bluuebunny/crossref_metadata_2025_split huggingface dataset:
INTACT EXTRUSION OF HYDATID CYSTS
Authors: WOODWARD W. W. 
Published: January 2008

Summary(1) Partial extrusions of three hepatic hydatid cysts are reported from Tasmania, thus adding to the existing accounts of these events. Two were downward into the peritoneum and one upward into an expanded subphrenic space. These partial extrusions were all seen at operation.(2) Total extrusions known to have occurred elsewhere are briefly mentioned. A Tasmanian total extrusion is described in a case report. Total extrusion from this patient's liver was followed by intact transperitoneal migration into the recto‐vesical pouch. Operation happened to be done before rupture occurred and the cyst was delivered intact from the recto‐vesical pouch, an operation to which the writer has not found previous reference in English, though it cannot be said that anything like an exhaustive search has been made.(3) Because of the risk of rupture of the newly uncovered hydatid it is recommended that surgery should be resorted to as an emergency when intact extrusion is a possibility.(4) If the cyst is not seen where it was to be expected, then a very gentle exploration of the remainder of the opened serosal cavity is indicated, in case the cyst has migrated intact.(5) Finally, there is the possibility that intact extrusion may be found to be not so extremely uncommon a phenomenon if operation in a suspected case is done early, i.e. before rupture of the cyst.
AN EXPERIMENTAL METHOD FOR THE PRODUCTION OF MITRAL INCOMPETENCE*
Authors: REEVE THOMAS S. , MONK IAN 
Published: January 2008

Summary1. A new method is described for producing mitral incompetence in sheep. It provides a high percentage of survivors for long‐term experiments.2. The pericardial envelope is not opened during the procedure, and no intrapericardial adhesions are produced. This allows easy access to cardiac structures when surgical correction is attempted subsequently.
TRAUMATIC AVULSION OF THE INSERTION OF FLEXOR DIGITORUM PROFUNDUS*
Authors: Gunter G. S. 
Published: January 2008

Summary1. Traumatic avulsion of the insertion of the tendon of flexor digitorum profundus of2. The probable mechanism responsible for the injury and the subsequent deformity in untreated cases is discussed.3. Various procedures undertaken at different stages in the progress of the injury, and under varying conditions, are described and discussed.4. The long term results in eight cases are demonstrated.
VESICAL DIVERTICULA IN CHILDREN
Authors: Mackellar Alasdair , Stephens F. Douglas 
Published: January 2008

Summary1. Twenty‐three patients with diverticula of the bladder were treated during an eight‐year period at the Royal Children's Hospital, Melbourne. In 13 patients, the diverticulaco‐existed with proven urethral obstruction. In 10 patients the diverticula were not associated with an obstructive factor. These 10 patients and their diverticula are described in this paper.2. The aetiological factor responsible for the formation of the diverticula unassociated with obstruction of the urethra, is a localized developmental muscular defect of the bladder wall. The diverticulum itself is a protrusion caused by the normal ranges of intra‐vesical pressure exerted on the bladder wall in the course of normal function.Two types of diverticula were identified‐the localized globular pocket with narrow neck, and the less common diffuse wide necked bulge of the lateral wall of the bladder.3. The relationship between diverticula and the occurrence of vesico‐ureteral reflux is discussed. Reflux is related not to the proximity of the body of the diverticulum to the ureter wall nor to the size of the diverticulum but to the intimacy of their orifices.4. The view is put forward that the anomaly of muscular development which results in diverticulum formation also involves the terminal ureter and is responsible for impairment of the intrinsic uretero‐vesical valve mechanism.5. Orthodox techniques were used to repair the globular narrow neck type of diverticulum, but an overlapping repair was invoked for the wide neck variety.
CONGENITAL LOBAR EMPHYSEMA
Authors: Myers N. A. 
Published: January 2008

Summary1. A case of congenital lobar emphysema is described.2. Attention is drawn to the fact that three clinical groups of this condition can be recognized.3. Although a common aetiological factor has not yet been described, a cartilage deficiency in the bronchi has been demonstrated in many of the reported cases.3. The possible surgical significance of breathlessness in babies is stressed.
ATRIAL SEPTAL DEFECT†: SIGNIFICANCE, PHYSIOLOGICAL AND CLINICAL ASPECTS
Authors: Fleming H. A. 
Published: January 2008

