bluuebunny/crossref_metadata_2025 huggingface dataset:
Ketamine: A New Anaesthetic Agent
Authors: Brown T. C. K. , Cole W. H. J. , Murray G. H.
Published: January 2008

The results are presented of a clinical trial of a new anesthetic agent, ketamine, carried out at the Royal Children's Hospital, Melbourne. It was administered intravenously or intramuscularly or by both routes for 401 procedures on 285 children. Ketamine is a cyclohexylamine belonging to the same drug group as phencyclidine and is described as a dissociative anesthetic. The duration of its action is related to the dose employed. It has been used for procedures lasting up to one hour, usually in doses not exceeding 10 mg/kg. It has a wide range of application, but offers special advantages where the maintenance of the airway without an endotracheal tube is desirable, and where it is useful to shorten the preoperative and postoperative period of starvation in order to maintain the nutritional intake in patients requiring repeateB anesthesia, such as those suffering from severe burns. The cardiovascular system is stirraarlated rather than depressed. The laryngeal reflexes are well maintained. Respiratory complications, which are unusual, are more common in infants and are usually associated with pneumoencephalography or the concurrent use of halothane. Vomiting is uncommon and usually occurs after the patient is fully conscious. It is probable that ketamine, which has already been widely investigated, will achieve an important place in anesthesia.
A Study of the Surgical Anatomy of Congenital Rectobulbar Fistula
Authors: Kitchen P. R. B.
Published: January 2008

The microscopic anatomy of two rectobulbar fistula specimens was studied histologically in serial sections to determine the route taken by the fistulœ and the arrangement of the associated muscles and sphincters. It was found that the sole muscle available for reconstructive sghincter surgery was the levator ani complex, adapted and modified to the visceral ubnormality. In each case, the puborectalis sling was short, aid confluent inferiorly and posteriorly beneath the fistula with the bulbocavernosus muscle. The findings proved to be relevant to the techniques of surgical reconstruction of the anal canal in patients exhibiting this deformity.
Chronic Gastric Ulcer in an Infant Treated by Gastrectomy
Authors: Glynn P. J.
Published: January 2008

A case of chronic gastric ulccr in Q 12‐month‐old aboriginal infant who presented with hœmatemesis and melœna is described. The diagnosis was made at laparotomy, and a Billroth I gastrectomy was performed. A 12 months' follow‐up is presented, and diagnostic problems and possible nutritional scquelœ are discussed.
Hepatic Resection for Severe Liver Trauma1
Authors: SORRELL V. F.
Published: January 2008

In order to define the place of hepatic resection in the treatment of severe liver trauma, a clinical survey was carried out in the Auckland area. In the first 10 years no cases were treated by liver resection, and the mortality was 37%. In the more recent period since resection has been employed the mortality has been 7'7%. Case reports are presented to illustrate the type of patients suitable for resection. The theoretical basis for resection in trauma is outlined. Preoperative resuscitation, points of operative technique and the special problems in the after‐care of these patients are discussed.
A Comparison of Pentazocine with Morphine in Premedication for Adenotonsillectomy in Children
Authors: Sleeman K. W. , Brown T. C. K.
Published: January 2008

Pentazocine, in dosage of 0°5 mg per kilogram of body weight, has been compared with morphine (0°2 nig/kg) for premedication in children undergoing adenotonsillectomy. The parameters measured were the presence or absence of apprehension, the incidence of postoperative vomiting, the postoperative analgesic requirements and the time that elapsed from prenzedication to the postoperative injection. It is concluded that pentazocine compares favourably with morphine in these doses as a prenzedication and nnalgcsic for children.
Primary Hyperparathyroidism
Authors: Evans R. A. , Benson R. E. , Wyndham N.
Published: January 2008

The cases of 60 patients who underwent parathyroidectomy are described. Past, present and future aspects of the diagnosis of hyperparathyroidism, are discussed. In several patients in the series renal calculi had been present for over 20 years before the diagnosis was made. The reasons for this delay are considered.
The Histological Establishment of the Diagnosis in Suspected Malignancy
Authors: Stephens Frederick O.
Published: January 2008

With continuing improvements in cytological, histological and frozen section techniques, the clinician is becoming increasingly dependent upon the histologist for early and accurate diagnosis of malignant lesions. Newer techniques, using direct smears, fluid aspiration and needle and drill biopsy, will sometimes allow accurate diagnosis to be established with minimal handling of or interference with a tumour mass. This probably reduces the risk of tumour dissemination when compared with more traditional biopsy procedures. When, as with most deep tissue masses, more formal incisional or excisional biopsy is required, the individual circumstances should be assessed and certain appropriate precautions should be taken in order to obtain the most accurate information with a minimum of risk. The scope, suitability accuracy and safety of the various available procedures are outlined in this paper.
Traumatic Pulmonary Insufficiency and Non‐Mechanical Bleeding in Battle Casualties
Authors: Morton A.
Published: January 2008

Post‐traumatic pulmonary insufficiency and non‐mechanical bleeding are important complications of massive battle injuries. It is suggested that these conditions are inter‐related, and a small series of illustrative cases is described. It is further suggested that this syndrome may be important in some cases of death following severe injuries sustained in civilian life. Although treatment of this syndrome is not yet standardized, the management of the cases presented is described, and its rationale is discussed. It is to be noted that fibrinogen solution is unavailable in South Vietnam, as its use is believed by the American authorities to be contraindicated. In theory, its consumption may aggravate the disseminated intravascular coagulation process.
Acute Appendicitis in a Premature Infant: A Case Report
Authors: Broadbent N. R. G. , Jardine J. L.
Published: January 2008

