bluuebunny/crossref_metadata_2025_split huggingface dataset:
REGIONAL PERFUSION FOR PERIPHERAL MELANOMA
Authors: Cox Kenneth R. 
Published: January 2008

SummaryThe rationale, technique, and results of 34 regional perfusions of cytotoxic drugs for peripheral melanoma are described.While individuals have benefited dramatically, it is not easy to demonstrate a real effect on the group as a whole.The place of regional perfusion in an orderly plan of management of recurrent melanoma is discussed.Whether prophylactic perfusion at the time of node dissection can compensate for a discontinuous operation between primary site and nodes, is not yet clear.
A CASE OF CARDIAC ARREST ASSOCIATED WITH BRONCHOSPASM AND D‐TUBOCURARINE
Authors: Harrison G. A. 
Published: January 2008

SummaryA case is reported of cardiac arrest following respiratory obstruction in a 58‐year‐old woman. The obstruction appeared to be bronchospasm precipitated by the administration of d‐tubocurarine. Because of the nature of anaesthetic technique it was possible to exclude many of the causes which mimic true bronchospasm. It is possible that the patient was sensitive to histamine released by d‐tubocurarine as she had a minor past history of bronchial asthma.
A NEW EXPERIMENTAL PREPARATION FOR THE STUDY OF SKIN TRANSPLANTATION
Authors: Ross Harry 
Published: January 2008

SummaryAn experimental preparation for the study of skin transplantation is described. It involves the construction of an explant of the ileum of the dog with restoration of the continuity of the bowel. The submucosa of die explant provides a site for implantation of skin, which has several advantages compared with the more usual techniques.
THE FATE OF SKIN HOMOTRANSPLANTS IN THE SUBMUCOSA OF THE ILEUM
Authors: Ross Harry 
Published: January 2008

SummaryA technique using ileal explants has been applied to the investigation of the fate of skin homotransplants in the ileal submucosa of the dog. The results indicate that the ileal submucosa is not a “privileged” recipient site.The preponderance of polymorphonuclear leucocytes in the cellular infiltrate associated with rejection is noted.
PRIMARY SUTURE OF THE OPERATIVE WOUNDS AFTER HAEMORRHOIDECTOMY*
Authors: Failes David 
Published: January 2008

Summary1. A small series of 24 patients is presentee in whom haemorrhoidectomy was followec by primary suture of the operatior wounds.2. The chief advantage of the technique was quicker healing of the wounds and shortened convalescence.3. The only disadvantage was an increased incidence of skin tags.4. No difference in post‐operative pain was noted in patients in this series compared to patients undergoing the “standard” Milligan‐Morgan operation.
SEVERE SODIUM DEPLETION WITH RENAL FAILURE FOLLOWING COMMON BILE DUCT DRAINAGE
Authors: Basten A. , Opit L. J. 
Published: January 2008

SummaryA case of severe sodium deficit following drainage of the common bile duct is described with oliguric renal failure. It is emphasized that despite extensive studies of sodium metabolism in man, clinical recognition of depletion of this cation in surgical patients is difficult, and may not be appreciated until late. Methods of early diagnosis, the mechanism of development of acute renal failure in such subjects, and the existence of “susceptible” groups of patients are discussed. Finally, a number of recommendations for the management of sodium depletion are made.
THE DEVELOPMENT OF A TECHNIQUE FOR EXPERIMENTAL HEART‐LUNG BY‐PASS
Authors: O'Donovan T. G. 
Published: January 2008

SummaryExperimental heart‐lung by‐pass surgery presents some problems not generally encountered in human open‐heart surgery, not the least of these being the additional burden this essential surgery places on an already hard‐pressed by‐pass unit.In evolving a simpler and more satisfactory technique for use in the experimental laboratory various modifications were made to the technique generally employed at Green Lane Hospital. These modifications, and the underlying reasons for making them are outlined.
SMITH'S FRACTURE: A REVIEW
Authors: Paterson Dennis C. 
Published: January 2008

