bluuebunny/crossref_metadata_2025 huggingface dataset:
A Simple Method of Measuring Host Immune Rejection Response After Renal Transplantation1
Authors: Hunt P. , Scott D. , Trotter S. , Atkins R.
Published: January 2008

The 3‐hour uptake of tritiated thymidine (3HT) is a simple reproducible estimation of spontaneous lymphocyte activation in the peripheral blood as evidenced by the constancy of results in control studies. Three patterns in 3HT uptake were seen in 13 patients after renal transplantation. Four patients without clinical evidence of rejection at one year had normal daily uptakes during the 3 weeks after transplantation. In another group of 5 patients, uptakes were initially normal before a rise in uptake of more than 100%, on consecutive days antedating a clinical rejection episode. In the other group of 4 patients, there was a significant rise in uptake of 2HT from the day of grafting, which resulted in the loss of the graft on 3 occasions.
Dissolution of Stones in the Common Bile Duct with Bile‐Salt Solutions1
Authors: Toouli J. , Jablonski P. , Watts J. McK.
Published: January 2008

Sixteen patients with stones in the biliary tree were treated by infusion of bile‐salt solutions into the T‐tube. In 13 of these patients the stones were removed by this procedure. This method provides a safe, effective and non‐invasive technique for the removal of such stones.
The Diagnosis of Abdominal Aortic Aneurysms1
Authors: Roberts Andrew , Johnson Neil , Royle John , Buttery Beresford , Buxton Brian
Published: January 2008

Aortic size has been studied in 21 patients, not only by the conventional techniques of clinical assessment, plain radiology and aortography, but also by the use of reflected ultrasound or echography. Echography has provided the correct diagnosis in 16 of our last 18 patients and is a helpful investigation in the diagnosis of abdominal aortic aneurysms.
Haematemesis and Melaena: A Clinical Study of 251 Hospital Admissions
Authors: Hardy K. J.
Published: January 2008

The consecutive admissions to hospital of 251 patients for hœmatemesis, melœna or both are documented. Duodenal ulcer was the most frequent diagnosis. Recent salicylate ingestion was found in 87% of patients, and 41% said that they took two or more tablets each day. The overall fatality rate was 11.6%, while it was 7.9% in the combined gastric and duodenal ulcer group. There were more deaths amongst those patients who on admission had a hœmoglobin level of less than 8 gm/100 ml, a blood pressure of less than 100 mm Hg, or a pulse rate greater than 100 per minute, or a combination of these; also amongst those aged over 60 years. The average age of the whole group was 59 years, and the average age of those dying was 72. Hœmorrhage was the major cause of death in 50%. Surgery was performed in 16% of patients, with Pólya gastrectomy the most frequent operation.
The Spontaneous Healing of Hand Wounds
Authors: Conolly W. Bruce
Published: January 2008

Selected transverse palmar and finger wounds, septic amputation stumps, and fingertip wounds were allowed to heal spontaneously. This healing process had advantages over primary wound closure in being virtually free of hœmatoma and infective complications and in allowing early postoperative finger movements.
Anæsthesia for Intracranial Vascular Surgery1
Authors: Brophy Tess
Published: January 2008

The surgery of intracranial vascular lesions provides special challenges for the anesthetist. The control of intracranial pressure, the prevention of cerebral ædema and the preservation of cerebral perfusion and oxygenation are leading requirements, to which are added measures to improve surgical access and to lower intravascular pressure in order to increase operability. Appropriate techniques and general provisions for meeting these requirements are discussed.
The Place of Isotope Myelography in the Definition of Spinal Cord Swelling Following Trauma: An Experimental Study
Authors: Yeo John D. , Collins Lee
Published: January 2008

Isotope myelography is suggested as an efficient and suitable investigation for establishing if an absolute spinal block has occurred after spinal cord injury. The technique of using isotope myelography with a portable static detector for point counting along the spinal cord in sheep is described, and the results are compared with those obtained by contrast myelography. Under general anæsthesia six adult sheep were subjected to a reproducible contusion injury to the lower thoracic spinal cord (Tro). Contrast and isotope myelography were used to investigate the development and duration of the spinal cord swelling that followed the trauma.
Pleural Fibrolipoma: Report of a Case
Authors: Peacock M. J. , Cradcock D. R. , Allen P. W.
Published: January 2008

A case of fibrolipoma of the pleura is described. To the authors' knowledge, this is the first time a fibrolipoma of the pleura has been reported.
Rectal Complications of Carcinoma of the Uterine Body Treated with Radiotherapy
Authors: Brownstein E. G.
Published: January 2008

Two patients are reported illustrating the early and late rectal complications of radiotherapy used in the treatment of carcinoma of the body of the uterus. The first developed a florid proctocolitis during a course of intracavitary and vaginal radiotherapy. This was followed by rectal stenosis requiring a one‐stage anterior resection. The second presented with a rectal stenosis and a vesicorectal fistula ten years after radiotherapy. She was treated by a two‐stage anterior resection, with an excision of the fistulous tract and repair of the bladder wall. The pathogenesis of radiation‐induced rectal stenosis is discussed, the literature is reviewed, and the cwrent concepts in management are outlined.
Delayed Rupture of the Ureter
Authors: Hardy K. J. , Hughes E. S. R. , FOLD J. C. B. Pen
Published: January 2008

