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Biomedical subjects

E M Mason

Publications and source records attributed to E M Mason.

32 records · Page 2Linked to original sources
PubMed1995

1525 laparoscopic cholecystectomies without biliary injury: a single institution's experience.

Laparoscopic Cholecystectomy (LC) has become the preferred treatment of gallbladder disease. The indications for LC remain unchanged from those for open cholecystectomy (OC). A total of 1525 patients underwent LC at Georgia Baptist Medical Center between December 1989 and December 1992. The procedure was completed in 1,492 patients (97.8%) and required conversion to OC in 33 patients (2.2%). Selective intraoperative cholangiography was used in 165 patients (10.8%). Overall morbidity was 4.06%, and there were four deaths not operatively related, for a 0.26% mortality rate. There have been no biliary ductal injuries. The average hospital stay was 0.82 days, with 37.4% of the patients going home as true outpatients and 44.5% going home on postop Day one. Most published series on LC report a small incidence of biliary injury. We feel that with meticulous dissection of the cystic duct and use of selective intraoperative cholangiography to define unsure anatomy, biliary injury can be minimized.

Biliary Tract↗
PubMed1995

A comparison of transabdominal preperitoneal (TAPP) and total extraperitoneal approach (TEPA) laparoscopic herniorrhaphies.

There are a variety of accepted techniques for herniorrhaphy. With the advent of laparoscopic general surgery, laparoscopic transabdominal and total extraperitoneal techniques have been added to the many options for repair of the inguinal hernia. From 5/91 to 6/93 we had performed 290 transabdominal preperitoneal (TAPP) laparoscopic herniorrhaphies on 244 adult patients. Due to concerns of potential early and late complications associated with entering the abdominal cavity, we adopted the total extraperitoneal approach (TEPA) for laparoscopic herniorrhaphies in 6/93. Between 6/93 and 12/93, 118 hernias have been repaired in 95 patients using the total extraperitoneal approach. In a retrospective comparison between these two procedures, the recurrence rate is 1.7% (5/290) for TAPP herniorrhaphies and 0% (0/118) for the TEPA. The overall complication rate for TAPP herniorrhaphies was 11.1% and included thigh paresthesias (6), inferior epigastric artery injuries (4), enterotomy (1), bowel obstruction (1), bladder injury (1), and urinary retention (14). The overall complication rate for the TEPA was 3.2% and included bladder injury (1), and urinary retention (2). Mean operative time was similar between these groups (TAPP-81.2 minutes, TEPA-92.9 minutes).

Adolescent↗
PubMed1992

Percent of agreement among raters and rater reliability of the copying subtest of the Stanford-Binet Intelligence Scale: Fourth Edition.

The purpose of this study was to investigate the interrater reliability of the visual-motor portion of the Copying subtest of the Stanford-Binet Intelligence Scale: Fourth Edition. Eight raters independently scored 11 protocols completed by children aged 5 through 10 years, using the scoring criteria and guidelines in the manual. The raters marked each of 10 items pass or fail and computed a total raw score for each protocol. Interrater reliability coefficients were obtained for each child's protocol, and the Kappa coefficient was computed for each item. Significant raters' reliability coefficients ranged from .82 to .91, which were low in comparison to test-retest reliability and Kuder-Richardson-20 coefficients for this and other subtests of the Stanford-Binet in the technical manual. Percent agreement among 8 raters also indicated weak reliability. Although the obtained results suggested some interrater reliability coefficients within acceptable levels, questions were raised about the scoring criteria for individual items. Caution is warranted in the use of cognitive measures which include subjective judgement of the examiner in applying scoring criteria.

Child↗
PubMed1992

An early review of 800 laparoscopic cholecystectomies at a university-affiliated community teaching hospital.

Laparoscopic cholecystectomy (LC) was first performed at Georgia Baptist Medical Center (GBMC) in December 1989, subsequently becoming the treatment of choice for most patients with symptomatic gallbladder disease. Early in the authors' series, all patients evaluated for cholecystitis were treated laparoscopically, unless the third party refused reimbursement or the attending surgeon was not trained in LC. Indications for LC were no different than for standard open cholecystectomy (OC). Eight hundred patients from December 1989 to March 1991 had an attempted LC at GBMC. The procedure was completed in 782 patients (97.7%) and required conversion to OC in 18 patients, (2.3%) primarily because of technical difficulties such as dense adhesions or gangrenous changes. No patient sustained a trocar injury to the intra-abdominal viscera, bile ducts injury, or major vascular injury. Overall morbidity was 3.1 per cent and mortality 0.13 per cent. Selective cholangiography (SIOC) was used in 14 per cent. Endoscopic retrograde cholangiopancreatography (ERCP), choledochoscopy, and Fogarty catheter techniques were used for common bile duct stone management. Average hospitalization was 0.89 days, with 85 per cent discharged in less than 24 hours. Average operative time was 86 minutes (range: 25 to 353). Patients returned to full activities at home in 8.4 days. Savings on hospital charges to patients averaged $1,100 for inpatient LC and $2,500 for outpatient LC when compared to 1989 costs for OC. Laparoscopic cholecystectomy is the current surgical procedure of choice for most patients with cholecystitis and can be done at least as safely as standard open cholecystectomy. The morbidity appears to be significantly less with LC, but longer follow-up is needed to confirm these preliminary findings.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1989

Routine breast screening for cancer.