SummaryAlthough an uncommon injury, Smith's fracture is a fracture around a wrist joint which must be remembered in all injuries in this vicinity. Its diagnosis was missed in 75 per cent of cases in this series.Smith's fractures fall into 4 distinct types as determined by the patient's age and X‐ray appearances.It is suggested that all Smith's fractures should be reduced with the hand in maximum supination, in an above‐elbow plaster cast, for six weeks.Even when adequately treated, all patients are left with some disability, but this is very much less than in those where the diagnosis is missed or the fracture treated as a Colles' fracture, or treated by open reduction.
CARCINOMA OF THE SIGMOID COLON
Authors: Hughes E. S. R. 
Published: January 2008

Summary1. Carcinoma of the sigmoid colon occurred mostly between 40 and 80 years of age, with the highest incidence between 60–70 years. The disease affected 3 patients in their twenties. Females are slightly more commonly involved.2. Two‐thirds of the patients had a typical non‐urgent mode of presentation. The barium enema occasionally produced a false negative result. The remaining one‐third presented either with acute large bowel obstruction or with perforation of the tumour. When perforation occurs, it causes an abscess (or intense inflammatory reaction) which may remain localized, burst into the peritoneal cavity, or discharge into the bladder and produce a vesico‐colic fistula.3. Sixteen per cent, of cases were not resected. Multiple peritoneal metastases, a large fixed mass (sometimes partly inflammatory) and poor condition of the patient were responsible.4. Palliative resection was performed in about 25 per cent, of cases. There were 3 deaths after resection. Two survived unexpectedly. One had a large sub‐serosal plaque of malignant tissue in relation to the primary tumour and associated with peritoneal free fluid; the other had small nodules on the surface of the small bowel, thought to be secondary deposits, but later shown to be carcinoid tissue.5. Curative resections were performed in 59 per cent, of the patients. Two of the 86 patients so treated died in the post‐operative period. A further patient developed a faecal fistula and required a colostomy to close it. A total of 51 patients were treated five years or more ago, and 44 (86 per cent.) survived. Five of the 7 failures had curative excisions after earlier treatment for acute large bowel obstruction. There have been 3 late deaths from recurrence, all intra‐abdominal.6. Large bowel obstruction complicated 36 of the patients. Caecostomy proved a satisfactory method of overcoming the obstruction, and was performed on 16 occasions. Resection was performed in 14 of the 16 patients, and an anastomosis in 13. Colostomy was an alternative method of decompressing the bowel, but did not appear to have any advantage over caecostomy. Immediate resection was used on occasions, but its place appeared limited. The long term prognosis of obstructed patients is only fair with 5 of 21 patients treated five years or more ago surviving.7. Perforation with abscess formation is a formidable complication because it complicates subsequent removal. If the abscess should discharge into the bladder, one‐stage resection is not only a satisfactory operation but is followed by good 5‐year survivals.8. A total of 80 patients were referred 5 years or more ago and 46 survived at least that period, an absolute five‐year survival rate of 57.5 per cent. Of 22 patients seen ten years or more ago, 8 survived, an absolute ten‐year survival of 36 per cent.9. It is concluded that one‐stage partial sigmoid colectomy with end‐to‐end anastomosis, without mobilization of the splenic flexure or rectum, and completed. without drainage or post‐operative antibiotics is the treatment of choice for carcinoma of the sigmoid colon.
CHRONIC ULCERATION AND MALIGNANCY*
Authors: Manchanda R. L. , Khanna S. D. 
Published: January 2008

Summary1. The history and histology of 114 chronic ulcers which were excised in the surgical unit, Government Medical College, Patiala, have been presented.2. Twenty cases showed definite malignancy, 6 were diagnosed as carcinoma‐in‐situ and in 2 cases features were suspicious of early malignancy.3. The histological details of chronic ulcer cases have been discussed in detail and some conclusions have been arrived at.
Experimental Studies on the Use of Diaphragmatic Flaps for Myocardial Revascularization: Preliminary Report
Authors: Clarke C. Peter 
Published: January 2008

Animal experiments were performed to evaluate the use of a diaphragmatic flap, based on a major branch of the phrenic artery, for myocardial revascularization. Even without the stimulus of ischæmia, a significant cross‐anastomosis of blood vessels between the myocardium and flap was demonstrated.There may be a useful place for such a flap for myocardial revascularization as an alternative or additional procedure to internal mammary artery implantation.
REVIEW OF 280 TRACHEOSTOMIES
Authors: LORD REGINALD 
Published: January 2008

