bluuebunny/crossref_metadata_2025 huggingface dataset:
Neuropharmacology of HIV/AIDS
Authors: Houff Sidney A. , Major Eugene O.
Published: March 2007

The development of antiretroviral agents has altered the types of neurological diseases seen in patients with HIV/AIDS. The direct effects of HIV infection on nervous system functions underlie the neurological complications of HIV/AIDS in most patients. These changes have resulted in an increase emphasis on the biochemical and neuropharmacological features of HIV‐associated neurological diseases. The role of the nigra‐striatal system and drugs of abuse in HIV‐associated neurological disease as well as the concurrent development of neurodegenerative diseases will become of increasing importance as the age of patients with HIV/AIDS increases as a result of highly active antiretroviral therapies. In this chapter, we will review the neuropathogenesis of HIV/AIDS related neurological disease emphasizing the role of neuropharmacological pathways in the development and treatment of HIV‐associated neurological disease.
Leptin: A Metabolic Perspective
Authors: Penn Dawn M. , Rooks Cherie R. , Harris Ruth B. S.
Published: March 2007

The history of discovery of leptin is given and current knowledge on the factors that regulate ob gene expression and leptin protein secretion is summarized. The chapter focuses on the metabolic effects of leptin, the pathways involved in the suppression of food intake and stimulation of energy expenditure are described. The role of central activation of sympathetic outflow to peripheral tissues, compared with direct effects of leptin on insulin‐sensitive tissues, in mediating metabolic responses to leptin is discussed. Recent work elucidating the cellular basis for the shift in metabolism of adipose and non‐adipose tissue to lipid oxidation and triglyceride depletion is reviewed.
Ghrelin: Structural and Functional Properties
Authors: Holst Birgitte , Egerod Kristoffer , Schwartz Thue W.
Published: March 2007

Ghrelin is a gastro‐intestinal peptide hormone acting on important brain including the hypothalamus where it modulates appetite, metabolism and the autonomous nervous system. In the pariphery ghrelin has been described as a modulator of the cardiovascular system and various endocrine tissues involved in metabolism. Importantly, ghrelin is the only peptide hormone modified by a fatty acid chain, being essential for its activity. The receptor for ghrelin is a member of the 7TM/G‐protein coupled receptor super family and signal mainly through Gq coupling. Interestingly, the ghrelin receptor is constitutively active providing increased signaling by increased receptor expression independent of thc endogenous ligand.
A novel missense mutation in the NDP gene in a child with Norrie disease and severe neurological involvement including infantile spasms
Authors: Lev Dorit , Weigl Yuval , Hasan Mariana , Gak Eva , Davidovich Michael , Vinkler Chana , Leshinsky‐Silver Esther , Lerman‐Sagie Tally , Watemberg Nathan
Published: March 2007

Norrie disease (ND) is a rare X‐linked recessive disorder characterized by congenital blindness and in some cases, mental retardation and deafness. Other neurological complications, particularly epilepsy, are rare. We report on a novel mutation identified in a patient with ND and profound mental retardation. The patient was diagnosed at the age of 6 months due to congenital blindness. At the age of 8 months he developed infantile spasms, which were diagnosed at 11 months as his EEG demonstrated hypsarrhythmia. Mutation analysis of the ND gene (NDP) of the affected child and his mother revealed a novel missense mutation at position c.134T > A resulting in amino acid change at codon V45E. To the best of our knowledge, such severe neurological involvement has not been previously reported in ND patients. The severity of the phenotype may suggest the functional importance of this site of the NDP gene. © 2007 Wiley‐Liss, Inc.
Diet and feeding behavior of Rhinopithecus bieti at Xiaochangdu, Tibet: adaptations to a marginal environment
Authors: Xiang Zuo‐fu , Huo Sheng , Xiao Wen , Quan Rui‐chang , Grueter Cyril C.
Published: March 2007

The diet and feeding ecology of a wild subpopulation of black‐and‐white snub‐nosed monkeys (Rhinopithecus bieti) were studied at Xiaochangdu in Honglaxueshan Nature Reserve, Tibet. This region is climatologically harsher than any other inhabited by non‐human primates. Black‐and‐white snub‐nosed monkeys fed on 48 parts of 25 plant species, at least three species of lichens and seven species of invertebrates. The number of food items exploited varied markedly among seasons, with dietary diversity being greatest in spring and summer. In winter, black‐and‐white snub‐nosed monkeys had to subsist on fallback foods such as dried grass and bark. Ubiquitous lichens formed a major dietary constituent throughout the year, contributing about 75% of feeding records. Even though lichens act as a staple, our findings signify that the monkeys at Xiaochangdu prefer feeding on foliage, which is higher in protein content than the former. We provide evidence that black‐and‐white snub‐nosed monkeys are able to cope with an array of food items other than lichens and hence can be regarded as feeding generalists. We discuss the results with reference to previous studies on other subpopulations living in habitats that are floristically more diverse and offer more plant food items than the marginal habitat at Xiaochangdu. Am. J. Primatol. 69:1141–1158, 2007. © 2007 Wiley‐Liss, Inc.
Population genetic studies of Alouatta caraya (Alouattinae, Primates): inferences on geographic distribution and ecology
Authors: Do Nascimento Fabrícia F. , Bonvicino Cibele R. , Seuánez Héctor N.
Published: March 2007