A case of perforated acute appendicitis is described, presenting as intestinal obstruction in a premature infant 16 days after birth. The appendix was removed at laparotomy, and the infant made an uneventful recovery. A brief comment is made on the rarity of acute appendicitis in the premature newborn. The infant whose case is reported had been fed on a cow's milk mixture. It is suggested that this may have been a factor in the came of the appendicitis.
Hæmaturia as a Feature of the Munchausen Syndrome: Report of a Case
Authors: Carrodus A. L. , Earlam M. S. S.
Published: January 2008

A case is reported of self‐induced hrematuria in a young woman. The source of the hrematuria defied diagnosis over a period of four months ' hospitalization and, on the evidence, at intervals over the previous two years. The fact finally emerged that the patient from time to time obtained blood from an antecubital vein, then injected it &to her bladder by catheter.
In‐Vitro Motility Studies on the Canine and Human Extrahepatic Biliary Tracts
Authors: Toouli J. , Watts J. McK.
Published: January 2008

The spontaneous and stimulated in vitro activity of the common bile duct, the sphincter, choledochus and the gallbladder of the dog, the in vitro activity of the common bile duct of man and the histological appearances of canine and human common bile ducts were studied. All parts of the extrahepatic biliary tract exhibited spontaneous activity and were stimulated by acetylcholine, acetyl beta‐methyl‐choline, noradrenaline tartrate, adrenaline tartrate, isoprenaline hydrochloride and 5‐hydroxy‐tryptamine. Morphine sulphate was found to be a weak stimulant of the biliary tract in vitro.

Histological examination of the common bile duct in both man and dog showed the presence of small amounts of smooth muscle, maximal in quantity near the duodenum and minimal at the hepatic end, and arranged chiefly in a longitudinal direction.

The results suggest that the common bile duct, along with the gallbladder and sphincter choledochus, has a role in the dynamics of the extrahepatic biliary tract of both man and dog.
Intestinal Infarction following Spontaneous Reduction of Strangulated Hernia
Authors: MENON K. A.
Published: January 2008

Infarction of the bowel after the spontaneous reduction of a strangulated hernia is rare, and no mention of such a condition appears in the literature. A case is reported, both for its rarity and for consideration of a possible ætiology.
The Treatment of Hydrocephalus by Ventriculo‐Atrial Shunt1
Authors: BEAL S. , SIMPSON D. A.
Published: January 2008

The operation of ventriculo‐venous shunt in the management of obstructive hydrocephalus is discussed in the light of a series of 100 patients suffering from this condition who came under the care of a single neurological service over a six‐year period, 79 being children, the remaindren adolescent or adult. Technical details of the operation, complications and results are discussed, consideration also being given to the factors influencing the decision whether in any given case this or some other procedure would appear to be in the best interests of the patient.
A Method of Anæsthesia for Carotid Disobliterative Endarterectomy
Authors: OWIES ALFRED
Published: January 2008

The anæsthetic management of vascular disease affecting the brain is discussed. A technique is described and physiological reasons for its use are advanced.
A Compound Pectoral Flap
Authors: HUESTON J. T. , MCCONCHTE I. H.
Published: January 2008

The principle of including an underlying skeletal muscle in the design of a large skin flap, to assure a safer blood supply during transfer, has been applied to the chest wall. Pectoralis major is included in a chest flap used for the repair of a large defect of all layers of the anterior chest wall, including the medial ends of the clavicles and upper two ribs and the manubrium sterni.
An Assessment of the Xenon‐ 133 Method of Measuring Muscle Blood Flow1
Authors: HOFFMANN D. C.
Published: January 2008

The 113Xe method for measuring muscle blood flow is discussed, and has been evaluated in both normal and ischæmic limbs, a standard amount of ischæmic exercise being employed as the stimulus to hyperæmia. This is considered to be a reliable technique with a high degree of reproducibility, which may be applied to advantage in the clinical assessment of patients with peripheral vascular disease.
The Use of Reno‐Portal Anastomosis in the Treatment of Portal Hypertension: An Experimental Study
Authors: PARKINSON S. W. , SUMMERS M. B.
Published: January 2008

An operation of porta‐caval and reno‐portal shunt has been performed on dogs. These dogs were shown by an ammonia tolerance test to clear ammonia more quickly than dogs with only a porta‐caval shunt. It is suggested that the reason for this was the supplementation of the hepatic artery flow by the reno‐portal shunt, to maintain a near‐normal hepatic blood flow. The clinical application is discussed.
The Absorption and Survival of Red Blood Cells Labelled with Chromium‐51 from the Peritoneal Cavity in Man
Authors: ALLCOCK EDWARD A.
Published: January 2008

This is a study of the rate of absorption and period of survival of tagged red blood cells introduced into the peritoneal cavity. The investigation was carried out on to healthy adult males, and the red cells were introduced in the course of operations for inguinal hernia.
Blood Volume in Malignant Disease: Case Studies in 86 Females1
Authors: REEVE T. S. , VINCENT P. C. , BRITTLE NEA , NICHOLLS ANNETTE
Published: January 2008

