bluuebunny/crossref_metadata_2025_split huggingface dataset:
HYPOTENSION IN NEUROSURGERY
Authors: Marshall S. V. 
Published: January 2008

Summary

The development of induced hypotension is discussed and its hazards briefly outlined.
The superiority of trimetaphan camphor‐sulphonate (Arfonad) for hypotensive purposes is stressed.
The restricted utility of induced hypotension in neurosurgery, and the value of simpler alternatives for the control of bleeding, are indicated.
The necessity for adequate facilities and assistance, as well as for complete liaison between surgeon and anaesthetist in the conduct induced hypotension, is emphasized.
SPONTANEOUS RUPTURE OF THE OESOPHAGUS A GROUP OF NINE CASES TREATED SURGICALLY
Authors: McConchie Ian 
Published: January 2008

SummaryThe pathology and clinical picture in typical cases of spontaneous rupture of the oesophagus have been described. The rupture is usually a longitudinal tear in the left lateral wall of the oesophagus commencing just above the diaphragm. Mediastinitis, mediastinal emphysema, and pyopneumothorax develop. Vomiting, pain, dyspnoea, abdominal rigidity, and surgical emphysema in the neck, occurring in that sequence, is the typical clinical picture. Untreated cases usually die in forty‐eight hours.Atypical clinical pictures and their causal atypical pathology have been described.Awareness that the condition exists, a knowledge of the symptom sequence, a carefully taken history, the detection of air in the mediastinum or neck, and signs of fluid and air in the pleural cavity, will enable an early correct diagnosis to be made in typical cases. A portable X‐ray film which includes the neck, chest and upper abdomen should always be done. Air in the mediastinum and the absence of air under the diaphragm are the two most significant radiological findings. Aids to diagnosis are pleural aspiration, a lipiodol swallow followed by a chest X‐ray, and thoracoscopy.When the history is atypical, and when the hydro‐pneumothorax is confined to the right pleural cavity, a lipiodol swallow and an oeso‐phagoscopy must be done, as such patients may have pre‐existing oesophageal disease or a perforation at a level higher than the usual supra‐diaphragmatic site.Cases are classified as follows:–“Early”—diagnosed within thirty‐six hours of onset.“Intermediate”—diagnosed between thirty‐six hours and one month of onset.“Late”—diagnosed more than one month from the onset.The following treatment has been recommended:—(a) “Early” cases — immediate thoracotomy with repair of the oesophagus and drainage of the mediastinum and the pleural cavity should be done.(b) “Intermediate” cases —(i) If a total empyema is present— thoracotomy, decortication, and drainage of the pleural cavity and mediastinum should be done. The oesophageal rent should not be repaired.(ii) If the empyema is small and loculated—drainage of the empyema and the mediastinal abscess is all that is required.(c) “Late” cases—thoracotomy, decortication, excision of the oesophago‐pleural fistulous track, and repair of the oesophagus should be done.Management of the post‐operative feeding problems in all three groups of cases have been discussed.Nine cases of spontaneous rupture of the oesophagus treated surgically between 1952 and 1957 have been described. Six of these cases have survived.
BLOOD VOLUME STUDIES IN AGED MEN*
Authors: REEVE T. S. , ODDIE T. H. , BOWMAN SHEILAH , RUNDLE F. F. 
Published: January 2008

Summary1. Using the isotope Cr51, the red cell and total blood volumes have been determined in a group of 97 men aged from 55 to 89 years. A description of the method is given.2. The total blood volume of these geriatric patients was found to be systematically reduced both in relation to body weight and to body surface area. The total blood volume deficit was chiefly dependent on a reduction of the red cell mass.3. Determination of the blood volume is advocated in all aged patients who are to undergo major surgery. The red cell mass if deficient should be brought up to an approximately normal value for the patient's age and carefully maintained during and after operation.
PSYCHOLOGICAL ASPECTS OF SURGICAL PRACTICE†
Authors: Maddison David C. 
Published: January 2008

