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Biomedical subjects

F M Massey

Publications and source records attributed to F M Massey.

17 recordsLinked to original sources
PubMed1980

Cholecystectomy and abdominal hysterectomy.

Cholelithiasis is a common disease in women and can lead to serious complications. At Wilford Hall USAF Medical Center, we have performed 21 cholecystectomies at the time of abdominal hysterectomy. All patients had been asymptomatic with regard to gallbladder disease, but showed either preoperative or intraoperative evidence of gallbladder disease. The mean surgical time was 3.3 hours, mean blood loss was 474 mL, and only one patient had febrile morbidity (> 38.3 degrees C). Because of the low morbidity, we recommend that this combined surgical approach be considered by both the gynecologist and general surgeon.

Adult↗
PubMed1980

Estrogen therapy and breast cancer in postmenopausal women.

During the 6-year period 1972-77, 123 postmenopausal women with breast cancer either had the disease diagnosed at Wilford Hall USAF Medical Center or were referred there for therapy. Their ages ranged from 33 to 90 (mean, 56.6 years). Of these women 64.2 percent had never taken hormones, 25.2 percent were estrogen users, 4.9 percent were estrogen-progestogen users, 4.9 percent had a history of hormone usage, and 1 patient was using estrogen vaginal cream. In a subgroup of 27 clinic patients (1975-77 period) during 14,548 patient-years of observation, breast cancer was diagnosed for an overall incidence of 185.6:100,000 women per year. Among the 27 patients, the annual incidence of breast cancer was highest in the untreated group at 410.5:100,000 women. In comparison, the incidence in the estrogen users was 137.7:100,000 women-a significant difference (p less than 0.01). The incidence in estrogen-progestogen users was 155.6:100,000 compared with the incidence in the untreated patients; this difference was also statistically significant (p less than 0.05). There was no significant difference in the incidence of breast cancer between the estrogen users (137.7:100,000) and the estrogen-progestogen users (155.6:100,000). These data indicate that estrogen therapy decreases the risk of breast cancer and that, unlike the situation with adenocarcinoma of the endometrium, progestogens do not offer additional protection from breast carcinoma.

Adult↗
PubMed1980

Use of the progestogen challenge test to reduce the risk of endometrial cancer.

In contrast to several retrospective studies reporting an increased risk of endometrial cancer during the mid-1970s, especially in estrogens.gen-treated postmenopausal women, the number of cancers at Wilford Hall USAF Medical Center has steadily declined despite continued estrogen use. In a 4-year study from 1975 to 1978, there were 17 adenocarcinomas of the endometrium during 10,872 patient-years of observation, for an overall annual incidence of 156.4:100,000 women. The highest incidence of endometrial cancer (359.1:100,000) was found in those women using estrogens alone. The lowest incidence of cancer was observed in the estrogen-progestogen users (56.4:100,000) and was significantly lower (P less than .01) than that found in the estrogen users. The incidence of corpus malignancy in the estrogen-progestogen users was also significantly lower (P less than .05) than that observed in the untreated women (248.3:1000,000). The progestogen challenge test has been devised to identify postmenopausal women at greatest risk for adenocarcinoma of the endometrium. It is concluded that the use of this test will reduce the risk of endometrial cancer in both estrogen-treated postmenopausal women and women with increased endogenous estrogens.

Adenocarcinoma↗
PubMed1979

Vulvar neoplasia in the young.

Vulvar intraepithelial neoplasms may be occurring more frequently among younger age groups. Six patients with carcinoma in situ or severe vulvar dysplasia are reported, as well as one patient with microinvasive carcinoma, all under the age of 30 years. The vulvar lesions were noted to be mostly multicentric. They were associated with other intraepithelial neoplasias of the cervix or vagina in four of the six cases. The lesions were most often mistaken for condyloma acuminatum. Histologic changes were primarily Bowen's disease or Bowenoid dysplasia.

Adult↗
PubMed1979

Musculocutaneous flaps in reconstructive pelvic surgery.

Gracilis musculocutaneous flaps are useful in reconstruction of many crippling pelvic defects. They are especially beneficial for vaginal reconstruction at the time of pelvic exenteration. Twenty patients having vaginal reconstruction with musculocutaneous flaps are presented. Nineteen (95%) have vaginas adequate for sexual function.

Adult↗
PubMed1976

Vaginal reconstruction with gracilis myocutaneous flaps.

The definition, history, experimental background, surgical technique, and clinical applications of compound gracilis myocutaneous flaps are presented. This flap has been our method of choice for neo-vaginal reconstruction after radical pelvic surgery.

Female↗
PubMed1975

Use of medroxyprogesterone acetate to prevent menopausal symptoms.

A number of patients with severe vasomotor symptoms of menopause, specifically hot flashes, are unable to take exogenous estrogens because of intolerance of contraindications. Others achieve less than satisfactory relief of symptoms with extrogen. A double-blind study was established to determine whether depomedroxyprogesterone acetate (DMPA) injectable (Depo-Provera, Upjohn) could be used as a satisfactory substitute in these patients. The basis of the study was to evaluate clinical impressions that some menopausal patients taking DMPA for other purposes achieved relief from these distressing symptoms. Fifty-seven patients were treated with DMPA, 150 mg IM monthly, and 12 controls were given 1.5 ml sterile saline IM monthly. Serum FSH and LH were measured initially and serially. Clinical response was determined by the patients' estimates of the frequency and severity of their hot flashes. Of 57 patients in the treatment group, 51 (89.5%) were relieved of symptoms compared to 3 of 12 (25%) in the control group. DMPA can be an effective alternate to estrogen therapy in selected menopausal patients.

Adult↗
PubMed1975

Cancer of the colon during pregnancy. A review of the literature and report of a case associated with ulcerative colitis.

The first case of adenocarcinoma of the transverse colon and splenic flexture during pregnancy associated with ulcerative colitis is reported. The patient presented with perforation and widespread metastatic disease. After 10 years' duration of symptoms of ulcerative colitis, the risk of coexisting cancer of the colon is 3 to 5% each year. As ulcerative colitis frequently coexists with pregnancy, the obstetrician needs to be alert to the potential for malignant changes in these patients. With the addition of this patient, there are now 18 reported cases of cancer of the colon during pregnancy. These 18 cases are reviewed especially as to management, outcome of the pregnancy, and prognosis.

Adenocarcinoma↗
PubMed1975

Treatment of irradiation injury to the ureter by ileal substitution.

Ureteral obstruction following radiotherapy for cervical cancer is most often due to recurrent tumor. However, in a few patients ureteral stricture is secondary to radiation damage. Surgical treatment of this obstruction requires special consideration since many procedures for urinary diversion may be contraindicated in an irradiated pelvis. Ileal substitution (uretero-ileoneocystostomy) preserves renal function without resorting to external diversion of urine. A discussion of the method together with a report of 6 patients treated in this manner is presented. Results were excellent, with followup ranging from 11/2 to 4 years. A brief history of irradiation damage to the ureter and the use of small bowel as substitute ureter is discussed. Patient acceptance of this surgical approach was gratifying.

Adult↗