The problem of blood replacement in the individual cancer patient remains unanswered. On present evidence, such a patient must be assumed to be drawn from a population with a mean total blood volume and mean red‐cell volume below normal and thus must be assumed to have a better‐than‐even chance of having a depleted volume. However, it does not necessarily follow that transfusion is necessary; this should ideally be assessed by blood volume determination in each individual case.
Tumours of the Small Bowel1
Authors: MACBETH W. A. A. G. , GWYNNE J. F.
Published: January 2008

A series of small bowel neoplasms, benign, primary malignant and metastatic, representing the total local experience of a fourteen‐year period, is reviewed. The problems of diagnosis and management are presented and discussed. Argentaffin carcinoma is the most frequently encountered primary malignant tumour. The mode of presentation is considered to be related to the biological behaviour of the various tumours rather than to bear upon the attendant prognosis. It is apparent from our observations that knowledge of the epidemiology of these lesions must still be considered deficient.
A Simple Instrument to Facilitate Dissection in the Mediastinum from the Neck
Authors: MONK IAN
Published: January 2008

The use of a vaginal speculum to gain access to the mediastinum through the neck is described. This enables manipulative procedures to be carried out which include biopsy and also the placement of an electrode in the region of the sino‐atrial node where a cardiac pacemaker is being used.
The Treatment of Renal Tuberculosis
Authors: BECK A. DAVID
Published: January 2008

Despite the introduction of potent anti‐tubercutosis drugs, no decline in the incidence of genito‐urinary tuberculosis had been noted in New Zealand over the last 15 years. Of all M. tuberculosis isolated at the Auckland Hospital Laboratory, 10% were resistant to one or more of the three commonly used drugs. Chemotherapeutic regimens, which may employ only oral medications, form the mainstay of successful treatment, and the possible benefits from surgical intervention are now limited to patients with advanced disease. Conservative surgery may prevent further renal parenchymal destruction and permit more effective sterilization of tuberculous foci. Nephrectomy may be undertaken with little risk and is still permissible in the presence of complete renal destruction, though there is a school of responsible thought that advocates the conservative treatment of all patients with renal tuberculosis.
Acute Frontal and Ethmoid Sinusitis with Subperiosteal Abscess
Authors: CLARK GRAEME M.
Published: January 2008

The treatment of a patient with acute frontal and ethmoid sinusitis complicated by a subperiosteal abscess is described. At the initial operation these sinuses were drained into the middle meatus of the nose using a large polythene tube. The advantages of intranasal in addition to external drainage are discussed.
Cæcal Pull‐Through Operations for Distal Ulcerative Colitis: A Preliminary Report
Authors: HUGHES E. S. R. , BENNETT R. C.
Published: January 2008

Six patients with distal ulcerative colitis and a relatively normal proximal colon have been treated by colectomy followed by a caecal pull‐through type of anastomosis and preservation of the anal sphincters. The early results in five patients have been quite encouraging and suggest that this procedure may earn a place in the management of selected patients with this disease.
Intravenous Pyelography before Prostatectomy: An Evaluation of its Use
Authors: BOEREMA W. J.
Published: January 2008

An analysis is made of 125 intravenous pyelograms performed before open prostatectomy upon cases of benign prostatomegaly. It is noted that the incidence of associated pathology was low, and that the decision to operate was adhered to in all cases. The tenet that prcopcrative intravenous pyelography is mandatory is therefore held questionable.
The Nerve Supply of the Internal Anal Sphincter
Authors: SHEPHERD J. J.
Published: January 2008

The traditional concept of a motor sympathetic and an inhibitory parasympathetic nerve supply to the internal anal sphincter has no experimental support in the human. Inhibitory fibres are present in the sympathetic thoracolumbar outflow and can also be demonstrated by organ‐bath techniques. However, these may not be adrenergic nerves.
The Clinical and Radiological Assessment of Anal Continence in Childhood
Authors: KELLY JUSTIN H.
Published: January 2008

A simple numerical clinical method of scoring fœcal continence has been developed for use in children after repair of imperforate anus. A similar numerical score was then devised, using functional and structural parameters from a radiographic assessment of defœcation. Comparison of the two scores showed close correlation in the individual child, and the clinical score has been found to match closely the measured sphincter pressure at rest.
Glomus Jugulare Tumour: A Case Report
Authors: COLEMAN MAXWELL J. , TONKIN JOHN , BLEASEL KEVIN , LIM GERALD H. K.
Published: January 2008

A case of glomus jugulare tumour is reported, together with an account of current practice in diagnosis and treatment.
Acquired Diverticula of the Vermiform Appendix
Authors: CAMERON CYRIL T. M. , CRAIG STANLEY H.
Published: January 2008

A case of multiple acquired diverticula of the vermiform appendix is reported, in which the diagnosis was made before operation by barium enema examination. This event has not previously been reported in the English literature.
A Clinico‐Pathological Study of Some Factors Influencing Survival in Cancer of the œsophagus: A Survey of Ten Years' Experience1
Authors: Nicks Rowan , Green David , McClatchie Gordon
Published: January 2008

Three hundred and thirty‐two patients with histologically proved carcinoma of the œesophagus, admitted over a ten‐year period to the Royal Prince Alfred Hospital, Sydney, were studied according to the site, histological type, stage and grading of their malignancies. The survival rates after resection and palliative treatments, including radiotherapy, were correlated with these factors.
Reticulo‐Endothelial and Blood‐Pool Scanning in the Diagnosis and Differentiation of Space Occupying Lesions of the Liver
Authors: Andrews J. T. , Steven L. W. , Arkles L. B. , Sephton R. G. , Martin J. J.
Published: January 2008