Breast screening for cancer has increased the survival for women over age 50 as well as those younger than 50 years old. The 13-year average follow-up period disproves the claim that the survival gain is due to lead-time bias. The information brought forth in this presentation proves that higher-risk women must be screened in order to reduce the constant death rate from breast cancer.

Breast↗
PubMed1986

Routine breast screening. Survival after 10.5 years follow-up.

Beginning in 1973, the Breast Cancer Detection Demonstration Project at Georgia Baptist Medical Center screened 8058 supposedly asymptomatic volunteers. Those screenees found to have cancer were treated by various surgeons, using all types of treatment with varying expertise. There has been 100% follow-up after 10.5 years. The overall survival is 90.8%. The women over 50 in all categories survived longer than the younger age group. Those women with lesions 1 cm or smaller survived longer than those with larger lesions. The women whose tumor was not palpable clinically and was discovered by roentgenogram had the best survival rates (96.8%). In the less-than-50 age group whose cancer was detected by roentgenogram alone, 88.2% survived 10.5 years, while 100% of the older group is still living. These results do not consider the type of therapy nor the skill with which it was administered and is the result of routine screening only.

Age Factors↗
PubMed1981

Five-year-plus survival of breast screenees.

Seven years have elapsed since the first group of screenees were examined in the Georgia Baptist Medical Center (BCDDP). Of 8058 women studied, 135 had cancer. Forty-five percent of the tumors were found by x-ray alone. In 912 biopsies, 10.9% had axillary metastases and 8.5% had bilateral cancer. Among patients under 50 years of age, 26 had cancer lesions of which were less than 1 cm in diameter. There were 21 in situ carcinomas. Among those over 50 years of age, 46 had lesions 16 of which were 1 cm or less in diameter. There were 26 in situ carcinomas. Three of this latter group have died. Of those women undergoing surgery five or more years ago, 21 were in the group of patients under 50 years of age; one has died. Thirty-eight were in the group over 50 years of age and two have died. This is a 94.2% five-year survival rate. Two others are living with metastatic lesions, a five-year disease-free rate of 93.01%.

Breast Neoplasms↗
PubMed1980

The treatment of nonpalpable carcinoma of the breast.

Screening programs have discovered an increasing number of non-palpable breast cancers. There are several methods of locating these lesions by measuring the distance from the nipple and either excising an adequate margin around the measured point or more accurately locating it with a needle and further x-rays. The lesion, one excised, should be submitted for specimen radiography and compared with the mammogram to ascertain that the lesion has been excised. Many times, it is wise to submit the whole excised area for permanent sectioning to improve the reliability of diagnosis. For minimal carcinoma (0.5 cm or less), a total mastectomy with dissection of the level one nodes and with immediate pathological examination is done. If there is no metastasis or if metastasis in the nodes is two millimeters or less, it is probably adequate treatment. If larger metastases are present, a Patey Modified Mastectomy should be done. When the lesion is in the medial half of the breast, radiation to the parasternal area should be given.

Breast↗
PubMed1977

The value of breast screening in women less than fifty years of age.

In the four years our Breast Cancer Detection Demonstration Project has been receiving patients, 5,810 women under the age of fifty have been examined. Our findings definitely indicate screening of asymptomatic women by xeromammography is of advantage in this group whose greatest cause of death is cancer of the breast; 71.8% of their cancers were found by xeromammography. Of these 43.8% had in situ cancer and only 12.5% of those cancers found had axillary spread. This group should have a five-year cure rate of 87.1% rather than 63% as is the experience of unscreened women. The absorbed rads averaged 0.4632 to each breast per year. At the end of five years this would cause an estimated increase in risk from 7% to 7.162%. To increase survival rate by 24.1% against a theoretical increased risk of 0.16% is definitely worthwhile.

Adult↗
PubMedDate not supplied

Laparoscopy for construction of feeding enteral tubes and diverting stomas.

Laparoscopy has now assumed a new and important role in the treatment of malignant diseases. An important part of this role is the establishment of feeding enterostomies and stomas. This function is vital in both those patients who may not be candidates for curative therapy and those being staged for definitive therapy.

Enteral Nutrition↗