bluuebunny/crossref_metadata_2025 huggingface dataset:
PRIMARY UNILATERAL HARE LIP REPAIR
Authors: Fraser K. B.
Published: January 2008

Forty‐five cases of primary unilateral hare lip repair have been selected from a series of facial cleft operations and subjected to critical review. The deformities to be over come have been discussed and the technique of the operation has been described. Attention has been directed to the significance of the various stages in the operation and to the methods employed in an attempt to overcome the more common post‐operative defects. The importance of a photographic record of all cases has been stressed and a series of photographs showing progressive grades of deformity has been included to emphasise this.
SQUAMOUS EPITHELIUM IN BURSAE; THE IMPORT OF THE NON‐SPECIFICITY OF THE GERM‐LAYERS
Authors: King E. S. J.
Published: January 2008

An example of a prepatellar cyst lined by stratified epithelium is described. An opinion that this is an epidermal cyst or tumour depends on an acceptance of the three germ‐layer hypothesis, which would imply that stratified epithelium, especially if squamous, is necessarily of ectodermal origin.

The problem of the specificity of the germ layers is examined briefly from the general biological viewpoint. Although it is not possible to do more than indicate in a very sketchy way the, main points (biological details of species, etcetera, are not given), an indication of the breadth of the question and the great volume of investigation is provided. The experimental work is discussed and some of the pathological observations are mentioned. From whichever of these viewpoints the question is considered, it is apparent that the germ‐layer hypothesis is largely phantasy.

That there are three layers to be seen at certain stages of development of some animals (particularly those with large egg yolks 1 has been abundantly demonstrated, but it has been shewn that any a priori opinion that a condition such as that described here must be epidermal (that is ectodermal in origin) is unjustified. In normal conditions the three layers are separate and evolve in a usual, apparently predetermined fashion, but in “thunder, lightning or in rain (that is, in pathological states) they show a disregard for boundaries that is the more complete the more they are studied in such circumstances.

The variations in form of the synovial membrane of bursae are shown in several examples. The specimen described here is one in which a hidden potentiality is exposed a growth capacity of which synovial membrane is capable in abnormal conditions the development of a stratified and squamous epithelium.
CARCINOMA OF THE LOWER OESOPHAGUS AND UPPER STOMACH
Authors: Niesche F. W.
Published: January 2008

Records of 13 patients submitted to total gastrectomy or cardio‐oesophagectomy are presented.

Eight patients survived operation, one dying at the end of six months from acute intestinal obstruction.

Seven patients are still living, 4 having survived for a period of at least twelve months.

A plea for early diagnosis has been made because all these patients had advanced malignant disease and some were poor risks.

The operability rate has been extended as far as possible. With earlier diagnosis and increasing experience, it is felt that the mortality can be lowered.

These extensive operations may be considered justifiable if the patient can live in comparative comfort for a year or more.
EXPERIENCES WITH THE COMPOSITE OPERATION
Authors: Gleadell L. W.
Published: January 2008

The technique of the composite operation is described.

Its indications and limitations are considered.

The results of 24 cases are reviewed.
SUPPLEMENTARY COMMENTS ON SPLINTS FOR NERVE INJURIES
Authors: Lawson Robert S.
Published: January 2008

A new design of ulnar nerve splint is described and illustrated.

A case of bilateral median nerve injury is quoted as an illustration of the value of splinting for this nerve injury.

The advantage of an elastic‐traction splint for radial nerve injury is reiterated.
A CASE OF LATERAL DISLOCATION AT THE SUB‐TALOID JOINT
Authors: Lawson Robert S.
Published: January 2008

A case of lateral dislocation of the subtaloid joint is described.

The anatomy of the interosseous talo calcanean ligament and ef the blood supply of the talus is discussed.
CEREBRAL ANGIOGRAPHY IN NEUROSURGERY.: Part II. THE ANGIOGRAPHIC APPEARENCES IN INTRACRANIAL ANEURYSMS
Authors: Dowling J. L.
Published: January 2008

Intracranial aneurysms are briefly discussed with particular reference to the angiographic technique used in their diagnosis.

A series of tracings of angiograms is reproduced showing aneurysms in various situations. Their symptomatology and treatment are indicated.

The relationship between aneurysms and sub‐arachnoid haemorrhage is stressed and a line of surgical management discussed.
SOME PROBLEMS IN OESOPHAGEAL SURGERY
Authors: Robb Douglas
Published: January 2008

The problems of exact diagnosis, the correct treatment of advanced cardiospasm, and the management of acid regurgitation leading to oesophagitis and peptic ulcer are discussed.

It is suggested that it is necessary to use all available methods of diagnosis before deciding on treatment. That while Heller's operation with certain safeguards is probably the best procedure for advanced cardiospasm, it is not wholly reliable, and should notbe resorted to lightly. That a flap of gastric mucosa might be useful in checking reflux after resection and oesophago gastrostomy. That a graft of diaphragmatic tissue might be useful in the fortification of an otherwise doubtful repair of a hiatus hernia.
TRANSPLANTATION OF URETERS INTO THE COLON
Authors: Brown Grayton
Published: January 2008

THE CLOACAL LIFE.

1. The history of the operation of transplantation of the ureters into the bowel has been reviewed.

2. Careful pre‐operative preparation of these patients is emphasised.

3. An operative technique has been described in detail.

4. The mortality and morbidity of this operation is shown to be reasonably low.

5. The cloaca1 life is described.
UNILATERAL RENAL ECTOPIA WITH RENAL CARCINOMA
Authors: Earlam M. S. S. , Carrodus A. L. , Howarth V. S.
Published: January 2008

1. A record is made of a Grawitz tumour arising in an ectopic kidney. This is the third case to be placed on record and possibly the first case of successful surgical removal.