A series of 45 patients with space occupying lesions of the liver were investigated by a dual isotope scanning technique. The method is described, and the results are presented. The investigation is often helpful in the differentiation of malignant from non‐malignant lesions of the liver.
Profuse Bleeding from the Colon1
Authors: Failes David , Killingback Mark
Published: January 2008

In a personal series of 35 patients diverticular disease of the colon was shown to be the most common cause of profuse bleeding; nevertheless, it accounted for only half the cases in this series. A wide variety of other lesions may be responsible for bleeding, and it is important that each patient should be very carefully assessed before the acceptance of diverticular disease as the cause of the haemorrhage.
Suprapubic Bladder Drainage in Gynaecological Surgery
Authors: Baeham K. A.
Published: January 2008

Suprapubic bladder drainage was used in the postoperative management of 25 patients undergoing major gynecological procedures of the type following which catheterization in the ward was often required. The results were compared with those in a similar group of 25 patients for whom suprapubic drainage was not used. The procedure was found to minimize patient discomfort, ward catheterization and urinary infection, and to make the nursing management much easier.
Supraclavicular Catheterization of the Subclavian Vein
Authors: Nugent Richard P.
Published: January 2008

A technique of supraclavicular subclavian vein catheterization is described. Points are made concerning the maintenance of the catheter and measurement of the central venous pressure. The indications for and complications of the use of the catheter are discussed. Alternative methods of central vein catheterization are reviewed. Five case reports are presented.
Compressed Air Injury of the Colon: A Report of Two Cases
Authors: Thiele Brian L.
Published: January 2008

Two cases of colonic perforation as a result of compressed air injury are reported, with a description of their management. Features of the pathogenesis are discussed, and observations which act as guidelines for management are emphasized. A brief review of the world literature is presented.
Lateral Sinus Thrombosis following Radical Neck Dissection for Malignant Melanoma
Authors: Fielding I. R. , Grant J. M. F. , Selby George
Published: January 2008

A case of thrombosis of the right lateral sinus and petrosal sinus is reported. The thrombosis followed wide excision of a malignant melanoma and radical neck dissection, with ligation of the jugular vein, and this latter procedure was regarded as the most likely etiological factor. The relevant literature is briefly reviewed
Stress Fracture of the Tibia: Report of a Case
Authors: Kochhar V. L. , Srivastava K. K.
Published: January 2008

A case of stress fracture of the lower third of tibia is described. The fracture, the sixth case to be recorded in the literature, is so identical with five cases reported by Singer and Maudsley in 1954 as to constitute a separate entity
Post‐Prostatectomy Bleeding: Active Management by Early Endoscopic Haemostasis and Packing in a Series of 3,219 Prostatectomies
Authors: Wines Robert D. , Lane Victor , O'Flynn J. Dermot
Published: January 2008

This article reviews the results of active management of post‐prostatectomy bleeding in a series of 3,219 patients with an overall mortality of 1–6%. One hundred and thirty‐six patients with heavy bleeding or clot retention after prostatectomy were returned to the operating theatre for 162 procedures. Early clot evacuation and hcemostasis with the use of a resectoscope produced satisfactory control in 124 of the 136 patients so treated. Packing of the prostatic fossa, either at the time of prostatectomy or after failed early endoscopic was performed 26 times with good control of bleeding, but introduced an abtreciable measure of morbidity associated with the suprapubic wound
A Histological and Functional Study of the Gastric Mucosal Innervation in the Dog
Authors: Kemp Donald R.
Published: January 2008

The supradiaphragmatic vagus and its abdominal branches have been subjected to fibre counts both in normal dogs and in dogs that have undergone proximal vagal sections resulting in fibre degeneration. As a result of these studies, the absolute numbers of afferent, efferent and adventitial fibres present in the vagus nerve at these levels have been established
Superior Vena Cava Obstruction: Resection and Bypass for Malignant Lesions
Authors: EFFENEY DAVID J. , WINDSOR HARRY M. , SHANAHAN MARK X.
Published: January 2008

Seven patients have been operated on at St Vincent's Hospital since 1954 in attempts to relieve superior vena caval obstruction. Six of them had carcinoma of the lung, and synthetic bypass grafting was performed in four. The seventh patient had a malignant thymoma excised, with resection of the superior vena cava and replacement by a free pericardial graft. An adenocarcinoma of the lung was also resected at the original procedure. During the twoyear follow‐up he has developed pure red cell agenesis and hypogammaglobulinœmia.
Glandula in Glandula: The Intrathyroid Parathyroid
Authors: VELLAR IVO D. , SHAW JAMES , BROSNAN GERALD
Published: January 2008

Three cases are reported of proven parathyroid adenoma located in a lobe of the thyroid. This situation must always be borne in mind when searching for the parathyroid in the neck, and the excision of a lobe of the thyroid may save the patient from an unnecessary sternotomy and mediastinal exploration.
An Important Contribution of the Millard Flap to Cleft‐Lip Surgery
Authors: DEY DAVID L.
Published: January 2008