SummaryThe clinical and physiological features of atrial septal defect are reviewed.The prognosis for patients with this defect is quite limited and ideally repair should be carried out before adult life.Associated anomalies that may occur are detailed and their assessment described.Surgery restores the circulation to normal and gives symptomatic improvement. Improvement may also be noted by patients with no spontaneous complaints.
SARCOMA IN PAGET'S DISEASE OF BONE
Authors: Barry Hugh C. 
Published: January 2008

SummaryAlthough Paget's disease of bone is very common in the general population of New South Wales, sarcoma arising in bone affected by osteitis deformans is very rare and is considered to be less than 1 per cent.Twenty‐nine cases of sarcoma of this type were found in the records of the four teaching hospitals in Sydney during the last ten years. Included in this series are 5 personal cases which are reported in more detail.The commonest site of the primary malignant lesion was in the shoulder girdle (9 cases), a part of the skeleton not usually affected by Paget's disease in its early stages. Another striking feature was the development of multiple sarcomatous changes in bone and in six cases in this series these were noted in the skull.Although several patients developed sarcoma after a definite history of injury and some were associated with fractures when first noted, it was not considered that there was sufficient evidence to indicate the effect of trauma in determining a malignant change. It was noted that only one case of sarcoma developed after a subtrochanteric fracture, the commonest site for fractures in patients with Paget's disease, and no case developed after surgical intervention.In most cases where a biopsy or autopsy was made the tumour was described as an osteogenic sarcoma, but cases of fibrosarcoma and chondrosarcoma were also found in this series. Amputation of the lower limb was carried out in 7 patients and one forequarter amputation was performed. Only one of these patients lived more than a year after operation. Deep X‐ray was given in 16 cases, but appeared to have no effect and most patients died within a few months. There were two exceptions: a man of 56 years with a sclerosing osteogenic sarcoma of the upper end of the humerus lived three years and eight months, and a woman of 60 years with X‐ray evidence of a pathological fracture and a soft tissue tumour lived seven and a half years.
CARCINOMA OF THE THYROID GLAND IN CHILDHOOD ITS RELATION TO RADIOTHERAPY
Authors: Howard Russell 
Published: January 2008

Summary

Attention is drawn to the relationship of irradiation of the thyroid gland in infancy and childhood to the subsequent development of carcinoma in this gland.
Supplemental information is furnished concerning two of the children suffering from carcinoma of the thyroid gland whose case histories were reported by Webster and Howard in this journal in 1954. It is suggested that irradiation is likely to have been implicated in their aetiology.
Record is made of a further case of carcinoma of the thyroid gland in childhood in whom irradiation of the neck preceded the development of malignancy.
PERFORATION OF THE COLON IN LARGE BOWEL OBSTRUCTION DUE TO CARCINOMA*
Authors: Russell Ian , Johnson Neil 
Published: January 2008

Summary

Free perforation of the obstructed colon due to carcinoma has, not without reason; a sinister reputation.
With the aid of modern methods of resuscitation and antibiotics, recovery from this catastrophe is possible.
In order to ascertain the results of various methods of surgical management 34 cases were surveyed.
Untreated, the condition is uniformly fatal.
Simple drainage is little better than no treatment; the only patient surviving had only minimal contamination of the peritoneum.
The addition of colostomy or caecostomy to the procedure of drainage was uniformly unsuccessful. It is suggested that the reason for this is that continued infection of the peritoneum occurs from bowel severely damaged by distension and ischaemia.
The logical conclusion from the cases reviewed is that the perforated bowel should be exteriorized or excised. Where these procedures were carried out the results wert obviously better.
It is suggested that, for various reasons, excision of the devitalized bowel is preferable to simple exteriorization.
Review of the literature indicates that other authors have reached similar conclusions.
A REVIEW OF ARTERIAL REPLACEMENT†
Authors: Morris Kenneth N. , Stirling G. R. , Brown C. J. Officer , Barnett A. J. 
Published: January 2008