Two instances of late ureteric fistula are reported. Damage followed a second large‐bowel resection for recurrent carcinoma in both patients, the ureter being well visualized and intact at the conclusion of each operation. In each patient the fistula developed seven days after operation Spontaneous cessation of urinary drainage occurred in one, and in the second a nephrectomy was necessary. The cause of the delayed rupture of the ureter was considered to be interference with its blood supply. Special care in avoiding this complication in reoperative large‐bowel surgery is urged.
A Comparison of Perfusates for 24‐Hour Preservation of Ischæmically Damaged Canine Kidneys
Authors: Drummono J. Malcolm , Sheil A. G. K.
Published: January 2008

A comparison is made of the efficacies of three solutions for brief perfusion of ischæmically damaged canine kidneys before 24 hours' preservation in ice and autotransplantation. Perfusion with a plasma‐red‐cell mixture, with intracellular electrolyte solution (Collins C3), mid perfusion with an extracellular “electrolyte solution” all gave comparable results, similar to those in a control group with no perfusion.
The Ureter in Renal Transplantation: Results of a Simple Technique of Uretero‐Vesical Anastomosis
Authors: Clunie G. J. A. , Sidle K. J. , Hartley L. C. J. , Hardie I. R.
Published: January 2008

In a series of 50 cadaveric renal allotransplants performed between September, 1969, and February, 1973, a simple technique of uretero‐vesical anastomosis performed from outside the bladder was utilized. Intravenous pyelography with a micturating cystographic phase was performed at regular intervals following operation in an attempt to define the incidence of mechanical urinary tract complications. Four cases of urinary leakage occurred, three requiring reoperation, and there was one case of ureteric obstruction due to a lymph cyst, Five cases of reflux into the transplanted ureter were demonstrated. We conclude that the incidence of complications is equivalent to that reported following the more standard and time‐consuming uretero‐neocystostomy used by most groups, and that this simple technique of uretero‐vesical anastomosis provides a useful alternative procedure.
Emergency Resection and Anastomosis for Perforated Sigmoid Diverticulitis
Authors: Ryan Peter
Published: January 2008

Experiences in the management of perforation of sigmoid diverticulitis in a consecutive series of ‐3 patients are described. The conclusion is drawn that immediate resection with anastomosis is the treatment of choice, provided that certain limited contraindications are taken into account.
Œsophago‐Jejunal Anastomosis Following Total Gastrectomy: A New Technique
Authors: Rutherford John C.
Published: January 2008

Following gastrectomy for carcinoma, leakage at the cesophago‐jejunal anastomosis can be a major and indeed a fatal complication. It can be obviated by the use of a sleeve of small bowel to reinforce the suture line, and the results of this procedure in a small series of six patients are presented.
Internal Herniation of the Small Bowel after Gastro‐Enterostomy
Authors: Gupta Saroj , Rao T. R. G.
Published: January 2008

Herniation of the small bowel through the ring formed after posterior retrocolic gastro‐enterostomy is a possible cause of acute bowel obstruction. Although this well‐recognized complication of gastro‐enterostomy is rarely encountered, the possibility of its presence must be borne in mind if the clinical condition of the patient suggests small‐bowel obstruction following gastric surgery.
Priapism: An Unusual Sequela of Appendicectomy: Case Report with Review of the Literature
Authors: Gue S.
Published: January 2008

A case of idiopathic priapism following appendicectomy is described. It was successfully treated by corpus‐saphenous bypass, and impotence was prevented.
Angiography: A Diagnostic Aid in Delayed Traumatic Rupture of the Spleen
Authors: Flanc Charles , Syme James
Published: January 2008

Four cases are presented and discussed to illustrate the value of angiography in clinching a suspected diagnosis of delayed traumatic rupture of the spleen. Such confirmation was obtained in two patients and early splenectomy was performed. The possibility of splenic rupture was excluded in the third patient, and operation was thus avoided. In the fourth, an angiographic abnormality consistent with local rupture was shown at surgical exploration to be due to an artefact.
Forward Dislocation of the Elbow Joint without Fracture of the Olecranon
Authors: Srivastava K. K. , Kochhar V. L.
Published: January 2008

Two cases of anterior dislocation of the elbow without fracture of the olecranon process are described, which bring the total number of cases so far reported to thirty. The literature on the subject is briefly reviewed, and the mechanism of the injury is discussed.
Emphysematous Gastritis: Report of a Case
Authors: Weston T. S.
Published: January 2008

Emphysematous gastritis is a rare and frequently lethal disorder, characterized by phlegmonous gastritis caused by gas‐forming organisms. A patient with this condition is described, in whom the ante‐mortem diagnosis was made on clinical and radiological grounds.
Acute Diverticulitis of the Cæcum
Authors: Woo Wing‐hung , Cheng Frank C. Y.
Published: January 2008

Two cases of inflammation of a solitary diverticulum of the ccecum are reported. These probably represent the first cases to be reported in Chinese. The pathogenesis of solitary diverticulum of the ccecum is different from that of multiple diverticula sis of the colon. A study of these cases was made to understand better this uncommon entity. Before operation, the symptoms, signs and physical findings of ccecal diverticulitis are those found in appendicitis. The diagnosis at operation in some cases is difficult because the inflammatory reaction may simulate a malignant process. Local excision is the operation of choice. Our two patients were treated by right hemicolectomy. Discussion is presented of the clinical presentation, pathology and treatment of this condition, so that its prompt recognition may avoid the incorrect diagnosis of ccecal malignancy, which in turn would lead to unnecessary radical surgery resulting in a high mortality rate.
Pseudomyxoma Peritonei Diagnosed by Peritoneoscopy
Authors: Chui C. J. F. L.
Published: January 2008