Unexpectedly poor results frequently follow the repair of a simple bilateral incomplete cleft lip, due to the shortness of the central element in its vertical dimension. This problem may be overcome by a two‐stage procedure, in which a Millard rotation‐advancement flap on either side allows adequate lengthening of the central element.
A Trial of Salbutamol in an Intensive Therapy Unit
Authors: MERCER R. , MERCER S. , MORTON A.
Published: January 2008

An aqueous solution of salbutamol in a strength of 0.5%, administered by the intermittent positive pressure method, is a safe and effective bronchodilator drug when administered to acutely ill patients in an intensive therapy unit.
The Function of the Isolated Perfused Pig Liver after Cooling1
Authors: YEO B. W. , ROSE MARGARET , KERN I. B. , THOMSON JAN , HAM J. M.
Published: January 2008

Pig livers were cooled in situ by portal vein infusion with Tis‐u‐sol, and were then excised, rewarmed, and perfused in an isolated circuit with diluted autologous blood. The temperature of the cooling fluid was 10°C in one group and 17° C in the other. Bile flow and brom‐sulphllialein excretion in the bile were measured over a 90‐minute period of perfusion at 38° C. The total bile flow and bromsulphthalein excretion were not significantly different in the two groups. However, during the first 30 minutes of perfusion there was a significantly lower bile flow and bromsulphthalein excretion in the bile in the livers cooled to 10° C. The results demonstrated a significant delay in the return of excretory function, and this may be relevant in the choice of methods for preparation of livers for clinical liver perfusion or transplantation.
Capsulectomy1
Authors: SUTHERLAND GEOFFREY
Published: January 2008

Microsurgical techniques have greatly improved the treatment of pupillary membranes occurring after congenital cataract surgery or lens damage due to penetrating wounds. Very small incisions are used, and therefore early operation is possible in infants. The cosmetic results have been particularly satisfactory.
Intramural Hæmorrhage of the Bowel Complicating Anticoagulant Therapy
Authors: SHEINER H. J. , GLANCY J. J.
Published: January 2008

Patients receiving anticoagulant therapy may present with the clinical features of small‐bowel obstruction due to intramural hæmorrhage of the bowel. Four patients with this syndrome are described, and the clinical problems in diagnosis and management are discussed. Awareness of this complication is necessary so that the diagnosis can be confirmed by barium studies of the small bowel, particularly in patients in whom other anticoagulant complications such as hæmaturia, bruising and increased prothrombin time are absent. Once the diagnosis is established, treatment is by conservative rather than operative methods.
Definitive Surgery for Perforated Peptic Ulcer in Malaysia1
Authors: TI T. K. , YONG N. K.
Published: January 2008

Seventy‐three cases of perforated peptic ulcer (51 duodenal and 22 gastric) are reviewed. The condition is common in the Chinese, but rare in Malays, Indians, Pakistanis and Ceylonese. Simple closure is followed by a high recurrence rate. Emergency definitive surgery is safe. Difficulties with follow‐up of patients favour a wider use of emergency definitive surgery for perforated peptic ulcer in Malaysia.
The Use of Œsophageal Motility Studies in the Diagnosis of Dysphagia
Authors: HANSKY J.
Published: January 2008

The anatomy and the physiology of the œsophagus are briefly described. This description is followed by a discussion of the various types of disorder motility, which may be due to: deficient peristalsis; excessive or disordered peristalsis; defects in the lower sphincter; or defects in the upper sphincter. Motility studies can constitute a valuable adjunct to radiology and endoscopy if the diagnosis is in doubt.
Some Difficulties in the Treatment of Dysphagia in Adults
Authors: MCCONCHIE IAN
Published: January 2008

The conditions most commonly responsible for dysphagia in adults are mentioned, and the treatment of these causal conditions is summarized. It is stressed that the symptom of dysphagia should be relieved even if the causal condition cannot be cured.
Traumatic Rupture of the Inferior Vena Cava: Report of a Case
Authors: KUMAR B. S. , SHARMA G. D.
Published: January 2008

Injuries of the inferior vena cava are rare, and the survival rate is low. The case of a patient who had tears in the inferior vena cava, duodenum and transverse colon is presented. Despite severe blood loss and cardiac arrest in the course of the surgical repair, once the bleeding was controlled the patient's condition improved, and he made a phenomenal recovery without complications.
Vascular Hamartoma of Skeletal Muscles: A Clinico‐Pathological Study of Six Cases
Authors: VARMA B. P. , MULLICK A. C. , GUPTA I. M. , GANGULY S. P. , SIROHIA S. K.
Published: January 2008

A clinico‐pathological study of six cases of vascular hamartoma (hœmangioma) of skeletal muscles is presented. The literature on the subject is reviewed, and the importance of the clinical differentiation of these lesions from malignant soft‐tissue neoplasms is stressed.
Carcinoma of Müllerian Vestigial Origin: Report of a Case
Authors: GUPTA I. M. , PRASAD B. N.
Published: January 2008

Benign tumours of the epididymis, which are very rare, are variously regarded as adenomas, mesotheliomas and lymphangiomas, but an alternative opinion considers them to be of Müllerian vestigial origin. Their malignant counterparts are extremely rare, and this case is probably the second authentic instance to be reported in the English literature. Complete excision of the mass with wide resection of the cord followed by prophylactic local deep X‐ray therapy has provided total relief to the patient over the year which has elapsed since these measures were undertaken.
The Laboratory Diagnosis of Intestinal Tuberculosis: A Study of 50 Cases
Authors: SINGH H. N. , VAIDYA M. P. , ROY S. K.
Published: January 2008

