bluuebunny/crossref_metadata_2025 huggingface dataset:
Fibromuscular Hyperplasia of the Iliac Arteries
Authors: Horne Terence W.
Published: January 2008

Fibromuscular hyperplasia is an uncommon disease of arteries with an unknown (etiology and an obscure natural history. It occurs rarely in the iliac vessels and may cause intermittent claudication. Two cases of fibromuscular hyperplasia of these arteries are reported. Both patients are middle‐aged women. One presented with intermittent claudication and has been treated by aortofemoral bypass. The other is at present symptomless; the diagnosis was made in the course of the investigation of an abdominal bruit. Some features of the condition arc discussed.
Tracheal Injury Following Prolonged Intubation1
Authors: Windsor Harry M. , Shanahan Mark X. , Cherian K. , Chang Victor P.
Published: January 2008

Prolonged respiratory assistance by positive pressure ventilation via cuffed tracheosiomy or endotracheal tube can be complicated by mucosal erosions, tracheal stenosis, tracheomalacia, excavation of the tracheal wall with loss of tissue and tracheœsophageal fistula. Stenosis can occur at the subglottic region, at the stoma, or at the cuff site, whereas the other complications occur most often at the cuff site. This paper is concerned with complications occurring below the first tracheal ring.
Peptic Stricture of the Oesophagus: The Role of Oesophagogastrostomy1
Authors: Howard Russell , Myers N. A. , Stokes K.
Published: January 2008

Sixteen patients with severe peptic stricture of the œsophagus mere treated by cesophagogas‐trostomy at the Royal Children's Hospital, Melbourne, during the period 1048 to 1068. It has been possible to obtain a follow up on all patients, so that the period of follow up has varied from seven to 24 years. Although the early postoperative results were promising, later problems occurred in over half of the patients, the major complication being recurrence of peptic stricture at the anastomotic site.
The Place of Ileorectal Anastomosis in Crohn's Disease
Authors: Steinberg David M. , Allan Robert N. , Cooke W. Trevor , ‐Williams John Alexander
Published: January 2008

A study of 41 patients who underwent ileorectal anastomosis for Crohn's disease has shown this operation to be a relatively safe procedure with an immediate mortality of 2–5%. A defunciioning ileostomy may protect the patient against the consequences of anastomotic leakage. Ileorectal anastomosis is associated with a high early recurrence rate and an overall failure rate of up to 50% because of recurrence, intractable diarrhoea and exacerbation of perianal disease. However, half of the patients are able to retain the anastomosis and be restored to long‐standing good health. The surgical philosophy in this Centre has largely evolved from treatment of small‐bowel Crohn's disease, that is, resection of only the worst areas of involvement with the aim of symptomatic relief, and the results shown by this survey encourage us to pursue this policy by using ileorectal anastomosis for diffuse colonic disease, particularly if the rectum is uninvolved.
Hernia Through the Foramen of Winslow
Authors: Alexander Munro S.
Published: January 2008

This is a report of a hernia through the foramen of Winslow in which the right half of the colon was herniated. It was gangrenous and perforated. Following hemicolectomy the patient recovered.
Tropical Intussusception in Adults
Authors: Rasaretnam Rudra , Kumarakulasinghe C. Barr , Eaton H. L.
Published: January 2008

In contrast with the incidence in Britain and the United States, about 50% of intussusceptions in Sri Lanka occur in adults, the maximum age incidence being in the fourth decade. Seventy‐six cases of intussusception in adults are analysed in this paper, 62 of which were of the ccecocolic type, which though only rarely described in the West, have also been frequently reported from other tropical countries. The clinical picture was characteristic, and a mass was palpable in go% of the patients, facilitating diagnosis without ancillary investigations. On the basis of the histological examination of resected specimens it is concluded that amoebic granulomatous formation in the dependent “diverticulum” of the accum is the predisposing cause of the ccecocolic intussusception, accounting for the chronicity of a large number of cases. Irrespective of the duration of the illness, gangrene did not occur in any of the cases of this type, although resection was occasionally required on account of irrcducibility. In view of the proliferation of fibrous tissue in the wall of the eweum, complete cvagination of the intussusception can only be achieved by surgical exploration and manipulation, the results of which are excellent.
Ischæmic Ileal Necrosis and Carcinoid Tumour
Authors: Chapuis Pierre , Weedon David
Published: January 2008

A case of ischtemic ileal necrosis is reported. It was associated with elastic vascular sclerosis produced by mesenteric metastases of an ileal carcinoid tumour.
Paravertebral Lumbar Myelomeningocele: A Report of Three Cases
Authors: Reddy D. Raja , Hooper Reginald , Satyanarayana K. , Reddy A. Narsimha
Published: January 2008

Three cases of lateral myelomeningocele in the lumbar region are reported because of their rarity. It is stressed that in these laterally placed cystic swellings spinal dysplastic conditions should be also considered. The literature is briefly reviewed.
Pineal Tumours: A Clinical Study of 23 Cases
Authors: So S. C.
Published: January 2008

A series of 23 cases of pineal tumours is presented, and their salient clinical features are analysed. The rationale of the present trend of treatment is discussed, and the relevant literature is reviewed.
Perianal Vaccinia: A Case Report
Authors: Crapp A. R. , Macbeth W. A. A. G.
Published: January 2008

Accidental perianal vaccinia is a rare condition, presenting acutely with severe pain and characteristic superficial ulceration. There is no specific treatment, and complete resolution occurs. A case is described of autogenous perianal vaccinia occurring in an adult.
The Detection of Serological Factors in Acute Ulcerative Colitis Indicating a Favourable Short‐Term Prognosis
Authors: Hunt P. S. , Trotter S.
Published: January 2008

Large‐intestinal epithelial cells were obtained from operation specimens and by biopsy at sigmoidoscopy frotn 16 patients with acute severe mucosal ulcerative colitis and II control subjects with normal large‐bowel mucosa. The ability of lymphocytes to release 51Cr label from large‐intestinal epithelial cells was quantitatively assessed as percentage lymphocyte activity. The mean ± standard deviation of percentage lymphocyte activity in 16 patients with acute ulcerative colitis on admission to hospital (88 ± 8) was significantly greater than that in n normal subjects (16 ± 8) (P <0.01).