SummaryA presentation is made of the results that we have obtained from arterial replacement in the aorta and peripheral vessels over the past seven years.There is a big difference between the results obtained in the larger and smaller vessels. In the aorta good long term results can be expected in over 90 per cent, of patients in whom a successful insertion is achieved. In the femoro‐popliteal vessels this figure is probably nearer 50 per cent.Homograft and nylon prostheses have not stood up to the test of time and we have been very disappointed in our own experience with woven teflon prostheses in the smaller vessels. It is suggested that the best prosthesis available at present is knitted dacron.
SPLENOPORTOGRAPHY IN HYDATID DISEASE OF THE LIVER
Authors: Hare W. S. C. , Dawborn J. K. 
Published: January 2008

Summary1. Two cases are presented, in which percutaneous splenoportography in the antero‐posterior and lateral positions demonstrated the site, size and numher of hydatid cysts in the liver.2. This technique is of great value, as it allows a planned approach by the surgeon.3. The initial size of the cyst was determined at operation by injecting contrast medium into it. This gave an accurate comparison with the avascular area in the splenoportogram.
OESOPHAGO‐JEJUNAL ANASTOMOSIS WITH ASSOCIATED ANAEMIA IN A FOURTEEN YEARS OLD MALE
Authors: Robertson Athol 
Published: January 2008

Summary

A patient aged fourteen years with severe anaemia following oesophago‐jejunal anastomosis with by‐pass of the stomach, and formation of a jejunal blind loop at the age of eleven years, is described.
The anaemia responded to parenteral vitamin BIZ and iron sorbitol citrate (“Jectofer”).
Increased well‐being and weight‐gain resulted from correction of the anaemia and its symptoms.
POSTURING FOR ADHESIVE OBSTRUCTION OF BOWEL
Authors: Woodward W. W. 
Published: January 2008

Summary

In selected patients, clinically diagnosed adhesive obstruction of bowel can sometimes be relieved by posturing. This forestalls intubation or operation.
The considerations which led to trial of this treatment are mentioned.
Successful postures are described.
Posturing should not be used if a closed loop of small bowel or a colonic obstruction is suspected.
If unsuccessful, posturing must not delay intubation or operation.
Posturing in the post‐operative period may have some value in preventing adhesions.
CONGENITAL NEUROBLASTOMA
Authors: Mackenzie Douglas C. , Ham John M. , Hyslop Raymond S. 
Published: January 2008

Summary1. A rase of congenital neuroblastonia is reported.2. Forty‐five other cases reported since 19·10 are reviewed.3. Twenty‐six cases (56 per cent.) survived fifteen months or longer without evidence of metastases.4. Of 14 cases arising apart from the adrenals, 13 survived.5. The 10 cases which were both extra‐adrenal and extra‐abdominal all survived.
THE SURGICAL PATIENT WITH OLIGURIA*
Authors: Irvine By R. O. H. 
Published: January 2008

SummaryOliguria in the surgical patient, whether post‐operative or following trauma, can be an important factor in morbidity and mortality. It is essential to distinguish between acute renal circulatory insufficiency and renal tubular necrosis as causes of oliguria and to realize that anuria indicates an obstructive lesion until proved otherwise. Mannitol is a valuable aid in the diagnosis of oliguria.Conservative management of tubular necrosis is based on fluid and protein restriction and the prevention of infection. Peritoneal dialysis and the artificial kidney help to maintain life which is the primary aim of treatment.Post‐operative renal failure is seen particularly after cardiovascular surgery and in the presence of jaundice; post‐traumatic renal failure is liable to occur after crushing injuries and is common in war‐time. Despite modern methods of treatment the mortality rate in tubular necrosis of surgical origin is 68 per cent.
NEUROVASCULAR PEDICLE TRANSFERS IN THE HAND*
Authors: O'Brien Bernard 
Published: January 2008

SummaryThe place of neurovascular island pedicles in reconstructive hand surgery is outlined. The concept of tactilegnosis in the hand is mentioned and the island pedicle flaps related to this concept.The types of neurovascular island pedicles are described. Their donor sites and their many indications are detailed.The technique of the neurovascular island pedicle flap is described.In conclusion, it can be stated that neurovascular island pedicles by their versatility and excellent blood and nerve supply have a widening place in the improvement of hand function. Their early use following median nerve repairs in adults is advocated.
RECTAL BIOPSY AND AMOEBIASIS
Authors: Doxiades Th. , Yiotsas Z. 
Published: January 2008

