bluuebunny/crossref_metadata_2025_split huggingface dataset:
AORTO‐ILIAC STENOSIS: A COMPARISON OF TWO PROCEDURES
Authors: Harris J. D. , Jepson R. P. 
Published: January 2008

Summary1. A series of 40 reconstructive operations on 36 patients for aorto‐iliac stenosis is presented. The stenotic lesions were divided into 2 groups:(a) Liriche syndrome (15);(b) isolated stenotic lesions elsewhere in the aorto‐iliac system (21).The differential diagnosis of these 2 groups on clinical grounds has been discussed.2. A follow‐up of the 40 operations has been performed over a period of six years. Twenty‐four of these operations were endarterectomies while the remaining 16 were arterial grafts. Only 50 per cent. of the grafts are patent at the present time while 92 per cent. of endarterectomies are working. In our hands the results of the latter operation are so superior that we tend to perform it in preference to grafting, where possible.3. The mortality rate (3 to 5 per cent.) for these operations is surprisingly good considering the magnitude of some of these procedures and the fact that often the patients are not first‐class operative risks. However, post‐operative complications have been numerous and include pneumonia (6), pulmonary embolus (4), ileus and burst abdomen (3), incisional hernia (1), adhesive obstruction (2) and superior mesenteric artery thrombosis (1).A transverse subumbilical incision has been used in the last 10 cases and none of these patients has ruptured their wounds, This incision gives a good exposure and appears to heal more securely than paramedian incisions.4. The symptom of impotence in cases of Liriche syndrome has been investigated. In this series 4 out of 10 patients (40 per cent.) questioned complained of either partial or complete importence. This figure is roughly similar to other published series. To our surprise only one of these improved following operation, in otherwise successful results. Inaddition, 2 of the other patients who did not complain of impotence before operation developed this symptom afterwards.Although impotence in Leriche syndrome may be due to inadequate blood supply to the pelvis, its incidence after operation suggests this may be due to disruption of the pelvicnerve plexus at operation.
EXTRADURAL SPINAL HYDATID CYST: A CASE REPORT
Authors: Law W. B. 
Published: January 2008

SummaryHydatid disease in the extradural space of the spinal canal was a chance discovery made at an exploratory operation intended to relieve nerve root pressure.It would appear to offer almost insurmountable difficulties in detection even if the aphorism is recalled that recognition of a rarity demands only that it be borne in mind.
THE EFFECT OF EXTRINSIC FACTORS ON INTRARECTAL PRESSURE
Authors: Buntine J. A. , Hughes E. S. R. 
Published: January 2008

Summary1. An accurate and convenient method of recording intrarectal pressure has been described.2. By this method the effect of extrinsic factors on intrarectal pressure has been studied in five normal male subjects.3. The mechanisms by which physical activities influence intrarectal pressure have been investigated.4. Surgical significance of the results is suggested.
ACUTE CARPAL TUNNEL SYNDROME
Authors: Leditschke J. F. 
Published: January 2008

SummaryThree cases of acute median nerve palsy are presented due to compression in the carpal tunnel. The first case is due to haemorrhage following trauma, the other two cases due to inflammatory products following involvement by infection of the radial and ulnar synovial bursae. All were relieved by division of the flexor carpal retinaculum.A review of the literature reveals only one similar case recorded due to haematoma formation and a limited number following infections in the forearm, wrist, fingers and thumb.
TRAUMATIC RUPTURE OF THE DIAPHRAGM REPORT OF TWO CASES
Authors: Hardy K. J. 
Published: January 2008

Summary1. Two patients with rupture of the diaphragm due to non‐penetrating trauma have beendescribed.2. In the first patient there was displacement of the liver in toto into the chest, the problem being complicated by fat embolism.3. The second patient developed a delayed rupture of the left hemidiaphragm with the complications of renal failure, delirium tremens and severe bronchopneumonia. Both patients suffered fractures of the tibia and fibula.
LIVER INJURIES
Authors: Little J. M. 
Published: January 2008