In each study, samples of autologous serum were added to two reactions between lymphocytes and autologous large‐intestinal epithelial cells. The results in the seven patients who came to urgent colectomy differed significantly from those in the nine who responded to corticosteroids. The mean ± S.D. of percentage serological inhibition of lymphocyte activity in the group coming to colectomy was 44 ± 16, and in those responding to steroids 12 ± 5. When the serum of these patients was studied for immunofluorescent autoantibodies to normal human colonic mucosa, none of the seven patients treated by colectomy had detectable autoantibodies, in contrast with three of the nine patients with a more favourable short‐term prognosis, in that they responded to steroid treatment.
Experimental Coronary Occlusion in Calves: The Effect of Hyperglycæmia on Ventricular Fibrillation Threshold
Authors: Egerton W. S. , Balderson Glenda
Published: January 2008

Measurements of ventricular fibrillation threshold (VFT) were made in two groups of bovine calves, each weighing 25 to 30 kg, before and after ligation of the anterior descending branch of the coronary artery. In the control group, the VFT was determined before occlusion of the anterior descending coronary artery, and the observations were repeated at 20‐minute intervals after occlusion. A 33% reduction in VFT was observed 20 minutes after the occlusion. Prior loading with glucose by infusion of 100 ml of 10% glucose prevented the significant fall in VFT.
BLEEDING MUCOSAL LESIONS IN THE UPPER GASTROINTESTINAL TRACTS OF PATIENTS WITH OESOPHAGEAL VARICES and HEPATIC CIRRHOSIS
Authors: Hislop I. G. , Hall Pauline , Grant A. Kerr
Published: January 2008

Thirty panendoscopic examinations were carried out on 24 patients with oesophageal varices and hepatic cirrhosis who presented with gastrointestinal hemorrhage. A mucosal lesion, focal or diffuse, was found in the upper gastrointestinal tract in all but three instances. The findings confirmed previous reports that hemorrhage in patients with oesophageal varices frequently occurs from a source other than variceal. This study has also demonstrated that where hemorrhage occurs from oesophageal varices, erosions of the oesophageal mucosa may play a major role in its pathogenesis.
BILE DUCT INJURIES FROM NON‐PENETRATING ABDOMINAL TRAUMA IN CHILHOOD
Authors: Ahmed Saeed
Published: January 2008

Bile duct injuries from non‐penetrating abdominal trauma are uncommon, but when unrecognized cause serious morbidity and significant mortality. To elucidate the problem three cases encountered over a 15‐year period in the Manchester Children's Hospitals are reported, together with a review of the literature.
THE SURGICAL TREATMENT OF CONGENITAL CORONARY TO PULMONARY ARTERY FISTULA
Authors: Buxton Brian , Ventemiglia Rogelio , Reul Jr George J. , Cooley Denton A.
Published: January 2008

Six patients with coronary to pulmonary artery fistula underwent surgical treatment between January 1973 and August 1975. All fistulee terminated in the main pulmonary artery just distal to the pulmonary valve. Two patients had severe coronary artery disease associated with the fistula. In all patients, the fistula was over‐sewn from ivithin the pulmonary artery in addition to ligation of the fistulous vessel on the surface of the pulmonary artery or heart, cardiopulmonary bypass being employed. Two patients underwent concomitant aortocoronary artery saphenous vein bypass for occlusive coronary artery disease. Follow‐up data revealed that three patients were free of symptoms and two were improved, while one was lost to follow‐up.
POST­CHOLECYSTECTOMY WOUND MORBIDITY: THE INFLUENCE OF ELECTROSURGERY
Authors: Hall John C.
Published: January 2008

The wound morbidity patterns following elective cholecystectomy were reviewed in 235 patients. The method used to divide the musculo‐aponeurotic layers of the abdominal wall did not influence the overall wound morbidity rate. There was, however, a disproportionate number of males with wound morbidity following an electrosurgical incision. The explanation may be related to the increased rectus muscle mass in males.
ADVANCED INTRAABDOMINAL PREGNANCY: CASE REPORT WITH A BRIEF REVIEW OF THE LITERATURE
Authors: Skinner C. O. , Koelmeyer T. D.
Published: January 2008

We here present a case of advanced intraabdominal pregnancy diagnosed at laparotomy. A brief review of the literature is included, with special reference to the problems of diagnosis and of management of the placenta.
SYSTEME INTERNATIONAL d'UNITES (S.I. UNITS)
Authors: Bryant S.
Published: January 2008

The metric system is now used in most countries for expressing measurements in the health care field. The original metric system based on length (centimetre), mass (gramme) und time (second) has proved inadequate. The Internationul Bureau of Weights and Measures, which has the ultimate responsibility for standardization of measuring systems, has revised and extended the metric system, through a series of general conferences on weights and measures, to the Système International d'Unités (S.I.). This is now the internationally accepted language for measurements throughout science and industry.
METHODS AND RESULTS OF MECHANICAL MYOCARDIAL SUPPORT*
Authors: Malm James R. , Bregman David
Published: January 2008

