Thirty-five patients with blunt hepatic injuries treated in a 7-year period are reviewed. The difficulties of diagnosis are stressed in that only 48.6%c were diagnosed
preoperatively. Associated intra-abdominal and concomitant head, chest, pelvic and skeletal injuries accounted for most of these difficulties. Seventeen of the 35 patients had extensive lacerations or intra-lobar ruptures of the liver. Simple linear or stellate lacerated wounds were treated by drainage, or suture, or debridement of the ragged liver edges and suture. Prior to 1964 extensively lacerated liver wounds were treated by gauze packing. Three (60%c) of five patients thus treated died, while the others had multiple complications. Since 1964, packing has been abandoned in favor of major resection and of 11 patients who underwent such procedures only one died. Hepatic resection for severe blunt injuries has the advantages of removal of all devitalized liver, control of hemorrhage, reduction of postoperative complications such as secondary hemorrhage, intraabdominal and hepatic abscesses and hemobilia. Hepatic resection is recommended for subeapsular hematomas with intra-lobar rupture of the liver to avoid hepatic necrosis. These injuries are diagnosed by injection of methylene blue into the common hepatic duct. Low mortality and morbidity in this series is due to improved care of injured pa-tients, early surgical intervention and adequate removal of devitalized lacerated and injured tissues by debridement or major hepatic resection.
Industrial development in Malaysia is discussed in relation to impact on health. Trends in Malaysia are evaluated and the findings of some studies in Malaysia are reviewed.
The peculiar anatomical features render the common peroneal nerve particularly susceptible to injury at the knee. The present investigation revealed that the deep division of the nerve is more inclined to be injured when compared to the superficial division.
A retrospective study of intraocular foreign bodies treated at the University Hospital over 10 years from 1970 - 1979 was carried out. Of the 48 cases reviewed, nine were anterior chamber foreign bodies while the rest were posterior segment foreign bodies. The anterior chamber foreign bodies had better visual prognosis as compared to the posterior segment foreign bodies. Most of the patients were young Chinese males and most of the injuries were due to accidents at work involving the 'hand hammer' (includes other implements used as a hammer).
A case of traumatic chylothorax is presented with its typical clinical presentation. Failure of conservative measures led to a transthoracic ligation of the thoracic duct, with good result.
A retrospective analysis of 285 patients who had sustained maxillojacial fractures over a period of a decade was undertaken. The commonest cause of injury was motor vehicle accidents (71.9%). The mandibular body was the most common site fractured. 80% of the patients were males and almost 50% were Chinese. Practically all types of fixation were employed. The results obtained were satisfactory.