Summary1. Patterns of liver injury, their causes, anatomy and mortality are reviewed.2. Twenty‐nine cases managed at Royal Prince Alfred Hospital between 1958 and 1963 are analysed. The predominance of blunt trauma is noted. The overall mortality of 48 per cent. and the 62 per cent. mortality for blunt trauma are presented as being capable of improvement.3. A regime of management is presented.4. Several cases from the literature and two recent cases from this hospital are cited as examples of the application of this regime.
AN EXPERIMENTAL STUDY ON BILIARY STRICTURES WITH EMPHASIS ON THEIR RELATIONSHIP TO THE COMMON CHANNEL
Authors: Orlay George , Liddelow Aubrey G. 
Published: January 2008

SummaryThe dog's common bile duct was subjected to various injuries and shown to be relatively immune from severe stricture formation after simple crushing or simple incisional injuries. The construction of a pancreatico‐biliary common channel, however, with similar trauma commonly caused severe strictures. The likelihood that pancreatic juice is responsible for this difference and the literature relevant to this subject are discussed.
THE LIMITED ROLE OF ATTENUATED SMALLPOX VIRUS IN THE MANAGEMENT OF ADVANCED MALIGNANT MELANOMA*
Authors: Milton G. W. , Brown M. M. Lane 
Published: January 2008

SummaryFour cases of incurable malignant melanoma treated with attenuated smallpox (B.P.) virus inoculation are reported. The findings suggest that occasionally a worthwhile remission of the disease can be achieved by this means provided the dose of virus used is large, the patient is not immune and there are no gross visceral metastases.
A CASE OF RUPTURED ANEURYSM OF THE RENAL ARTERY
Authors: Thomas David 
Published: January 2008

SummaryA case of ruptured aneurysm of the renal artery which was successfully treated by nephrectomy is presented.It appears to be the first recorded case of rupture in which calcification of the aneurysm has been seen on a pre‐operative X‐ray of the abdomen, and the fifth reported case to have survived the complication of rupture.The subject of aneurysm of the renal artery is briefly reviewed.
TORSION OF THE GALL‐BLADDER
Authors: Gillett D. J. 
Published: January 2008

SummaryStrangulating torsion of the gall‐bladder is a rare acute abdominal emergency that occurs typically in elderly visceroptotic female patients, but can occur in either sex at any age. The presenting symptom is midline epigastric pain that resembles biliary colic. In about twenty‐four hours it passes to the right hypochondrium and signs of very localized tenderness and peritoneal irritation develop. The differentiation from acute cholecystitis is the absence of toxicity at the time of presentation.
DUODENAL INJURIES
Authors: Thevathasan C. G. 
Published: January 2008

Summary1. Nine cases of duodenal injury were encountered in six years in the Professorial Surgical Unit, General Hospital, Singapore.2. Four were stab wounds and five were closed injuries with a mortality of 22 per cent.3. Case summaries are reported.4. Experience suggests that stab wounds are more easily diagnosed, treated and managed post‐operatively. Blunt injuries on the other hand are seldom diagnosed pre‐operatively; their more varied course and treatment is discussed, and management of some complications noted.
BLOOD OXYGEN SATURATION AND DYE‐DILUTION STUDIES IN THE INVESTIGATION OF THE AETIOLOGY OF VARICOSE VEINS
Authors: Schraibman I. G. 
Published: January 2008

SummaryMeasurements of blood oxygen saturation and dye‐dilution studies in patients with varicose veins have failed to support the standard theories of the aetiology of this condition. No real evidence has been obtained to indicate that this condition may be due to the presence of abnormal arteriovenous communications. By a process of exclusion, it has been indicated that the primary pathology may lie in the vein wall.
URIC ACID STONE FORMATION FOLLOWING ILEOSTOMY*
Authors: Bennett R. C. , Jepson R. P. 
Published: January 2008