Cytochrome b DNA sequence data (ca. 1,140 bp) of 44 Alouatta caraya, including 42 specimens from three localities of Brazil and two from Bolivia, were used for phylogenetic reconstructions and population studies. Seventeen haplotypes were identified, eight of which were present in more than one individual. Seven of these eight haplotypes were shared by individuals from a same locality and one by individuals from two localities. We found 26 variable sites along the entire gene, consisting of 18 transitions and eight transversions; most replacements occurring at the third codon position (65.39%) in contrast to first and second positions (26.92 and 7.69%, respectively). In the sample collected at Chapada dos Guimarães (Brazil), nucleotide and haplotype diversity estimates were π=0.002325 and h=0.8772, respectively. Maximum parsimony analysis grouped all haplotypes in two clades, separating Bolivian haplotypes from Brazilian haplotypes, the grouping of which did not show a straightforward correspondence with geographic distribution. Median‐joining and TCS network pointed to haplotypes 11 or 12 as the most likely ancestral ones. Mismatch distribution and the goodness‐of‐fit test (SSD estimate=0.0027; P=0.6999) indicated that the population from Chapada dos Guimarães experienced a demographic expansion, in agreement with the median‐joining star‐like pattern, although this finding could not be confirmed by Fu's Fs test. Am. J. Primatol. 69:1093–1104, 2007. © 2007 Wiley‐Liss, Inc.
Innentitelbild: Bioinspired Design of Nanocages by Self‐Assembling Triskelion Peptide Elements (Angew. Chem. 12/2007)
Authors: Ghosh Surajit , Reches Meital , Gazit Ehud , Verma Sandeep
Published: March 2007

Inspiriert durch Clathrin, ein Protein, das wegen der einzigartigen Triskelion‐Konformation seiner drei Polypeptidketten geschlossene Käfigstrukturen bildet, berichten E. Gazit, S. Verma et al. in ihrer Zuschrift auf S. 2048 ff. über ein synthetisches tripodales Konjugat mit drei strahlenförmig um einen Kern angeordneten Dipeptideinheiten. Die „Beine“ verschränken sich so, dass kugelförmige Strukturen resultieren (siehe Bild), die Gastmoleküle wie fluoreszierende Farbstoffe fangen und wieder freisetzen können.
Inside Cover: Bioinspired Design of Nanocages by Self‐Assembling Triskelion Peptide Elements (Angew. Chem. Int. Ed. 12/2007)
Authors: Ghosh Surajit , Reches Meital , Gazit Ehud , Verma Sandeep
Published: March 2007

Inspired by clathrin, a protein that assembles into closed‐cage structures as a result of the unique triskelion conformation of its three pendant polypeptide chains, E. Gazit, S. Verma, and co‐workers report in their Communication on page 2002 ff. on a synthetic tripodal conjugate with three dipeptide units radiating from a central core. The legs interdigitate to reveal highly spherical structures, as shown in the picture, in which guest molecules such as fluorescent dyes can be trapped and subsequently released.
Social capital and the search for information: Examining the role of social capital in information seeking behavior in Mongolia
Authors: Johnson Catherine A.
Published: March 2007

The process of finding information to address problems that arise in everyday life situations is complex. Individuals are influenced by many factors when the information need occurs, including their social, psychological, political, economic, physical, and work environments. Research focusing on the social factors affecting information has stressed the importance of interpersonal communication and the quality of social networks in facilitating access to information. The study reported in this article investigates the role of social networks in affecting access to information and, more particularly, how social capital or the resources made available to individuals through their social networks influence their success in finding the information they need. Questionnaires were administered in a face‐to‐face format to a random sample of 320 residents of the city of Ulaanbaatar, Mongolia. The theoretical framework for the study is Lin's theory of social capital whose main proposition is that the ability of people to achieve desired outcomes is positively associated with social capital. The findings indicate that social capital did have a significant effect on information behavior, particularly on the choice of source, which in turn had a direct influence on successful search outcomes.
The origin of chief and parietal cells in regenerating gastric mucosa
Authors: Lawson H H
Published: March 2007

No uptake of tritiated thymidine was observed in the chief and parietal cells of normal mice. When mice, labelled with tritiated thymidine while normal, recovered from irradiation gastritis, the radioactive index of the specialized cells increased to 10 per cent. It is concluded that in regenerating mucosa, chief and parietal cells are derived directly or indirectly from mucous neck cells.
The obturator canal as a route for iliofemoral by-pass
Authors: Spiro M , Cotton L T
Published: March 2007

Three cases of iliofemoral arterial by-pass utilizing a route passing through the obturator canal are presented. The literature is reviewed and the indications for this operation discussed. In a group of patients all of whom would most certainly have lost a limb without reconstructive surgery our results are encouraging.
Non-vitelline accessory enteric formations
Authors: Howat J M , Grant J C
Published: March 2007

Twenty-two patients with non-vitelline accessory enteric formations are reported. The clinical and pathological features and the management of the cases are described. The value of radiography of the whole vertebral column as an investigation in undiagnosed rectal bleeding is emphasized. The pathogenesis of non-vitelline accessory enteric formations and the significance of associated spinal malformations are discussed.
Gaucher's disease and portal hypertension
Authors: Sales J E L , Hunt A H
Published: March 2007