A case of pseudomyxoma peritonei diagnosed by peritoneoscopy is reported. The rarity of the tumour and the unfamiliarity of the surgeon with the vagaries of this condition often lead to a pessimistic diagnosis of advanced metastatic mucinous adenocarcinoma. It is suggested that peritoneoscopy may be of help both in the early diagnosis of pseudomyxoma peritonei, thus sparing patients from unnecessary investigations, and in their follow up, especially when the aggressive policy of multiple repeated resections of the recurrent or persistent lesions is to be adopted.
The Management of Solitary Thyroid Nodules Under Local Anaesthesia
Authors: Cunningham Lan G. E. , Lee Yax Kor
Published: January 2008

A groups of patients with solitary nodules of the thyroid were treated at the University of Malaya by surgery under local anesthesia. This was done in order to expedite exploration of a potentially malignant condition. This group comprised 43 patients, and four cancers were found. The standard technique used was satisfactory from the viewpoint of both the patient and the surgeon. The pattern of this condition in a Malaysian population is documented, the technique used is described, and thyroidectomy under local ancesthesia is discussed.
Mean Flow Measurements in Aortofemoral Arterial Reconstructions
Authors: Little J. M. , Sheil A. G. R. , Loewenthal J. , May J. , Goodman A. H.
Published: January 2008

Eighty‐seven limbs in 48 patients have been studied with an electromagnetic flow meter at the time of arterial reconstruction designed to restore blood flow from the aorta to the femoral artery system. The mean overall flow was 339 ml per minute. Blood flow in aneurysmal disease was significantly higher than that recorded in obstructive disease. Blood flow in arteries running into a fully patent femoral system was significantly higher than in those that ran only into the profunda. Age, sex, type of surgery and size of graft had no influence on the flow achieved. Reconstructions for rest pain or advanced trophic change produced flows of the same magnitude as reconstructions for intermittent claudication. The patient's weight correlated significantly with the intraoperative flow. The mean flow in the limbs of 28 patients in whom an accurate preoperative weight was known was 2–56 mil 100 gm/minute, taking the hind limb and hemi‐pelvis as 25% of the body weight. This is an acceptably “normal” value. A flow of less than 100 ml per minute in an aortoiliac reconstruction was found to be not likely to result in long‐term patency.
Temporo‐Mandibular Joint Ankylosis and Oro‐Nasal Fistula as Complications of Facial Trauma
Authors: Summers L. , Pearce Robert L.
Published: January 2008

Condylar fractures with or without disruption of the temporo‐mandibular joint occur commonly with other facial injuries. The subsequent development of ankylosis presents surgical and ancesthetic problems in management and results in severe physical disability to the patictit. Oro‐nasal fistula is a rare complication of fractures involving the middle third of the facial skeleton, and two cases are reported
Evaluation of a Single‐layer Intestinal Anastomosis: An Experimental Study
Authors: Singh Bholla , Singh Joginder
Published: January 2008

Fifteen single‐layer and 15 double‐layer inverting intestinal anastomoses were made in the small intestines of is healthy mongrel dogs and the results were compared. The single‐layer anastomosis was found to be superior to the double‐layer procedure in many respects
Nodular Goitre in Northern India: A Clinicopathological Profile
Authors: Prakash A. , Sharma Lalit K. , Koshal A. , Rao Ch. S. P. , Ahuja M. M. S.
Published: January 2008

Three hundred and six patients with nodular goitre were studied clinically, investigated, and operated upon in the Professorial Unit of the All‐India Institute of Medical Sciences Hospital, New Delhi. The clinical profile, the pattern of investigations, and the results of surgery are presented.
Percutaneous Radiofrequency Gangliotomy in the Treatment of Trigeminal Neuralgia and Other Facial Pain
Authors: Vaughan Richard
Published: January 2008

Thirty‐eight patients with facial pain in the trigeminal distribution have been treated by percutaneous coagulation of the trigeminal ganglion. Although use has been made of radiological criteria, it has been found from the physiological data obtained from stimulation that motor and sensory phenomena provide more information of electrode placement and that good pain relief results when these criteria are met. The advantages of the method are: (i) minimal operative risk; (ii) control of the extent of the lesion created; (in) small sensibility deficit; (iv) minimal complication rate; (v) short hospitalisation; (vi) satisfactory results in more than go% of patients; (vii) no reccurrence of pain to date
Gallstone Erosion of the Aorta
Authors: Broadbent N. R. G. , Taylor D. E. M.
Published: January 2008

A case of fatal erosion of the abdominal aorta by gallstones is reported. The patient presented with a six‐day history of melcena and died suddenly 39 hours after admission to hospital, with massive blood loss per rectum. At post‐mortem examination a saccular cavity containing gallstones was found at the lower end of the common bile duct. The cavity communicated in front with the duodenum and behind with the aorta. This case appears to be the first of its kind to be reported
The Natural History of Osteoid Osteoma
Authors: Simm R. J.
Published: January 2008

A long‐term follow‐up of three patients suffering from osteoid osteoma who have not undergone surgery is reported. Only eight similar cases have been reported in the literature. It is shown that over a period of years the pain of osteoid osteoma eventually disappears, but the radiological appearance may remain unaltered or gradually resolve. Surgical management of osteoid osteoma is advised because of the prolonged symptoms.
Ruptured Iliac Aneurysms
Authors: Thiele Brian , Geddes Neil , Johnson Neil , Macleish Don , Royle John , Buxton Brian
Published: January 2008