In recent years the development of modern direct techniques for revascularization surgery has resulted in a multitude of critically ill patients undergoing open heart surgery. To deal with the increasing numbers of patients who both require urgent open heart surgery and present with many complicated patterns of disease, a spectrum of cardiac assist measures, ranging from simple pharmacological interventions to mechanical cardiac assist techniques, has been developed. Those temporary mechanical cardiac assist devices which employ the principle of counterpulsation and balloon pumping have met with the most consistent clinical success. We now report our experience and progress in this field since early 1972.
SURGERY FOR UNSTABLE ANGINA
Authors: Clarebrough J. K. , Westlake G. W. , Richardson J. P. , Mullerworth M. , Wilson A. C. , Nathan K.
Published: January 2008

A series of 84 patients with unstable angina, treated surgically by grafting procedures between October 1970 and September 1976, have been reviewed. The study indicates that extensive coronary artery disease is common in these patients, and suggests that operation may favourably influence mortality, both immediate and delayed, but does not reduce the risk of myocardial infarction. Eighty per cent of the patients were relieved of angina and able to lead a reasonably normal existence.
CLAUDICATION OF THE CAUDA EQUINA
Authors: Macleish D. G.
Published: January 2008

The term “claudication of the cauda equina” is examined. It has arisen from semantic errors, and a belief in ischæmia for which there is no scientific evidence. Its use tends to hamper rather than assist the investigation of patients with obscure pain in the lower limb. A preferable alternative term, “atypical sciatica”, is suggested.
PERFORATED PEPTIC ULCER: AN ANALYSIS OF 246 CASES1
Authors: Anseline P.
Published: January 2008

An analysis of 246 cases of perforated peptic ulcer, treated at the Royal Newcastle Hospital from 1964 to 1974, is presented. The incidence has fallen considerably over that period. The rising proportion of women has reached a plateau. A perforated peptic ulcer in an Australian woman is still just as likely to be located in the stomach as In the duodenum. In men, however, 84% of perforations are pyloroduodenal. A perforated gastric ulcer is closely associated with the use of salicylate preparations. The mortality rate has remained steady at 15% over the last 30 years. It is significantly higher in women.

There is a highly significant relationship between the mortality and (a) the duration of perforation; and (b) the size of the perforation, particularly if it is located in the stomach.
STRANGULATED PARA‐ILEOSTOMY HERNIA
Authors: Cuthbertson A. M. , Collins John P.
Published: January 2008

Para‐ileostomy hernia is an uncommon cause of bowel obstruction following ileostomy. Two cases are reported that demonstrate the difficulty in diagnosis and the high morbidity associated with this condition. Early recognition and repair of the uncomplicated and strangulated hernia are recommended.
AN OVERVIEW OF CARDIAC SURGERY
Authors: Wright John , Newman David
Published: January 2008

The scope of cardiac surgery has extended greatly in the last decade, advances being particularly in the areas of perfusion technology, ischæmic heart disease, and congenital defects in the infant. This paper sets out to summarize accepted current practice in the surgery of the heart and great vessels. Principles have been emphasized at the expense of detail, since the aim has been to present information which might be of interest to surgeons in general. Some aspects which have a special relevance to general surgical practice have been grouped separately for the sake of emphasis.
ASPECTS OF INJURY PATTERNS IN AUTOMOBILE ACCIDENTS
Authors: Nelson Peter G.
Published: January 2008

During the period June 1971 to June 1973, the injuries of 34,378 persons involved in accidents attended by ambulance officers, and treated by hospitals, together with the injuries received by 1,699 victims investigated by coroners, were analysed. Clear‐cut injury patterns emerged for different types of road users. Pedestrians in general suffered injuries of greater severity than cyclists, who in turn had injuries of greater severity than vehicle occupants. The extent to which car occupant injury patterns are modified by seat belts is demonstrated. Injuries suffered by the wearers of seat belts occur less frequently, and are less severe, less likely to prove fatal, and less likely to cause long stays in hospitals.
THE TREATMENT OF FLAIL CHEST INJURY
Authors: Baker A. B.
Published: January 2008

Flail chest injuries are traditionally managed by long‐term artificial ventilation, which in itself is hazardous and expensive. A more conservative therapeutic regime is described, and the results of this regime are compared with those following the previous traditional regime used in the Respiratory Unit, Royal Brisbane Hospital. The place of artificial ventilation in relation to spontaneous ventilation is redefined in the context of this new regime.
OSTEOMALACIA IN THE ELDERLY
Authors: Rush Jonathan H.
Published: January 2008

Over recent years it has been demonstrated that there is a significant incidence of osteomalacia in elderly patients presenting with fractures of the femoral neck. The results of a survey carried out on all patients admitted to St Vincent's Hospital, Melbourne, with fractures of the upper end of the femur over a 12‐month period are presented, and the condition of osteomalacia in the elderly is discussed. It is concluded that in this community osteomalacia does not present as a practical problem except in those patients who have the condition as a result of a definite predisposing factor.
CRANIOFACIAL SURGERY: THE TEAM APPROACH
Authors: David David John
Published: January 2008

