Hydradenitis Suppurativa1

The surgical treatment of a group of 24 patients with hydradenitis suppurativa is described and the clinical features, aetiological factors and other methods of treatment are reviewed. An abnormally high incidence of atopy is noted within the group.

Intra-Abdominal Adhesions and Their Prevention by Topical Tissue Plasminogen Activator

Recent work shows that a common pathway in adhesion production is a reduction in local plasminogen activator activity (PAA). This deficit permits deposited surface fibrin to become organized to fibrous adhesions. A rabbit model for adhesion formation was used to assess the effect of replacing the deficit with recombinant tissue plasminogen activator (rt-PA). Adhesions were produced by stripping peritoneum from corresponding parietal and visceral areas. One week later the adhesions were divided. Either rt-PA or placebo was applied to the divided adhesion. After a further week the animal was killed and the adhesions assessed. Sixty strips were performed. Fifty-five adhesions were produced (92%). Placebo gel was applied to 28 sides and rt-PA applied to 27. Twenty-two of the placebo group recurred (79%). Two of the rt-PA group reformed (7%, chi 2 = 20.883, P less than 0.001). Recombinant tissue plasminogen activator is an effective inhibitor of adhesion formation in the experimental animal.

Carcinoma of the Rectum in Male Homosexuals

Two male homosexuals with carcinomata of the rectum with transitional cell changes are reported, and the possible aetiology of these lesions is discussed.

Pioneers of pneumonectomy for carcinoma of the lung

The first reports of successful pneumonectomy for carcinoma.

The early days of surgery for cardiac injuries

Over many centuries, wounds of the heart were thought to be fatal. With the introduction of first anaesthesia and then antiseptic surgery in the second half of the 19th century, there was an explosion in surgery; the abdominal cavity, the chest, the skull were explored and operated upon and yet the heart was considered to be a 'no go' region of the body. One of the greatest and most innovative surgeons of that time, Theodor Billroth of Vienna, who must be considered one of the fathers of modern surgery, with pioneering work on many parts of the body, wrote: 'The surgeon who attempts to suture a wound of the heart should lose the respect of his colleagues'.

John Hunter's operation for popliteal aneurysm

An aneurysm is defined as a "sac communicating with the lumen of an artery" and the treatment of the various types of this disease has intrigued surgeons through the ages. Aneurysms of the popliteal artery today are fairly uncommon. However, in the 18th century they were quite frequently encountered, many of them in coach drivers. We can only surmise that this was the result of repetitive trauma to the artery, already the seat of arteriosclerosis, against the rim at the top of the long leather riding boot which was worn at that time.