Biomedical subjects

E E Mason

Publications and source records attributed to E E Mason.

At least 73 records · Page 4Linked to original sources

PubMed1975

Esophageal stricture secondary to reflux esophagitis.

Since 1966 we have used esophageal dilation plus Nissen fundoplication as our sole method of treating esophageal strictures caused by reflux esophagitis. Twenty-six patients were treated for esophageal strictures. Dysphagia, vomiting, and weight loss were the main complaints. All had roentgenographic evidence of esophageal stricture confirmed by endoscopy. All patients had preoperative or intraoperative dilation of the stenotic segment with a Hurst dilator, followed by Nissen fundoplication as the antireflux operation of choice. This more conservative approach, which corrects both the reflux and stricture problem, has not been associated with mortality nor has there been any morbidity associated with the dilation procedure. All patients thus treated have remained asymptomatic on normal alimentation for the follow-up period, which ranges from six months to seven years.

Body Weight↗

PubMed1975

Analysis of gallbladder bile in morbid obesity.

Thirty-seven per cent of our grossly obese patients selected for gastric bypass had cholesterol gallstones. To document the composition of the biliary lipids prior to weight loss, the bile taken from eleven obese patients at the time of gastric bypass was analyzed and the results compared with those in eleven nonobese patients undergoing elective surgery. There was extreme supersaturation of both gallbladder and hepatic bile in all obese patients. The gallbladder bile of all obese patients fell well outside the micellar zone whereas the bile from all but one of the controls fell within the micellar zone. These data provide biochemical support for the clinical association of obesity and cholesterol gallstone formation and are evidence against the possibility that gastric bypass is a lithogenic operation.

Adolescent↗

PubMed1975

Gastric bypass for morbid obesity in children and adolescents.

This report reviews 25 patients 20 yr of age or younger who were treated for morbid obesity by gastric bypass or gastroplasty. Eighteen genetically normal obese adolescents averaged 15% body weight loss 6 mo after operation and 25% weight loss 36 mo postoperatively; the eight males lost more weight than did the ten females. Seven younger children had Prader-Willi syndrome; six of them lost weight postoperatively although not so dramatically as the genetically normal obese patients. Four patients required later revisions to reduce the size of the gastric pouch or stoma. These operations were performed with acceptable morbidity and no mortality. Growth in height was not interrupted and no metabolic problems were encountered postoperatively. Gastric bypass is a safe and effective method of controlling body weight in morbidly obese children and adolescents.

Adolescent↗

PubMed1975

Optimizing results of gastric bypass.

Gastric bypass is an extensive gastric exclusion operation used in patients who are more than twice their ideal weight. Most of the early postoperative deaths observed in 3% of 442 patients during the initial 9 years, could have been prevented by more attention to operative technique and early recognition and correction of leaks when they occurred. The best weight loss can be produced by adherence to three components of the operation: 1) Bypass of stomach and duodenum, 2) a small fundic segment and 3) a small (12 mm diameter) gastroenterostomy stoma. The average patient of 142 kg can expect to have a weight of around 107 kg at 1 year 103 kg at 5 years. Revision of a large stoma to a smaller (9 mm) diameter can induce further weight loss in some patients whose loss has been inadequate. The 1.8% incidence of stoma ulceration may be lowered with the present emphasis on a smaller fundic pouch, but could increase with longer observation. Presently stoma ulcers occur once in every 140 patient years at risk.

Adolescent↗

PubMed1975

Acute postoperative wound complications after gastric surgery for morbid obesity.

The acute postoperative wound complications of 225 morbidly obese patients undergoing gastric bypass were compared against the complications observed in 225 normal-sized individuals who underwent elective gastric resection for peptic ulcer disease. Not only were there more wound infections (8.9 percent to 5.3 percent) in the obese population, but these infections inflicted more serious complications and a significantly increased hospital stay. While the exact cause of the increase in infections in the obese patients is unclear, it is a real phenomenon to be dealt with in surgery for obesity.

Acute Disease↗

PubMed1975

Hyperparathyroidism: evaluation of four decades of parathyroid surgery.

A review of 98 patients with hyperparathyroidism operated on at the University of Iowa during a 45-year period reveals a very great increase in the frequency of the clinical diagnosis. More patients are being operated on each year and more glands are being removed or biopsied. The proportion of patients in whom light microscopic examination of the parathyroid reveals hyperplasia remains less than 25%. Better methods are needed for identification of hyperplasia. Clinically, a few patients in whom the diagnosis of adenoma is made appear later to have more diffuse parathyroid disease. At present, however, when an adenoma is found, the decision to perform subtotal removal of apparently normal parathyroid tissue is made only reluctantly. The conclusion drawn from this review is that patients with hyperparathyroidism must be studied more intensively and followed for many years, whether or not an operation is performed. Although the diagnosis of hyperparathyroidism is now made readily and operative treatment seems to be more effective, much has yet to be learned about hyperparathyroidism.

Adenoma↗

PubMed1975