SummaryThe contribution of rectal biopsy to the diagnosis of chronic amoebiasis has been described in this paper.Out of 1,725 examined patients, 415 (24 per cent.) were found to be positive for E. histolytica on rectal biopsy and 207 (12 per cent.) on stool examination, while 74 were found to be positive by both methods.In 1,653 out of the 1,725 cases, the proctosigmoidoscopy findings varied from moderate or mild to a normal mucosa, with 402 positive cases on rectal biopsy.Of 1,058 cases with moderate or mild colitis, rectal biopsy results were positive in 257 instances.On the other hand, out of 595 cases with apparent normal mucosa, 145 were found to have E. histolytica on rectal biopsy.The above facts are of great importance and indicate that rectal biopsy is a more reliable method in positive findings than the stool examination and should be applied to patients with apparently normal mucosa as well as to those with proctosigmoidoscopic findings of chronic amoebic colitis. The diagnostic method described becomes still more important when medical men realize that negative results of stool examinations do not exclude amoebiasis.
A PILONIDAL SINUS OF THE EAR
Authors: Woodward W. W. 
Published: January 2008

SummaryPresented is the clinical record, with commentary, of a young man who had a pilonidal sinus in the external ear. Sinuses were later found in the natal cleft. Colourless hair‐shafts when first discharged from the sinus at the ear were so small as to be discovered only by microscopy.
CIRCULATORY REFILLING AFTER SURGERY
Authors: Marshall Vernon 
Published: January 2008

SummaryMonitoring of blood volume during surgical procedures may now be performed with considerable precision.After experimental haemorrhage of approximately one fifth of the total blood volume in man, transcapillary refilling of the circulation from interstitial fluid is brisk and results in a restored volume with a stable haemodilution after forty‐eight hours. The degree of haemoglobin or haematocrit fall is proportional to the initial blood loss.Minor or moderate surgical trauma with unreplaced loss results in a similar haemodilution. However, post‐operative extravasation into tissue planes may delay the process of haemodilution for twenty‐four hours, and the haematocrit or haemoglobin level is of no predictable clinical value in the first twenty‐four hours after surgery.Replacement of the blood lost at operation by various fluids has been studied. Whole blood replacement results in inhibition of transcapillary refilling. Electrolyte solutions such as saline have a minor and transient effect, and protein solutions markedly accelerate refilling. Isotonic protein solutions such as 5 per cent, albumin in Hartmann's solution, free of risks of transfusion reactions or of virus hepatitis, are thus of great merit in replacement of moderate blood loss during surgery. Their expense and limited availability makes investigation of synthetic volume substitutes desirable.
MASSIVE RESECTION OF INTESTINE IN INFANCY
Authors: MacMahon By R. A. 
Published: January 2008

SummaryA case of massive resection of intestine is presented in whom 20 centimetres of jejunum was anastomosed to the transverse colon.After six months in hospital, the transit time of a carmine marker from mouth to anus was only thirty minutes. The management of this case is detailed.The definition of massive resection in relationship to infancy is discussed and a new definition suggested.From experimental work and from reported clinical cases it seems that with adequate care, small remaining segments of ileum and jejunum are sufficient for survival, growth and development, provided the terminal ileum, ileo‐caecal valve and colon are intact. If this complex has been excised and the jejunal segment is less than approximately 100 centimetres in length, the use of a Hammer type reversed segment interposed between the jejunal segment and the colon may well be a life‐saving procedure.
AUTOGENOUS VENOUS PATCH GRAFTING OF PERIPHERAL ARTERIES
Authors: Hunt P. S. , Reeve T. S. 
Published: January 2008

SummaryPost‐operative occlusion of an obstructed femoral artery repaired with a vein patch may be prevented by extending arteriotomy incisions in both directions further than the removed intima. At the graft ends the reduction in lumen of the vessel is gradual, the intima is more easily re‐attached to adven‐titia and the patch is less embedded.
CLOSED TRAUMATIC RUPTURE OF THE DIAPHRAGM
Authors: Hardy K. J. 
Published: January 2008