Fifty cases of chronic benign obstructive lesions of the ilco‐caccal region have been studied. The histopathology, particularly of the lymph nodes, provides the maximal confirmatory evidence of tuberculosis. Guinea‐pig inoculation is more informative, offering greater possibilities of indentifying acid‐fast bacilli. The demonstration of granuloma formation with caseation represents a significant advance in the laboratory diagnosis of tuberculosis.
Problems of Digital Amputations: A Clinical Review of 260 Patients and 301 Amputations1
Authors: Conolly W. Bruce , Goulston Eric
Published: January 2008

Three hundred and one digital amputations have been reviewed. There was a high complication rate, including poor pad, neuroma, joint stiffness, nail remnant, osteomyelitis, retracted tendon stump and stiff shotdder. In 20% of patients a second operation, usually reamputation, was necessary because of neuroma or poor pad. Fifty per cent of patients were away from work for more than two months, and prolonged disability often followed when the amputation stump was covered by a skin graft or flap, because of impaired sensation. Reference is made to five digits which were reimplanted and subsequently amputated. It is recommended that when amputating through the digit, the surgeon should not aim at preserving length at all costs, but at covering the amputation stump with a satisfactory soft‐tissue pad and maintaining full finger function.
Pneumatosis Coli1
Authors: O'Reilly Kevin
Published: January 2008

Eleven eases of pneumatosis coli are presented, these being the sum total of the readily accessible examples of this disease in Queensland to date. The clinicopathological features of these cases are similar to those reported by other authors. Remissions of the disease may follow persigmoidoscopic rupture of the cysts in the colon. Synonyms of pneumatosis coli are pneumatosis cystoides intestinalis (involving the colon) and colonic gas cysts.
Some Unusual Aspects of Clefts of the Lip1
Authors: Dey David L.
Published: January 2008

Experience with children with unusual clefts of the lip seen in Sydney in recent years is described and tabulated. Their embryological background and the basis of their production are considered.
Trichophytobezoar
Authors: Kutty M. Kannan , Menon K. A.
Published: January 2008

A rare case of trichophytobezoar with its successful removal in a ten‐year‐old Indian girl with a normal mentality is presented. It is thought to be the first case reported from Malaysia. The literature relating to certain aspects of this condition is briefly reviewed.
The Place of the Rosette Inhibition Test in the Preparation and Assay of Antilymphocytic Globulin1
Authors: Hogg D. F. , Clunie G. J. A. , Morton H. , Hegh V.
Published: January 2008

An anti‐dog thymocyte serum was prepared in six horses by four weekly injections of dog thymocytes, and was tested for immunosuppressive capacity during the course of immunisation by its ability to inhibit the formation of rosettes between dog spleen cells and sheep red blood cells.

Antithymocyte globulin prepared from the individual sera was administered to dogs receiving renal allografts with simultaneous bilateral nephrectomy, and the prolongation of survival was correlated with the rosette inhibition litres (RIT) of the sera.

A rise in serum RIT occurred after the third immunizing dose in all four horses producing immunosuppressive serum, with little or no response in the two horses producing non‐immunosuppressive serum.

These observations have led to considerable saving in time and expense in the production of antithymocyte globulin for experimental and clinical purposes in our own laboratories, and we recommend that continued immunisation and final bleeding out should be performed only if such a rise in RIT has been demonstrated.
A Comparison of Restorative Resection of Carcinoma of the Middle Third of the Rectum with Abdominoperineal Excision
Authors: Penfold J. C. B.
Published: January 2008

The results in patients with middle‐third rectal cancers treated by restorative resection have been predicted by careful examination of 546 abdominoperineal excision specimens, for tumour that might have been left behind if the more limited resection had been performed. It was found that in the patient who had such tumours the survival rate was very poor. It is, therefore, concluded that restorative resection for middle‐third rectal cancers, when technically possible, is justified on pathological grounds.
The Use of an Automatic Stapling Device for Closure of Surgical Wounds1
Authors: Stephens Frederick O. , Niesche John W.
Published: January 2008

A sterile prepackaged disposable applicator for metal skin clips has been used in 72 patients with a variety of standard incisions in the neck, thorax, abdomen, and limbs. The applicator has been found to be simple to use after very little experience. Its outstanding advantage is that it furnishes a significantly more rapid method of closing wounds than the use of interrupted skin sutures. There have been no problems with wound healing, and patients have found no significant discomfort either with having the clips in place or with their removal. There are a few minor points of technique to learn in the use of clips and their removal, but these have been rapidly learnt without any problem by the members of our surgical and nursing staffs.
The Prevention of Acute Tubular Necrosis in Renal Transplantation by Chronic Salt Loading of the Recipient1
Authors: Silber Sherman J.
Published: January 2008

By replacing normal water intake with 0–9% saline solution on a continuing basis, animals are protected against acute is chœmic tubular necrosis. Last‐minute plasma volume expansion does not provide this protection. To see whether the protection is intrinsic to the kidney or merely involves the host, kidneys were transplanted syngeneically from salt‐drinking rats to water‐drinking rats, and vice versa, and the recipients were injected with glycerol to produce myohœmoglobinuric renal failure. The kidneys transplanted from water‐drinking animals did not develop failure in the salt‐drinking animals, but those from salt drinkers did develop failure in the water drinkers. Therefore overhydration of the recipient by continuous salt loading is important in preventing acute tubular necrosis in renal transplantation.
Dural Arteriovenous Shunts in the Region of the Cavernous Sinus1
Authors: Siu Kevin , Henderson Keith
Published: January 2008

