of cervical rib, and this confusion has often led to incorrect treatment with serious consequences, in this regard it is particularly important for the surgeon to deal with the diseased artery at the same time as the cervical rib is excised. Nine cases of cervical rib with arterial compression are reported. The importance of recognition of arterial compression, before surgery is undertaken, is stressed.
RUPTURE OF THE AORTA IN ROAD CRASH VICTIMS
Authors: Hossack Donald W.
Published: January 2008

Traumatic rupture of the aorta following vehicular colllsions is a more frequent occurrence than is generally realized by the members of the medical staff in hospital casualty departments. In the past there has been a tendency to concentrate efforts on other Injuries, especially those relating to the head. With the recognition that 12.7% of all fatal road crash victims have a rupture of the aorta, special attention can be directed to Its early diagnosis. Despite the grave prognosis of this condition, initial rupture may be incomplete, and if emergency surgery is undertaken, the defect may be repaired before it extends and death occurs.
THE TECHNIQUE AND EARLY RESULTS OF HIGH GASTRIC REDUCTION FOR OBESITY
Authors: Long Michael , Collins John P.
Published: January 2008

The high gastric reduction operation has been performed on one hundred and nine obese patients over a sixteen‐month period. Patient selection, preoperative care, operative technique and postoperative care are described. Our early results show that a satisfactory initial and continuing weight loss can be sustained for a twelve‐month period with a low morbidity and mortality. Further follow‐up of these patients is required before the ultimate place of this procedure is established.
IMMEDIATE OPERATION FOR ACUTE NON‐VARICEAL GASTROINTESTINAL HAEMORRHAGE IN PATIENTS AGED 50 YEARS AND OVER
Authors: Wong J. , Lam S. K. , Lee N. W. , Lai C. L. , Lam P. , Ong G. B.
Published: January 2008

A prospective trial of immediate operation was carried out on all 123 patients aged 50 years and over who presented with acute non‐variceal bleeding as shown endoscopically. The mortality rate was 11·4%. Four hundred and sixty‐seven similar patients treated by a conventional and more conservative approach, viz., surgery only for massive, continuous or recurrent bleeding, over an earlier period of three years, had a mortality rate of 6·4% during the acute bleeding episode. In the latter series, the mortality for the 161 patients with emergency surgery was 11.8%. The aggressive approach carries no advantage over the conservative approach and is not to be recommended. In both series surgery for haemorrhage with associated medical illness carried a similarly high mortality (27·3% and 26·3% respectively), indicating that the timing of surgery in such patients, whether it is done as early or as late as possible, does not influence the outcome. The mortality rate of immedate Billroth gastrectomy for gastric ulcer was low (4·8%), so that operation in such patients should not be delayed.
THE SURGICAL TREATMENT OF SPASMODIC TORTICOLLIS1
Authors: Fabinyi Gavin , Dutton John
Published: January 2008

The results of upper cervical anterior rhizotomy and accessory nerve section in the treatment of twenty patients with spasmodic torticollis are reviewed. The majority of these patients presented with pain in addition to postural deformity. There was no evidence in any of them to suggest that the condition was psychogenic. Good results can be expected, particularly in those patients without evidence of cervical spondylosis. We suggest that in symptomatic torticollis surgery is more effective than medical, psychiatric, or other described forms of treatment. Electromyogra‐phy may be helpful to delineate the affected musculature and to assess postoperative improvement. The operating microscope is a valuable adjunct to surgery to preserve radicular vessels and ensure total division of the relevant motor roots.
TENDON INJURIES ABOUT THE FOOT AND ANKLE IN CHILDREN
Authors: Wicks Malcolm H. , J. Scott Harbison  , Paterson Dennis C.
Published: January 2008

Sixty‐four children with tendon injuries about the foot and ankle have been reviewed in order to present a plan of management when such injuries occur. One‐third involved the tendo Achillis; the others were equally distributed between the dorsum and sole of the foot, and in only 12% was more than one tendon involved. Sensory nerves were frequently severed, but nearly all recovered completely after early repair. The results of immediate repair of tendons were good. When repair was delayed the results were less satisfactory, as severe deformities developed in the growing feet. Early exploration and surgical repair of selected tendons are recommended to avoid future disability.
COLONIC INFARCTION AND PANCREATITIS: A CASE REPORT
Authors: Nottle Peter
Published: January 2008