Iliac aneurysms are uncommon as compared with aneurysms of the abdominal aorta. Rupture is the most serious complication of aneurysms of both vessels. Considerable attention has been focused on the management of ruptured abdominal aortic aneurysms, but ruptured iliac aneurysms have received little notice. The problems in the management of ten ruptured iliac aneurysms, seen over the last five years, together with the rarity of other reports of this condition, have stimulated this review.
End Thoracic Duct Pressures in Man1
Authors: Isbister William H. , Balderson Glenda , Noonan Frances P. , Halliday W. J. , Clunie G. J. A.
Published: January 2008

Thoracic duct end pressures have been measured in a conscious patient undergoing cannula‐tion in an attempt to remove serum blocking activity. Pressures were measured during rest, coughing, straining and laughing, and during the last‐mentioned activity pressures of the order of 85 mm Hg were recorded. It is suggested that formal ligation of the thoracic duct would be necessary to withstand these pressures following removal of the cannula at the termination of treatment.
A Device for Surface Cooling and Rewarming in Operations on the “Dry” Heart in Babies and Children During Moderate, Deep and Profound Hypothermia
Authors: Lacis A. T. , Breicis J. H. , Kalnins J. R. , Volkolakov J.
Published: January 2008

Following a clinical experience of too cardiac operations in infants during deep hypothermia, as low as 15°C, the authors have designed a new bath for the procedure which incorporates several improvements over those used previously. The device described allows continuous cooling or rewarming of the patient at any stage of the operation by addition of more cold or hot water as required. It is possible to operate with the patient prone or on the side at any level of hypothermia, and while using heart lung bypass: The construction facilitates the even distribution of the circulating water, and a thermostatic control allows the temperature to be fixed at any level required.
Splenectomy: A Review of Morbidity
Authors: Little J. M.
Published: January 2008

One hundred and fifty consecutive splenectomies, performed at the Royal Prince Alfred Hospital over a five‐year period beginning in 1968, have been reviewed in a retrospective study. Splenectomy incidental to some other resectional procedure in the upper abdomen carried a mortality of 17%, accidental injury to the spleen during upper abdominal surgery carried a mortality of 28%, external trauma to the spleen a 7% mortality, while splenectomy for the diagnosis or therapy of a hematological disorder carried the lowest mortality, namely 4%. Morbidity and mortality were related to the age of the patient, and the mortality among patients 60 years or more was 26%. Pulmonary complications (excluding pidmonary embolus) occurred in 48% of patients. Clinically evident thromboembolism was delected in 10‐7% of patients. A definite relationship to platelet counts of more than 500,000/mm was noted amongst patients who were not heparinized.

Splenectomy is associated with a high morbidity and a significant mortality. Surgeons performing the operation and physicians referring patients for splenectomy need to be aware of the risks involved. Careful patient selection, scrupulous perioperative management, and. meticulous surgery may reduce both morbidity and mortality. Elective splenectomy should be managed by a team of surgeons and physicians with a specific interest in the problems involved.
One‐Stage Repair of Distal Hypospadias
Authors: Madan N. C. , Agarwal S. B. , Dhiawan I. K.
Published: January 2008

This paper reviews a short series of patients with distal hypospadias who were treated by Mustardc's one‐stage technique, to which we have added a minor modification by tubing the flap before penis tunnelization. A single‐stage repair has obvious advantages over a more conventional multistage procedure. The advantage of tubing the flap is early healing, and it reduces the risk of fistula formation, even in the presence of infection, which is very common in this country. The new urethral opening is situated at the fossa navicularis, and the functional results are excellent.
Hæmangiomatous Malformation of the Orbito‐Sphenoidal Region: Cure by Radiotherapy
Authors: Miller Douglas , Wilde F. De
Published: January 2008

This case was previously reported in 1973 at the 46th annual general scientific meeting of this College. Following a suggestion made at the meeting the patient was referred for radiotherapy, with a result so satisfactory as to call for a restatement of the case.

case of gross hHæmangiomatous malformation of the orbit was treated and observed for 20 years. The condition had progressed to the point where further surgical attack was impossible. Radiotherapy was applied with a resultant remarkable cure.
Retroperitoneal Liposarcoma
Authors: Moulik B. K. , Prakash Atm , Siniia S. N.
Published: January 2008

The diagnosis of retroperitoneal fatty tumour is not extremely difficult provided that the possibility of its presence is kept in mind by the surgeon in all cases of distended abdomen in an apparently well‐nourished patient. A careful clinical examination and a good excretory Myelogram arc very important in the diagnosis. Surgical excision requires a considerable amount of patience and boldness on the part of the surgeon and is always gratifying, even if the tumour cannot be totally removed. Three cases of retroperitoneal tumour treated by us arc presented. All three had had previous unsatisfactory treatment, the firs two being incorrectly diagnosed and the third being inadequately excised. The pathology, diagnosis and treatment of these tumours are briefly discussed.
A Neck Incision
Authors: Bridger G. Patrick
Published: January 2008

A “hockey stick” neck incision is recommended for laryngectomy with neck dissection, especially ivhen the surgery follows radiotherapy.
TRAUMATIC RETROPERITONEAL RUPTURE OF THE DUODENUM
Authors: Vellar D. J. , Vellar I. D. A. , Pianta R. M.
Published: January 2008