Craniofacial surgery offers a new hope to some grossly deformed people. This complex surgery, which is based on a multidisciplinary team approach, needs to be carefully rationalized and regionalized to facilitate investigation, to improve planning, to reduce the number of complications, and to conserve financial resources. To date the Cranio‐Facial Clinic at the Adelaide Children's Hospital and the Royal Adelaide Hospital has reviewed 37 cases and operated upon 13 of these. This work is presented together with a review of the team approach.
ULTRASONIC ECHOGRAPHY IN THE DIAGNOSIS OF ABDOMINAL DISEASE
Authors: Garrett William J. , Kossoff George
Published: January 2008

The place of two‐dimensional ultrasonic echography in the diagnosis of surgical diseases of the abdomen is outlined, and Illustrative cases are described. The method is safe and can be repeated as often as required. It does not replace radiological or radionuclide examinations, but complements those techniques.
XANTHOGRANULOMATOUS PYELONEPHRITIS IN MALAYSIANS
Authors: Yong S. L. , Prathap K.
Published: January 2008

Eight cases of xanthogranulomatous pyelonephritis occurring in an oriental population are reported. The patients were mostly middle‐aged, and there was a female preponderence. Nephrectomy controlled the disease In all cases. Diagnosis on clinical and radiological grounds is difficult, and it is often only made on pathological examination of the kidney after nephrectomy. The nature of the disease remains obscure.
TRANSPERINEAL INTRAPROSTATIC INJECTION TREATMENT OF BENIGN PROSTATIC ENLARGEMENT
Authors: Sharma G. D. , Goel P. P.
Published: January 2008

Thirty‐nine patients with benign prostatic enlargement were treated by transperineal intraprostatic injections composed of phenol 2%, glacial acetic acid 2%, and glycerine 4%, in distilled water. A success rate of 56.41% was achieved, which is much less than that previously reported. Complications were negligible. Follow‐up for two years was satisfactory. The patients in whom injection therapy failed could still be treated by any standard operative treatment. Why this mode of treatment was successful in some cases and not in others is not clear.
SURGICAL REPAIR OF A LARGE INCOMPLETE CLEFT STERNUM
Authors: Brown J. H. , Paterson Dennis
Published: January 2008

Congenital deformities of the chest are not uncommon, are frequently symptomatic, and are readily correctable. This applies particularly to malfusion of the manubrium and upper sternum, which results in a bony deficiency together with divarication of the sternomastoid muscles and the sternoclavicular joints. Such defects of the sternum are best corrected as soon after birth as possible. Two patients are reported who had such a defect, and the technique for a satisfactory repair is described.
ON THE FORM AND FUNCTION OF THE ABDUCTOR POLLICIS BREVIS MUSCLE
Authors: Fahrer M.
Published: January 2008

The abductor pollicis brevis muscle acts In conjunction with the palmaris longus and the abductor pollicis longus to abduct the first metacarpal in the sagittal plane. Segments of the abductor pollicis brevis which arise from the tendons of the palmaris longus and/or the abductor pollicis longus and are inserted into the extensor expansion are the lumbricals of the thumb. The lateral border of the abductor pollicis brevis presents an important muscular (in four cases out of ten neurovascular) hilum. The tendinous slip to the abductor pollicis brevis from the palmaris longus presents near its origin an orifice which the palmar branch of the median nerve traverses to become superficial.
TISSUE DEFECTS IN THE LIMBS: REPLACEMENT WITH FREE VASCULARIZED TISSUE TRANSFERS
Authors: Taylor G. Ian
Published: January 2008

The use of free vascularized tissue transfers in reconstructive surgery is an exciting new development. Such procedures require careful planning and meticulous attention to detail. Illustrative cases are described to indicate the value and scope of this concept, which has been made possible by the development of microsurgery.
MICROSURGICAL VASOVASOSTOMY: A RELIABLE VASECTOMY REVERSAL
Authors: Owen Earl R.
Published: January 2008

Optimal results of repair of a severed tube can be expected when a meticulous atraumatic microsurgical technique is based on a detailed knowledge of the anatomy and function of the tube. A reliable vas repair after vasectomy involves the avoidance of leakage or scarring in a tube of which the ends differ in internal diameter from 1 mm to 0.2 mm and in which the inner mucosal layer is difficult of access because of its solid muscular core surround. In addition, the healing will only occur without massive scarring and the nerve supply will only return if the blood supply can be retained as close as possible to the anastomosis. The technique described was first researched in the Macaque monkey and requires considerable microsurgical expertise. It has proved reliable in that 98% of the first 50 patients showed sperms in their ejaculates three months after operation, with a 62% pregnancy rate after an operation on one side only. The vasectomies had been performed up to 13 years before, and one can only conclude that a routine scrotal vasectomy should not be considered irreversible.
THE CATHETER TEAM: AN ESSENTIAL SERVICE FOR REHABILITATING NEUROGENIC BLADDERS
Authors: Pearman John W.
Published: January 2008

A carefully controlled programme of intermittent catheterization provides substantially better care of the bladder than indwelling catheters during the initial period after acute spinal cord injury. It is very difficult to maintain a programme of intermittent catheterization around the clock without a small team of nursing personnel highly skilled in the technique of aseptic catheterization. The practical details of setting up a catheter team are described. Some of the results that have been associated with the establishment of such a team at the Rehabilitation Branch of the Royal Perth Hospital are presented.
FITTING PROBLEMS OF THE ARTIFICIAL LOWER LIMB: THE SURGEON'S CONTRIBUTION
Authors: Fay Franklin R.
Published: January 2008