A case of almost total colonic infarction secondary to pancreatitis is described. This appears to be a very rare complication of acute pancreatitis and is a result of mesenteric venous thrombosis secondary to the acute inflammatory process. The clue to the diagnosis was the passage of bright blood per rectum and a rapid deterioration in the condition of a patient with severe pancreatitis. Subtotal colectomy with ileostomy and mucous fistula formation was the treatment of choice. lleosigmoid anastomosis was performed six months later.
NECROTIZING GASTRITIS AND PHLEGMONOUS GASTRITIS ­ ARE THEY SEPARATE ENTITIES?
Authors: Webster V. J.
Published: January 2008

Phlegmonous gastritis, although a rare condition, is a submucosal bacterial infection strictly confined to the stomach with characteristic macroscopic and histological findings. A case of necrotizing gastritis with perforation is presented, and another similar case is reviewed, In which the gross and microscopic features are considerably different from those ascribed to classical phlegmonous gastritis. There was no evidence of an infectious aetiology in either case, and the predominant feature was necrosis. It Is proposed that this variant may represent a separate disease entity of unknown aetiology. A combination of early radical gastric resection and vigorous antibiotic therapy appeara to be the treatment of choice in both classical phlegmonous gastritis and necrotizing gastritis.
ANTERIOR RECTAL ADVANCEMENT FLAP IN THE REPAIR OF BENIGN RECTOPROSTATIC FISTULA
Authors: JOHNSON WILLIAM R. , DRUITT DOUGLAS M. , MASTERTON JOHN P.
Published: January 2008

Rectoprostatic fistula following open prostatectomy for benign prostatic disease is a rare occurrence today. This paper reviews such a case and describes the technique of anterior rectal advancement flap used In the repair of this complication.
RESULTS OF GEOMETRIC ARTHROPLASTY FOR RHEUMATOID AND OSTEOARTHRITIS OF THE KNEE
Authors: LOWE G. P. , MCNEUR J. C.
Published: January 2008

The Geometric Total Knee Arthroplasty was one ot the earliest unconstrained knee arthroplasties available for the replacement of knees severely affected by destructive arthritis. This paper presents the results of Geometric knee arthroplasty performed by surgeons of the Alfred Hospital, Melbourne, during the years 1973 to 1977, this being the initial five years experience with this procedure. One hundred and fifty arthroplasty operations were performed in 106 patients, 78 for osteoarthritis and 72 for rheumatoid arthritis, with the average time from operation to review being four years. The Geometric arthroplasty was used In 147 of these operations. Assessment was based on a modification of the British Orthopaedic Association Knee Function Assessment Chart (1978) and 137 knees were available for review. Eighty nine percent of patients suffering osteoarthritis, and 79% of patients with rheumatoid arthritis were satisfied or enthusiastic with their prosthesis. Nineteen percent of rheumatoid patients and 4% of osteoarthritlc patients considered the result of their operation disappointing. In both groups, the operated knee constituted minimal persisting disability to the patient when reviewed. Seventeen knees (11.3%) were assessed as unsatisfactory, of which 7 (4.6%) were due to Infection, and 5 (3.3%) were due to loosening. Revision procedures were performed In 7 knees (5%), for instability or loosening. Improvements in arthroplasty design have resulted in alternative prostheses now being chosen by most surgeons for knee replacement, and the long term results of these newer prostheses must be evaluated with those results obtained using the original geometric prosthesis.
DEMOGRAPHY OF ARTERIAL SURGERY IN NEW SOUTH WALES
Authors: HILL DAVID A. , LORD REGINALD S. A.
Published: January 2008

In New South Wales In 1978, 2545 patients received arterial reconstructions excluding procedures which were primarily intrathoracic. Seventy‐one per cent of these involved the abdominal aorta and lower limb arteries, 22 per cent were associated with renal transplantation and angioaccess, while only seven per cent involved the extracranial arteries. Fifty‐two surgeons regularly practised arterial surgery of whom 39 worked In the metropolitan health regions and 13 in country areas. The optimum number required for the whole state probably lies between 30 and 50. On a population basis the number of aortic and lower limb reconstructions seems appropriate to the projected need based on clinical Indications, but the number of carotid reconstructions was less than 10 per cent of the projected need.
GLUTARALDEHYDE TANNED OVINE COLLAGEN COMPARED WITH POLYTETRAFLUOROETHYLENE (GORE‐TEX) AS A CONDUIT FOR SMALL CALIBRE ARTERY SUBSTITUTION; AN EXPERIMENTAL STUDY IN DOGS
Authors: KETHARANATHAN V. , CHRISTIE BRUCE A.
Published: January 2008

