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Biomedical subjects

J L Freeman

Publications and source records attributed to J L Freeman.

At least 145 records · Page 8Linked to original sources
PubMed1982

Changes in age and sex specific tonsillectomy rates: United States, 1970-1977.

National estimates of tonsillectomy rates were generated from the Hospital Discharge Survey for the years 1970 and 1977. A comparison of the rates over the seven-year period revealed significant declines in T&A for all age and sex categories and in tonsillectomy alone for males aged 20 through 29. It was also observed that sex differences found in 1970 persisted in 1977. (Am J Public Health 1982; 72:488-491.)

Adenoidectomy↗
PubMed1982

Head and neck manifestations of mycobacteria in the absence of pulmonary disease.

Mycobacterial infections, once relatively rare in North America have recently shown an upsurge with the influx of Asian and African immigrants. The infections are usually due to M. tuberculosis and present with pulmonary symptoms. However, an uncommon presentation is that of a mass in the head and neck region without any pulmonary manifestations. Although these infections are usually secondary to invasion by "atypical" mycobacteria, unusual presentations due to mycobacterium tuberculosis have been noted. Case reports depicting the very rare presentations of M. tuberculosis in the thyroglossal duct cyst, parotid, and submandibular lymph node are described. A very unusual case of atypical mycobacteria in the larynx is noted and cervical adenitis is also included. The initial subtle presentation emphasizes the importance of mycobacteria in the differential diagnosis of lesions in the head and neck region.

Adult↗
PubMed1981

The vascular anatomy of the pectoralis major myocutaneous flap.

The vascular anatomy of the pectoralis major muscle and overlying skin and subcutaneous tissue was investigated in seventeen cadaver specimens by cannulation of the arterial supply and injection of contrast medium. A rich anastomosis between the internal mammary artery and the pectoral branch of the thoraco-acromial artery and between the pectoral branch and the lateral thoracic artery was demonstrated. In 36% of cases a major axial cutaneous vessel, originating close to the thoraco-acromial artery, was shown to extend caudad. The lateral thoracic artery, in addition to the pectoral branch, contributed significantly to the vascularity of the pectoralis major muscle and was the main blood supply to the female breast. The skin overlying the muscle was abundantly supplied from the muscle vasculature. Both the major arteries were enclosed within the muscle's fascial envelope. A technique for developing a standard pectoralis major myocutaneous island flap is described. Our studies show that a hemichest flap incorporating all the skin of the chest over the muscle is feasible.

Arteries↗
PubMed1981

Ossifying capillary hemangioma of the maxillary and ethmoid sinuses - a case report.

A rare lesion of the maxillary and ethmoid sinuses, an ossifying capillary hemangioma, is presented. The therapeutic options and our choice of embolization followed one day later by radical surgery under hypotensive, hypothermic anesthesia are discussed. The principles of therapy involved in this lesion apply to the management of any large vascular tumor of the head and neck.

Adolescent↗
PubMed1981

Muco-epidermoid carcinoma of the palate.

Muco-epidermoid carcinoma is the second most frequently occurring malignancy of the minor salivary glands representing 25 per cent of all malignancies, adenoid cystic being the more common tumor. It invariably presents as an asymptomatic lung without mucosal ulceration, 50 per cent of which occur on the palate. It is of great interest to the physician because it may be divided into two distinct categories dependent upon its cell composition - low grade malignancy or high grade. These have widely differing prognostic significance and require different modes of therapy. This is illustrated by five case histories which span the past seven years of the author's experience.

Adult↗
PubMed1977

A general methodology for the analysis of experiments with repeated measurement of categorical data.

This paper is concerned with the analysis of multivariate categorical data which are obtained from repeated measurement experiments. An expository discussion of pertinent hypotheses for such situations is given, and appropriate test statistics are developed through the application of weighted least squares methods. Special consideration is given to computational problems associated with the manipulation of large tables including the treatment of empty cells. Three applications of the methodology are provided.

Drug Evaluation↗
PubMed1976

A computer program for the generalized chi-square analysis of categorical data using weighted least squares (GENCAT).

GENCAT is a computer program which implements an extremely general methodology for the analysis of multivariate categorical data. This approach essentially involves the construction of test statistics for hypotheses involving functions of the observed proportions which are directed at the relationships under investigation and the estimation of corresponding model parameters via weighted least squares computations. Any compounded function of the observed proportions which can be formulated as a sequence of the following transformations of the data vector--linear, logarithmic, exponential, or the addition of a vector of constants--can be analyzed within this general framework. This algorithm produces minimum modified chi-square statistics which are obtained by partitioning the sums of squares as in ANOVA. The input data can be either: (a) frequencies from a multidimentional contingency table; (b) a victor of functions with its estimated covariance matrix; and (c) raw data in the form of integer-valued variables associated with each subject. The input format is completely flexible for the data as well as for the matrices.