A report of six cases of retroperitoneal rupture of the duodenum is presented. A high index of suspicion is necessary to enable early diagnosis to be made and appropriate treatment carried out. Early treatment will prevent the extremely rare, but at present uniformly fatal complication of gas gangrene. Plain X‐ray and Gastrografm studies may kelp to elucidate the situation in particular cases, but are no substitute for repeated careful abdominal examination. It is suggested that large doses of penicillin be employed where possible in the management of these cases, in addition to such antibiotic therapy as may be expected to be effective against the usual Gram‐negative bowel flora.
THE TREATMENT OF PRIAPISM BY CAVERNOSOSPONGIOSAL SHUNT: RESULTS OF OPERATION IN FIVE PATIENTS
Authors: Harewood Laurence , McOmish Donald
Published: January 2008

The cavernosospongiosal shunt operation is an effective method of treatment of priapism. Experience with five cases has led the writers to suggest early operation, avoidance of needle aspiration and the use of steroids.
GIANT INTRACRANIAL EPIDERMOID TUMOUR: A SINGULAR PEARL?
Authors: Dan Noel G. , Caspary Eric J.
Published: January 2008

The chronic benign course and occasional gigantic size of posterior fossa epidermoids are illustrated by a case report, and the features of these tumours are reviewed.
A PROSPECTIVE TRIAL OF POVODONE IODINE SOLUTION IN THE PREVENTION OF WOUND SEPSIS
Authors: McCluskey Brian
Published: January 2008

In a prospective blind trial in patients undergoing intraabdominal surgery, instillation of povodone iodine (PVI) solution into the wound failed to reduce the incidence of wound sepsis.
QUALITY CONTROL IN THE PART I F.R.A.C.S. EXAMINATION
Authors: Cox Kenneth R.
Published: January 2008

The conduct of College examinations has seemed a mystery to many candidates. Both candidates and supervisors of training have echoed this concern with the R.A.C.S. new Part I examination. This paper describes the work of the Board of Examiners1 of the Royal Australasian College of Surgeons and the procedures by which the new Part I examination is constructed, administered, analysed and refined. It sets out how the examination has been developed into an educational instrument to provide feedback to candidates, to teachers and to examiners, so that each can improve his performance. In addition, the Board has acquired data from each candidate on his learning opportunities, and from each candidate's mentor on various performance characteristics of the candidate.
ARTERIAL COUNTERPULSATION IN THE MANAGEMENT OF ISCHAEMIC HEART DISEASE
Authors: O'Rourke Michael F.
Published: January 2008

Arterial counterpulsation is a major advance in the treatment of myocardial Ischaemla in association with myocardial infarction. Counterpulsation is based on sound physiological principles and can be expected to limit ischaemia and necrosis when applied within the first 12 to 24 hours of infarction. It has been used in massive infarction with cardiogenic shock, and in threatening Infarction. Good results at both ends of a clinical spectrum suggest an important role throughout the spectrum. Studies in progress are attempting to define this role.
RUPTURED ABDOMINAL AORTIC ANEURYSMS: A REVIEW OF 168 CASES
Authors: Magee H. R. , Cohen J. R. , Mellick S. A.
Published: January 2008

One hundred and sixty‐eight ruptured aortic aneurysms presenting at the Princess Alexandra Hospital in an 11‐year period have been reviewed. Surgical treatment still carries a high mortality and a very high postoperative morbidity. The survival rate in the Vascular Unit of this hospital has improved during the period studied and in the last five years has risen to 61%. The operative technique is described in detail, and the operative problems and complications are discussed. It is felt that prompt surgical treatment, and accurate assessment of blood loss with adequate replacement during surgery, combined with attention to early postoperative problems, particularly those of a respiratory nature, are the most important factors in survival.
THE INCIDENCE OF UNSUSPECTED PERIPHERAL ARTERIAL DISEASE AMONGST SURGICAL PATIENTS IN HONG KONG
Authors: Wong John , Lam Peter , Ong G. B.
Published: January 2008

A survey of surgical in‐patients in Hong Kong has shown that subclinical peripheral arterial disease caused by atherosclerosis and detected by palpation is not uncommon and is similar in incidence to that reported in European populations. However, only a small proportion of affected patients had any associated symptoms. Reduced or absent ankle and ulnar pulses occurred with the same frequency in our patients as in those in Europe. Cigarette smoking does not appear to be associated with symptomatic arterial disease in the local population in Hong Kong.
MALIGNANT MELANOMA: SOME ASPECTS OF PATHOLOGY AND PROGNOSIS
Authors: Ironside P. , Pitt T. T. E. , Rank B. K.
Published: January 2008

This is a report on the periods of survival, and the factors that influence survival, in a series of 509 patients treated for malignant melanoma in the Peter MacCallum Clinic, Melbourne. Not the least of these factors is education of the public and the medical profession in its early recognition, which has greatly improved the prognosis. In this context, it is also firmly believed that whenever possible, one clinician only should be responsible for the total surgical management of any patient suffering from this disease.
LIVER SCANNING IN PATIENTS WITH COLORECTAL CARCINOMA
Authors: Wong John , Ong G. B.
Published: January 2008

Three hundred liver scans were performed on a routine basis in patients with colorectal carcinoma, before and after operation, to detect hepatic metastases. In 98 of 106 pre‐operative and 28 of 194 postoperative scans, confirmation of the pathological condition was obtained at operation or post‐mortem examination. The overall diagnostic accuracy of the scan was 77.4%, but the false‐positive rate was high.