Collagen tubes with a polyester mesh endoskeleton were grown in sheep around silastic mandrils and were then tanned In alkaline glutaraldehyde. Tanned ovine collagen conduits and polytetrafluoroethylene conduits (Gore‐Tex), each 10 cm long and 6 mm wide, were deployed in parallel as aorto‐illac bypass grafts in 10 dogs. The grafts remained patent for periods up to and exceeding 23 months. No grafts showed aneurysmal dilatation. All grafts formed a neointima lined with cells. In the Gore‐Tex grafts there was fibrous tissue ingrowth through the wall which resulted in progressive and irregular luminal narrowing. This was not seen in the tanned ovine collagen grafts.
CONTROL OF THE UPPER INFRARENAL AORTA1
Authors: LORD REGINALD S. A. , TRACY G. DOUGLAS , GRAHAM ANTONY R. , HILL DAVID A.
Published: January 2008

Variations in technique used to control the infrarenal aorta in a variety of circumstances are described. Usually direct clamping of the aorta below the renal arteries Is appropriate. Alternatives Include suprarenal, supracoeliac, and intrathoracic clamping, balloon catheters and external pressure. Renal vein ligation improves access to the infrarenal aorta but in the occasional patient produces renal congestion.
TRACHEOSTOMY IN THE MANAGEMENT OF CHEST INJURIES: ITS USE AND COMPLICATIONS
Authors: JAMES O. F. , MOORE P. G.
Published: January 2008

During the period March 1968 to June 1978 a total of 238 adult patients received long term artificial ventilation for acute respiratory failure following chest and associated injuries. In 180 of these tracheostomy was used as the means of access to the tracheobronchial tree. Our indications for tracheostomy in these patients, details of treatment and the complications which resulted from this aid to management are given. The lack of serious complications suggests that tracheostomy can be used safely and with advantage in the management of acute respiratory failure after injury.
PHARYNGEAL RECONSTRUCTION AFTER PHARYNGOLARYNGOESOPHAGECTOMY IN AFRICAN PATIENTS
Authors: MANNELL AYLWYN , DAVIDGE‐PITTS K.
Published: January 2008

Six African patients with squamous cancer of the laryngopharynx underwent pharyngolaryngoesophagectomy. Transposition of the stomach to the neck was the method selected for reconstruction of the pharynx. The operative technique and results of this method of pharyngeal reconstruction are discussed. Pharyngogastric anastomosis Is compared to other methods of pharyngeal reconstruction.
WILLIAM R. WILDE, ANDREW. S. GRAY, AND TWO EYE AND EAR HOSPITALS OF VERY SIMILAR NAME
Authors: LOWE RONALD F.
Published: January 2008

Historical background is given for the development of the Royal Victoria Eye and Ear Hospital, Dublin, and The Royal Victorian Eye and Ear Hospital, Melbourne. The similarity of names was fortuitous, but both have strong Influences derived from William R. Wilde and his St Mark's Ophthalmic Hospital In Dublin.
ACCURATE LOCALIZATION AND EXTRAPERITONEAL DRAINAGE OF PANCREATIC ABSCESS
Authors: Porter T. R. , COUPLAND G. A. E.
Published: January 2008

Localization of a pancreatic abscess can be difficult. CT scanning can confirm the presence of an intraabdominal collection and define its extent. Five consecutive patients with pancreatic abscess have been investigated by CT scanning and the site and extent of the abscess defined. Extraperitoneal dissection with drainage was undertaken in all five patients. In four patients the abscess resolved completely, and in one laparotomy with further drainage was necessary. No complications occurred as a result of the procedure.
THE EPIDEMIOLOGY OF LOWER LIMB ISCHAEMIA IN A NEW SOUTH WALES RURAL COMMUNITY
Authors: HILL DAVID A. , MCGRATH MICHAEL A.
Published: January 2008