Summary1. Seventy‐two members of the Ileostomy Association of South Australia were reviewed and 9 (12.5 per cent) found to have associated urolithiasis. The majority of stones (5 out of 7 chemically analyzed) proved to be uric acid in nature.2. The main aetiological factor would seem to be the loss of alkaline fluid and electrolytes from the ileostomy, resulting in the passage of persistently acid urine of low volume and high specific gravity.3. Prevention may prove difficult and the importance of a properly functioning ileostomy without stenosis is stressed.
INFARCTION OF THE OMENTUM MASQUERADING AS LARGE BOWEL OBSTRUCTION
Authors: Annetts D. L. 
Published: January 2008

SummaryA case of omental infarction is reported. As the clinical picture presents no specific signs it enters into the differential diagnosis of the acute abdomen. Laparotomy is usually resorted to but the lesion may be easily overlooked unless the surgeon is aware of the existence of this condition.
THE VALUE AND LIMITATIONS OF BIOPSY EXAMINATIONS
Authors: Gault Edward W. 
Published: January 2008

SummaryA biopsy involves close co‐operation between a surgeon and a pathologist if a representative piece of tissue is to be obtained, and diagnosed.The surgeon must appreciate the limitations placed on the pathologist as he examines many tissues at an early stage of disease.The pathologist must seize every opportunity of correlating his histological evidence with the clinical history, X‐ray appearance, other laboratory investigations, and the ultimate course of the disease.Only in these ways can the patient benefit to the full from a biopsy.
CARCINOMA OF THE UPPER LEFT COLON
Authors: Hughes By E. S. R. 
Published: January 2008

Summary1. Carcinoma occurs in the upper left colon a little less frequently than in other segments of the bowel.2. Chronic ulcerative colitis is an important predisposing cause.3. There is a high incidence of obstruction and of perforation in carcinoma in this segment. 34/96 had large bowel obstruction, and 6/96 had perforations of the tumour.4. The resectability rate was 87.5 per cent. Palliative resection was performed in about a third of the cases, curative resection in just over half.5. Segmental resection with end‐to‐end anastomosis, whether palliative or curative, had a very high incidence of suture line separation. Twelve out of 53 had suture line disruption, and 2/53 had suture line recurrence.6. A total of 23 patients had subtotal colectomy with ileosigmoid anastomosis. There was one death, and one possible suture line leak. The bowel function has been excellent.7. The treatment of large bowel obstruction caused by carcinoma of the upper left colon has been mostly by one of two methods — preliminary caecostomy or by subtotal colectomy. Both give good results. If a transverse colostomy has been performed in a subsequent subtotal colectomy, it is best to excise it.
AN UNUSUAL CASE OF SYNOVIAL SARCOMA
Authors: Meadows Robert , Sage Robert E. 
Published: January 2008

SummaryA case of synovial sarcoma with an unusual presentation occurring in a 77 years old man is described. The primary tumour was a groin nodule, present for thirty years.Two uncommon associated features were a positive hydatid complement fixation test and a neutrophil polymorphonuclear leucocytosis of 100,000 per cubic millimetre.
VERTEBRAL HYDATIDOSIS
Authors: Stewart GeorgeR. , Loewenthal John 
Published: January 2008

Summaryfive cases of hydatid disease involving vertebrae have been presented and a brief review of the incidence, pathology, and current treatment of this condition included. it appears that until more effective antiparasitic agents are developed, early, radical and if necessary repeated surgery provides the best prognosis in the management of vertebral hydatidosis.
PLASTIC AND RECONSTRUCTIVE CONSIDERATIONS IN SELECTING INCISIONS USED FOR RADICAL NECK DISSECTION
Authors: Bakamjian V. Y. , Marshall Donald 
Published: January 2008

Summary1. The radical excision of a head and neck cancer can often be accompanied by the first major step towards acceptable reconstruction in a reasonable time.2. A convenient donor site for skin flaps to be used in such reconstruction is the neck but this area is frequently compromised by the incisions commonly used for neck dissections.3. Each case should be approached on its own merits and a decision should be made as to whether a cervical flap is desirable for closing the anticipated defect.4. If no such flap is needed, then 2 parallel transverse incisions provide sufficient exposure for neck dissection and have appreciable advantages over other approaches.5. On the other hand, if a flap is considered necessary, the incisions appropriate for the case should be planned initially to allow the most efficient repair.6. Possible methods for attaining these goals have been shown with examples.7. A clear plan of reconstruction should be available before proceeding to the excision, as failure to have one may prevent the use of the most convenient and satisfactory method of repair.
HOST RESISTANCE TO CANCER*
Authors: Goldstein G. 
Published: January 2008