Two cases of carotid‐cavernous fistula are presented. The departure from the classical picture is described, with emphasis on the radiological diagnosis. The ætiology of these fistulæ is uncertain, but several theories are discussed.
Cerebral Embolism Following Blunt Extra cranial Vascular Trauma: A Report of Two Cases
Authors: Fletcher Richard , Woodward John , Royle John , Buxton Brian
Published: January 2008

This paper reports two patients, each of whom presented with a neurological deficit following extra cranial vascular trauma without complete vascular occlusion. It is suggested that in each case embolism occurred from the damaged intima.
Occult Intrasacral Meningocele: Report of a Case
Authors: Reddy D. Raja , Sathyanarayana K. , Krishnamurthi D.
Published: January 2008

A rare case of occult intrasacral meningocele in association with a lumbosacral myelomeningocele and a perineural cyst is reported. Its genesis and symptomatology are discussed and the treatment outlined. Apart from developmental factors, possible contributing roles of CSF dynamics are stressed.
The Prophylaxis of Deep Vein Thrombosis with Low‐Dose Heparin: A Trial
Authors: Propsting J. , Williams O. , Stathis M. , Mccaffrey J. F.
Published: January 2008

The prophylactic effect of lowaosc heparm (Calciparine)administered subcutaneously to a series of 50 patients undergoing a variety of surgical operations was studied. Four out of a control group of 25 patients (16%)developed deep vem thrombosis, while no patient in the treated group developed it. There was no evidence of pulmonary embolus in either group of patients. Twenty out of the 25 patients who received Calciparine had a complication related to the treatment, in five this was severe enough to cause the Calciparine administration to be stopped.
Secondary Surgical Intervention in Acute Renal Failure
Authors: Marshall Vernos
Published: January 2008

In a series of 118 patients postoperative acute renal failure was usually the result of a severe, but occult, surgical complication. Abdominal reexploration was often required. Postoperative hypotension, even without abdominal signs, commonly indicated an intraabdominal complication. Pancreatitis with abscess formation was a particularly serious complication. Peritoneal lavage was thought to have an important role in the management of diffuse intraabdominal sepsis.
The Stressed Lung in Severe Non‐Thoracic Sepsis
Authors: McCluskey Brian
Published: January 2008

The concept that respiratory failure with its attendant arterial hypoxmnia and increased pulmonary vascular resistance is the principal cause of death in patients with severe extrathoracic sepsis is supported. It is postulated that this is a direct result of circulating toxins from the infected area acting on the pulmonary vasculature. The principles in management are outlined
Tourniquet Paralysis1
Authors: Middleton K. W. D. , Varian J. P.
Published: January 2008

The principles of the use of the limb tourniquet have been unchanged for over 100 years, but the details of the techniques involved have gradually altered. This paper describes the modern practice of the use of the limb tourniquet in Australia, estimates the incidence of complications and indicates the pressure which may be produced by the Esmarch bandage.
Atherosclerotic Popliteal Aneurysms
Authors: King Barry , Scott David , Myers Kenneth
Published: January 2008

A review of 11 patients with 19 popliteal aneurysms is presented. Seven episodes of acute ischæmia due to thrombosis of the popliteal aneurysm necessitated major limb ampzitation in five patients, in spite of attempts to save the limb by sympathectonzy or vein‐bypass grafting. Conversely, in 11 limbs with asymptomatic aneurysms, large aneurysms causing pressure symptoms, or aneurysms with distal embolization, all aneurysms were reconstructed with a bypass graft. All but one limb survived for periods ranging froin four months to four years. One patient was considered unfit for surgcry on medical qrounds.
Focal Nodular Hyperplasia of the Liver
Authors: O'Reilly Kevin
Published: January 2008

Focal nodular hyperplasia of the liver can masquerade as neoplasia of the liver. It is, however, benign, and it is therefore very important that the entity be recognized.
Epididymal Tuberculosis: An Unusual Presentation
Authors: Raghavaiah N. V.
Published: January 2008

Primary epididymal tuberculosis is not common. It presents as a nodule, as a cold abscess, or as a scrotal sinus. Its presentation as a cold abscess in the suprapubic region is extremely unusual, and for this reason the present case is reported.
The Use of the Ultrasonic Flow Meter in Peripheral Vascular Disease
Authors: Nayman J.
Published: January 2008

This paper assesses the value of the ultrasonic flow meter in the diagnosis and management of peripheral arterial disease. The principles of the use of ultrasound are discussed and illustrated with the use of the Parkes Model 806 Directional Doppler instrument. The four types of velocity flow patterns are described, and the clinical applications indicated with particular reference to postoperative monitoring and the hœmodynamic assessment of reconstructive surgery.
Calculi and Chronic Skin Sinus in Nodular Goitre: Two Case Reports
Authors: Moulik B. K. , Sinha S. N. , Walia H. S.
Published: January 2008