A cross‐sectional survey was carried out in the Bangalow Valley on the far north coast of New South Wales to determine the prevalence of lower limb ischaemia. A study was made of 80.2% of the population aged thirty years and over. The presence or absence of peripheral vascular disease was determined by clinical history, clinical examination, and measurement of peripheral arterial pressures with a Doppler ultrasonic velocity detector. Twelve out of 232 (5.2%) males and seven out of 282 (2.5%) females had symptomatic lower limb ischaemia. From these data the predicted incidence of lower limb ischaemia in the sixth and seventh decades in New South Wales is 40/10,000/year in males and 14.5/10,000/year in females. These N.S.W. data are compared with studies in the United Kingdom, the United States of America, and Switzerland, and similarities are noted indicating the universal nature of lower limb atherosclerosis in developed countries.
AN ANALYSIS OF THE PATHOLOGY OF 3003 APPENDICES
Authors: CHANG. ALEXANDER R.
Published: January 2008

An analysis was made of 3003 appendices seen in a ten‐year period (1969–1978) in the Dunedin Hospital Surgical Pathology Laboratory. Acute appendicitis was found to be a disease of the young, with 1385 (80%) cases out of 1711 occurring in patients less than 30 years of age. Faecaliths and lymphoid hyperplasia were found only in a very small percentage of acute appendicitis cases, and this lends further support to the hypothesis that acute appendicitis is a disease of western culture where the diet is low in cellulose. There was no seasonal predilection for acute appendicitis. of her pathological conditions were discussed and illustrated. More normal appendices and more of those exhibiting non‐acute conditions were removed from females. The submission of appendices for histological evaluation is a most worthwhile procedure, with a significant yield of unexpected important information.
THE EFFECT OF AN ANABOLIC STEROID ON BODY COMPOSITION IN PATIENTS RECEIVING INTRAVENOUS NUTRITION
Authors: YULE ALASTAIR G. , MACFIE JOHN , HILL GRAHAM L.
Published: January 2008

In this controlled trial we investigated the effect of an anabolic steroid, in terms of the changes in body composition that occurred in ill surgical patients requiring intravenous nutrition. Glucose was the sole non‐protein energy source. The study was conducted over a 14‐day study period in two comparable groups of 13 patients. The changes in body weight, fat, protein and water were measured. The control group received a nutrient solution of hypertonic dextrose and amino acids (44.8 ± 8.2 kcal/kg/day), and the comparative group received the same solution (44.3 ± 5.2 kcal/kg/day) and 100 mg of an intramuscular injection of nandrolone decanoate at the commencement of the study and again one week later. Over the two‐week study period both groups gained body weight. In the controls this was composed of fat (0.4 kg) and water 1.5 kg). In the anabolic steroid group, weight gain was mainly water, and fat gain did not occur. Neither group gained body protein. Diuretic therapy was required more often (21 patient days compared with 5 patient days; p > 0.001) in the anabolic steroid group to control excessive water retention. Our study has shown no benefit from an anabolic steroid when given in combination with a 14‐day course of intravenous nutrition. Water retention was more of a problem with this therapy.
ENDOSCOPIC SPHINCTEROTOMY IN HIGH‐RISK PATIENTS WITH BILIARY TRACT DISEASE1
Authors: ROBERTS‐THOMSON IAN C.
Published: January 2008

Endoscopic sphincterotomy was performed in 53 patients with biliary tract disease who were considered to be at high risk from conventional surgical procedures. Forty‐five patients had choledocholithiasis, while eight had miscellaneous disorders including carcinoma, stenosis of the papilla, and postoperative biliary fistulae. Forty‐three of 45 patients with choledocholithiasis have been free of symptoms since the procedure, and most have had repeat retrograde cholangiography confirming the absence of bile duct stones. Endoscopic sphincterotomy is a safe and effective procedure in selected high‐risk patients, particularly those with choledocholithiasis after cholecystectomy.
URINARY BLADDER STONES IN ABORIGINAL CHILDREN
Authors: WISNIEWSKI Z. S. , BROCKIS J. G. , RYAN G. D.
Published: January 2008