Two cases of Gaucher's disease with portal hypertension are dscribed, of which one was relieved by splenectomy and the other, which had recurrent bleeding from oesophageal varices, by portacaval anastomosis. These cases demonstrate that portal hypertension in this condition may be due to increased forward portal blood-flow due to splenomegaly, to intrahepatic obstruction from extensive deposits of Gaucher cells, and probably in some cases to a combination of these factors. The case with bleeding oesophageal varices was also infantile and neither of these conditions has previously been described in Gaucher's disease.
Pericardial cyst in the superior mediastinum treated by mediastinoscopy: A case report
Authors: Sarin C L
Published: March 2007

A case of pericardial cyst in the superior mediastinum has been described. This is only the ninth such patient to be reported in the literature and the first one in which diagnosis and treatment have been carried out by mediastinoscopy.
Calcific enterolith obstruction of the intestine
Authors: McL. Singleton J
Published: March 2007

A case of acute intestinal obstruction in a woman aged 67 years, due to calcific enterolith obstruction, is presented. Enteroliths are defined; they are of endogenous origin and most usually formed from the bile constituents.

However, when calcium salts predominate (calcine enterolith), they form in the distal small bowel. It is suggested that stasis is the most important factor in their production as they are most commonly associated with an intestinal stricture. The clinical features of calcific enteroliths are reviwed.
Spinal-cord compression in paget's disease
Authors: Direkze M , Milnes J N
Published: March 2007

The literature on the subject of spinal-cord compression in Paget's disease including its association with a paravertebral mass is reviewed. This mass is thought to be a pseudocallus and is an attempt on the part of the diseased bone to stabilize its structure and is seen at sites in the vertebral column where the disease process is most active. The symptoms including girdle pains are relieved by laminectomy. A decompressive laminectomy is indicated in the treatment of these patients and produces good results.
Ureteral varicosities—A cause of the corkscrew ureter
Authors: Heal Michael R
Published: March 2007

Fifteen cases of ureteric varicose veins are discussed. They nearly all (a) present with haematuria or (b) show a scalloped corkscrew-like appearance to the ureter on the intravenous pyelogram without evidence of proximal obstruction. Varicose veins of the lower limbs and varicocoele are commonly present. It is suggested that there are two main types: those draining vertically via the renal pedicle and those draining via a ‘communicating’ vein in the gonadal vessels. Spermatic phlebography is suggested as a possible aid to differential diagnosis in the future.
Liver transplantation in man. The significance, patterns, and control of infection
Authors: Murray-lyon Iain M , Evans D B , Foster W D , Holden R J , Rake M O , Stern H , Calne R Y , Williams Roger
Published: March 2007

Of 9 patients who survived the immediate postoperative period after hepatic transplantation, 6 later died from infection. Pulmonary infection was the major problem. Biliary infection related to bile fistulas may be less in the future with the improved technique of a cholecystdochostomy which was carried out in the last 2 patients. Frequent bacteriaemias were noted and the organisms were often the same as those found in the bile. Most infections were thought to be autogenous. Cytomegalovirus infection occurred in 6 patients, but in none was there evidence that the virus did harm. Broad-spectrum antibiotic therapy was freely used in the earlier patients but was often followed by superinfection with resistant organisms and fungi. The present policy is not only to use antibiotics sparingly but to rely on narrow-spectrum drugs wherever possible.
Vaginal avulsion complicating pelvic fracture
Authors: Ikpeme James O , Morison C Rutherford
Published: March 2007

A case of vaginal avulsion complicating compression-type fracture of the pelvis is reported. It is a very rare injury. Although cases of rectal and anal avulsions have been described previously, we have so far not seen any comparable vaginal lesion mentioned. The likely mode of causation has been discussed.
Controlled trial of an anticoagulant (warfarin sodium) in the prevention of venous thrombosis following hip surgery
Authors: Pinto D J
Published: March 2007

A prospective study was undertaken to assess the value of warfarin sodium, given prophylactically, in the prevention of postoperative deep-vein thrombosis. The radio-isotope method was used for the detection of venous thrombosis and the results obtained were compared with physical signs of the disease process and phlebography. Fifty consecutive patients over the age of 50 years, undergoing hip operations, were studied. Twenty-five patients were treated with warfarin sodium and 25 acted as controls.

Nine in the treated group and 8 in the control group developed postoperative deep-vein thrombosis.
Subcutaneous liposarcoma of forearm followed by liposarcoma of omentum
Authors: Hassan M A
Published: March 2007

A case of a well-differentiated subcutaneous liposarcoma, followed after an interval of over 8 years by a poorly differentiated myxoid liposarcoma of the omentum, is described. It is not possible to conclude whether this is a case of multicentricity or metastasis. From the review of the literature this appears to be the second case of subcutaneous liposarcoma reported.
Visceral complications of supervoltage radiotherapy for carcinoma of the bladder
Authors: Ram M D
Published: March 2007

Thirteen of 65 patients suffering from carcinoma of the bladder and treated by supervoltage radiotherapy developed late visceral complications. In 8 patients these lesions were in the bladder and in 7 the gastrointestinal tract was involved. The factors that are responsible for these lesions and the problems in their management are discussed.
Pedicled skin-flaps: The fallacy of the length: Width ratio
Authors: Milton S H
Published: March 2007