The presence of focal defects in liver scans before operation did not influence our decision regarding abdominal exploration. After operation on patients who did not have disseminated disease and whose liver scans showed localized focal defects, selective hepatic arteriography and abdominal exploration did not reveal resectable metastatic disease. In one‐third of patients with abnormal liver scans after operation, subsequent scans returned to normal.

Of the patients with true positive liver scans, three‐quarters had clinically evident hepatic metastases. Serum alkaline phosphatase estimations were as accurate in detecting liver metastases as the liver scan, and returned fewer false‐positive results. Routine liver scanning before or after operation is not recommended for patients with colorectal carcinoma and should be reserved for patients with clinical features or biochemical abnormalities suggestive of liver metastases.
MEDIASTINOSCOPY IN THE DIAGNOSIS OF THORACIC DISEASE
Authors: Nandi P. , Leung J.S.M. , Ong G. B.
Published: January 2008

One hundred and forty‐one patients have undergone mediastinoscopy in the Hong Kong University Surgical Unit since March 1974. Among these there were 109 cases of bronchogenic carcinoma. In approximately 50% of these patients the carcinoma had already spread to involve the mediastinal lymph nodes at the time of examination. Mediastinoscopy may be the only source of positive histological proof of the diagnosis in bronchogenic carcinoma as well as in other types of intrathoracic disease such as tuberculosis. We believe that mediastinoscopy reduces the number of unnecessary exploratory thoracotomies.
TECHNIQUES OF REINFORCING THE ASCENDING THORACIC AORTA
Authors: Buxton Brian , Harlan Bradley J. , Cooley Denton
Published: January 2008

Two techniques of reinforcing the ascending thoracic aorta with Dacron vascular prosthetic material are described. Circular reinforcement has been used in patients with fusiform dilatation of the ascending thoracic aorta in whom it was considered that graft replacement was unsuitable, and also in patients with a thin‐walled aorta, where reinforcement was thought to be beneficial in preventing dehiscence of an aortic suture line. The techniques are described in two patients who underwent aortic valve replacement and who had aneurysmal dilatation of the ascending thoracic aorta.
THE OPTIMUM DURATION OF SYSTEMIC ANTIBIOTIC ADMINISTRATION IN THE TREATMENT OF EXPERIMENTAL PERITONITIS*
Authors: Law D. , Law C. , Todd J. K. , Eiseman B.
Published: January 2008

The duration of antibiotic therapy for peritonitis is commonly decided on an empirical basis. There is obvious advantage in determining the shortest, yet most effective, period for such drug therapy. This study Is a comparison of short‐course and long‐course antibiotic administration following peritonitis produced by experimental rupture of the rabbit appendix.
SEVERE CHAINSAW INJURIES
Authors: Macfarlane Iain , Harry Nick
Published: January 2008

A survey of 47 patients who sustained severe chainsaw injuries has been carried out. It shows that this machine, while an extremely useful one, is hazardous. Most of the patients were young, and over half of the injuries involved a hand. One fatality was recorded.
ACUTE PANCREATITIS: THE QUEENSLAND SCENE
Authors: Battersby Cameron , Crapuis Pierre
Published: January 2008

One hundred patients suffering from acute pancreatitis and studied in two large teaching hospitals in Brisbane between 1959 and 1973 were reviewed. Gallstones were present in 43 patients (of whom 31 were female), and a history of alcoholic excess was elicited in 23. Sixty‐three patients were aged over 50 years. Characteristic clinical features included spreading epigastric pain with radiation to either of the upper quadrants of the abdomen. Left‐sided upper abdominal peritonitis associated with severe repetitive vomiting was suggestive of the diagnosis. The serum amylase level in most cases fell below the arbitrary diagnostic level of 500 Somogyi units/100 ml within 72 hours of the onset of the pain. Acute hæmorrhagic necrosis of the pancreas was positively diagnosed in 15 patients, six of whom died. The overall mortality rate in the series was 9%.
BENIGN NON‐PARASITIC CYSTS OF THE LIVER: A REVIEW OF 18 CASES
Authors: Wong John , Little J. M.
Published: January 2008

Benign non‐parasitic cysts of the liver are a clinical and pathological curiosity except when they cause symptoms or are incorrectly diagnosed as metastases in patients with abdominal malignancy. It is difficult to make a correct diagnosis of benign liver cysts in spite of the armamentarium of modern diagnostic aids available, and on many occasions the diagnosis is made at laparotomy. This is a report of 18 patients with benign cysts of the liver, two of whom suffered complications which we believe have not previously been reported.
LEFT HEPATIC LOBECTOMY AND RESECTION OF A CARCINOMA INVOLVING THE CONFLUENCE OF THE RIGHT, LEFT, AND COMMON HEPATIC DUCTS
Authors: Mann Arnold
Published: January 2008

This is a report of a single case of carcinoma involving the confluence of the right, left, and common hepatic ducts, treated by left hepatic lobectomy and resection of the tumour. The clinical onset of symptoms with pruritus and steadily deepening jaundice was typical of the condition, as was the difficulty in establishing a diagnosis. Radical treatment for this tumour, which is frequently slow to metastasize, is advocated. The importance of complete filling of the billary tree during operative choledochography is highlighted.
URETEROURETEROSTOMY FOR URETERIC DUPLICATION WITH ONE PATHOLOGICAL RENAL SEGMENT
Authors: Walton J. K.
Published: January 2008

An operation for the management of ureteric duplication with one pathological renal segment is described. A report of 13 cases with 15 duplex systems is presented, showing the merits of ureteroureterostomy as measured against the established procedures.
INJURY CONTROL: A STATE‐OF‐THE‐ART REVIEW
Authors: Wigglesworth E. C.
Published: January 2008