Summary1. The patients suffering from closed traumatic rupture of the diaphragm for the years 1953‐63 at the Royal Melbourne Hospital have been reviewed.2. There were 10 immediate and one delayed ruptures; 6 being on the left and 5 on the right side.3. The modes of trauma, the commonness of associated injuries and the frequency of thoracic or abdominal signs are recorded.4. The possible clinical features and the appropriate investigation are pointed out. An analysis of the low rate of correct diagnoses is then made and the importance of an awareness of the condition of chest X‐rays has been emphasised.
I131 STUDIES OF THE LIVER AND PORTAL CIRCULATION
Authors: Rozenbilds J. G. , Bennett R. C. 
Published: January 2008

Summary1. The hepatic uptake of rectally administered I131 has been studied in 36 patients.2. A wide range of values was obtained in normal subjects.3. There was considerable overlap between the range of values obtained in normal subjects and in patients with cirrhosis of the liver and hepatic tumours; the mean values for each group were almost identical.4. These results do not support the findings and conclusions of previous workers.
CYSTIC DEGENERATION OF THE POPLITEAL ARTERY
Authors: Flanc C. 
Published: January 2008

Summary1. a case of cystic degeneration of the popliteal artery has been presented.2. the literature relating to this rare condition has been reviewed.3. the significance of a preceding history of trauma is discussed.4. it is emphasized that physical signs of arterial insufficiency may be absent and may develop only when the limb is exercised.
Vesicocolic Fistula due to Diverticulitis
Authors: Gillett David J. , Pheils Murray T. 
Published: January 2008

A retrospective review of 35 patients treated for vesicocolic fistula due to diverticuclitis has been undertaken. The relative value of different methods of investigation and treatment is discussed. Pneumaturia was the most frequent presenting symptom. There was no mortality after staged surgical intervention, in contrast with the occurrence of two deaths after one‐stage resections.SummaryThirty‐five cases of vesicocolic fistula have been reviewed. Pneumaturia was the most frequent presenting symptom, and sometimes the only urinary symptom present. Both barium enema examination and cystoscopy were valuable investigations, frequently providing com‐ plementary information. There were two operative deaths following one‐stage resections, and none after staged procedures.
In‐Vitro Motility Studies on the Canine and Human Extrahepatic Biliary Tracts
Authors: Toouli J. , Watts J. McK. 
Published: January 2008

The spontaneous and stimulated in vitro activity of the common bile duct, the sphincter, choledochus and the gallbladder of the dog, the in vitro activity of the common bile duct of man and the histological appearances of canine and human common bile ducts were studied. All parts of the extrahepatic biliary tract exhibited spontaneous activity and were stimulated by acetylcholine, acetyl beta‐methyl‐choline, noradrenaline tartrate, adrenaline tartrate, isoprenaline hydrochloride and 5‐hydroxy‐tryptamine. Morphine sulphate was found to be a weak stimulant of the biliary tract in vitro. Histological examination of the common bile duct in both man and dog showed the presence of small amounts of smooth muscle, maximal in quantity near the duodenum and minimal at the hepatic end, and arranged chiefly in a longitudinal direction. The results suggest that the common bile duct, along with the gallbladder and sphincter choledochus, has a role in the dynamics of the extrahepatic biliary tract of both man and dog.
The Place of the Rosette Inhibition Test in the Preparation and Assay of Antilymphocytic Globulin1
Authors: Hogg D. F. , Clunie G. J. A. , Morton H. , Hegh V. 
Published: January 2008

An anti‐dog thymocyte serum was prepared in six horses by four weekly injections of dog thymocytes, and was tested for immunosuppressive capacity during the course of immunisation by its ability to inhibit the formation of rosettes between dog spleen cells and sheep red blood cells.Antithymocyte globulin prepared from the individual sera was administered to dogs receiving renal allografts with simultaneous bilateral nephrectomy, and the prolongation of survival was correlated with the rosette inhibition litres (RIT) of the sera.A rise in serum RIT occurred after the third immunizing dose in all four horses producing immunosuppressive serum, with little or no response in the two horses producing non‐immunosuppressive serum.These observations have led to considerable saving in time and expense in the production of antithymocyte globulin for experimental and clinical purposes in our own laboratories, and we recommend that continued immunisation and final bleeding out should be performed only if such a rise in RIT has been demonstrated.