The viable length of a skin-flap is said to depend on the width of its pedicle. This is one of the established principles of plastic surgery, which is often quoted and never questioned. It was not intended to question this principle when the surviving lengths of flaps of different widths were measured in the pig. The intention was to correlate survival with the appearance after injection of an intravital dye. Flaps were made of different widths to spread the range of observations. The results were unexpected; surviving length was not directly proportional to width. Elaboration of this relationship, by experimental and mathematical methods, forms the subject of this paper. The old concept of a length: width ratio gradually evolved into a new one: that flaps made under similar conditions of blood-supply survive to the same length regardless of width. The steps of this change in concept will be presented.
The significance of rebound tenderness in the acute abdomen
Authors: Prout W G
Published: March 2007

The physical sign of rebound tenderness has been studied in 100 patients with acute abdominal pain. In the majority of cases this sign proved unhelpful and was actually misleading in many instances. There seems little justification for the use of a sign which relies on causing a sudden and unexpected pain in a patient in whom confidence in the gentleness of the examining hand is vital.
The deep inguinal ring, development, function and repair
Authors: Lytle W J
Published: March 2007

The deep inguinal ring opening, due to the outgrowth of the processus vaginalis around the gubernaculum, appears at the end of the 2nd month of foetal life. Around this opening the U-shaped ring of transversalis fascia begins to develop about the 5th month. The U-shaped ring is well formed and its valvular design established at the 7th month. Descent of the testis usually takes place during the 7th or 8th month of intra-uterine life, but the processus vaginalis, which should normally close before or soon after birth, may remain open throughout life. The pressure valve of the deep inguinal ring, with its active closure mechanism, is capable of protecting an open processus vaginalis, often for months or years, against the onset of a hernia. The need to join together cut or raw edges to give sound union is emphasized and the indications for ring repair in oblique hernia and major repair in direct hernia are outlined.
The medical treatment of large group III goitres with thyroid extract
Authors: Ward J P
Published: March 2007

The reasons for treatment of large goitre by thyroid extract are discussed and the preliminary results of treatment are reported. The problems are discussed.

A more extensive study is essential to draw any conclusions from this mode of therapy.
Carcinoma of the stomach in a woman of 19
Authors: Kalbasi H
Published: March 2007

Carcinoma of the stomach in the young is rare and often difficult to diagnose. At this stage the carcinoma appears usually to be superimposed on a previously existing peptic ulcer.

In this instance the case reported is that of a 19-year-old woman who gave a 2½-year history of gastric pain. A diagnosis of duodenal ulcer with pyloric hypertrophy was made and she was treated conservatively at first, but the symptoms persisted. She was admitted to hospital and an antecolic Polya gastrectomy was performed. Subsequent histological examination revealed a carcinoma of the stomach.
Chronic relapsing pancreatitis in childhood. A report of 3 cases
Authors: Vernon James K , Stening Frank , Smith Rodney
Published: March 2007

Three cases of chronic relapsing pancreatitis arising in childhood are reported. The consideration of this condition in children with unexplained, recurrent abdominal pain is urged. The results of surgery in these 3 cases and in others elsewhere appear to be excellent.
Mortality of perforated duodenal ulcer treated by simple suture
Authors: Booth R A D , Williams J Alexander
Published: March 2007

A 10-year experience is reported of 344 patients undergoing surgical treatment of perforated duodenal ulcer; almost all were treated by surgeons in training and all but 12 patients by simple suture of the perforation. The very low operative mortality of 2.9 per cent indicates the safety of simple suture closure in the hands of the inexperienced surgeon. Analysis of the régime of management of the 10 patients who died suggests that reduction in mortality might follow greater use of non-operative treatment in patients with severe complicating cardiorespiratory disease.
The place of subfascial ligation of perforating veins in the treatment of the post-phlebitic syndrome
Authors: Halliday P
Published: March 2007

Subfascial ligation of incompetent perforating veins was employed in the treatment of 103 patients. The patients were selected on clinical grounds and the existence of perforating veins was established by phlebography.

The description of the technique employed stresses details contributing to safe and rapid healing when a radical exploration is performed through skin and subcutaneous tissues of poor vitality.

The role of subfascial ligation in the treatment of the post-phlebitic syndrome is to control the disordered venous return consequent on obstruction of the calf-muscle pump. As such, the procedure is one part of the treatment of the limb as a whole.
Polyposis of the stomach and small intestine in association with familial polyposis coli
Authors: Hoffmann D C , Goligher J C
Published: March 2007

Three cases of familial polyposis coli with adenomatous polyps of the upper gastro-intestinal tract are reported. This association has not previously been described in Britain, probably because no special attempt has been made to detect polyps in these situations.