2. The main complaint was of atypical abdominal pain which was referred to the opposite side of the upper abdomen. This pain was reproduced by over distension of the pelvis of the ectopic kidney and disappeared after nephrectomy.

3. There were no complaints that could be clinically attributed to the ectopic organ.

4. Technical difficulties in the surgicalapproach are discussed.

5. A review of the literature is included.
GRAFTING OF HOMOGENOUS BONE AND CARTILAGE
Authors: Christie H. K.
Published: January 2008

1. The place of homogenous grafts of bone and cartilage has been briefly described, in the light of modern progress.

2. A small number of cases is presented illustrative of their uses.

3. Selections have been made from the extensive bibliography.
HYDRONEPHROSIS OF AN ECTOPIC KIDNEY RESULTING FROM ACCIDENTAL SURGICAL LIGATION OF THE URETER
Authors: Howarth V. S.
Published: January 2008

1. An example of accidental surgical ligation of the ureter with hydronephrotic atrophy is a low lumbar ectopic kidney is recorded.

2. The development of hydronephrosis following surgical ligation of the ureter is insidious.

3. Pain may not be a clinical feature until hydronephrotic atrophy is complete, and in the case recorded, three and a half years passed without symptoms or signs.

4. The presence of infection would appear to determine the onset of acute symptoms following surgical ligation of the ureter.
SUBTOTAL PAROTIDECTOMY FOR MIXED SALIVARY TUMOUR.*
Authors: Eddey Howard H.
Published: January 2008

A technique for removal of the superficial lobe of the parotid salivary gland, with early and constant visualization of the facial nerve, is described. Some points in the anatomy of the facial nerve in relation to the parotid gland are discussed.
MALIGNANT GIANT CELL TUMOUR OF BONE.*
Authors: King E. S. J.
Published: January 2008

The malignant giant cell tumour of bone is described here as the malignant growth which contains many foreign body giant cells (osteoclasts).

This tumour is at first localized to one part of a bone, radiologically shows characteristic trabeculation and histologically shows a structure closely resembling that of the benign giant cell tumour.

The features distinguishing it from the benign giant cell tumour are the relatively uniform stroma and the presence of mitotic figures.

It is the less malignant form of this tumour, and the lack of clear segregation of it from the benign giant cell tumour that is responsible for much of the confusion regarding the benign tumour.

Difficulties of histological diagnosis are due to foreign body giant cells and a superadded pleomorphic stroma occurring in malignant tumours as the result of haemorrhage and infection.

The benign giant cell tumour does not fulfil the criterion of a neoplasm, namely that of progressive growth, and thus its distinction from the true neoplastic form is extremely important.
TUMOURS AND CYSTS OF THE MEDIASTINUM PART TWO*
Authors: Hirschfeld Konrad
Published: January 2008

Twenty‐four cases of tumours and cysts of the mediastinum are described, and in‐clude two cases of posterior mediastinal goitre, 1 haemangioma, and 1 lymphatic cyst.

A survey of the literature of some 600 tuniours and cysts has been made.

A brief description of the various types tumours and cysts is given.
MUCOUS CYSTS OF THE FINGERS.
Authors: King E. S. J.
Published: January 2008

The condition of mucous cysts of the fingers has well‐defined clinical features and is due to mucoid change in the sub‐cutaneous tissues.

2. The condition is not “synovial” in the sense that the cysts are related to or communicate with joints.

3.Ganglia and synovial cysts are clinically distinguishable conditions.

4.Fundamentally the processes in the two conditions are similar but, though this is important pathologically, it should not be allowed to sustain the confusion which has arisen in the literature concerning what are, in their fully developed forms. distinguishable conditions.

5.Peri‐articular nodules may occur also in cystic form but are readily distinguishable by their site and structure.

6.Thus the three conditions which have been confused in the literature and which may become morphologically similar by synovial differentiation of their tissues are:

(i)mucous cysts of the fingers,

(ii) ganglion,

(iii) peri‐articular nodules.

Clinically they are readily distinguishable.
TENDON REPAIR IN THE HAND‐A SUPPLEMENTARY PAPER.
Authors: Rank B. K. , Wakefield A. R.
Published: January 2008

The vastly improved results in the latter series of cases as compared with those pre‐viously presented, we attribute mainly to the following:‐

(a)A better knowledge of what cases have no prospect of any improvement. This does not mean that we discard any cases where there is any prospect of success what‐ever. A good condition of the joints and absence of scar embarrassment are essential to success.

(b) A more patient attitude in waiting until any scar residuum, which is not going tohe replaced, has softened.

(c) A more practised and standardized technique which, if done in proper sequence, permits of a quicker, more orderly and less traumatic procedure which, in the case of a single finger, can be completed under tourni‐quet avascularity.

(d) A. personal conduct of all phases of lreatment.

In conclusion, we consider that a stage has now been reached when we can tell patients with ordinary confidence what can or cannot be achieved by operations of tendon repair.

Moreover, in general consideration of tendon repair in the hand we would now‐ make this statement, which might surprise many ‐ 111 relation to the criteria of normal function. our worst results from cut tendons are where these injuries involve not the flexor tendons on the front of the finger, but the extensor tendons on the back of the finger. This statement is made with sound reason which we will discuss elsewhere.
ACUTE HAEMORRHAGIC PANCREATITIS IN A CHILD.
Authors: Dey David L.
Published: January 2008

1.A case of acute haemorrhagic pancrea‐titis in a child of twenty‐two months is reported.