Primary bladder stones are described as occurring in aboriginal children from native reserves. Here breast feeding is supplemented early in life with white flour and little else. A comparison is made between this diet and that of children in endemic bladder stone regions, and reasons are advanced for the formation of these stones, with biochemical evidence to support the thesis that ammonium acid urate precipitation is the initiating factor.
PSYCHOLOGICAL IMPLICATIONS OF MASTECTOMY
Authors: BATTERSBY CAMERON
Published: January 2008

Some recent studies on the psychological trauma endured by patients with breast disease are summarized and a number of conclusions are drawn. There appear to be a number of stages through which a patient with a breast lump passes psychologically. Breast cancer attitudes in a community are dependent upon accumulated experience and cannot be changed overnight. Delay in presentation results from unconscious factors which may not be amenable to rational public health appeals. It is possible to identity a group of patients high at risk in breast surgery, although human resilience is such that the outcome is often satisfactory. There is a great need for controlled prospective studies in many areas of breast surgery rehabilitation. Some personal observations are included to stimulate discussion and interest in the area.
ENTEROLITH ILEUS COMPLICATING A JEJUNAL DIVERTICULUM
Authors: CADE R. , COLLOPY B. , RYAN P.
Published: January 2008

A 76‐year‐old man presented with recurrent small bowel obstruction, which, at laparotomy, was found to be due to an enterolith which had become distodged from a solitary jejunal diverticulum.
EARLY DIAGNOSIS OF METACHRONOUS COLORECTAL CARCINOMA
Authors: TÖRNQVIST ANDERS , EKELUND GÖRAN , LEANDOER LENNART
Published: January 2008

The frequency of metachronous colorectal tumours in a prospective 20‐year series of patients with colorectal cancer is reported. Thirty‐one patients, that Is 2.1% of the patients operated on for cure, had metachronous carcinomas, and 5.4% had metachronous polyps. One‐third of the metachronous carcinomas were diagnosed at scheduled postoperative control examinations, and the others because of their symptoms or at autopsy. The reported metachronous carcinomas are considered to represent failures of follow‐up only and not to indicate their true incidence, since their natural course has been arrested by removal of adenomas whenever found. Several of the metachronous tumours were judged to be overlooked synchronous ones, and therefore a thorough postoperative examination of the remaining large bowel is advocated. The finding of subsequent tumours in this series indicates that continuous follow‐up is worthwhile.
MULTIPLE METACHRONOUS GASTRO‐INTESTINAL CARCINOMA
Authors: BROWNSTEIN E. G.
Published: January 2008

A patient who developed multiple metachronous gastro‐intestlnal carcinoma is described. This patient has had multiple invasive carcinoma of the colon, Jejunum and stomach over a 34 year period, commencing at the age of 44 years. All the colonic tumours have been Duke's A Grade, although penetration has occurred to the serosal level. The family pedigree of the propositus shows an autosomal Mendelian dominant gene pattern with a characteristic early age of onset and a significant frequency of multiple metachronous primary malignant neoplasms. Identification of this syndrome provides an opportunity to include In a surveillance program, those unaffected patients in the pedigree who have an extra risk of early development of cancer at specific sites.
READMISSIONS TO HOSPITAL AFTER APPENDICECTOMY FOR NON‐SPECIFIC ABDOMINAL PAIN
Authors: JOYCE P. R. , WALSHE J. W. B. , BUSHNELL J. A. , MORTON J. B.
Published: January 2008

Appendicitis is the most common cause of acute abdominal pain, but in ten per cent of appendicectomies the appendix is normal. Follow up of 54 patients having a normal appendix removed reveals that in only two cases was a physical diagnosis missed and yet these patients were more likely to be readmitted with suicidal behaviour or further unexplained pain than patients who had an inflamed appendix removed. Psychological factors may be of aetiological importance in patients having a normal appendix removed, and although none of these patients had multiple admissions or further abdominal surgery it is suggested that patients be told that their appendix was normal.
PRIMARY HISTIOCYTIC LYMPHOMA OF THE BLADDER
Authors: CATO A. R.
Published: January 2008