Summary1. A series of 280 tracheostomies from St. Vincent's Hospital, Sydney, is reported.2. Indications for operation are classified and figures presented to show that the operation is more common than formerly.3. Operative techniques are described.4. Complications, in particular those relating to cuffed tubes, are tabulated.5. A case report of tracheo‐arterial fistula is added to the literature.6. Overall mortality was 40 per cent.
MYCOTIC ANEURYSM OF THE HEPATIC ARTERY RECOVERY AFTER RESECTION
Authors: Nash Thomas 
Published: January 2008

SummaryA case of mycotic aneurysm of the hepatic artery is presented in which recovery of the patient occurred after excision of the aneurysm. The literature of hepatic aneurysm is reviewed and this appears to be the first mycotic aneurysm of the hepatic artery recorded with recovery of the patient after excision of the aneurysm. The diagnosis, clinical features and treatment are discussed together with the significance of the blood supply to the liver. The use of operative angiography is advocated as a possible means of demonstrating the actual alternative blood supply of the liver when ligation of the hepatic artery seems necessary.
ANEURYSMAL BONE CYST
Authors: Bridger Patrick 
Published: January 2008

SummaryFive cases of aneurysmal bone cyst are presented.The aetiology, clinical signs, radiology and pathology are outlined. They illustrate the typical features of this lesion: a short history of a painful bony swelling which radiologically is eccentric, ballooned out and honeycombed. They also emphasize the protean clinical and radiological manifestations which present diagnostic difficulties. The lesion has masqueraded as a benign bone cyst, giant cell tumour, osteogenic sarcoma and even hydatid.The pathologist must have an adequate biopsy, for without this he may find it difficult to distinguish the cyst from other giant cell bone lesion.Complete resection or curettage is a satisfactory form of treatment.
HASHIMOTO'S DISEASE
Authors: Jepson R. P. , Miller J. H. 
Published: January 2008

Summary1. Thirty‐four cases of Hashimoto's disease are presented, in some instances in association with Sjogren's syndrome, rheumatoid arthritis, and adrenal‐pituitary atrophy.2. The difficulties in diagnosis are stressed by reason of the frequent nodular nature of the enlargement and the lack of precision in pre‐operative tests.3. It is advocated that all patients prior to thyroidectomy should have antibody tests performed, and where the index of suspicion is high a surgical biopsy performed before a major ablation is proceeded with.4. The place for surgery is well defined: pressure symptoms, cosmetic reasons, or pain, and this should be restricted to a limited subtotal resection without risk to the parathyroid glands or recurrent laryngeal nerves.
PRIMARY AND SECONDARY REPAIR OF THE POSTERIOR URETHRA
Authors: Carswell W. R. 
Published: January 2008

Summarythe follow‐up of a patient who sustained a rupture of the deep urethra and ensuing multiple fistulae, first seen eighteen months after injury in 1957, shows eight years after reconstruction, and nine and one half years after the original injury, a result which should encourage all surgeons to attempt this reconstruction. at least nothing is to be lost and all is to be regained, except perhaps fertility.the injuries involve, often, good quality lives.reconstruction operation should be chosen in preference to recto‐vesicostomy, in the writer's opinion.primary repair results are encouraging and no strictures have so far been seen in four primary and one major secondary reconstruction.all patients so treated will be followed up, including comparatively recent repairs, not here included.retropubic primary and secondary repair is again recommended in this serious injury.
AN OPERATIVE TECHNIQUE FOR THE TREATMENT OF PILONIDAL SINUS
Authors: Hobbs Alan F. 
Published: January 2008

Summaryan account is given of the use of an operative technique for the treatment of pilonidal sinus, which was described by ziegler et alii in 1946, and which has been employed by me 42 times in 41 patients over a period of seventeen years. the technique is described and an account given of the results obtained recently by examination or response to a questionnaire in 24 of the operations. in three further cases, details up to the time of resuming work are given. the method is considered to have given satisfactory results.
The Place of Fundoplication in the Treatment of Hiatal Hernia1
Authors: Morgan A. G. 
Published: January 2008