2.The aetiological factor precipitating the condition appeared to be mumps (epi‐demic parotitis 1 .
EXTRA‐DURAL HAEMORRHAGE
Authors: Bradley K. C.
Published: January 2008

“And if amongst these examples, I may adde one of a brother of mine, called Captaine Saint Martin, a man of three and twentie yeares of age, who had alreadie given good testimonie of his worth and forward valour, playing at tennis, received a blow with a ball, that hit him a little above the right eare, without apparance of any contusion, bruse, or hurt, and never sitting or resting upon it, died within six houres after of an Apoplexie, which the blow of the ball caused in him.”
PAGET'S DISEASE OF THE NIPPLE
Authors: Johnson Neil
Published: January 2008

(1) macroscopically, paget's disease of the nipple may present a variable picture. in the majority of cases the lesion is red, raw and granular in appearance, but in others, it may be eczematous or dry andscaling. paget's disease should be suspected when any nipple lesion persists for more thanthree to four weeks.

(4) microscopically characteristic changes are seen. typical paget cells occur around the edge of the lesion, whilst centrally the superficial layers of the epidermis may be lost.

(5) carcinoma is present in the underlying breast in 75 per cent. of cases when first seen.

(6) in those cases without a palpable tumour, treatment should be as for carcinoma of the breast.
CAROTID BODY TUMOURS: A STUDY OF THREE CASES INCLUDING A BILATERAL EXAMPLE
Authors: Birrell J. H. W.
Published: January 2008

three patients who had carotid body tumours subjected to surgery are described, including a patient with bilateral tumours. in no case were any carotid vessels ligated, yet death occurred in a patient who had a unilateral tumour removed.

post‐operative investigations, performed on the patient who had had bilateral tumours, involving a variation in the percentage of oxygen in the inspired air, provide suggestive evidence in favour of the hypothesis that anoxaemia with a subnormal okygen tension is the stimulus to the carotid bodies.

the histology of the tumours is examined and similarities to the glomus tumour noted. their general structure indicates that they are hyperplasias; the tumour is extensively, if irregularly, innervated and many club‐shaped nerve endings can be demonstrated. the “tumour” is therefore probably a functioning tissue.

diagnosis and treatment are briefly discussed, early surgery being the treatment of choice, whilst angiography may help in diagnosis.

the literature of bilateral carotid bodies is briefly reviewed.

the percentage of malignant carotid body tumours is considered to be negligible.
HYPOTHERMIA
Authors: Nicks Rowan
Published: January 2008

1 A short review of hypothermic development has been attempted.

2 Physiological data obtained from pigs and sheep undergoing hypothermia have been discussed.

3 Experience on these animals with hypotherinia in intra‐cardiac surgery has been presented.

4 Clinical applications are briefly summarized.
CASE OF ADMANTINOMA OF LOWER JAW
Authors: Maddern John
Published: January 2008

This is a case report of an adamantinoma treated by resection of the mandible with insertion of a Sherman plate as an internal prosthesis.
DETERMINATION OF SHARPNESS OF CUTTING EDGES BY MICROSCOPIC EXAMINATION
Authors: Goad P. W.
Published: January 2008

A method of determination of sharpness of cutting edges by means of microscopic examination at x500 is described. Accompanying illustrations show the microscopic appearance of cutting edges of various qualities. A definition of sharpness and other methods of determining it are outlined.
TIDAL DRAINAGE OF THE BLADDER
Authors: Ferguson I. A.
Published: January 2008

1. The principle of the tidal drainage. machine is reviewed.

2. A further modification of the basic apparatus in the form of the addition of a rubber diaphragm is described.

3. Some difficulties in the operation of these machines are mentioned.
DIVERGENT STRABISMUS
Authors: Ryan Hugh
Published: January 2008

An analysis of 145 of divergent strabismus is made and shows they fall in three groups. The feature of each group and its treatment is indicated.
THE MULTIPLE GROWTH OF MOLLUSCUM SEBACEUM IN DONOR AND RECIPIENT SITES OF SKIN GRAFT
Authors: Dibden F. A. , Fowler Malcolm
Published: January 2008

Following the removal of a molluscum sebaceum from the back of the hand of male aged 76, further tumours appeared, in two months, on the donor and recipient sites of skin graft. Two were completely excised and one is regressing; the other lesions disappeared spontaneously.
POST‐OPERATIVE INTESTINAL OBSTRUCTION
Authors: Davis Neville C.
Published: January 2008

1. Twenty‐four cases of early post‐operative intestinal obstruction are discussed. Of these four were due to paralytic ileus, and twenty to mechanical obstruction.

2. There was a fatal termination in six Gases, all of which were mechanically obstructed.

3. Paralytic ileus caw‐d delay and confusion in diagnosis.

4. The classical features of mechanical obstruction are often absent in the early postoperative period. In eleven cases, pain was either absent or insufficient to attract attention.

5. Vomiting and distension which recurs after it has once subsided is usually due to a mechanical obstruction and not to a relapse of paralytic ileus.

6. Good X‐rays are of great importance in the differential diagnosis between mechanical obstruction and paralytic ileus.

7. Intestinal intubation using the GraftonSmith stylet is of value as an immediate preoperative manocuvre.
RADICAL SURGERY IN THE PELVIS
Authors: Godfrey Graham
Published: January 2008

1. Certain pathological features of uterine cancer are considered.

2. The following aspects of radical surgery in the pelvis are discussed:

(i) Preparation of the patient.