A careful study of known cases of polyposis coli is required to establish the frequency and fate of associated gastric or small intestinal polyps, with particular reference to the risk of malignant degeneration and the possibility of prophylactic surgical measures.
The effect of dipyridamole on tissue perfusion following freezing injury in the rat
Authors: da Costa John , Sharp F Ross , Gill William
Published: March 2007

A drug with known platelet disaggregating properties, dipyridamole, has been used for the treatment of experimental frost-bite in the rat. A standardized cold injury applied to the rat tail was treated by a variety of régimes. Tissue survival was then assessed by several methods and correlated with the therapeutic régimes. The results suggested that dipyridamole had a beneficial effect on the maintenance of tissue perfusion and subsequent viability of the injured tail.
The healing of tissues incised by a carbon-dioxide laser
Authors: Hall R R
Published: March 2007

The healing of surgical incisions made with a carbon-dioxide laser, cutting diathermy, and scalpel has been compared. Laser and diathermy incisions of skin healed more slowly than scalpel wounds, but no such delay occurred in incisions of the abdominal wall. It is suggested that the differences result from terminal necrosis of the wound edges and variations in the sequence of wound repair.
Effective and safe control of incontinence by the intra-anal plug electrode
Authors: Glen Eric S
Published: March 2007

A régime is described for treatment of urinary and faecal incontinence by the intra-anal plug electrode, giving results in 30 patients. Therapy is safe, inexpensive, and involves the minimum of hospital or general practitioner supervision. Positioning and control are easy with the modified electrode. Stimulation causes no appreciable discomfort in most patients. Possible modes of action are discussed and it is suggested that stimulation works by strengthening levator tone rather than local sphincters. Perineal awareness is enhanced, making conscious muscle contraction easier in exercises. Greater use should be made of this device.
Effect of antroneurolysis on gastric secretion in dogs with total gastric fistula
Authors: Hall R , Humphrey C S , Wilkinson A R , Johnston D
Published: March 2007

The operation of antroneurolysis is performed by circumferential sharp dissection in the submucosal plane of the entire gastric antrum, which severs the vagal nerve-supply to the antral mucosa. It might thus be regarded as a conservative variant of antrectomy, the purpose of which is to diminish gastrin release without disturbing antral peristalsis or the mechanism of the pylorus. Its possible value as an adjunct to highly selective vagotomy in man is evaluated in this study in the dog.

The antroneurolysed antrum was left in continuity with the remainder of the stomach whose vagal nerve-supply remained intact. Gastric secretion was collected via a cannula or fistula draining the whole stomach. Outputs of acid and pepsin in response to insulin, pentagastrin, meat extract, and acetylcholine were found to be undiminished after antroneurolysis. It is concluded that antroneurolysis has no place at present in clinical gastric surgery.
Multiple gastric polyposis: A case report
Authors: Crowley J G
Published: March 2007

A case of multiple gastric polyposis is described. A large number of polyps were present, concentrated in a broad band in the body of the stomach. Histology was benign, and an atrophic gastritis was present.
A bacteriological study of the immediate environment of a surgical wound
Authors: Davidson A I G , Smith G , Smylie H G
Published: March 2007

In an attempt to assess the importance of different aspects of the immediate wound environment during an operation, detailed bacteriological data were obtained in the operating theatre from 1000 patients operated upon in two different theatres.

Nasal and skin carriage of Staphylococcus pyogenes were found to be associated with a small number of autogenous infections, but no significant increase in the staphylococcal wound infection incidence could be shown in these groups. Skin carriage of other pathogens seemed to be of no importance with the disinfection methods used in the present study.

Settle-plate studies showed no apparent difference in the bacteriological hazard of the two operating theatre environments, neither appearing to constitute any real danger. Samples at the end of operation confirmed the importance of endogenous contamination with intestinal organisms during potentially dirty operations. Apart from the few autogenous infections, there was little evidence of staphylococcal wound sepsis arising as a result of contamination in the operating theatre. Hands and masks of members of the operating team could not be demonstrated as sources of contamination during operation.

There was no apparent difference in the bacteriological findings as they related to the different operating theatre environments.
Effects of open and closed decompression on the water content and motility of experimentally obstructed small bowel in the rabbit
Authors: Shields M A , Dudley H A F
Published: March 2007

Oedema is a feature of obstructed bowel. In experimental low small intestinal obstruction the obstructed bowel of the rabbit contained 7.4 per cent more water than normal. After relief of obstruction, with or without active surgical decompression, oedema regressed. However, when there was no net loss of fluid from the animal a temporary increase to 16.6 per cent of normal occurred at 12 hours after relief, diminishing to 6.1 per cent above normal at 24 hours. The rate of recovery of motility as measured by fluctuations in intraluminal pressure was unaffected by the temporary increase in oedema or by surgical decompression.
Lung hypoplasia in congenital diaphragmatic hernia: A quantitative study of airway, artery, and alveolar development
Authors: Kitagawa M , Hislop Alison , Boyden E A , Reid Lynne
Published: March 2007

From a case of congenital diaphragmatic hernia the pattern of growth of the airways, alveoli, and pulmonary arteries of both lungs, each hypoplastic, has been analysed quantitatively. The impairment of growth for each type of structure is not necessarily the same and differs in each lung. Airway and alveolar numbers are both greatly reduced, although the latter are more nearly normal when related to the number of terminal bronchioli in the lung. In each lung the size of the pulmonary artery at the hilum is appropriate to the lung volume but small for the age of the child. Muscle is found in much smaller arteries than is normal but not to a more peripheral level.