Difficulties are experienced by the artificial limb maker and fitter when fitting prostheses to some lower extremity amputation stumps. These difficulties, due partly to operative techniques, are outlined, and suggestions are made for their correction.
ORTHOPÆDIC SURGERY AND REHABILITATION IN RHEUMATOID ARTHRITIS
Authors: Tinning R. N.
Published: January 2008

Orthopædic surgical procedures are episodes in the continuing management and rehabilitation of the patient with rheumatold arthritis. Well‐chosen procedures give excellent relief of symptoms and deformity, and successful management is a prime example of rehabilitation requiring considerable team work from physician, surgeon, therapists, social workers and nursing staff. Team work enables the rheumatologist to be in charge of the overall management of the patient through the clinic with responsibility for general medical care, while the surgeon can take charge during periods in hospital for surgery and the immediate postoperative outpatient care. Cooperation between physician and surgeon eases each of some of the clinical burden that is at present provided by this disease.
HEPATIC METASTASES FROM COLORECTAL CARCINOMA: AN ANALYSIS OF SURVIVAL RATES AND HISTOPATHOLOGY1
Authors: Morris M. J. , Newland R. C. , Pheils Murray T. , Macpherson J. G.
Published: January 2008

Out of 338 patients undergoing laparotomy and resection of a primary colorectal carcinoma, 49 (14.5%) were found to have liver metastases. The average age was 70 years. The median period of survival was 11.4 months. The histological grade of malignancy of the primary tumour did not appear to influence the survival rate. Compared with similar tumours in patients without hepatic metastases, the primary growth showed a significantly increased incidence of venous invasion, a higher grade of malignancy, and a more frequent origin from the right colon. When the local spread of the primary tumours was investigated it was found that one‐third of them had not progressed beyond Stage Dukes A or B.
THE INITIAL PHASE OF GASTRIC EMPTYING BEFORE AND AFTER VAGOTOMY AND PYLOROPLASTY
Authors: Sheiner H. J. , Thompson I. J. , Hamilton S. G. L. , Quinlan M. F.
Published: January 2008

The initial phase of gastric emptying of solid food was monitored with the use of a gamma camera and on‐line computer facilities. In normal subjects a consistent pattern was seen comprising an early delay in the ‘onset of emptying (“plateau”), followed by an exponential decay curve. After vagotomy the plateau was lost, and the exponential pattern of emptying commenced once the stomach was full. There was no evidence of sudden “dumping” of contents from the stomach. The overall rates of emptying as measured by the half emptying time (T 1/2) were the same in normal and postvagotomy subjects.
A COMPARISON OF THE INCIDENCE OF WOUND INFECTION FOLLOWING THE USE OF PERCUTANEOUS AND SUBCUTICULAR SUTURES: AN EXPERIMENTAL STUDY
Authors: Polglase A. , Nayman J.
Published: January 2008

This is a study in which the results have shown that the use of subcuticular sutures in the pig is associated with a lower rate of wound infection when compared with that following percutaneous sutures.
SURGICAL AND EXTERNAL URETERIC TRAUMA
Authors: Brown Ronald B.
Published: January 2008

This paper details the ætiology, presentation, diagnosis, prophylaxis, treatment, and results, of 84 surgical and external ureteric injuries. Although the incidence of surgical ureteric trauma was found to be low it was related to both the particular operation performed and certain faults in surgical technique. The series emphasizes the importance of prophylaxis, early diagnosis, and specific therapy. There were 94 operations carried out on the 84 ureters, resulting in 22 nephrectomies and 63 open repair procedures, of which 55 were regarded as successful and 8 as failures.
THE SURGICAL TREATMENT OF RETROCAVAL URETER
Authors: Kennedy David R. H. , Lenaghan Daniel
Published: January 2008

Ureteric obstruction resulting from retrocaval ureter may be due to either compression of the ureter by the vena cava or stenosis of the postoaval segment. If obstruction is due to stenosis, the commonly described operation of division and anastomosis through the proximal dilated ureter or pelvis, after repositioning of the ureter, is likely to fail, as is division of the vena cava itself. Excision of the postcaval segment with anastomosis of the spatulated ureter over a Silastic splint is therefore recommended. Three case histories of patients with retrocaval ureter treated surgically are presented and support this view.
TESTICULAR TUMOURS: TREATMENT BY SURGERY AND RADIOTHERAPY
Authors: McGirr V. G. , Goldstein A. M. , Thompson D. M. , Utley W. L. F.
Published: January 2008

The treatment of testicular tumours, particularly teratomas, remains controversial. The results of treatment in 146 such tumours treated by surgery and radiotherapy are discussed. A case is made for a selective policy towards retroperitoneal lymph node dissection in teratomatous tumours. Where isolated pulmonary metastases occur, resection of these is well worth while.
RADIONUCLIDE PANCREATIC SCANNING: A RETROSPECTIVE ANALYSIS
Authors: Kitchen P. R. B. , Wettenhall J. M. , Andrews J. T.
Published: January 2008

Records of 346 patients were studied to determine the reliability and diagnostic value of pancreatic scanning. In 157 the pancreatic diagnosis was established subsequent to scanning. The scan was abnormal in 28 of 34 patients (82%) with pancreatic neoplasm, and in 21 of 26 patients (81%) with chronic pancreatitis. Of 71 with normal scans, 56 (79%) had a normal pancreas, and 15 had pancreatic disease (a false negative rate of 21%). Of the 86 with abnormal scans, the pancreas was diseased in 56 (65%), and of the others, 14 had extrapancreatic conditions known to be associated with a high incidence of scan abnormalities. In obstructive jaundice all 21 patients with pancreatic carcinoma had abnormal scans (and the scan accurately diagnosed all four cases of bile duct carcinoma). A normal scan reliably indicated that the cause of jaundice was outside the pancreas. In chronic abdominal pain an abnormal scan was unreliable, but a normal scan excluded pancreatic disease with reasonable accuracy.
ARTERIAL PROBLEMS SEEN IN A TEACHING HOSPITAL IN HONG KONG
Authors: Wong John , Ong G. B.
Published: January 2008