Summary1. Consideration of patients as whole persons functioning in a certain social environment, rather than as aggregates of diseased or healthy organs, requires an understanding of certain basic tenets of modern dynamic psychology. The concepts of unconscious motivation, the body image, narcissism and castration anxiety are vital in this connection.2. All surgical procedures must inevitably arouse some degree of anxiety; the manner in which this is dealt with, both by patient and surgeon, will frequently have profound effects on the individual's total adjustment. Failure to recognise anxiety may vitiate an otherwise successful technical result.3. Many surgical patients can be helped by psychiatric assessment and by brief psycho‐therapy, either in the pre‐operative or post‐operative periods or both.4. Surgery in the aged poses special psychological problems, which may be substanti‐5. Surgery in childhood represents an important and potentially very harmful emotional stress; elective operations should be postponed as long as possible, and admission to hospital recommended only when strictly unavoidable.6. There are enormous potentialities for future research in the areas of interrelationship between psychiatric and surgical practice. For this reason, in addition to the implications for therapy of such a move, there is a real and urgent need for the provision
NECROTIZING ENTERITIS
Authors: Woodward W. W. 
Published: January 2008

Summary1. Three fatal examples of necrotic enteritis are reported. In two patients the disease followed neither surgery nor antibiotic therapy.2. The lower abdomen of one patient was dull to percussion though the urinary bladderwas empty and ascites absent at necropsy. For want of other explanation this is ascribed to fluid in the lumen and cngestion in the wall of the ileum.3. At necropsy on that patient the disease was not visible from the serosal aspect ofthe bowel. Hence at laparatomy recog‐nition might require palpation of the bowel.
CARCINOMA OF THE PHARYNX
Authors: Newton N. C. 
Published: January 2008

SummaryAn experience with cases of carcinoma of the pyriform fossa and hypopharyrix is reviewed. The need for awareness of early symptoms and thorough examination of patients with such suggestive symptoms is stressed.The uniformly bad results of carcinoma of the pyriform fossa are noted and suggestion, for the consideration of radical surgery in some of these cases is made. The problems associated with the management of carcinoma of the hypopharynx are discussed and the results of treatment of 9 cases are reviewed.Case histories of these 9 cases are given in some detail.
DESMOID TUMOUR IN FAMILIAL POLYPOSIS OF THE COLON
Authors: Hughes E. S. R. , Hueston J. T. 
Published: January 2008

SummaryFamilial polyposis is associated sometimes with an abnormal behaviour in certain other tissues. Osteomata, soft tissue tumours, sebaceous cysts and intra‐abdominal fibrous tissue masses may co‐exist with familial polyposis.A case is recorded in which a desmoid tumour appeared in the wound after surgical treatment of familial polyposis. This is the 17th case to be reported in the literature.Pathologically, the tumour appears to be histologically distinct. from palmar and plantar fibromatosis nor does it seem to be inflammatory in origin.Desmoid tumours in surgical incisions are rare but the number that have been reportedin familial polyposis seems to indicate that in this disease there is a special tendency. The desmoid tumour may or may not be associated with fibrous tissue masses and osteomas elsewhere. In the case reported here these were present. It is known that this latter abnormality is transmitted as a Mendelian dominant. The curious association with polyposis has suggested two closely linked genes, or a pleotropic gene; a more acceptable theory is that the mutant gene has but a single action many steps removed from any clinically obvious manifestations.Recurrence after removal is so common that it seems excision should be very wide, to avoid the involved fascia1 sheets. The prognosis of these desmoids has not been established and it is possible that removal is not essential.
SURGICAL REPAIR OF POST‐OPERATIVE PERINEAL HERNIA
Authors: Kelly By Anthony R. 
Published: January 2008

SummaryPerineal incisional hernia following ab‐domino‐perineal excision of the rectum is discussed, with special reference to the incidence, pathology, and a recommended technique for surgical repair.A case of post operative perineal hernia following abdomino‐perincal excision of the rectum, successfully treated by surgical repair, is reported.
THE CHANGING PROGNOSIS IN APPENDICITIS
Authors: Kidd D. S. 
Published: January 2008

Summary

The history of appendicitis mortality prior to 1933 is briefly reviewed.
Mortality statistics for appendicitis in Australia from 1933 to 1957 are presented, both for the population as a whole, and for the various age groups. A remarkable reduction in mortality rates is in evidence.
Possible reasons for the improving prognosis are advanced. These possibilities ar.e examined in the light of two series of appendicitis cases from the Royal Adelaide Hospital (Series A from 1936‐8, Series B from 1956‐7). Antibiotics, intestinal decompression and intravenous infusions appear to have been the main factors contributing to the improved prognosis. This improvement has occurred principally in the group of perforative‐appendicitis.
The graver prognosis of appendicitis in the aged is shown; and factors responsible for this are summarized. This older group remains a challenge for further improvement.
Post‐operative complications in the Royal Adelaide Hospital Series are reviewed.
ESSENTIAL RENAL HAEMATURIA A STUDY OF SEVEN CASES
Authors: Somerset J. B. , Darkness G. G. 
Published: January 2008