There is a growing body of new knowledge suggesting that trauma should no longer be conceptualized as a behavioural phenomenon with the associated connotations of chance, unexpectedness and blame worthiness. Instead, it should be regarded as a public health problem amenable to scientific, research‐based strategies of the type that have been successfully introduced in the fight to conquer infectious disease. If progress is to be made in reducing the toll of accidental mortality and morbidity, the current need is for the increased allocation of resources to develop, extend and disseminate this new knowledge.
THE MICROSURGICAL BASIS OF FALLOPIAN TUBE RECONSTRUCTION
Authors: Owen Earl R. , Pickett‐Heaps Anthony A.
Published: January 2008

A rational approach to the reconstruction of the Fallopian tube, blocked either intentionally or by disease processes, can only be made on the basis of sound anatomical and physiological understanding. It would accordingly not be logical to expect the tube to function normally again after too great a disorganization by sterilization procedures followed by traumatic restorative operations. It is therefore recommended that any sterilization should be carried out by a midtubal atraumatic Pomeroy method, tissue being conserved for possible future reconstruction, and that a proven microsurgical technique be utilized for the best results of reconstruction to be obtained. This paper briefly details the anatomy and physiology of the Fallopian tubes, evaluates a microsurgical tubal repair in the rabbit, reports a series of tubal repairs in women, and suggests a working protocol for future tubal surgery.
VASCULAR COMPRESSION OF LOWER CRANIAL NERVES: OBSERVATIONS USING MICROSURGERY, WITH PARTICULAR REFERENCE TO TRIGEMINAL NEURALGIA
Authors: Petty Peter G. , Southby Robert
Published: January 2008

A new finding made possible by the use of the operating microscope in neurosurgery is discussed. Nineteen patients with trigeminal neuralgia have been explored, and in 14 of these vascular compression of the fifth nerve at its entry zone to the pons has been found. Relief of this vascular compression has caused cessation of pain in all these patients. In addition, one patient with hemifacial spasm, and one patient with glossopharyngeal neuralgia, are reported; each of these also had vascular compression of the appropriate nerve causing the symptoms.
RECENT ADVANCES IN THE MANAGEMENT OF SPINAL INJURIES WITH PARALYSIS
Authors: Bedbrook G. M.
Published: January 2008

In the last decade, by application of detailed methods of care, the previously accepted complications of urinary infection, pressure sores and motor skeletal problems of contractures and spasm, have largely been eliminated from the clinical picture of patients with spinal paralysis. Many professionals in medicine have contributed to these advances. Long‐term or extended care in the area of tetraplegia and paraplegia need further stimulation, with continued application of all those methods used in acute rehabilitation in properly organized spinal units.
EARLY MOBILIZATION AND REHABILITATION IN FRACTURES AND ORTHOPÆDIC CONDITIONS
Authors: Huckstep R. L.
Published: January 2008

Many advances have taken place during the past decade in the early mobilization of orthopædic patients and those with injuries. Light‐weight scientific splinting, early rigid fixation with compression plates and nails, and the early mobilization of patients with pathological fractures in neoplastic disease, have meant that these patients can often be mobile in days, and home in a fortnight, instead of spending months languishing in hospital. Scientific treatment of patients with neck and low back pain may similarly minimize chronic disability, while early rehabilitation can enable their early return to employment. It is the purpose of this paper to underline some of the important advances in treatment which have made this possible.
OSTEOMA INVOLVING MULTIPLE PARANASAL SINUSES
Authors: Bridger G. P. , Lindsay R. A. , Payten R.
Published: January 2008

A case of osteoma involving multiple paranasal sinuses is described. The tumour was removed completely through an extended lateral rhinotomy approach.
A NEW MICROSURGICAL NEEDLEHOLDER
Authors: Vickers D. W.
Published: January 2008

Microsurgery demands precise and rapid manipulation of needle and thread with maintenance of special respect for the fragility of the tissues. The design of the needleholder is of paramount importance in achieving these goals. The Instrument described below is light, long enough to rest comfortably in the hand, and balanced in such a way that it can be manipulated into awkward corners with relative ease.
ENDOVENOUS DIATHERMY SCLEROSIS OF VARICOSE VEINS1
Authors: O'Reilly Kevin
Published: January 2008

The results of endovenous diathermy sclerosis treatment of 68 limbs on 48 patients (endovenous diathermy) are reported.
RECENT ADVANCES IN GENERAL SURGERY1
Authors: Nanson Eric M.
Published: January 2008

In order to give an overview of recent advances in general surgery, it is necessary to define: (i) what is general surgery; (ii) what is recent; and (iii) what constitutes an advance. General surgery appears to have entered an era of conservatism. This is particularly evident in the surgery of breast cancer, peptic ulceration, varicose velns, liver trauma, portal hypertension, upper gastrointestinal bleeding, and hiatal hernia. Controlled clinical trials in surgery have become popular. The following are considered to be advances: parenteral nutrition, suction drainage, control of Gram‐negative sepsis, bypass surgery for pathological obesity, and a discriminatory approach to transplant surgery.
EXPERIENCES WITH CRYOSURGERY IN THE MANAGEMENT OF BENIGN PROSTATIC OBSTRUCTION
Authors: Green N. Alan
Published: January 2008