A case of chronic discharging sinus originating from a calcified nodide of a multinodular qoitre is reported. Surgical treatment was extremely dificult in view of the dense fibrosis. A further case of thyroid cyst filled with multiple calculi, a condition which is quite rare, is also reported.
Hindquarter Amputations: Review of a Personal Series
Authors: Jones Paul
Published: January 2008

A record is given of 17 hindquarter amputations performed by the author between 1949 and 1970. The history of the development of this procedure is given, together with an account of the indications and results.
An Unusual Case of Intrathoracic Phaeochromocytoma1
Authors: Wilson A. C. , Bennett R. C. , Niall J. F. , Clarebrough J. K. , Doyle A. E. , Louis W. J.
Published: January 2008

Phœochromocytomas have many pathological and clinical features of interest. The present case report concerns a patient with two tumours, one of which was present in the middle mediastinum. This is only the second time that such an occurrence has been reported. Only one of the tumours (that in the right adrenal gland) secreted adrenaline, and difficulty was experienced in localising the mediastinal tumour. It was found that direct adrenal venous sampling proved misleading for purposes of localisation.
Infantile Strangulated Littré's Hernia with a Gangrenous Homolateral Testis: Report of a Case
Authors: Krausz M. , Rubin S. , Schiller M.
Published: January 2008

A case of strangulated Littré's hernia in a six‐week‐old infant is reported and the literature reviewed. The late presentation and clinical findings, with resultant gangrene and perforation of the bowel, are stressed. In infancy and childhood, testicular gangrene can be an additional early complication of strangulated inguinal hernia.
Recurrent Pyogenic Cholangitis in Children
Authors: Yue Paul C. K.
Published: January 2008

A review of six children with recurrent pyogenic cholangitis is presented with the main object of introducing this disease entity. The disease is one of the common causes of acute abdominal emergencies among Chinese in Hong Kong, but is also seen in other countries along the west coast of the Pacific. It mainly affects adults, but on rare occasions may affect children. The pathology and the clinical features are described, and the problems of diagnosis and treatment are discussed.
Congenital Constriction Band of the Thigh
Authors: Owen‐Smith M. S.
Published: January 2008

A case of congenital constriction band of the thigh, occurring in a baby born of Australian parents, is described. The condition and its treatment are discussed. It is believed to be the first case of this rare abnormality to be reported in an Australian.
Large Abdominal Wall Hernias: An Easy Method of Repair without Prosthetic Material, with the Induction of Pneumoperitoneum
Authors: Buddee F. W. , Coupland G. A. E. , Reeve T. S.
Published: January 2008

Large abdominal wall hernice may pose problems of management, particularly in the presence of obstructive airway and cardiovascular disease. Preoperative induction of pneumoperitoneum usually permits the anatomical repair of large hernia without complications and without the use of prosthetic materials to close the defect.
Portal Pyæmia Secondary to Carcinoma of the Rectum
Authors: Ritchie James D.
Published: January 2008

A case of multiple liver abscesses occurring in association with a carcinoma of the rectum is presented. This complication has not been previously recorded. It gave rise to an unexplained pyrexia and a confusing liver scan.
Experimental Gut Anastomoses and Their Revascularization
Authors: Nakanishi H.
Published: January 2008

A study was made of the healing and revascularisation of intestinal anastomoses in the small and large intestines of rabbits. Single‐layer and double‐layer suture techniques were used and compared, and revascularization of the anastomoses was particularly examined after devasoularization of their distal segments. The anastomotic segments were removed at intervals after construction varying from one to six zveeks and studied histologically after hematoxylin and eosin staining, by xylol‐clear thick sections and by angiography, a gelatin Micropaque emulsion being used to fill the vascular network.

Forty‐four rabbit intestinal anastomoses were studied. Inverted intestinal anastomoses look about two weeks to develop continuous mucosa on the luminal side, and were completely healed after six zveeks. Revascularization began after eight days with both single‐layer and double‐layer anastomoses, proceeding from the submucosal and the surrounding muscular layers. The vascular pattern mirrored the healing stage of the anastomosis. Irregular fine vessels crossing the anastomoses were seen in specimens examined at the second week. After three or four weeks, the vascular patterns of. the anastomoses showed an irregularity of calibre and direction because of the presence of residual scar tissue, and the mucosal surfaces were covered with regenerating epithelium. Healing and revascularization were complete after six weeks.
Torsion of the Testis in the Newborn
Authors: Auldist Alex W. , Ferguson R. Stuart
Published: January 2008

A series of 12 patients with torsion of the testis in the newborn is reported. In all patients the torsion occurred above the investment of the tunica vaginalis. Torsion occurred on the right side in six patients, on the left side in. five, and was bilateral in one. The clinical features, operative findings and treatment are described
Postoperative Complications of Thyroidectomy: A Comparison of Two Series at an Interval of Ten Years1
Authors: Barraclough B. H. , Reeve T. S.
Published: January 2008

A comparison is presented of the complications found in two series each consisting of 331 consecutive patients undergoing thyroidectomy in the same Unit ten years apart. The overall incidence of postoperative complications has been reduced, particularly in the group of patients having thyroidectomy for thyrotoxicosis, following which it is now no greater than after thyroidectomy for benign non‐toxic goitre. The techniques used to try to reduce the postoperative complication rate are discussed. The incidence of permanent recurrent laryngeal nerve palsy has been reduced to 0–3% and of permanent hypoparathyroidism to 1.2/. The overall incidence of complications causing permanent disability is now 3–9%