Summary

A brief review of the history of essential haematuria has been made.
The clinical and pathological findings in a series of seven cases of essential haematuria submitted to nephrectomy is given.
It is suggested that management should tend towards conservatism, with repeated and prolonged follow‐up investigation.However one cannot give an absolute assurance that a malignant neoplasm is not present, and it is surprising in this small series how much pressure was brought to bear by patients and relatives in favour of nephrectomy, for this reason.
FATAL POST‐OPERATIVE PANCREATITIS
Authors: Hughes E. S. R. , Kune G. A. 
Published: January 2008

Summary

Three cases of fatal post‐operative pancreatitis are presented.
In each case the preceding operation was conducted on the biliary tract. In one the operation was confined to removal of the gall‐bladder but in the other two the common bile duct was explored.
The complication appeared within four days of the operation.
The pancreas, at autopsy, showed oedema and fat necrosis but minimal haemorrhage.
Circulatory collapse and upper abdominal pain were the initial symptoms in two patients; in the third, the onset was less acute.
A second exploratory operation was not well tolerated in the two patients in whom it was conducted.
The complication might be prevented by the surgeon handling the pancreas with great care, by his avoiding unnecessary explorations of the common duct, and by his exercise of extreme care when performing pancreatic biopsy.
THE SWEAT GLANDS AND SUPPURATIVE HIDRADENITIS
Authors: Kent Maxwell 
Published: January 2008

SummaryThe morphology of the cutaneous glands is reviewed, with particular reference to the apocrine sweat glands. The latter have been studied by macroscopic and histological examination of axillary and perineal skin from newborn babies, adults and the very elderly. The apocrine glands are situated deep in the dermis, and are found in the skin of the axilla, mons veneris, perineum, about the anus, in the external auditory meatus, and around the nipples. Unlike the common eccrine sweat glands, they are not fully developed until puberty, and only then give rise to their characteristic secretion. They remain active until old age, when retrogression occurs.Infection of the apocrine glands occurs, and is recognised by its characteristic distribution (affecting simultaneously the axilla and perineum) and its tendency to incomplete resolution and recrudescences. A typical case history is presented. Wide excision of the involved skin and subcutaneous tissue, with graft replacement, has proven a successful means of treatment.
INTESTINAL ATRESIA AND STENOSIS IN THE NEWBORN†
Authors: Maclaurin Campbell 
Published: January 2008

SummarySeventeen cases of intestinal atresia and stenosis are reviewed. The lesion was in the jejuno‐ileum in 12 and the duodenum in the remaining five.In the jejuno‐ileal group, 5 infants died of causes unrelated to the method of surgical treatment. Five of the remainder were treated by direct anastomosis of the blind ends and one by wide resection and end‐to‐end union.Of the 5 treated without resection, only one had no further trouble. Two patients showed persisting functional obstruction, one dying and the other requiring resection before recovery, while 2 more developed late complications in which persisting functional inefficiency of the proximal blind end was felt to be an important factor.The pathogenesis of the condition is discussed, with particular reference to the work of Louw (1959) and current concepts of treatment are reviewed.The experience recorded in this paper supports the view of Nixon (1955) and Louw (1959) that the blind ends, especially the dilated proximal one, are liable to be functionally and mechanically inefficient and should therefore be resected before anastomosis which itself should be end‐to‐end, rather than side‐to‐side.
FAT EMBOLISM†
Authors: Watts J. McK. 
Published: January 2008

SummaryAn attempt has been made to assess the problem of fat embolism, a condition certain to become more common because of the increasing amount of trauma occurring today.Seven case records of this condition are presented and are used as illustrations in a discussion of the clinical features, diagnosis and treatment. The importance of chest X‐rays in the diagnosis of pulmonary fat embolism is stressed. Treatment has been discussed with emphasis on the means of prophylaxis and the recent use of heparin. Hypothermia is suggested as a possible advance in the treatment of cerebral fat embolism.Despite the accumulated knowledge of many investigators, we seem little closer to solving the problem of the true aetiology of fat embolism. It has been established quite convincingly that mechanical embolization of fat does occur after trauma. hut what part this plays in the ultimate disease is not certain. The finding of fat emboli in non‐traumatic conditions and recent work in the composition of the emboli have lent weight to the theory that at least some of the emboli ate derived from circulating blood lipids.
EOSINOPHILIC INFILTRATION OF THE STOMACH
Authors: Blackwell J. B. , Gild A. 
Published: January 2008