(ii) Anaesthesia and resuscitation.

(iii) The incision.

(iv) The operation.

(a) Mobilization of pelvic contents.

(b) Control of venous haemorrhage.

3. The results of the anterior, posterior, and total exenteration operations performed in the Radio‐Surgical Clinic at the Royal Women's Hospital are presented.

4. Methods of dealing with the ureters following cystectomy are discussed.

5. Criteria used in the selection of patients for exenteration operations are outlined.
DIABETIC GANGRENE SOME OBSERVATIONS ON ITS PATHOLOGY AND TREATMENT
Authors: Webb Rowan
Published: January 2008

1. The problem of conservative amputation in the diabetic is discussed.

2. The pathology of some common infective and ischaemic lesions of the feet of diabetics is described.

3. The technique of conservative amputation in such cases, with special reference to metatarsal resection, is described.

4. Case histories, selected to illustrate the variety of problems which may present to the surgeon, are given.
HEAT AND CORROSION EFFECTS DURING STERILIZATION OF SURGICAL CUTTING INSTRUMENTS
Authors: Goad P. W.
Published: January 2008

EFFECTS of heat and corrosion during sterilization by hot air, steam pressure and boiling in alkaline solutions are investigated. The temper of cutting instruments is unlikely to be seriously affected by exposure to temperatures up to 320°F. Sterilization by steam under pressure may under certain conditions cause heavy corrosion. Sodium carbonate and sodium carbonate‐sodium nitrite sterilizing solutions inhibit corrosion. Corrosive attack does not occur preferentially at fine cutting edges.
HAEMOPERITONEUM FROM ENDOMETRIOSIS
Authors: Raine Evan
Published: January 2008

A further case of haemoperitoneum from endometriosis is reported.
ALVEOLAR SOFT PART SARCOMA
Authors: Hurley John V.
Published: January 2008

1. The literature on alveolar soft part sarcoma –a distinct and recently recognized tumour arising in association with skeletal muscle, is reviewed.

2. Three new cases are recorded, and their clinical and pathological features are described.

3. The differential diagnosis of the tumour is discussed, with especial reference to its separation from secondary carcinoma.

4. The evidence for the histogenesis of the tumour is outlined, and it is concluded that it bears no relation to tumours arising in chemoreceptor tissue such as the carotid body.
SARCOMA IN A FAMILY A CASE REPORT
Authors: Dunn R. M. , Constance T. J.
Published: January 2008

Two cases of sarcoma, a liposarcoma and a lymphosarcoma, are described in one family. Such a familial occurrence is rare and purelv fortuitous.
INTRACRANIAL TUMOURS: AN ANALYSIS OF 157 CONSECUTIVE CASES
Authors: GAULT E. W. , Chandy J. , Hadley G.
Published: January 2008

One hundred and fifty‐seven consecutive intracranial tumours encountered at the Christian Medical College, Vellore, South India, have been studied and classified.

The history of the classification of the glioma group has been discussed and the relation of astrocytoma and glioblastoma in terms of age, site and sex has been analyzed. It is considered that the type of a tumour is related to its life history.

The incidence of the types of tumour in this series has been found comparable with the series of other countries.

Rupture of a dermoid cyst with subarachnoid patchy foreign body reaction is reported.

The incidence of space occupying lesions due to tuberculomata torulosis and cysticercosis is found to be high. This is related to the general incidence of such infections in India.
BILIARY SURGERY IN CHLORPROMAZINE JAUNDICE
Authors: Duhig J. T.
Published: January 2008

A case of chlorpromazine induced jaundice is described together with the laboratory findings.

The literature relating to the etiology and pathogenesis of the condition is briefly reviewed.

Reasons are advanced for attempting to avoid surgery in these cases.

It is suggested that puncture biopsy of the liver be performed in order to obtain this end.

It is further suggested that in prolonged jaundice treatment with A.C.T.H. or cortisone be instituted.
SECTION‐CUTTING OF UN‐DECALCIFIED BONE
Authors: Mills Kingsley W.
Published: January 2008

A method of obtaining histological sections of bone which has not been decalcified is presented. The method is applicable mainly to cancellous bone but can also be used on cortical bone which is not too dense. The importance of this method in the understanding of normal structure and interpretation of pathological conditions is well recognized and a brief account of results already obtained is given, with representative photographs to illustrate these.
THE CLASSIFICATION OF ANO‐RECTAL FISTULAE
Authors: Hughes E. S. R.
Published: January 2008

1. A series of 111 cases of anal fistula has been studied.

2. There were 3 cases of submucous anal fistula. Each of these cases possessed a track which passed deep to smooth muscle. This muscle may be muscularis mucosae alone, but part or whole of the internal sphincter may be included.

3. The majority of anal fistulae were classified as peri‐anal anal fistulae because they appeared to be the sequel of a perianal abscess. There were 81 cases; in 11 no internal opening could be found, whilst in 3 there was no external opening.

4. In 24 cases, the fistula appeared to involve primarily the ischiorectal fossa and, in most, to originate in the middle line posteriorly, very close to the ano‐rectal ring. The fistulous track lay in the deep post‐anal space and usually involved one or both ischiorectal fossae. An external opening was absent in two patients. Secondary tracks may lie in the peri‐anal space and, in two, secondary tracks passed through the iliococcygeus portion of the levator ani muscle.

5. In 3 cases the fistula coursed from an external opening in the skin to an internal opening in the rectum. The pathology of these was uncertain, but they did not appear to be a sequel of ischiorectal infection.