Over a 12‐month period, 58 patients presented with arterial disease or other arterial problems to the University Surgical Unit, Queen Mary Hospital, Hong Kong. These patients accounted for only 0.6% of this Unit's annual admissions. In spite of the reported rarity of atherosclerotic arterial disease in this part of the world, this was the cause of the disease in nearly half of our patients. Abdominal aortic aneurysm was the single most common condition encountered. In at least one‐third of patients with atheromatous disease of the aortoiliac segment, chronic peptic ulcers were demonstrated. It is concluded that peripheral arterial disease is rare, but atherosclerosis is the most common cause.
RIGHT CORONARY ENDARTERECTOMY: A PROCEDURE WITH INCREASED RISK OF PERIOPERATIVE INFARCTION
Authors: Gale Alan W. , Chang Victor P. , Shanahan Mark X. , Windsor Harry M.
Published: January 2008

Although right coronary endarterectomy extends operability on this vessel, the procedure is associated with increased risk of perioperative infarction. Forty‐nine patients at St Vincent's Hospital underwent endarterectomy and saphenous vein grafting to the distal right coronary artery, with a hospital mortality of 6.1% and a perloperative infarction rate of 20.4%, compared with rates of 4.2% and 10.9% respectively in a group of patients who did not require endarterectomy. These figures show a trend toward statistical significance which suggests that careful patient selection for endarterectomy is required to obviate an increased risk of complications with this procedure.
A CASE OF TRANSITIONAL CELL CARCINOMA OF THE RENAL PELVIS, CLEAR CELL RENAL CARCINOMA, AND ANALGESIC NEPHROPATHY
Authors: Anseline P. , Howarth V. S.
Published: January 2008

A case of synchronous transitional cell carcinoma of the renal pelvis and clear cell renal carcinoma in a woman with analgesic nephropathy is presented. The literature is briefly reviewed.
ILEAL REPLACEMENT FOR GUNSHOT INJURY OF THE URETER
Authors: Bhandari M. , Mufti G. R. , Singh S. M.
Published: January 2008

A case of gunshot injury of the upper third of the ureter is reported. The injury was managed by ileal replacement with complete conservation of the kidney, after an attempt at primary repair had failed. A survey of the literature has not disclosed any previous report of a gunshot injury of ureter being treated by this method. However, we recommend it only in cases where the conventional procedure of end‐to‐end repair fails.
PSYCHOSOCIAL ASPECTS OF HEAD AND NECK CANCER SURGERY
Authors: David D. J. , Barritt J. A.
Published: January 2008

Thirty‐six patients who underwent major surgical excision and reconstruction for head and neck cancer were subjected to a psychosocial assessment in hospital and, later, in their home environments. The information gained from the survey is discussed, with particular reference to those factors which can be used by the head and neck surgical team to improve the quality of the patients' existence.
THE CAVERNOUS SINUS: AN ANATOMICAL SURVEY1
Authors: McGrath Philomena
Published: January 2008

An anatomical survey of the cavernous sinus in 16 adult cadavers has been made, based on serial sections cut at 15μ in the coronal and sagittal planes. Certain aspects of the survey are of particular interest: (1) the oculomotor, trochlear, and ophthalmic nerves do not run in the lateral dural wall of the cavernous sinus; (2) venous sinuses of the cavernous sinus flow freely in a medial direction both anterior and posterior to the dorsum sellæ; (3) trabeculæ in the form of collections of fine areolar tissue extend between the vascular and neural elements. The amount present is variable; (4) the horizontal section of the internal carotid artery within the cavernous sinus runs a variable course in relation to the hypophysis and the lateral dural wall; (5) the oculomotor nerve lies within a meningeal envelope as far anteriorly as the tip of the anterior clinoid process; (6) the ophthalmic nerve communicates with the oculomotor, trochlear, and abducent nerves in the anterior part of the cavernous sinus; (7) the abducent nerve may lie within a meningeal envelope in the posterior part of the cavernous sinus; (8) the greater part of the sympathetic nerve plexus around the vertical part of the internal carotid artery passes into the abducent and ophthalmic nerves. Sympathetic fibres pass into the sheaths surrounding the oculomotor and trochlear nerves. Sympathetic ganglia are suspended from the ophthalmic nerve.
THE APPLICATION OF CLINICAL TRIALS TO SOLID TUMOUR MANAGEMENT: AN INTRODUCTION
Authors: Forbes John F.
Published: January 2008

This paper discusses the relevance of clinical trials to the management of solid tumours. It introduces the types of clinical trials, the requirements for patient assessment, and an overall strategy for improved patient care, based on the central role of the clinical trial. The importance of statistical and ethical considerations is discussed. There is an invitation for practising surgeons to participate in trials relevant to their speciality. The necessary framework and requirements for a clinical protocol are discussed separately in the following paper.
BYPASS SURGERY FOR OBESITY1
Authors: Sorrell V. F.
Published: January 2008