The way the lungs in a case of congenital diaphragmatic hernia might grow after surgical correction of the hernia is discussed and a plea made for respiratory physiological studies in such cases.
Ileovaginal fistula: Complicating internal hernial strangulation through a broad ligament defect
Authors: Mathieson A J M , Millar W G
Published: March 2007

The causes of ileovaginal fistula are discusse.

A case of ileovaginal fistula due to incrceration of ileum in a broad ligament defect is presented and the anatomy and aetiology of broad ligament pouches and foramina are discussed.
A new cannula for the collection of pancreatic juice in the dog
Authors: Thambugala R L
Published: March 2007

A new technique is described for the collection of pancreatic juice in the dog using a cannula of simple design which allows free drainage of pancreatic juice into the duodenum between experiments, thus maintaining the health of the animal for prolonged periods.
The injuries and management of riot casualties admitted to the belfast hospital wards, August to October, 1969
Authors: Robb J D A , Matthews J G W
Published: March 2007

Belfast has experienced intermittent rioting for 18 months. An analysis of riot casualties admitted to the wards of Belfast hospitals from 1 Aug. to 31 Oct., 1969, is presented.

Approximately 500 casualties came to hospital and of these only 164 were admitted. Eighty-three (50·6 per cent of admissions) required surgery. One-third of all admissions had left hospital within 48 hours and only 23 (14 per cent) remained for longer than 2 weeks. The demand for resuscitation was not high and the need for blood unexpectedly low. We describe in this article the types of injury and the treatment they were given.

During rioting there are many reasons why surgical preparations may exceed the need for them. Pro-longed dislocation of normal hospital services does not seem justified by the pattern which emerged. The reception of the large number of casualties arriving over a 2–3-hour period on the first peak night is discussed. Some of the ethical difficulties of the riot situation are mentioned. Problems of internal security and communication are discussed.
Bacteriaemia following urological surgery
Authors: Ives J C J , Browne A K , Jones W W , Marshall A , Campbell D
Published: March 2007

This is a study of postoperative bacteriaemia in 100 consecutive patients having urological surgery under general anaesthesia. Bacteriaemia was noted in 12 per cent of patients and was found to be much commoner in patients having prostatic surgery than in those having bladder, ureteral, or upper urinary-tract surgery. Bacteriaemia was commoner in those patients whose urine was infected at the time of operation. The use of prophylactic antimicrobial cover in patients with infected urine is discussed.
Metastatic tumours of the diaphragm
Authors: Brennan J L
Published: March 2007

In a series of 151 autopsies on cases of malignant disease, 12 (7.9 per cent) were found to have involvement of the diaphragm as compared with 5 (3.4 per cent) which had metastases in the spleen. Secondary deposits from the bronchus and stomach were rarely seen in comparison with those from more distant organs and the surgical importance of this finding is discussed.
Infiltrating angiolipomata of skeletal muscle
Authors: Stimpson N
Published: March 2007

Seven cases of infiltrating angiolipomata of voluntary muscle are presented, varying in site but recognizable at operation by needing sharp dissection rather than enucleation to free them. It is suggested that this be follwed by radiotherapy to stop recurrence from microscopic infiltration.
Heller's operation for achalasia of the cardia. A study of the early and late results
Authors: Barker John R , Franklin R H
Published: March 2007

Thirty patients who had undergone Heller's operation for achalasia of the cardia have been studied. All but I had relief of the dysphagia at 1 year's follow-up. Five of the 14 patients followed for 10 years or more had severe reflux oesophagitis, 3 requiring further operative treatment.
The fate of 5-hydroxytryptamine in the lungs
Authors: Gruby Lesley A , Rowlands Christine , Varley B Q , Wyllie J H
Published: March 2007

Isolated guinea-pig lungs perfused with Krebs solution were found to remove 5-hydroxytryptamine (5HT) from the fluid perfusing them. Two processes were involved: (1) the active uptake of 5HT by cells in the lungs, and (2) the metabolism of 5HT to 5-hydroxyindole-acetic acid (5HIAA). The experiments emphasize that the lungs have a metabolic capacity in addition to their passive function of gas diffusion.

Derangement of the metabolic functions of the lungs may prove to be as serious clinically as derangement of their respiratory functions. Failure to clear the venous plasma of free 5HT would affect the aggregation of platelets and might thus have a bearing on the problem of deep venous thrombosis in man.
Stenosing jejunitis
Authors: Aubrey D A
Published: March 2007

A case of multiple strictures of the upper mid-gut, here described, was associated with malabsorption, a feature not previously recorded. The condition most frequently affects the jejunum, but the duodenum and ileum may also be involved. The disease produces multiple strictures due to the formation of mucosal valves, which may almost occlude the intestinal lumen. Histologically the lesion affects only the mucosal and submucosa. It may result from atypical Crohn's disease or subacute non-specific enteritis. It remains to be seen whether simple incision of the strictures will suffice in treatment.
The effect of 17-alpha-hydroxy-19-norprogesterone caproate (SH 582) on benign prostatic hypertrophy
Authors: Aubrey D A , Khosla T
Published: March 2007

The therapeutic efficacy of 17-alpha-hydroxy-19-norprogesterone caproate (SH 582) in the treatment of benign prostatic hypertrophy has been assessed in a double-blind cross-over trial in 24 volunteers.