6. It is believed that the term “ano‐rectal fistula” should not be applied to any one type of fistula, but should be used in the widest sense of the term to include all fistulae in the region. Classification should be revised to incorporate modern views on the anatomy of the region.
SOLITARY DIVERTICULUM OF THE CAECUM A REPORT OF THREE CASES
Authors: Johnson Neil
Published: January 2008

1. Three cases of diverticulitis of the caecum have been reported.

2. A brief survey of the literature has been given.

3. It is pointed out that, provided the condition is thought of, a high percentage of correct diagnoses should be made in those cases where the diverticulum is in the peri‐tonealized area of the caecum.

4. A common diagnostic error is that of regarding the lesion as a carcinoma. This will occur particularly when the lesion is situated on the posterior aspect of the caecum or ascending colon.

5. A simple excision of the diverticulum is the treatment of choice.
PLASTIC RECONSTRUCTION OF THE BLADDER NECK AND PROSTATECTOMY AN OPERATION SUITABLE FOR ALL TYPES OF NON‐MALIGNANT BLADDER NECK OBSTRUCTION
Authors: Bonnin N. J.
Published: January 2008

The mode of healing of the post‐operative prostatic cavity and of the bladder neck have been considered. It is noted that the “false capsule of the prostate behaves as if itwere an abraded mucosa.
EXPERIMENTALLY INDUCED TUMOURS OF THE INTESTINE
Authors: King E. S. J. , Varasdi G.
Published: January 2008

Carcinoma of the bowel can be produced readily in rats using an aromatic amine. A study was made of a group of examples which developed following subcutaneous administration of 3:2‘‐Dimethyl‐4‐aminodi‐phenyl and 3: 3’‐Dimethyl‐4‐aminodiphenyl. The tumours occurred particularly in the colon though some arose in the small intestine and one in the stomach. Diffuse hyperplasia of the mucosa occurred commonly and multiple growths were found on several occasions. Complications such as obstruction, early ulceration (with haemorrhage) and intussusception occurred. The staining characteristics of the tumours with fluorescein globulin corresponded with those of other malignant neoplasms. Areas of “loss of staining,” indicating a “precancerous” development, were common.
COMPLICATED ANAL FISTULAE*
Authors: Wilson Edward
Published: January 2008

The management of cases of complicated anal fistulae is discussed in detail.

It is concluded that there should be no further trouble from a fistula after operation, and that in no case should rectal incontinence develop as a result of the operation.

These conclusions are based on a personal series of 164 cases of anal fistulae, both complicated and uncomplicated.
POST‐OPERATIVE COMPLICATIONS IN INFANCY AND CHILDHOOD
Authors: Wyllie G. G.
Published: January 2008

The greatest number of deaths in the series followed operations on newborn babies.

The common causes of fatal complications in the neonatal group were delay in treatment, respiratory depression, fluid and electrolyte imbalance, infection and defective intestinal anastomosis. Measures which may prevent these complications have been reviewed.

Deaths of older infants and children most commonly followed intussusception, appendicitis and post‐operative intestinal obstruction.
BICEPS CINEPLASTY FOR FOREARM AMPUTEES
Authors: HUESTON J. T.
Published: January 2008

The present trends in the application of the cineplasty principle are outlined indicating the current use of a muscle motor in the next proximal segment of the arm.

In forearm amputees the biceps cineplasty is found to give more precise control and an increased sphere of activity to the terminal prosthesis.

The elimination of the shoulder harness allows greater comfort and, in a bilateral amputee, complete independence of each limb.

The technique and management of biceps cineplasty is outlined. However the important factors in securing a useful cineplasty lie not in the surgery but in

(a) selection of an intelligent, co‐operative patient.

(b) a thorough programme of pre‐ and post‐operative physiotherapy

(c) a light and comfortable prosthesis, and

(d) full rehabilitation until a normal life and occupation are resumed.
PILONIDAL SINUS OF THE AXILLA
Authors: KING E. S. J.
Published: January 2008

A typical pilonidal sinus occurring in the axilla is described. It contained hair and there was, at its apex, a characteristic talc granuloma.

Not only ‐ did the position of this sinus support the general view of the acquired nature of these sinuses but the granuloma indicated that the contained material did in fact enter the region (and the sinus) from the exterior.
THE EFFECT OF CORTISONE ON NORMAL AND FRACTURED BONE IN THE RAT
Authors: Storey E.
Published: January 2008

Cortisone treated rats develop dense metaphyseal bone and, during the healing of frac‐tures, dense callus. At endochondral growth sites there is delay in maturation of chondrocytes and decreased extracellular Alcian blue‐staining mucopolysaccharide. Resorption ofcartilage is decreased so that more remains encased by bone in the metaphysis where trabeculae in their turn are not remodelled to form the diaphysis. In contrast to epiphyseal cartilage early callus growth is not greatly inhibited, but similar changes occur during remodelling. The result is a dense callus consisting of bone in various stages of maturation, prolonged retention of cartilage and failure of bony union. Thus in contrast to rabbits, where increased resorption is associated with osteoporosis, rats develop dense bone due partly to decreased resorption.
CAROTICO‐CAVERNOUS FISTULA WITH CONTRALATERAL SIGNS
Authors: Jamieson K. G. , Sutherland J. M. , Yelland J. D. N.
Published: January 2008

A case of carotid‐cavernous sinus fistula with ocular symptoms on the contralateral side is reported.

Carotid ligation resulted in heniiplegia one and a half hours after ligation. This was relieved when the ligature was removed. Subsequently slow occlusion of the internal carotid by a clamp was carried out successfully.