SummaryTwo types of lesion may result when there is eosinophilic infiltration of the deeper layers of the stomach. The first is diffuse eosinophilic infiltration which may involve also the duodenum and jejunum and is five cases of an intermediate nature are compared with both the diffuse and localized types and it is concluded that they are probably a variant of the diffuse form.
PRIMARY RESECTION WITHOUT ANASTOMOSIS FOR CARCINOMA OF THE SIGMOID COLON WITH OBSTRUCTION
Authors: Nayman Jack 
Published: January 2008

SummaryThe total overall five‐year survival for carcinoma of the colon still leaves a lot tobe desired.In obstruction due to carcinoma of the sigmoid colon, preliminary decompression may facilitate the spread of the carcinoma.For tumours of the sigmoid colon with obstruction a technique of primary resection with proximal terminal colostomy and invagination of the distal stump performed in 2 cases is described. Continuity being re‐established at a later date.
RENAL HAMARTOMA
Authors: Blackwell J. B. , Saunders J. M. , Vaughan B. F. 
Published: January 2008

SummaryThis paper deals with a patient with tuberous sclerosis but no mental defect who presented with haemorrhage into a large renal hamartoma. The radiological features including those found on a renal arteriogram have been described. Multiple hamartomata were demonstrated by abnormal vascular channels within them and this was confirmed by pathological examination of the nephrectomy specimen.
SOME ASPECTS OF ANAESTHETIC MANAGEMENT OF NEONATAL SURGICAL PATIENTS
Authors: McDonald I. H. 
Published: January 2008

SummaryThis paper reviews some aspects of neonatal anaesthetic methods developed at the Royal Children's Hospital, Melbourne. Urgency, technique, humidification, warmth blood replacement and ventilation are dealt with in a general context, whilst specific problems relating to thoracotomies and laparotomies are discussed.
TRANS‐SPHENOIDAL HYPOPHYSECTOMY IN CARCINOMA OF THE BREAST
Authors: Gray George 
Published: January 2008

Summary1. The operation of trans‐sphenoidal hypophysectomy is described and the complications discussed.2. Attention is directed to the advantages of this procedure when compared with trans‐frontal hypophysectomy, pituitary stalk section and yttrium implantation in cases of breast cancer.3. The advantages of hypophysectomy over adrenalectorny are described briefly.4. Factors for consideration when cases are selected for hypophysectomy are enumerated.
VASCULAR COMPLICATIONS OF CERVICAL RIBS
Authors: Harris James D. , Jepson R. P. 
Published: January 2008

Summary1. Six cases of subclavian artery aneurysms associated with cervical ribs are reported.2. The natural history of progression from a fusiform dilatation to a grossly abnormal vessel liable to massive or mural thrombosis with embolization is described.3. For those cases with thrombosis and significant ischaemia, aneurysmal formation of great size or fragility, containing mural thrombosis with embolization, it is recommended that the segment should be resected and a graft inserted.4. A method of graft insertion without resection of the clavicle is described.
ELECTROLYTE DEPLETION ASSOCIATED WITH VILLOUS TUMOUR OF THE RECTUM
Authors: Battersby Cameron 
Published: January 2008

SummaryThe case report of a seventy‐four‐year‐old male who presented with severe electrolyte and water depletion as a result of a large villous tumour of the rectum is presented.Collection of a twenty‐four hour specimen of the mucus discharged from this tumour resulted in 250 C·C. of fluid being obtained. This fluid contained 87 mEq/litre of sodium and 62 mEq/litre of potassium. The liability of the large villous tumour toundergo malignant change or to be associated with a carcinoma elsewhere in the large gut is stressed.
RUPTURED KIDNEY A RETROSPECTIVE STUDY OF 100 CASES
Authors: Wright J. E. 
Published: January 2008