Cryosurgery of the prostate gland has been used on mainly unfit patients for ten years as an alternative to open and endoscopic surgery in over 250 patients. With the use of a simple “rule of thumb” technique, blind cryosurgery can be recommended as causing few complications. Furthermore, the patient's early discharge from hospital can be achieved. Long‐term functional results are satisfactory. More complicated techniques have been described and are mentioned, but as a result of experience simplicity of technique is recommended.
CAROTID BODY TUMOURS
Authors: Connell John
Published: January 2008

Carotid body tumours are rare, but important. Their reputation for slow growth and virtual non‐malignancy has had, in the light of experience, to be revised. Sudden spurts of growth are well known, and the tumour may become irremovable in a relatively short time. Aggressive local invasion and widespread metastasis are now well recognized. Histological features are no guide to malignancy. These tumours can nearly all be removed with an acceptable mortality and morbidity, without damage to the internal carotid artery. Ideally the diagnosis should be made by clinical acumen and confirmatory X‐ray examination. Biopsy makes subsequent removal of the tumour much more difficult, and should be avoided if at all possible. Eleven personal cases of carotid body tumours are reported, and the technique of surgical excision is discussed in detail.
MIGRATION OF A URETERIC CALCULUS TO THE BLADDER VIA A URETEROCOLIC AND A VESICOCOLIC FISTULA
Authors: Earlam Malcolm S. S.
Published: January 2008

Following a difficult nephrectomy for pyonephrosis, two large calculi in the left pelvic ureter were not removed. The upper of these two calculi finally found its way into the bladder after ulcerating into the sigmoid colon and thence into the bladder. The calculi and the residual ureter were removed and the fistulæ closed, with a successful outcome.
ISOLATED PERFORATIONS OF THE ILEUM AND JEJUNUM IN BLUNT ABDOMINAL TRAUMA
Authors: Musa M. Bakri , Meah Freda
Published: January 2008

A report of ten cases of perforations of the ileum and jejunum from blunt abdominal trauma is presented. The perforation was the only injury in eight patients, while in two there were other visceral injuries. The perforations were single in seven patients and double in three. Simple closure was used in seven cases and resection in three. Of the three patients who were operated upon late, one died.
ABDOMINAL PAIN AND GONORRHŒA
Authors: MacLean A. B. , Platts W. M.
Published: January 2008

Two patients are described who presented with features of the Fitz‐Hugh‐Curtis syndrome. Recognition of this entity may prevent unnecessary investigation before diagnosis and treatment. As the incidence of gonorrhœa is increasing, complications such as this may be seen more frequently among patients presenting to surgical or gynæcological wards.
THE POTENTIAL OF AN EDUCATIONAL COMPUTER IN MEDICAL EDUCATION
Authors: Nanson Eric M.
Published: January 2008

The use of an educational computer for a medical course is reviewed. It is of value for assessment, small group teaching, self‐instruction, and continuing medical education. It is particularly useful for patient management problems.
THE MANAGEMENT OF BLUNT INJURIES OF THE URINARY TRACT
Authors: Marshall Villis
Published: January 2008

An attempt has been made to review the methods of diagnosing and treating blunt injuries of the urinary tract, with special attention to the kidney and urethra.
THE COMBINED APPROACH TO CANCER THERAPY IN CANCER CENTRES
Authors: Ilbery Peter
Published: January 2008

In the complex field of cancer therapy the cancer centre approach may be seen more clearly by division of its structure into vertical and horizontal components. Vertically, there are numerous special consultative clinics in types of cancer usually associated with a body region (lung, breast, melanoma, etc.). Horizontally, there are teams of specialists (surgeons, radiotherapists, solid tumour chemotherapists), in some clinics supplemented by hæmatologists, immunologists, and endocrinologists, providing a wide therapeutic spectrum. Working together in a particular consultative team, the specialists are clinical oncologists, but without the summed wisdom and expertise of the group, the members are more accurately designated individually as specialists in the field from which they spring, for example, thoracic surgeon, hæmatologist, radiotherapist, and so on. The team approach lends itself to full exploitation of all the centralized sophisticated cancer machinery, be it in the form of equipment like celltrifuges and linear accelerators, a range and depth of cancer monitoring aids, or a medical record system aligned to a computer, with consequent immediate and long‐term therapeutic gain to patients. For the State there is greater efficiency and hence economy. In teaching, the aggregation of all matters relating to cancer therapy presents enhanced opportunities for training of technicians and scientists and nurses as well as doctors, for postgraduate instruction, and for continuing education. For progress in understanding cancer, it is clear that clinical research in conjunction with the combined approach in cancer centres can be conducted with sufficient numbers of patients to give statistical credence to clinical trials.
HYPERTHERMIA AND CANCER
Authors: Burkhardt Daniel , Ghosh Peter
Published: January 2008

The effects of heat and its possible significance in cancer therapy have been documented for more than a century. Hyperthermia has been widely investigated as an alternative or adjuvant to conventional therapies such as surgery, radiation, and chemotherapy. The clinical reports are interesting, notwithstanding some harmful side effects and other complications which, however, may be attributable to an advanced stage of the disease at the time of treatment. In view of the extreme difficulty in matching suitable controls for cancer patients undertaking such therapy, it is essential to extend knowledge of the effects of hyperthermia on normal and neoplastic tissue by experimental studies. Further, the different methods of utilizing heat therapy have need for substantial technological improvements. To stimulate interest in this area, we have gathered together in this review some of the more pertinent reports on the application of hyperthermia to neoplastic and normal tissues as observed clinically and in the laboratory.