In most subjects there was subjective and objective evidence that SH 582 had a beneficial effect which exceeded that of the placebo. Only 2 subjects emerged from the trial without improvement.

Treatment with SH 582 did not significantly affect the serum prostatic acid phosphatase.

Thyroid function was not inhibited by SH 582, thus suggesting that the drug acted peripherally rather than via pituitary inhibition.

Side-effects were negligible.
Arteriomegaly
Authors: Thomas M Lea
Published: March 2007

The angiographic and clinical findings in 30 patients with smoothly dilated, tortuous, elongated arteries with a slow blood-flow on arteriography are presented.

In many patients there was a short history of intermittent claudication, and in some a tendency to peripheral embolism and gangrene.

Twenty patients (66 per cent) had aneurysms.

The term ‘arteriomegaly’ is suggested, as the aetiology of the condition is not clearly defined.
The handling of water and electrolytes by the small bowel following the relief of intestinal obstruction
Authors: Grace R H
Published: March 2007

A study has been made of the intestinal handling of water and electrolytes following the relief of smallbowel obstruction. A new technique has been described for perfusing the ileum of conscious animals. It has been shown that the ileum secretes water and electrolytes for at least 48 hours following the relief of obstruction, and that decompression increases this fluid loss during the first 6 hours after surgery. It is suggested that the fluid and electrolyte requirements during this period will be increased when decompression is performed.
Infective complications of choledochotomy with T-tube drainage
Authors: Keighley M R B , Graham N G
Published: March 2007

A high incidence of infective complications followed choledochotomy and T-tube drainage when compared with closed biliary-tract procedures. Organisms cultured from infective sites were identical to those isolated from the T-tube in the postoperative period. Postoperative infection was associated with an increased morbidity in terms of length of hospital stay. As infection in these sites was independent of the presence of stones in the common bile-duct, complications would have been reduced if unnecessary exploration had been avoided. The routine use of operative cholangiography in the avoidance of these complications is discussed.
The early and late results of surgical treatment for Crohn's disease
Authors: de Dombal F T , Burton I , Goligher J C
Published: March 2007

An analysis is presented of the early results of 415 operations performed for Crohn's disease on 295 patients at the Leeds General Infirmary from 1939 to 1968 inclusive. Two hundred and forty-four of the operations were primary and the other 171 were reoperations.

The operative mortality was 4.1 per cent after primary operation, 8.2 per cent after reoperation, and 5.8 per cent overall. The most important factor influencing the immediate mortality after primary surgery was the age of the patients, the mortality in patients under 50 years being 2.6 per cent and that in patients over that age 8.9 per cent.

The main postoperative complications were sepsis, fluid and electrolyte imbalance, and delay in the healing of the perineal wound, which persisted unhealed for over 6 months in 42 per cent of the patients who had had rectal excision.

In the interests of simplicity assessment of the ultimate outcome of surgery is confined to an examination of the late results in the 234 immediate survivors of primary operations by means of a follow-up ranging from 6 months to 30 years. Four patients could not be traced and 2 had had their operations less than 6 months before the completion of the review in 1968, which left 228 patients for analysis.

The overall late mortality in this group was 13 per cent. Much of it was due to intercurrent conditions such as would be expected in a matched sample of the general population, but 7 per cent was related to Crohn's disease, being due mostly to septic complications following reoperations.

Thirty-four per cent of the patients needed at least one further operation after their initial one for Crohn's disease. However, after reoperation the chances of a third or fourth operation being necessary were not increased. The reoperation rate varied considerably after different primary operations, being lowest after proctocolectomy and highest after by-pass operations and colectomy and ileorectal anastomosis.

Symptomatically most of the patients have done well. At the time of review 87 per cent of them were enjoying good or very good general health (76 per cent of patients after small-bowel operations, but 96 per cent of those after large-bowel operations), and over the period of follow-up 72 per cent of the patient-years' were spent free of symptoms.

At the time of review persistent disease was clearly demonstrated in 16 per cent of patients and was possibly present in 9 per cent, but was absent in 75 per cent.

The outcome of surgery for Crohn's disease sometimes leaves a good deal to be desired. It is suggested, however, that the results demonstrated here amply justify its frequent use as a means of alleviating symptoms and of restoring the patient to a reasonable state of health.
Iliacus compartment compression syndrome
Authors: Aichroth Paul , Rowe-Jones D C
Published: March 2007

Two cases of femoral nerve compression are described. In the first a large haematoma developed in the iliacus compartment whilst the patient was on anticoagulant therapy. In the second, compression was due to an appendix abscess within the iliacus compartment. This complication of appendicitis has not previously been recorded.
Pancreatic secretion after selective and truncal vagotomy in the dog
Authors: Thambugala R L , Baron J H
Published: March 2007

External pancreatic secretion was studied in 4 dogs: 2 with a Thomas cannula and 2 with a new cannula in which a duodenal pouch acts as an extension of the pancreatic duct. Peak bicarbonate outputs after a meal were about a third of the maximal secretory capacity of the pancreas in response to single intravenous injections of pure secretin, whereas peak protein concentrations and outputs after a meal were of the order of the maximum response to injections of secretin and pancreozymin.

