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M F Saad

Publications and source records attributed to M F Saad.

82 records · Page 5Linked to original sources
PubMed1985

A linkage study of multiple endocrine neoplasia type IIa.

Members of four families segregating for multiple endocrine neoplasia type IIa (Sipple's syndrome) were typed for 16 segregating blood group, erythrocyte enzyme, and plasma protein loci. Linkage analysis failed to find evidence favoring linkage between the multiple endocrine neoplasia mutation and any segregating marker. The data from this study were combined with the published data to rule out linkage for the HLA, ABO, Rh, or MNS loci at theta less than or equal to 0.25, the ADA, PGMI, AcP, GLOI, or GM loci at theta less than or equal to 0.10, and for GPT, PGD, or HpA at theta less than or equal to 0.05. The pooled data are inconclusive with respect to the previously suggested linkage to the P blood group locus.

Genetic Linkage↗
PubMed1984

Occult Cushing's disease presenting with acute psychosis.

A 37-year-old woman presented with acute psychosis and cognitive impairment. Skull x-ray showed an enlarged sella turcica with erosion of the floor. Endocrinologic workup suggested the diagnosis of Cushing's disease and hyperprolactinemia. She had no cushingoid feature, and the only physical sign was mild generalized obesity. She showed a paradoxic response to dexamethasone suppression, and underwent trans-sphenoidal resection of a pituitary macroadenoma. Electron microscopy showed the tumor to be a Crooke's cell adenoma. Results of immunohistochemical staining were positive only for ACTH and beta-endorphin. The neuropsychiatric manifestations resolved after surgery.

Adenoma↗
PubMed1984

Diagnostic and prognostic values of carcinoembryonic antigen in medullary carcinoma of the thyroid.

This study was conducted to compare the diagnostic and prognostic values of calcitonin (CT) and carcinoembryonic antigen (CEA) measurements in patients with medullary carcinoma of the thyroid (MCT). Plasma CEA, basal CT (BCT), and peak CT (PCT) levels after pentagastrin stimulation were determined in 15 patients with occult familial MCT before treatment. CEA was elevated in 11 patients (73%), BCT in 8 patients (53%), and PCT in all patients. The prognostic values of serial CEA and BCT determinations were studied in 24 other MCT patients followed for a period of 1.5-8 yr. These patients were divided into 2 groups; group I consisted of 11 patients with normal serial CEA levels, and group II consisted of 13 patients with persistently elevated CEA levels. In group I, 2 patients (18%) developed metastases compared with 10 patients (77%) in group II (P less than 0.001). Elevated BCT levels were found in all patients with metastases as well as in 63% of patients with no evidence of disease. When CEA time curves were studied, three patterns could be identified: 1) a steep slope with rapidly rising CEA levels in patients with rapidly progressive disease, 2) a flat slope in patients with no metastasis or nonprogressive disease, and 3) an intermediate type of slope in patients with slowly progressive disease. Slope analysis of BCT time curves was not done because of marked fluctuations in BCT levels. PCT after pentagastrin stimulation remains the best diagnostic marker for MCT. However, CEA may be a better prognostic indicator, as it discriminated more efficiently between patients with and without metastasis. Slope analysis of CEA time curve and calculation of the doubling time are recommended, as they correlated well with the course of the disease.

Adolescent↗
PubMed1984

The prognostic value of calcitonin immunostaining in medullary carcinoma of the thyroid.

This study was undertaken to evaluate the prognostic value of calcitonin (CT) immunostaining in medullary carcinoma of the thyroid (MCT). Primary tumors and metastases from 44 patients with MCT were stained for CT using the immunoperoxidase method. According to the number of cells stained in the primary tumors, the patients were subdivided into 3 groups. Group A included 9 patients with CT-poor tumors (less than 25% of cells stained), group C consisted of 21 patients with CT-rich tumors (greater than 75% of cells stained), and group B included 14 patients with intermediate tumors (25-75% of cells stained). Group A and B patients presented with more advanced disease and had a higher rate of recurrence than group C patients, but the difference was not statistically significant. The number of cells stained correlated well with survival, which was significantly longer for group C than groups B (P = 0.044) and A (P = 0.001). Group B patients survived longer than did those of group A (P = 0.036). The 5-yr survival rates were 52.7%, 93%, and 100% for groups A, B, and C, respectively. Eighty-three percent of patients with multiple endocrine neoplasia IIa had CT-rich tumors, whereas 78.3% of those with sporadic disease had CT-poor ones (P less than 0.001). CT-rich metastases were compatible with prolonged survival even if they were affecting vital organs, whereas CT-poor metastases were virulent and carried a poor prognosis. Therefore, CT immunostaining is recommended for all patients with MCT, as it can predict the course of the disease. It also can be used as a staging procedure and may help the clinician in making a decision regarding the therapeutic approach.

Adult↗
PubMed1984

Medullary carcinoma of the thyroid. A study of the clinical features and prognostic factors in 161 patients.