Summary1. Experimental studies on immunity to tumours in animals show that tumour growth is modified by an immunological reaction provided that the immunological system of the host is intact and the tumour carries antigens which are different to those of the host and therefore recognizably “foreign.”2. Human cancers show deletions of normal antigens and also contain new antigens. Human patients with cancer may show reactivity in vitro against their own tumours, and immunological reactivity in vivo is evidenced by infiltration with lymphocytic and plasma cells; this is associated with a slower growth for certain human tumours.3. Human patients with cancer have a general impairment of immunological reactivity and it is suggested that this permits the emergence of cancer.4. The thymus plays an important role in regulating the development and maintenance of immunological reactivity. The declining size of the thymus with age was correlated with the rising cancer incidence with age. Declining thymic activity may lead to impaired immunological function and this may allow the development of human cancer.
A CASE OF MALIGNANT TRANSFORMATION IN FIBROUS DYSPLASIA
Authors: Brownbill David , Snell John A. 
Published: January 2008

SummaryA girl of 7 years developed fibrous dysplasia and subsequent to surgical treatment and deep X‐ray therapy fibro‐sarcomatous change appeared after eleven years. The treatment and time intervals are compared with recorded cases of malignant change in fibrous dysplasia.
RUPTURE OF ABDOMINAL ANEURYSM INTO INFERIOR VENA CAVA
Authors: Jepson R. P. , Miller J. H. 
Published: January 2008

Summary1. two cases, one successfully treated, of aorto‐caval fistulae, due to rupture of an abdominal aneurysm are reported.2. it is re‐emphasized that such a lesion is compatible with life and the duration of symptoms and survival is in major part dependent on the size of the communication.3. the syndrome of pain, abdominal mass, bruit and thrill, and high caval pressure leading to collapse, venous congestion and renal failure is described.4. it is suggested that such cases are surgical emergencies: that infusions may be dangerous and the presence of cardiac failure should not automatically eliminate the possibility of surgical care. the fistula, which may be several centimetres in length can be managed with or without caval control.
A BIZARRE SMOOTH MUSCLE TUMOUR OF THE STOMACH
Authors: AND L. J. H. Butterfield , Casey T. P. 
Published: January 2008

Summarya case is reported of a female patient, aged 68 years, who presented with swollen legs. this common symptom had an uncommon cause, a leiomyosarcoma of the stomach. the tumour itself was also unusual in that it was large and cystic and showed pseudoepithelial features.
Diagnosis by Frozen Section Examination, II: Results in Skin Lesions
Authors: HIRST E. , CAINS G. D. , BALE PATRICIA M. 
Published: January 2008

A series of 910 frozen section examination of skin lesions is presented, and the results are analysed in detail and compared with others in the literature. The difficulties in histological diagnosis are discussed and contrasted with those of clinical diagnosis especially of pigmented lesions.SummaryIn 910 consecutive frozen section examinations of skin lesions nine false positive reports were submitted, but only two were of major importance. False negative reports occurred with malignant melanomas when the lesion was small or heavily pigmented, and with other malignant lesions when the specimens were large (sampling error). Frozen section examination accurately identifies lesions that tend to be mistaken for malignant melanoma on clinical examination.
Fish‐Bone Impaction of the Throat
Authors: AHMED NAZIR 
Published: January 2008