There were no consistent changes in hormonestimulated pancreatic secretion after selective vagotomy. Meal-stimulated pancreatic secretion was markedly reduced after truncal vagotomy (81 per cent reduction in peak bicarbonate output, 65 per cent in peak protein output). Secretin-stimulated bicarbonate output was markedly decreased 3 weeks after truncal vagotomy, but then gradually increased to control values, and in 1 dog to twice the control. Pancreozymin-stimulated protein output was increased after truncal vagotomy, reaching values two to three times the control. Local anaesthetics applied topically to the periampullary duodenal mucosa markedly inhibited secretin-stimulated bicarbonate output even after truncal vagotomy, but there was only slight reduction after subcutaneous lignocaine.

The reduction in food-stimulated pancreatic secretion after truncal vagotomy is unlikely to be caused by pancreatic denervation, since the postvagotomy pancreatic response to direct stimulation with exogenous hormones is normal or supranormal, and is probably due to decreased release of gastrointestinal hormones after a meal. Local reflex arcs may influence the pancreas and may explain (by denervation supersensitivity) the post-vagotomy increase in pancreatic secretion as well as the effects of topical local anaesthetics.

The role of neural factors in the regulation of external pancreatic secretion has long been disputed. This subject is now of particular clinical interest in relation to the causes of post-vagotomy diarrhoea and steatorrhoea (for a review of the literature, see Cox, 1969). With the development of a new cannula for studying external pancreatic secretion in the unanaesthetized dog (Thambugala, 1971) the opportunity was taken to study the effects of selective and truncal vagotomy on the pancreatic secretory responses to food and pure secretin and pancreozymin.
Complete prolapse of the rectum a report on 140 cases treated by rectopexy
Authors: Loygue J , Huguier M , Malafosse M , Biotois H
Published: March 2007

Indirect fixation of the rectum to the anterior ongitudinal ligament over the sacral promontory was performed at 146 operations for procidentia recti in a homogeneous series of 140 patients. Before fixation the rectum was widely dissected and thoroughly mobilized. The recurrence rate after follow-up intervals of up to 15 years was 3.6 per cent. The procedure is simple to perform and eliminates the hazard of anastomotic breakdown which is associated with excisional methods. The authors regard it as the method of choice in the operative treatment of complete rectal prolapse.
The operative diagnosis of carcinoma of the pancreas
Authors: Trapnell John
Published: March 2007

The radiological appearances of the main pancreatic duct in patients with carcinoma of the head of the pancreas is described. It is suggested that both a uniform dilatation of the duct system and a gap between the head of the dye and the duodenum may be taken as indicative of the presence of a carcinoma and hence allow an immediate distinction between this condition and chronic relapsing pancreatitis.
Malignant oncocytoma of the parotid gland
Authors: Whittam D E , Bose B
Published: March 2007

A case of malignant oncocytoma of the parotid gland is presented. The theory of origin of the oncocytes is briefly discussed. A short account of the naked-eye appearances and the histological features of oncoytoma is given. It is suggested that angiography may be a valuable diagnostic procedure in detecting malignancy in selected cases.
Chromaffin-cell tumours a review of 10 cases
Authors: Georgakakis A K
Published: March 2007

Experiences with 10 cases of phaeochromocytoma are recorded. Seven of them were located in the suprarenals, and 3 were in a rare ectopic location.

We feel that there are lessons to be learnt from this series and that it should be reported, in spite of the Acient Athenian proverb which says: ‘Do not bring mother owl to the City, there are already too many…’.
Femoral hernia: A recent appraisal
Authors: Waddington R T
Published: March 2007

In a series of 128 cases of femoral hernia the female to male ratio was 3 : 1. The incidence of strangulation remained evenly distributed throughout all age-groups, but because of the tendency for femoral hernia to develop in the elderly most cases of strangulation occurred over the age of 60 years. The low approach was used in 119 patients and the mortality was less than 1 per cent. In only 1 of the 14 patients requiring bowel resection was a further (paramedian) incision necessary in order to return the bowel to the peritoneal cavity. The improvement in mortality in recent years is considered to be due to improvements in fluid and electrolyte management, to more effective antibiotics, and to safe anaesthesia.
Occupational true aneurysm of the ulnar artery in the palm
Authors: Mukerjea S K
Published: March 2007

A case of true traumatic aneurysm of the ulnar artery is reported. There is no problem in diagnosing this condition due to the typical sequence of events with characteristic physical signs. Arteriography is not necessary. Treatment is by simple ligation of all involved feeding vessels and total excision of the aneurysm.
Pylorus-preserving gastrectomy in the treatment of duodenal ulcer
Authors: Hennessy T P J , Weir D G , D'auria D
Published: March 2007

Twenty patients with duodenal ulcer have been treated by a pylorus-preserving gastrectomy. A functioning pyloric sphincter was maintained by retaining a 2-cm. cuff of antrum and carrying out a Billroth-I type of resection proximally. Basal acid output was reduced by 52.4 per cent and maximal acid output by 65 per cent. Gastric emptying time was prolonged, without producing stasis. A provocative test for the presence of dumping produced symptoms in only 1 patient following this operation in comparison with a high incidence of symptoms in patients who had had a Polya gastrectomy or vagotomy and drainage.

The results suggest that the procedure may be of value in the treatment of chronic duodenal ulcer.