Experiences with Nissen's operation of fundoplication by the abdominal route in the treatment of sliding hiatal hernia with reflux are described. Cadaver studies were carried out, and showed that the fundal cuff encircling the lower arsophagus has a positive valve action preventing reflux. Twenty‐eight fundo plications were performed, and 23 of these were followed for periods ranging from six months to three years. These patients are compared with another group of 25 patients treated by other operations. Fundoplication provided complete control of reflux clinically and radiologically in over 95% of cases, and the results were superior to those of the other operations. The sequela of fundoplication were more acceptable to patients than those of vagotomy and pyloroplasty. It proved an effective and safe addition to the repair of the hiatus, and its use is advocated selectively for patients with severe reflux œsophagitis. Some modifications of the technique of operation are suggested.
Factors Influencing the Incidence of Postoperative Abdominal Adhesions: An Experimental Study
Authors: Storey Brian G. , Lawrenson Kevin B. , Chant Susan , Stephens Frederick O. 
Published: January 2008

The incidence of fibrinous intestinal adhesions following laparotomy in rats was increased by removing the intestines from the peritoneal cavity. This incidence was not significantly influenced by placing the intestines either in sterile plastic bags or in gauze swabs soaked in normal saline. The incidence of plastic adhesions in laparotomy wounds closed without suturing the peritoneal layer was less than when this was sutured. The use of non‐absorbable silk sutures when compared with that of absorbable catgut made no difference to this incidence, nor did the use of interrupted sutures as opposed to continuous.It is postulated that the presence of sutures in the peritoneal layer would cause a prolonged defect in serosal cell cover which could result in a reduction of fibrinolysin activity of serosa cells at that site. The suture material would also offer a site of protection of an immature fibrinous adhesion from adjacent serosa cell fibrinolytic activity. Such conditions would facilitate organization of an otherwise temporary and reabsorbable immature adhesion into a permanent mature fibrous structure, as has been observed in long‐term studies following the use of non‐absorbable suture material or talcum powder in the peritoneal cavity.
Contact Spread of Carcinoma of the Skin
Authors: FAGAN P. A. 
Published: January 2008

The case history of a patient with basal cell carcinomas on the thumb and the ear is presented. The patient had burnt the thumb 17 months prior to presentation and the burn had never fully healed. He volunteered that he habitually slept on his side with the thumb in contact with the ear. The histological features of the two lesions were identical. Similar reported cases and the experimental data on basal cell tumour implantation are reviewed in an attempt to prove that this case is one of implantation metastasis. Some of the evidence is strongly in favour of this possibility, but the verdict must be one of “not proven”.SummaryA case of simultaneously occurring basal cell carcinomas with identical histology is presented. In the light of published clinical cases and experimental data, an attempt has been made to prove that one lesion was an implantation metastasis of the other. The available evidence allows only the Scottish verdict of “not proven” to be made.The points for and against a diagnosis of implantation metastasis are listed.Points in favour are the long history of contact, the rarity of basal cell carcinoma of the thumb, the histological features of the tumours, the unusual time interval if the tumour was a “burn cancer”, and the suitable “culture medium” for metastasis following the burn.Points against such a diagnosis are the occurrence of many histologically similar basal cell carcinomas in a series of ten cases, the possibility that the tumour was a burn cancer, the experimental difficulty in transplanting basal cell carcinomas, and the experimental evidence that stroma is required to transplant basal cell carcinomas successfully.
Benign Tumours of the Common Bile Duct: Report of a Case and Review of the Literature
Authors: HOSSACK K. F. , HERRON J. J. 
Published: January 2008

In this paper the case report of a patient with a benign tumour of the common bile duct is presented, and a review of the literature relating to the subject is made. Reference is also made to the value of percutaneous cholangiograms in the diagnosis and management of cases of obstructive jaundice of obscure origin.SummaryA report of a benign papillary cystadenoma of the common bile duct is presented. The literature on this subject is reviewed, and 76 cases were found. The different histological types are listed. Although there are no cardinal diagnostic features in the clinical picture, it should be remembered that benign tumours are a rare cause of jaundice. This condition is surgically correctable and has a good prognosis. Percutaneous transhepatic cholangiography is discussed in relation to this case.
The Use of Colon for Œsophageal Replacement in Children
Authors: MARTIN LESTER W. 
Published: January 2008