A case of primary histiocytic lymphoma of the bladder is presented, and the management of the condition is discussed. Endoscopic resection of the tumour followed by pelvic irradiation appears to give a good prognosis.
AORTOCAVAL FISTULA ‐ A CASE REPORT1
Authors: BOOSHANAM M. V. , MURALIDHARAN S. , KRISHNASVVAMY SHANKAR , BANERJEE ASISH , NARAYANAN RAMJI
Published: January 2008

Aortocaval fistula is an unusual complication of an abdominal aortic aneurysm with a characteristic clinical presentation. Early recognition and aggressive treatment carry a good prognosis. We describe our experience with one patient with this condition.
BILATERAL BREAST CANCER IN A CHINESE MALE
Authors: ALAGARATNAM T. T. , DING‐PING J. SHUM , CHENG F.C.Y. , ONG G. B.
Published: January 2008

The occurrence of metachronous bilateral breast cancer In a Chinese male Is described, and the difficulties in distinguishing between a second primary tumour and metastatic spread from an earlier tumour are discussed.
LARGE BOWEL CANCER: AN OVERVIEW
Authors: Higgins GEORGE A.
Published: January 2008

Cancer of the large bowel is a problem of International scope but with wide national incidence variations possibly related to climatic factors. Neither etiologic studies nor improved methods of early detection have thus far had an impact on national death rates. Surgical treatment, while comparatively effective, does not promise a significant increase in survival data, and thus far, adjuvant therapies have failed to fulfil early enthusiastic expectations. Nevertheless, continued research pursuit of the nature of the neoplastic process, development and application of improved diagnostic and screening methods, and synthesis of better combined modality therapy, will result in substantial improvements in therapeutic results.
PERITONEO‐VENOUS SHUNTS FOR MALIGNANT ASCITES
Authors: GOUGH IAN R.
Published: January 2008

Ten patients with uncontrollable malignant ascites had a Le Veen perltoneo‐venous shunt inserted. A shunt controlled ascites (for up to 15 months) In five of seven patients until death occurred from the underlying malignancy. In two of three surviving patients, a shunt has controlled ascites for six and seven months respectively; in the third patient a shunt blocked after three months and was replaced by another shunt which is still functioning after six months. Peritoneo‐venous shunting is indicated for the treatment of uncontrollable malignant ascites when the patient is expected to survive more than one month.
AXILLARY SKIN EXCISION FOR THE TREATMENT OF AXILLARY HYPERHIDROSIS
Authors: TAYLOR GREGORY D.
Published: January 2008

In fourteen patients with axillary hyperhidrosis, good control of sweating has been achieved by resection of a longitudinal ellipse of axillary skin and Z‐plasty closure. Axillary scarring has been extensive, but inconspicuous.
LOCAL RECURRENCE OF BREAST CANCER: ITS SIGNIFICANCE IN RELATION TO BREAST RECONSTRUCTION
Authors: MENDELSON BRYAN C.
Published: January 2008

Questions regarding local recurrences are a major concern in considering mastectomy patients for breast reconstruction. A critical analysis of the literature on local recurrences Indirectly provides answers to several of these concerns. Local recurrence Is a relatively predictable event, and is uncommon In those with a favourable breast cancer. Its presence reflects concurrent systemic disease which is usually lethal within a short time. Concern over subsequent local recurrences should not be a contraindication to breast reconstruction In selected patients.
CLOSED RENAL TRAUMA IN CHILDREN
Authors: WOODWARD ALAN , SMITH E. DURHAM
Published: January 2008

Closed renal trauma in children often results in serious Injury. In a series of 100 consecutive patients with closed renal trauma treated at the Royal Children's Hospital from 1967 to 1978, 32 children required surgery. Of these, eight children came to nephrectomy, whereas in 19 children viable renal tissue was conserved by the use of techniques such as renal suture or partial nephrectomy. The remaining five children had surgery, not for trauma, but rather for preexisting hydronephrosis discovered during investigation. There was a close relationship between the classification of renal injuries and the need for surgery. In this series there were two deaths and two late complications.
THE EARLY MANAGEMENT OF THORACOLUMBAR FRACTURES BY OPEN REDUCTION AND INTERNAL FIXATION
Authors: RYAN M. D. , TAYLOR T. K. F.
Published: January 2008