Failure of conservative methods of control of gross obesity has led to the adoption of surgical measures. In our experience intestinal bypass, though resulting in significant weight loss, is associated with a number of unpleasant complications. For this reason our programme now involves the use of 90% gastric bypass. The results in our first 39 patients undergoing this operation are presented, with a six‐month to three‐year follow up. Weight loss has been satisfactory. Although it is a more major procedure than intestinal bypass, the lack of major metabolic sequelæ makes gastric bypass the more acceptable form of management.
ACUTE ACROMIOCLAVICULAR JOINT DISLOCATION: RESULTS OF OPERATIVE TREATMENT WITH THE BOSWORTH SCREW
Authors: Lowe G. P. , Fqgarty M. J. P.
Published: January 2008

The results are reported in 21 patients who had acute acromioclavicular joint dislocation treated by open reduction and Bosworth screw fixation, with an average follow‐up period of ten years. Nineteen patients had a good or excellent functional result. Good cosmetic results were obtained. Full recovery of shoulder movement occurred in all patients but one, although coracoclavicular calcification was a frequent finding. Complications following this technique were few.
SPINAL EPIDURAL ABSCESS IN PREGNANCY
Authors: Hunter J. C. , Ryan M. D. , Taylor T. K. F. , Pennington J. C.
Published: January 2008

A case of spontaneous epidural abscess occuring in a pregnant woman is reported. Some delay in diagnosis occurred. Decompression resulted in prompt recovery and improvement of a mild neurological deficit.
A METHOD OF CLOSED INTRAMEDULLARY NAILING OF THE FRACTURED TIBIA
Authors: Einoder B. J. , McIntyre E. D.
Published: January 2008

This paper describes a method of closed intramedullary nailing of the tibia, which has now been used in 30 cases, and is simple, quick, and efficient. It requires one additional fitting to the standard orthopaedic table, and the instruments used for an ordinary closed intramedullary nailing of the fractured femur.
A SIMPLIFIED KIDNEY PRESERVATION SYSTEM: THE USE OF HYPEROSMOLAR PERFUSATES FOR CONTINUOUS PERFUSION PRESERVATION OF CANINE KIDNEYS
Authors: Balderson Glenda A. , Hardie Ian R. , Hamlyn Lizzi , Clunie Gordon J. A.
Published: January 2008

Since the quality of renal preservation following simple ice storage is improved by the use of hyperosmolar washout solutions, hyperosmolar perfusates were evaluated for continuous perfusion preservation. Canine kidneys were preserved for 48 hours by continuous perfusion at 5°C, using hyperosmolar cryoprecipitated plasma and 5% albumin perfusates of osmolalities 397 to 430 mOsm/kg H2O. Hyperosmolar plasma gave significantly better preservation than isosmolar plasma, but the results were only marginally sperior to those already obtainable with isosmolar albumin solution. No further improvement in preservation by albumin perfusion was obtained with the hyperosmolar formulations. Because isosmolar albumin solution is easier to prepare than hyperosmolar cryoprecipitated plasma and gives comparable results, it remains our perfusate of choice for continuous perfusion preservation.
TUMOUR IMMUNOLOGY
Authors: Heslop Barbara F.
Published: January 2008

Antigens which distinguish neoplastic cells from their normal counterparts can be identified in some, but by no means all, experimental tumours. Specifically immunized hosts can in appropriate circumstances reject small tumours immunologically. The mechanisms of rejection remain unknown. The extent to which most human neoplasms excite a rejection reaction is still not clear. While the behaviour of neoplasms appears to be influenced by the immune system, the concept of immunological surveillance against neoplasia is losing spport. Clinical immunotherapy has not yet achieved notable success, and remains empirical.
INTRAABDOMINAL DESMOID CAUSING DEATH IN A YOUNG MAN WITH GARDNER'S SYNDROME
Authors: Godfrey P. J. , Moore A. W. , Clarke A. M.
Published: January 2008

The case is reported of a 22‐year‐old man with Gardner's syndrome who died as a consequence of unremitting spread of an intraabdominal desmold four and a half years after colectomy for polyposis, and two and a half years after cllnical presentation of the desmoid tumour.
THE FLARED NOSTRIL DEFORMITY IN CLEFT LIP AND PALATE: A METHOD OF CORRECTION
Authors: Snell John A.
Published: January 2008

Flared nostril deformlty is often seen following repair of congenital cleft lip and palate. The basis and cause of the deformity are described. It is contended that skin shortage over the alar and lateral cartilages of the nose is an integral part of the deformity. The use of Wolfe grafts in association with alar repositioning is described, and an illustrative case is presented.
AN OVERVIEW OF PLASTIC SURGERY
Authors: Mccomb Harold
Published: January 2008

In addition to many technical refinements during the past decade, plastic surgery has made particular advances through the use of microsurgery, in the control of burn wound infection, by the use of implantable silicones, in the correction of craniofacial deformities and through the development of axial‐pattern and other specialized flaps.
THE EFFECT OF COLLOID CONCENTRATION ON THE FUNCTIONAL CHARACTERISTICS OF ISOLATED PERFUSED RAT LIVER
Authors: Lee D. , Holland Robyn K. , Groufsky Anne K.
Published: January 2008

The volume of bile produced by isolated perfused rat liver was dependent on the concentration of bovine serum albumin (BSA) in the perfusate, the lowest volumes being obtained with Krebs Ringer bicarbonate (KRB) alone and with 70 g/l. BSA In KRB. Increasing amounts were produced as the concentration of BSA was reduced from 70 g/l. to 8.5 g/l. The concentration of bile salts in the bile decreased rapidly during the first hour, but much more slowly thereafter. The highest concentration observed during the first hour was with KRB alone and the lowest with 20 g/l. BSA; subsequently, the highest concentrations were obtained with 70 g/l. BSA and the lowest with 20 g/l. BSA.