The importance of anoxic cerebral infarction as a sequel to internal carotid occlusion is discussed.
THE AETIOLOGY, COURSE AND SURGICAL ASPECTS OF PANCREATITIS: A REVIEW OF 108 CASES
Authors: Boyer J. T. , Mackay I. R.
Published: January 2008

1. A consecutive series of 10s cases of pancreatitis comprised 29 patients who had a single acute attack, 73 who developed chronic relapsing pancreatitis, and 6 who presentedwith chronic “silent pancreatitis.

2. Gall‐stones in 46 patients and alcoholism in 24 patients were common associated conditions. Trauma, vascular disease and viral infection were true aetiological factors in some cases.

3. Laboratory studies disclosed jaundice in 29 cases, hyperlipaemia in 24 cases, disturbed glucose tolerance in 27 cases and an abnormal secretin test in 14 cases.

4. Surgical biopsies in relapsing pancreatitis showed a wide variety of histological appearances.

5. Ten deaths resulted from pancreatitis. Frank diabetes occurred in 16 patients and was directly related to the frequency of attacks of pancreatitis. Pancreatic insufficiency with steatorrhoea was rare except in chronic insidious pancreatitis.

6. In relapsing pancreatitis, remissions of two or more years eventually occurred in 44 per cent. of all cases, and in 36 per cent. of those who were not treated surgically. It is suggested that results of surgical treatment in pancreatitis be evaluated in terms of the expected cure rate in patients not receiving surgery.
MICRODISSECTION OF SPECIMEN OF HYDRONEPHROSIS WITH COMPARATIVE NEPHRON MEASUREMENTS
Authors: Bialestock Dora
Published: January 2008

In a baby, P.D., aged one month who died in renal failure, microdissection of the nephrons in the single large abnormal hydronephrotic kidney, associated with definite organic ureteral stricture in the upper ureter, revealed an extraordinary variation in structure from hypoplastic nephrons or parts thereof to the immensely hyperplastic units. These structures and their measurements are compared with those of a normal kidney and a kidney showing moderate hydronephrosis of unknown origin.

Greatest enlargement was in length and diameter of the convoluted tubules and in the diameter of the largest collecting tubules.

A gradation between almost normal elements to the grossly hypertropic nephrons, which made up the majority of the nephron population, was seen.

Localized abnormalities, scattered sporadically in a bizarre fashion along the length of a tubule were frequently seen.

Not only were there nephrons of grossly abnormal size, but also nephrons with gross abnormalities of structure. Gradations between these abnormal nephrons and isolated cystic bodies of glomerular, but also of possible tubular origin, were common.

Extensive infection in the peritubular connective tissues, without necessarily involving the continuity of tubules passing through such granulation tissues, was the usual finding.

Gast material was frequently seen within tubular lumens, more clearly in collecting tubules. These casts did not appear in any instance to block tubules completely. No collapse below nor dilatation above the site of the material was seen.

Quantitative nephron dimensions from three babes aged one month illustrate the enormous variation that can occur even at this young age.

The existence of extraglomerular blood vessels to tubules in this abnormal kidney was demonstrated.
HEALING OF END‐IN‐END ANASTOMOSES
Authors: Cuthbertson A. M.
Published: January 2008

An account is given of the series of changes observed in the healing of an end‐in‐end anastomosis constructed in the rates ileum.

It was found that mucosal continuity was re‐established mainly by the contraction of newly formed granulation tissue on the peritoneal surface of the intussuscepted bowel.

Some aspects of stricture formation are discussed.
INTRACRANIAL HAEMORRHAGE IN DISORDERS OF BLOOD COAGULATION
Authors: Simpson D. A. , Robson H. N.
Published: January 2008

The chief disorders of blood coagulation are discussed as predisposing or complicating factors in intracranial haemorrhage.

Six cases of intracranial haemorrhage associated with various coagulation defects (haemophilia, hypoprothrombinaemia, and platelet deficiencies) are presented. Their management is discussed.

If the coagulation defect can be corrected or controlled, there is a reasonable possibility that surgical evacuation may be successful, especially when the haema‐toma is superficially situated.
COMBINED COMMON BILE DUCT AND PANCREATIC DUCT INJURY OCCURRING DURING GASTRECTOMY SUCCESSFUL REPAIR
Authors: Hughes E. S. R. , Syme Graham A.
Published: January 2008

A case is reported in which during the course of emergency surgery for a bleeding anastomotic ulcer following a Billroth I gastrectomy (performed for duodenal ulcer), the lower ends of the bile and pancreatic ducts were severed. Repair was achieved by anastomosing the cut ends of the two ducts together, and the side of the common duct to the side of the duodenum. The convalescence. was good and two and a quarter years later the patient is in excellent health.
OSTEOSIS CUTIS
Authors: Marshall Vernon
Published: January 2008

Summary

A case of heterotopic bone formation in the scalp of a 39 year old woman is presented, with the relevant radiological and pathological findings.

A review of the previous literature is given and the lesion is discussed with reference to other examples of heterotopic ossification.

Factors such as trauma, ischaemia and inflammation are seen to be important predisposing factors in the formation of bone at abnormal sites.