This article reviews the author's experience in replacing the œsophagus with a portion of colon in 31 children over a period of 14 years. When carried out for atresia or stricture, the procedure has in general been satisfactory, and modification of the technique over recent years has eliminated the majority of the complications that previously occurred. There were two deaths, one related to the operation and the other not. Experience suggests that the procedure is not satisfactory in the treatment of œsophageal varices.SummaryA review of our experience with œsophageal replacement employing a portion of the colon is presented. In 21 patients, there was one unrelated death and one death directly related to the operation.The majority of the complications have been related to the upper anastomosis in the neck. They have not developed in recent cases, where distension of the colon segment has been prevented by a tangential tubeless cervical caecostomy which in each instance has subsequently closed spontaneously.The use of a colon segment to replace the resophagus because of atresia or stricture has been most satisfactory and has been relatively free from long‐term complications.Failure to gain weight in three patients was found to be related to stricture at the neck anastomosis, which was not evident in a barium œsophagram. The diagnoses were made by œsophagoscopy, and the strictures were corrected surgically.Our limited experience, but with long‐term follow‐up, indicates that colon replacement of the œsophagus is an unsatisfactory method for the treatment of œsophageal varices.
Delayed Ulnar Nerve Palsy in Colles' Fracture: A Case Report
Authors: Kochhar V. L. , Singh J. Man , Srivastava K. K. 
Published: January 2008

Ulnar nerve involvement in Colles fracture is almost unknown. A case of Colles' fracture with delayed ulnar nerve palsy is described with a view to highlighting this lesion, which can be of interest both clinically as well as medico‐legally, when the question of compensation in such cases is under consideration.Summary1. A case of Colles' fracture is described with delayed ulnar nerve involvement.2. The ulnar nerve was found on exploration to be strangulated by a fibrous band at the wrist.3. Neurolysis of the ulnar nerve at the wrist had produced no improvement when the patient was seen four months after the operation.4. This entity is of interest from the clinical viewpoint as well as from the medico‐legal viewpoint, if it is realized when compensatior is awarded that ulnar nerve involvement is possible following a Colles' fracture.
The Surgical Staging of Hodgkin's Disease
Authors: Battersby C. , Seymour A. E. , Kynaston B. 
Published: January 2008

Results of laparotomy staging of Hodgkin's disease are reported in a selected group of 14 patients with Stage 1 or Stage 2 disease, regarding whom a reasonable suspicion of intraabdominal involvement existed. Staging was advanced in 43% of patients, with consequent alteration in therapy.Intraabdominal Hodgkin's disease may be present focally in nodes and spleen which are not enlarged, and meticulous search for nodes is advocated with removal of perivascular fat if none can be located macroscopically. Examination of all tissue fresh and unfixed has given the best guide to the presence of disease foci, but multiple sections and careful search may be necessary to locate this occult disease. If intraabdominal Hodgkin's disease has not been located, subdiaphragmatic radiotherapy has not been given, but, in common with other reported series, the follow‐up period is as yet too short for full evaluation of this therapeutic concept.
Splenectomy: A Review of Morbidity
Authors: Little J. M. 
Published: January 2008

One hundred and fifty consecutive splenectomies, performed at the Royal Prince Alfred Hospital over a five‐year period beginning in 1968, have been reviewed in a retrospective study. Splenectomy incidental to some other resectional procedure in the upper abdomen carried a mortality of 17%, accidental injury to the spleen during upper abdominal surgery carried a mortality of 28%, external trauma to the spleen a 7% mortality, while splenectomy for the diagnosis or therapy of a hematological disorder carried the lowest mortality, namely 4%. Morbidity and mortality were related to the age of the patient, and the mortality among patients 60 years or more was 26%. Pulmonary complications (excluding pidmonary embolus) occurred in 48% of patients. Clinically evident thromboembolism was delected in 10‐7% of patients. A definite relationship to platelet counts of more than 500,000/mm was noted amongst patients who were not heparinized.Splenectomy is associated with a high morbidity and a significant mortality. Surgeons performing the operation and physicians referring patients for splenectomy need to be aware of the risks involved. Careful patient selection, scrupulous perioperative management, and. meticulous surgery may reduce both morbidity and mortality. Elective splenectomy should be managed by a team of surgeons and physicians with a specific interest in the problems involved.