The natural history and prognostic factors of medullary carcinoma of the thyroid (MCT) were studied in 161 patients seen at the University of Texas M. D. Anderson Hospital and Tumor Institute at Houston between 1944 and 1983. One hundred twenty-five patients (77.6%) had the sporadic variety of MCT, 31 patients (19.3%) had multiple endocrine neoplasm (MEN) type IIa and 5 patients (3.1%) had MEN-IIb. The disease occurred equally in both sexes (M:F ratio 1:1.05). Thyroid nodules were the most common presenting feature especially in patients with the sporadic disease and MEN-IIb. Fifteen patients with MEN-IIa had occult MCT; the diagnosis was made through screening of family members with calcitonin measurement before and after stimulation with calcium or pentagastrin. Sixteen patients with MEN-II had pheochromocytoma and 7 had hyperparathyroidism. Total thyroidectomy was the most commonly performed operation. The lowest incidence of recurrence occurred in patients who underwent total thyroidectomy and modified neck dissection. Radioactive 131I was used as adjunct to surgery in 19 patients but it did not improve the survival or lower the incidence of recurrence. Patients who received postoperative radiotherapy had significantly lower adjusted survival rates than those treated by surgery alone, but we tended to irradiate patients with more advanced disease. Chemotherapy was administered to 11 patients with disseminated metastases but the response was poor. The 5- and 10-year adjusted survival rates of all the patients with MCT were 78.2% and 61.4%, respectively. Patients with MEN-IIa had much better rates than patients with sporadic disease (p = 0.0005), who were 7.74 times more likely to die of MCT. The stage of the disease at presentation was a major prognostic factor. Patients with stages III or IV disease were 7.31 times more likely to die of MCT than those with stages I or II. There was no significant difference in survival between patients with stages I and II or III and IV. The presence of cervical lymph node metastases did not affect the survival adversely. Direct extension with involvement of tissue was a bad prognostic sign. Patients younger than 40 years old at the time of diagnosis of MCT had a significantly better adjusted survival rate than those who were older. Women had a better prognosis than men, who were 1.89 times more likely to die of MCT. Diarrhea was a bad prognostic sign. However, it occurred more frequently in patients with advanced stages of the disease and larger tumor mass.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1983

Intrapericardial pheochromocytoma.

A patient with intrapericardial pheochromocytoma is described, and the literature on this subject is reviewed. Iodine 131-labeled metaiodobenzylguanidine scintigraphy was superior to computed tomography in localizing the tumor. This newly introduced method is safe, specific, noninvasive, and may prove to be the method of choice for localizing pheochromocytomas. The patient was prepared for surgery with alpha- and beta-adrenoceptor blocking agents. The tumor was markedly adherent to the posterior wall of the left and right atria. Cardiopulmonary bypass was used to allow excision of the tumor. Hemostasis was attained with difficulty due to marked vascularity of the tumor.

3-Iodobenzylguanidine↗
PubMed1983

Radioactive iodine in the treatment of medullary carcinoma of the thyroid.

To determine the value of adjunct 131I therapy in medullary carcinoma of the thyroid (MCT), two groups of patients with histologically proved MCT were studied. Group A consisted of 15 patients (6 men and 9 women) treated by surgery, followed by an ablative dose of 131I, and group B included 84 patients (39 men and 45 women) treated by surgery alone. Patients in group A were followed for 1.5-14 yr (median, 53 months), and those in group B were followed for 1-27 hr (median, 75 months). Seven patients (46.6%) from group A and 36 patients (42.9%) from group B developed recurrence or metastasis. The 5- and 10-yr survival rates were 87.5% and 75% for group A and 89% and 74% for group B; the difference was not significant (P greater than 0.05). The changes in serum calcitonin levels in 4 patients of group A were not different from those in patients who did not receive 131I. We conclude that 131I has no value as an adjunct to surgery in the management of MCT.

Adolescent↗
PubMedDate not supplied

Insulin secretion, obesity, and potential behavioral influences: results from the Insulin Resistance Atherosclerosis Study (IRAS).

BACKGROUND: This work was conducted to evaluate associations of insulin secretion with overall and central obesity, dietary fats, physical activity, and alcohol. METHODS: A frequently sampled intravenous glucose tolerance test (FSIGT) was used to assess acute insulin response to glucose (AIR) and insulin sensitivity (S(I)) among adult participants (n=675 with normal, NGT; n=332 with impaired glucose tolerance, IGT) in the Insulin Resistance Atherosclerosis Study (IRAS). Disposition index (DI) was calculated as the sum of the log-transformed AIR and S(I) to reflect pancreatic compensation for insulin resistance. Obesity was measured as body mass index (kg/m(2), BMI) and central fat distribution by waist circumference (cm). Dietary fat intake (total, saturated, polyunsaturated, oleic acid), physical activity, and alcohol intake were assessed by standardized interview. RESULTS: In unadjusted analyses, BMI and waist were each positively correlated with AIR among NGTs (r=0.26 and 0.23, respectively; p<0.0001) but correlations were weaker among the IGTs (r=0.10, NS; r=0.13, p<0.05 for BMI and waist, respectively). BMI and waist were inversely correlated with DI among NGTs (r=-0.13 and -0.20, respectively; p<0.0001) and among IGTs (r=-0.20 and -0.19, respectively, p<0.0001). Dietary fat variables were positively related, and alcohol was inversely related, to AIR among NGTs (p<0.01) but not among IGTs. With all factors considered simultaneously in a pooled analysis of IGTs and NGTs, waist, but not BMI, was positively associated with AIR (p<0.001) and inversely associated with DI (p<0.01). None of the behavioral variables were independently related to either outcome. CONCLUSION: Among non-diabetic patients, central obesity appears to be related to higher insulin secretion, but to lower capacity of the pancreas to respond to the ambient insulin resistance.

Adult↗