A group of cases exists in which bone formation in the skin occurs without apparent cause. These can be grouped together under the descriptive term of osteosis cutis. They do not act as true neoplasms, some are hamartomas, the remainder are due to localized or diffuse metaplasia of connective tissue due to unknown stimuli.
TRANSDUODENAL AMPULLAPLASTY IN THE SURGERY OF THE COMMON BILE DUCT
Authors: Marshall R. D.
Published: January 2008

Summary

Primary exploration of the common bile duct from below, with ampullaplasty, is suggested as an alternative to choledochotomy. Orthodox surgical treatment gives rise to recurrent stone in the common duct and the post‐cholecystectomy syndrome too frequently. Transduodenal ampullaplasty helps to prevent these complications, and the technique, and advantages of the operation are discussed, with presentation of a series of cases extending over five years.
MEDULLOBLASTOMA WITH ONSET IN THE NEWBORN
Authors: Fine Ronald D.
Published: January 2008

Summary

Neonatal intracranial tumours are rare, nevertheless their presence should be suspected in cases of infantile hydrocephalus presenting in an atypical manner. Clinical features which will help to differentiate the 2 conditions are persistent vomiting, the finding of cranial nerve palsies and a raised protein content in the ventricular fluid. Early recognition of such cases may lead to considerable benefit from radiotherapy.
ACROPARAESTHESIA AND THE “CARPAL TUNNEL SYNDROME”
Authors: Opit L. J. , Rieger R. A.
Published: January 2008

Forty‐two patients were reviewed 2 to 6 years after being subjected to retinaculotomy following a diagnosis of carpal tunnel syndrome.

A relapse rate of 21 per cent, was found, a further 10 per cent, having developed other symptoms as a result of operation. The majority of recurrences occurred about two years post‐operatively.

Retrospective examination failed to reveal a clear‐cut compressive syndrome in the successful cases.

Three patients had evidence strongly suggesting rheumatoid arthritis as a concomitant disease and a further 12 were classified as possibly having rheumatoid arthritis.

Vascular symptoms occurred frequently, especially in the cases thought to have rheumatoid arthritis.

The aetiology of acroparesthesia is discussed and the suggestion made that a systemic disease is a common cause for this symptom.

No satisfactory method of selecting cases for operation is apparent, although immediate post‐operative relief guarantees a successful outcome.
A CASE OF FULMINATING AMOEBIASIS
Authors: Bhathal P. S. , Brown P. B. , Essex W. B.
Published: January 2008

A fatal case of fulminating amoebiasis which was erroneously diagnosed and treated as ulcerative colitis until too late is described.

The importance of being aware of the fact that amoebic dysentery is endemic in Australia is stressed. It follows then that in all cases presenting as ulcerative colitis, examination of warm stools for Enta‐noebae histolyticae should be performed.

It is sometimes possible to make a diagnosis of amoebic colitis from histological examination of a rectal or sigmoid biopsy. Entamoebae should be looked for not only in the bowel mucosa or submucosa but also, in any surface exudate that may be present.

The course of this man's illness was extremely short and was complicated by thrombocytopaenia, profuse haemorrhage from the colon and the development of hepatic abscess, miliary pulmonary abscesses and multiple brain abscesses.
A VENOUS LINE FLOWMETER FOR USE WITH AN EXTRACORPOREAL CIRCULATION
Authors: Currie Trevor T. , Cass Noel M.
Published: January 2008

A flowmeter suitable for use in the venous line of an extracorporeal circuit is described. The apparatus can measure systemic venous and cardiotoniy return, either together or separately. The calibration of the flowmeter is unaffected by temperature or by viscosity change.
TRAUMATIC RUPTURE OF THE DIAPHRAGM IN CHILDREN
Authors: Myers N. A.
Published: January 2008

(1)Two cases of traumatic rupture of the diaphragm are presented.

(2)Attention is drawn to the rarity of this condition in children.

(3)The condition has three major clinical phases and failure to appreciate the significance of, or actually remember, a traumatic incident may lead to diagnostic delay and death.
THE CLINICAL AND PATHOLOGICAL EFFECTS OF PROLONGED SOLAR EXPOSURE: I.‐THE ASSOCIATION WITH AGEING OF THE SKIN
Authors: Marshall Donald R.
Published: January 2008

Summary

A histological study of the skin of 50 patients is presented comparing the findings in exposed and unexposed regions and relating the changes seen to age and exposure.

The unexposed skin does not alter significantly in structure with age. The different appearance of the aged skin in unexposed areas is due to alterations in physical properties for which there is no matching alteration in morphology.

The exposed skin shows changes predominantly in the dermis. These are described as “basophilic degeneration of collagen or “elastotic degeneration of collagen, which are synonymous with “senile elastosis.

It is suggested that “collagen degeneration is a more suitable term than elastosis.

It is found that the changes occur only on exposed regions and should be termed “solar degeneration as they are not primarily due to age.

The factors influencing the development of solar collagen degeneration are as follows:

(a) The fair skinned lightly pigmented patient is most susceptible and despite prolonged exposure does not develop satisfactory protective pigmentation. Heavily pigmented skin is protected as evidenced by the lack of collagen degeneration in dark skinned people and particularly in the aboriginal.

(b) The degree of collagen degeneration corresponds well with the degree of exposure.

(c) As age increases the degree of collagen degeneration is greater. However, this is proportional to the amount of exposure rather than to the age.

(d) Sex: Men are affected more than women but this is related to increased exposure rather than to a variable susceptibility.

The changes seen microscopically correlate well with the macroscopic appearance of the skin and explain the difference between the exposed and covered areas.

These changes are responsible for the prematurely aged appearance of people exposed to the elements who are not heavily pigmented.