A series of 55 cases of fish‐bone impaction of the pharynx and œsophagus is discussed. Special reference is made to the serious and sometimes fatal complications that may result from delay in treatment, and cases illustrating these complications are reported in detail.SummaryFifty‐five cases of fish‐bone impaction of the pharynx and the œsophagus are reported. Spontaneous disimpaction can occur. Persistent simple impaction, although distressing for the patient, is easily managed. Delay in treatment or well‐intentioned but inexpert attempts at dislodging the fish bone by the patient or his friends may result in perforation of the pharyngo‐œsophageal wall with retropharyngeal inflammation and suppuration, a condition carrying high morbidity. Perforation of the carotid artery or the aorta is a grave complication, requiring urgent treatment if a high mortality is to be avoided. A brief review is made of the complications of fish‐bone impaction in the abdominal part of the alimentary tract.
The Stress Trajectories in the Femur
Authors: ALLCOCK E. A. , SVENSSON N. L. 
Published: January 2008

This article presents a three‐dimensional photoelastic technique for the investigation of the internal stresses in bones and joints.Summary1. The value of plastic models for the investigation of the distribution of weightbearing forces in bone has been discussed.2. The development of internal stresses in loaded plastic models has been investigated.3. The great value of assessment of stress patterns and trajectories by a frozen photoelastic technique using araldite D is reported.4. The practical application of these models to the design of prostheses and other implants has been investigated.
Squamous Cell Carcinoma of the Anal Canal and Anal Margin
Authors: HARDY K. J. , HUGHES E. S. R. , CUTHBERTSON A. M. 
Published: January 2008

This is a study of 41 patients with squamous carcinoma of the anus. There were 23 with a carcinoma situated above the dentate line, the five‐year survival rate being 27%, and 18 with a carcinoma below the dentate line, with a five‐year survival rate of 30%. Advanced local and lymphatic spread at the initial examination was a prominent feature of the series.SummaryThe records of 41 patients with squamous cell carcinoma of the anal canal and anal margin are reviewed. An exact follow‐up study was possible in every instance. There were 23 individuals with carcinoma of the anal canal and 18 with carcinoma of the anal margin. Spread to local structures or lymph nodes was observed in nearly half of the patients with anal canal carcinoma, and less frequently in anal margin carcinoma. The preferred method of treatment for anal canal carcinoma was a Miles abdominoperineal resection, and for anal margin carcinoma wide local excision. The combined five‐year survival was 28.6%, being 27% for anal canal carcinoma, and 30.5% for anal margin carcinoma.
Anastomotic Ulceration
Authors: PHEILS MURRAY T. , GILLETT DAVID J. 
Published: January 2008

Seventy‐eight operations on 68 patients with suspected anastomotic ulceration have been analysed. The incidence, investigation, diagnosis and management of this condition are discussed.SummarySeventy‐eight operations on 68 patients with anastomotic ulceration have been assessed. Only 50% of these patients had a completely satisfactory result. Problems of investigations and diagnosis are discussed. It is suggested that better results can be obtained by a careful selection of patients for operation, and choice of the appropriate operation following full investigation.
The Role of the Voluntary Anal Sphincter in the Maintenance of Fæcal Continence in Normal and Abnormal States
Authors: VARMA K. K. 
Published: January 2008

Manometric studies on normal and abnormal children showed that the voluntary sphincter complex of the anal canal subserved the most important role in the maintenance of continence by three mechanisms‐namely, by providing a resting pressure in the sphincter sone higher than that in the rectum, by reflex contractions in response to rectal distension, with consequent unconscious adjustment of the anal pressure to preserve continence, and by its action as a conscious response to reinforce the anal canal and control defæcation. Furthermore, stretch receptors in the voluntary sphincter complex of the anal canal gave a warning of impending defæcation. After rectoplasty procedures when the only sphincter present was the levator ani complex, the unconscious reflexes were abolished, but the children attained appropriate sensory perception and a high degree of continence provided that the resting tone of the puborectalis muscle was adequate.SummaryThe voluntary sphincter takes the lion's share of the responsibility of maintaining anorectal continence. Continence in the normal child is dependent on:(1) Resting tone of the sphincters; and (2) Neuromuscular reflexes ‐an unconscious Phase I and a conscious Phase II. After abdomino‐perineal pull‐through operations, these children can achieve a high degree of continence, even in the absence of a Phase T response, provided that the resting tone of the voluntary sphincter is high enough.