Urea synthesis was lowest with KRB alone, but increased as the concentration of BSA increased; however, values obtained with 8.5, 20, and 40 g/l. were fairly close together. With KRB alone there was a rapid release of potassium during the first hour, but thereafter the rate of release was similar to that found when BSA was present. The lowest concentrations of potassium were obtained with 20 and 40 g/l. BSA. With KRB alone, GOT was released from the start of perfusion of 300 units per minute. With BSA present, GOT release was delayed 4 hours, and thereafter the rate was dependent on the concentration of BSA, being lowest with 20 and 40 g/l. (200 units per min), higher with 8.5 g/l. (350 units per min) and highest with 70 g/l. (400 units per min).
BONE SCINTIGRAPHY IN DISCITIS AND RELATED DISORDERS IN CHILDREN
Authors: ATKINSON R. N. , PATERSON DENNISC. , MORRIS L. L. , SAVAGE J. P.
Published: January 2008

Thirty‐nine children with suspected pathology Involving the vertebral column were Investigated haematoiogi‐cally, radlographically, and by bone scintigraphy using technetium 99M pyrophosphate. Fifteen children were shown to have Inflammatory disease of the vertebrae. A further six suffered from Scheuermann's disease, two from benign tumours, and the remainder from miscellaneous diseases not specifically Involving bony pathology.

The nuclide scan was abnormal in all cases of discitis and osteomyelitis, and in the two tumours. All of the other conditions were associated with a normal bone scan. This finding is of considerable diagnostic importance, and lends support to the theory that discitis is due to bacterial infection.
THE MEASUREMENT OF ABDOMINAL AORTIC ANEURYSMS
Authors: BUXTON BRIAN , BUTTERY BERESFORD , BUCKLEY JOHN
Published: January 2008

A study was made of the accuracy of different methods currently used In assessing the transverse diameter of abdominal aortic aneurysms. The maximum transverse diameter of the abdominal aorta was estimated by clinical palpation, plain radiology, ultrasonography and aortography, In a group of 47 patients who were subjected to either a surgical exploration or elective aneurysm resection. The results of these estimations were compared with the actual measurements obtained during the surgical procedure. Measurements of aortic wall calcification seen on the plain X‐ray film correlated best with the operative findings. However, calcification was seen In only 30% of the patients. Ultrasonography was almost universally applicable as a technique of assessing aortic size and was found to be a reliable technique for measuring the aortic diameter.
CARCINOMA OF THE LARGE BOWEL IN PATIENTS AGED 70 YEARS AND OVER1
Authors: COHEN J. R. , THEILE D. E. , HOLT J. , DAVIS N. C.
Published: January 2008

In a prospective series of 443 cases of large‐bowel cancer there were 192 cases occurring In patients aged 70 years and over. The resectablllty rate In this group was 84.9% and was almost Identical with that of the whole series (84.6%). There was an overall operative mortality rate of 7.3% in the older age group, compared with 6.4% in the whole series. However, when octogenarians were considered, the resectablllty rate fell to 74.6% and the overall operative mortality rate Increased to 19%. In the treatment of large‐bowel cancer It would seem that special consideration should be given to octogenarians.
CALCIFICATION OF THE MITRAL ANNULUS
Authors: WINDSOR HARRY M. , SHANAHAN MARK X. , CHANG VICTOR P.
Published: January 2008

Successful valve replacement has been achieved within the first three years in two patients who had extensive calcification of the mitral valve annulus. This condition, although commonly reported in pathology and autopsy studies, has been rare in our clinical experience. Surgical management does not appear to us to have been reported previously. It was regarded in our earlier experience as a deterrent to mitral valve surgery. Certain technical factors which contributed to success are emphasized in the two cases described in this report.
THE “YO‐YO” OPERATION FOR INGUINAL HERNIA
Authors: LESLIE DOUGLAS
Published: January 2008

This article presents a new principle in the repair of inguinal hernia in the male. Like the yo‐yo, the testis, having come down, can be mobilized and drawn up again, and then made to redescend, this time by a more approriate route. The inguinal canal can then be obliterated without hazard to the blood supply of the testis.

This article presents a new principle in the repair of difficult inguinal herniae. The testis is mobilized from the scrotum, returned to the abdominal cavity, brought down again through a new canal constructed through the rectus abdominis muscle, and then restored to the scrotum. The original inguinal canal can then be completely obliterated.
TEMPORAL BONE RESECTION FOR CANCER
Authors: MILLAR HUGH S.
Published: January 2008

Fifteen patients with cancer involving the temporal bone have been considered for radical surgical treatment by partial resection of the temporal bone during the past 12 years. All but one had undergone previous treatment by local surgery and/or irradiation. Two patients proved to be inoperable at surgical exploration. Three types of partial resection of the temporal bone and described to encompass disease involving the concha, the mastoid and squamous areas of the temporal bone, the ear canal, the middle ear, and the parotid gland. Closure of the surgical defect has been achieved in five cases using the residual pinna, in four cases with scalp flaps, and in five cases with a deltopectoral flap. Complications have been surprisingly few, with only one postoperative death. In one case communicating hydrocephalus persisted until death from residual disease many months later. Minor repair failure occurred in two patients. No attempt has been made to restore facial nerve function by grafting procedures. Long‐term survival has been disappointing; however, it is considered that such radical surgery remains justified in selected cases for relief of the pain and disfigurement caused by chronic ulcerating neoplastic disease.