Biometry↗
PubMed1976

An analysis of physician visit data from a complex sample survey.

A generalization of ordinary least squares methods is used in the analysis of physician visit data from a complex sample survey. The emphasis, in this paper, is on the valid substantive inferences to be drawn from an analysis of this type of data. The procedure is found to be useful in two ways. First, the resultion on a national basis. It is concluded that age is an imp-s of a comparative sampling study are reported. Second, the procedure is used to remove statistically non-significant variation from the data in order to generate fitted or smoothed estimates on which the substantive analyst may focus his attention. These fitted values are then examined for implications to physician service utilization on a national basis. It is concluded that age is an important variable while the effect of sex and race depends on age. Similarly, residence and income are important but the effect of education depends on the level of income.

Adolescent↗
PubMed1976

An application of the clumped binomial model to the analysis of clustered attribute data.

This paper is concerned with the statistical analysis of situations where the experimental units are clusters of subjects, each of whom is classified with respect to the presence of a particular (binary response) attribute. For this purpose, the clumped binomial probability model is used to define an underlying mean rate parameter in terms of which the effects of certain treatments as well as cluster size itself can be investigated. The resulting methodology involves a synthesis of certain maximum likelihood and weighted least squares procedures; it is illustrated for a three-dimensional contingency table pertaining to numbers of deaths in litters of baby mice.

Analysis of Variance↗
PubMedDate not supplied

Transcervico-mandibulo-palatal approach for surgical salvage of recurrent nasopharyngeal cancer.

BACKGROUND: Local relapse of nasopharyngeal carcinoma is a difficult problem of management that is usually treated by re-irradiation. Surgical salvage is rarely offered, judging by the paucity of reports in the literature. METHODS: This article reviews the six previously described methods of performing nasopharyngectomy and recounts experience with a series of seven patients using a transcervico-mandibulo-palatal approach, which is described. RESULTS: The results of this small series show survivorship and morbidity which seem to compare favorably with other published surgical treatment options. CONCLUSIONS: If retreatment with radiotherapy is not favored, the transcervico-mandibulo-palatal approach may be a suitable method of surgical salvage for small, locally recurrent, nasopharyngeal cancer.

Adult↗
PubMedDate not supplied

Hürthle cell carcinoma of the thyroglossal duct.

A thyroglossal duct cyst is an embryologic remnant that often manifests as a swelling in the midline of the neck. The development of a carcinoma in a cyst is rare but well recognized. The majority of those reported are papillary carcinoma; there have been 4 cases of mixed follicular-papillary (which biologically and clinically behaves as a papillary carcinoma) and only 1 follicular. A computer search of the literature revealed no previous report of a Hürthle cell carcinoma arising in a thyroglossal duct. A case of Hürthle cell carcinoma arising in a thyroglossal duct is presented, and the pathology, clinical manifestations, and management are reviewed.

Carcinoma↗
PubMedDate not supplied

Role of modern imaging in decision-making for elective neck dissection.

This study examines patterns of early metastatic spread as recorded in 19 clinically negative, histologically positive (occult) neck dissection specimens. Microscopic metastatic deposits were detected in this study in nodes measuring 10 mm and less. No nodes with extension of tumor beyond the capsule and into adjacent structures were noted. Central necrosis was detected in only one node. We suggest that the first stages of metastatic disease as evaluated by the pathologist in clinically occult nodes are minimal and may easily evade the eyes of both pathologists and radiologists. Imaging proved to be efficacious in upstaging clinically occult necks that were previously irradiated.

Head and Neck Neoplasms↗
PubMedDate not supplied

Value of fine-needle aspiration in the diagnosis of Hürthle cell neoplasms.

The cytologic and histologic slides on all patients with a diagnosis of Hürthle cell tumor at Mount Sinai Hospital during the last 12 years were reviewed. There were 67 Hürthle cell tumors of which 15 (22%) were malignant. Four carcinomas (27%) occurred in a background of thyroiditis. Forty-three patients with Hürthle cell tumors had undergone preoperative fine-needle aspiration, of which 31 had satisfactory aspirates. For Hürthle cell neoplasia, fine-needle aspiration cytology had a sensitivity of 83.8% (26 of 31) and positive predictive value of 93% (26 of 28), provided that the aspirate was of adequate cellularity. All 3 cases predicted as Hürthle cell carcinoma on the basis of cellular and nuclear atypia were correctly predicted, but 3 carcinomas composed of bland cells were incorrectly predicted as adenomas. We conclude that aspiration cytology can differentiate nonneoplastic from neoplastic Hürthle cell lesions with high accuracy, but that the differentiation between benign and malignant lesions is less reliable.

Adenoma↗