SummaryA retrospective study of 100 patients with renal injury has been performed and immediate results assessed. Eighty‐six were males and 14 females. accidents were the commonest causes.Anterior, lateral or posterioi trauma can cause renal contusion. The pain experienced may be anterior or posterior. Haematuria was present in all except 2 patients. The severity and duration of haematuria bore no relation to the prognosis. Secondary haemorrhage occurred in only 6 patients and presented no clinical problem.Intravenous pyelography was performed in 49 patients, being normal in 16. Only 1 showed extravasation of dye. Two displaced ureters were detected and 2 pre‐existing lesions (a hydronephrosis and a polycystic kidney) were revealed. A definite calyceal abnormality (dilatation or distortion) was seen in 8 patients.A conservative policy was followed unless operation was forced by bleeding or deterioration in general condition. The mortality rate was 10 per cent. Only 3 of the deaths were unassociated with multiple severe injuries. These followed pulmonary infarction and tetanus. Sixteen nephrectomies were performed and 4 lacerated kidneys were surgically repaired.No reason was found from the study of immediate results to abandon the present policy.
THE DIAGNOSIS AND MANAGEMENT OF RENAL FAILURE IN SURGICAL PATIENTS
Authors: Marshall Vernon , Yoffa David 
Published: January 2008

SummaryA group of patients with renal failure due to surgical causes is described, emphasizing the difficulties in diagnosis and the significance of the urinary output after surgery. Difficulties in distinguishing between depletional oliguria and intrinsic renal failure are discussed.Treatment of established renal failure often requires dialysis, and the relative merits of peritoneal dialysis and haemodialysis are considered. The use of arteriovenous shunts, percutaneous cannulation and regional heparinization as aids to dialysis are discussed.It is believed that further lowering of the high mortality from renal failure due to surgical causes may be best achieved by earlier diagnosis and referral to a unit experienced in the management of these patients.
ASSESSMENT OF AUTOGENOUS AND PROSTHETIC MATERIALS IN THE RIGHT VENTRICULAR OUTFLOW TRACT
Authors: Egerton William S. , Windsor Morgan F. 
Published: January 2008

SummaryIn a series of 49 dogs, free atrial appendage grafts, free pericardial grafts, dacron arterial grafts, dacron plus pericardium grafts and 2 types of Teflon graft were each sutured into defects created in the outflow tract of the right ventricle. Twenty‐five six‐month survivors were studied by re‐examination of the graft site at thoracotomy and by histologic section of the implanted materials. Cine‐cardio‐angiography by selective right ventricular injection was performed on one animal in each group. All survivors tolerated the grafts well.Ease of surgical handling, ready attainment of haemostasis and excellent incorporation into the hosts' tissues favoured the use of a double‐layer patch of dacron and pericardium for the repair of defects in the outflow tract of dogs.
HODGKIN'S DISEASE OF THE COLON PRESENTING AS DISSEMINATED SCLEROSIS WITH ASSOCIATED ULCERATIVE COLITIS
Authors: Meadows Robert 
Published: January 2008

SummaryA case of Hodgkin's disease of the colon with associated demyelination is described which presented with neurological disturbances and was initially considered to be suffering from disseminated sclerosis. Persistent diarrhoea led to her admission to hospital where perforation of her sigmoid colon occurred. A colectomy was performed and her clinical features and the macroscopical appearances of the specimen suggested ulcerative colitis.
CAUDA EQUINA COMPRESSION RESULTING FROM MASSIVE LUMBAR DISC EXTRUSION
Authors: Schaeffer H. R. 
Published: January 2008

Summary

Massive rupture of lumbar intervertebral discs is discussed with particular emphasis on the clinical presentation of this important and to a large degree remediable condition. The varying modes of onset of symptoms are described, and the significance and prognosis of associated motor, sensory and sphincteric abnormalities is discussed.
This condition is a grave clinical emergency, and no delay in diagnosis is permissible. Operative decompression of the nerve roots is always essential and the sooner it is done the better will be the result.
THE EFFECT OF LARGE DOSES OF CYTOTOXIC DRUGS ON THE BLOOD VOLUME OF THE RAT*
Authors: Reeve T. S. , Vincent P. C. , Brittle Nea , Nicholls Annette 
Published: January 2008

SummaryStudies of blood volume in the rat following treatment with large doses of cytotoxic drugs revealed that significant depletion of red cell volume followed the use of cyclophos‐phamide and nitrogen mustard and, to a lesser extent, methotrexate. The anaemia in the case of nitrogen mustard is not revealed by haemoglobin or haematocrit studies, it being masked by hypovolemia following use of the drug. The results indicate that red cells as well as white cells are at risk in cancer chemotherapy.