A warning note is sounded in relationship to the ill effects of over exposure to the sun in fair skinned people. The price that sunlovers must pay is at least a prematurely aged appearance. The possible relationship between solar collagen degeneration and skin cancer will be discussed subsequently. Prevention of solar collagen degeneration by limitation of exposure in susceptible individuals is advised.
ANAL METASTASES FROM CARCINOMA OF THE RECTUM AND COLON
Authors: Killingback Mark , Wilson Edward , Hughes E. S. R.
Published: January 2008

Summary

Four cases of carcinoma of the sigmoid colon and rectum are described in each of which a metastasis was present in the anal region. It is concluded that in at least three of these cases the metastasis was due to surface implantation of fragments of the tumour. The diagnosis and the choice of operation in these cases is discussed.
SQUAMOUS CELL CARCINOMA OF THE BREAST REPORT OF A CASE
Authors: Essex W. B. , Rigg B. M.
Published: January 2008

Summary

A 46‐year‐old woman had a well differentiated squamous cell carcinoma of the hreast excised. This tumour was not attached to skin, there was no associated adenocarcinorna, and it had metastasized to axillary nodes as squamous cell carcinoma.

She remains well seven and one‐half years following operation.

This is thought to be an authentic example of a rare neoplasm. Despite the rarity of the cmndition its existence should be remembered in the differential diagnosis of a lump in the breast.
AORTO‐ILIAC STENOSIS: A COMPARISON OF TWO PROCEDURES
Authors: Harris J. D. , Jepson R. P.
Published: January 2008

Summary

1. A series of 40 reconstructive operations on 36 patients for aorto‐iliac stenosis is presented. The stenotic lesions were divided into 2 groups:

(a) Liriche syndrome (15);

(b) isolated stenotic lesions elsewhere in the aorto‐iliac system (21).

The differential diagnosis of these 2 groups on clinical grounds has been discussed.

2. A follow‐up of the 40 operations has been performed over a period of six years. Twenty‐four of these operations were endarterectomies while the remaining 16 were arterial grafts. Only 50 per cent. of the grafts are patent at the present time while 92 per cent. of endarterectomies are working. In our hands the results of the latter operation are so superior that we tend to perform it in preference to grafting, where possible.

3. The mortality rate (3 to 5 per cent.) for these operations is surprisingly good considering the magnitude of some of these procedures and the fact that often the patients are not first‐class operative risks. However, post‐operative complications have been numerous and include pneumonia (6), pulmonary embolus (4), ileus and burst abdomen (3), incisional hernia (1), adhesive obstruction (2) and superior mesenteric artery thrombosis (1).

A transverse subumbilical incision has been used in the last 10 cases and none of these patients has ruptured their wounds, This incision gives a good exposure and appears to heal more securely than paramedian incisions.

4. The symptom of impotence in cases of Liriche syndrome has been investigated. In this series 4 out of 10 patients (40 per cent.) questioned complained of either partial or complete importence. This figure is roughly similar to other published series. To our surprise only one of these improved following operation, in otherwise successful results. Inaddition, 2 of the other patients who did not complain of impotence before operation developed this symptom afterwards.

Although impotence in Leriche syndrome may be due to inadequate blood supply to the pelvis, its incidence after operation suggests this may be due to disruption of the pelvicnerve plexus at operation.
EXTRADURAL SPINAL HYDATID CYST: A CASE REPORT
Authors: Law W. B.
Published: January 2008

Summary

Hydatid disease in the extradural space of the spinal canal was a chance discovery made at an exploratory operation intended to relieve nerve root pressure.

It would appear to offer almost insurmountable difficulties in detection even if the aphorism is recalled that recognition of a rarity demands only that it be borne in mind.
THE EFFECT OF EXTRINSIC FACTORS ON INTRARECTAL PRESSURE
Authors: Buntine J. A. , Hughes E. S. R.
Published: January 2008

Summary

1. An accurate and convenient method of recording intrarectal pressure has been described.

2. By this method the effect of extrinsic factors on intrarectal pressure has been studied in five normal male subjects.

3. The mechanisms by which physical activities influence intrarectal pressure have been investigated.

4. Surgical significance of the results is suggested.
A DIFFICULT FOREIGN BODY IN THE CERVICAL OESOPHAGUS
Authors: Greig M. T. , Seeley A. J.
Published: January 2008

Summary

A large nectarine stone became impacted in the cervical oesophagus of a girl of 13. It was removed by oesophagotomy. The problems of the operation are discussed.
PRIMARY LINITIS PLASTICA CARCINOMA OF THE COLON
Authors: Nelson P. G.
Published: January 2008

Summary

1. A case of primary linitis plastica type of carcinoma of the colon is presented, with some discussion of the histological and macroscopic features. The primary colonic situation of the process has been established.

2. Diagnostic and operative difficulties are described.
ACUTE CARPAL TUNNEL SYNDROME
Authors: Leditschke J. F.
Published: January 2008

Summary

Three cases of acute median nerve palsy are presented due to compression in the carpal tunnel. The first case is due to haemorrhage following trauma, the other two cases due to inflammatory products following involvement by infection of the radial and ulnar synovial bursae. All were relieved by division of the flexor carpal retinaculum.

A review of the literature reveals only one similar case recorded due to haematoma formation and a limited number following infections in the forearm, wrist, fingers and thumb.
CEREBRAL ABSCESS DUE TO SKULL TRACTION
Authors: Jamieson K. G. , Yelland J. D. N.
Published: January 2008

Summary

Two cases of cerebral abscess due to skull traction for cervical spine injury are reported.

In both cases, local evidence of infection was followed by neurological signs which necessitated craniotomy for excision of abscess.