Twenty‐eight patients with thoracolumbar fractures treated by open reduction and internal fixation with Harrington instrumentation are reviewed. An unresolved problem is the selection of patients for surgical management. It is a major operation requiring a surgeon experienced in both the care of spinal cord injuries and the use of spinal instrumentation. The technique permits more rapid mobilization, retraining and rehabilitation than nonoperative management.
THE STABILITY OF COAGULATION FACTORS IN STORED BLOOD
Authors: HONDOW J. A. , RUSSELL W. J. , DUNCAN B. M. , LLOYD J. V.
Published: January 2008

The complete coagulation profile of citrate phosphate dextrose (CPD) stored blood has been studied during 21 days storage at 4°C. Ten donations were studied at zero, one, seven, 14 and 21 days. One donation contained small clots and was studied separately. Activities of factors I, II, IX, XII or XIII did not deteriorate significantly. Slight, but clinically unimportant deterioration occurred in factors VII, X and XI. There was marked deterioration in activities of factor V, and factor VIII, the levels decreasing from 1.0μ/ml at day zero to 0.51 to 0.30 respectively at day 21. The donation which contained small clots had more marked decreases in factors V and VIII from the first day. The general stability of coagulation factors suggests that even massive blood replacement is unlikely to result in clinically significant coagulation defects.
CYCLIC AMP AND GASTRIC ACID SECRETION IN THE DOG
Authors: HALL JOHN C. , JERUMS G. , DOUGLAS M. C.
Published: January 2008

Canine gastric secretions were collected for acid and cyclic AMP assay at zero, 15, 30, 45 and 60 minutes during intravenous infusion of zero, 2.5 and 5.0 μg/kg/hr of pentagastrin. A resulting brisk acid response was not accompanied by an elevation of cyclic AMP content. It is thereby suggested that cyclic AMP may not be an obligatory intermediary for gastric acid secretion.
PILONIDAL SINUS: EXCISION AND PRIMARY CLOSURE WITH A LATERALISED WOUND ‐ THE KARYDAKIS OPERATION
Authors: KITCHEN P.R.B.
Published: January 2008

In a personal series, forty‐five patients with postanal pilonidal sinus have been treated by the Karydakis operation.1 The sinus is excised using an eccentric elliptical incision, the medial edge of which is undermined and advanced across the midline to produce a lateral vertical scar and shallower natal cleft. Forty patients were followed up for an average of thirty‐three months. There were two wound haematomata, four wound infections and two recurrences, one of which was not in the scar. A low recurrence rate can be achieved by flattening the natal cleft and closing the skin away from the midline.
COMPLETE AGENESIS OF THE MID‐GUT: A CASE REPORT
Authors: BRUCE M. B. , COUTTS J. P.
Published: January 2008

A male child was born with complete agenesis of the mid gut, a condition incompatible with life. This was found in association with failure of development of the superior mesenteric artery. An extensive review of the literature failed to reveal another case similar to the report that follows.
PARAGANGLIOMA OF THE FALCIFORM LIGAMENT: A CASE REPORT
Authors: DELBRIDGE L. , CONNOLLY J.
Published: January 2008

A single case of an extra‐adrenal paraganglioma removed at laparotomy from the falciform ligament of a 16 year‐old girl is reported. Whilst extra‐adrenal paragangliomata have been frequently documented in specific sites in relation to the vascular axis, the occurrence of these tumours in other areas is rare. This is the first report of a paraganglioma occurring within the falciform ligament in the midline in apposition to the anterior abdominal wall.
TONSILLAR METASTASES FROM ADENOCARCINOMA OF THE STOMACH
Authors: PASSMORE ALLAN L. , HUGH THOMAS B. , COLEMAN MAXWELL J.
Published: January 2008

Two cases of tonsillar metastases from gastric adenocarcinoma are reported. Three possible modes of spread are considered, the most likely being cascade metastases from liver or lung secondaries.
CANCER OF THE PANCREAS IN NEW ZEALAND 1970–19741
Authors: STEWART RICHARD J. , STEWART ALISTAIR w. , STEWART JOANNA M. , IBISTER WILLIAM H.
Published: January 2008

There were 991 new cases of cancer of the exocrine pancreas in the New Zealand population for the five years 1970‐74. The disease had a higher incidence in men than women and in Maoris compared to Europeans. There was no increase in incidence in the period 1950‐52 to 1971 ‐73. Most of the cancers occurred in the head of the pancreas and were described as adenocarcinomas. Seventy seven per cent of the patients had lymph node metastases or advanced disease at the time of diagnosis. Only 7 per cent were able to have resectional surgery and in 90% specific therapy was not given. The estimated crude three‐year survival rate of all patients was four per cent and the median survival time was 1.7 months. The crude three year survival rate after resection was 9.8% and the median survival time was 5.8 months. The most important variables affecting survival were stage of disease and age of patient.
ACUTE CHOLECYSTITIS: A DIAGNOSTIC APPROACH USING 99mTc DIETHYL IDA SCINTIGRAPHY
Authors: GILCHRIST N. L. , BONIFACE G. R. , TURNER J. G. , OVENDEN B. M.
Published: January 2008

Fifty consecutive inpatients referred with the provisional diagnosis of acute cholecystitis were investigated with 99mTc diethyl IDA scintigraphy within 48 hours of the onset of symptoms. Scintigraphic results were correlated with other radiological investigations, surgery and histopathology, and showed that the nonvisualization of the gallbladder is a highly sensitive (100%) and specific (96.6%) indicator of acute cholecystitis. Other scintigraphic patterns that were observed were often helpful in the elucidation of other hepatobiliary disorders.
EXPLORATION OF THE COMMON BILE DUCT FOR BENIGN CONDITIONS: AN ANALYSIS OF 413 PATIENTS
Authors: WORTHLEY CHRISTOPHER S.
Published: January 2008

The morbidity and mortality following exploration of the common duct for benign conditions has been analysed retrospectively in 413 patients from the Royal Adelaide Hospital. Follow up ranged from one to 110 months (median 47 months). The major complication rates in patients having biliary “drainage procedures” (choledochoduodenostomy (56 patients), sphincterotomy or sphincteroplasty (65 patients)) compared favourably with those having choledochotomy with T‐tube insertion alone (307 patients). This was despite a greater incidence of potentially adverse factors in the former group. Problems related to retained or recurrent stones were effectively reduced by drainage procedures which were performed safely in the presence of acute inflammation. Symptomatic cholangitis was not more frequent after drainage procedures.
LONG TERM NUTRITIONAL EFFECTS OF EXTENSIVE RESECTION OF THE SMALL INTESTINE
Authors: BAMBACH CHRISTOPHER P. , HILL GRAHAM L.
Published: January 2008

A nutritional study was carried out on 36 patients several years after major resection of the small intestine (100 to 330 cm). Thirty one of these resections had been performed for Crohn's disease and only patients who had been clinically free of disease for more than one year were studied. The group of patients were 15% below their ideal weight. Total body fat was 24% below the predicted normal value and total body protein was 10% below. Although deficiencies of iron, vitamin B12 and folic acid were frequently found, only six patients were anaemic. Other vitamin and mineral deficiencies were common. Despite these abnormalities, two thirds of the patients were engaged in their normal occupation full time and were subjectively well. The others who did not regain their normal capacity for work, had a greater nutritional deficit and a shorter length of remaining small intestine. It is concluded that nutritional deficiencies are common following extensive small bowel resection and all patients need regular follow up and appropriate vitamin and mineral supplementation. However, major disturbances of body composition and severe protein energy malnutrition with a reduced capacity for work are restricted to a small number of patients with very short lengths of remaining small intestine.
VALUE OF SMALL BOWEL ENEMA IN INCOMPLETE INTESTINAL OBSTRUCTION
Authors: ROEDIGER W. E. W. , MARSHALL V. C. , ROBERTS S.
Published: January 2008

The usefulness of small bowel enema X‐ray examination was evaluated in 11 patients in whom a provisional diagnosis of Incomplete small bowel obstruction was made. Dilute barium was introduced through a nasojejunal tube. In one patient intubation of the Jejunum was unsuccessful. In six patients the suspected obstruction was confirmed and information obtained about the site of obstruction. The small bowel enema X‐ray examination was normal in three patients and subsequent clinical outcome was uneventful. In one patient, with normal findings on small bowel enema X‐ray examination, acute obstruction developed after two days, necessitating operation. Small bowel enema X‐ray examination appears a worthwhile adjuvant to clinical assessment but decisions for operative intervention still need to be based on clinical evaluation of patients.