Ataxia-telangiectasia and stomach cancer.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to M Massad.
Explore the source record for details and available documents.
From 1980 to 1986, during the Lebanon war, five patients with missile embolization were seen at the American University of Beirut Medical Center. Three had entry in the heart or thoracic aorta with peripheral embolization, and two had entry in the internal carotid artery and inferior vena cava with embolization to the middle cerebral artery and heart, respectively. Embolization was suspected when, in the absence of an exit, routine x-ray films showed the missile in a distant location. Angiography and echocardiography confirmed the diagnosis. Peripheral arterial emboli were extracted while cerebral and venous emboli were kept, as they caused transient symptoms and remained silent.
Explore the source record for details and available documents.
This is a review of 80 patients with neuroblastoma managed at the American University of Beirut Medical Center between 1963 and 1983. Three patients had ganglioneuroblastoma of whom one showed histologic evidence of maturation into a ganglioneuroma. Four patients were less than 1 month of age and 33 were less than 2 years of age. The site of origin was intra-abdominal in 56 patients of whom 34 were intra-adrenal. Intraspinal involvement was noted in 12 patients, of whom one was a newborn. Treatment and adequate follow-up were possible in 63 patients. Total excision of the tumor was performed in 17 patients, and partial excision in 14. The 2-year and 5-year survival rates were 36% and 25%, respectively. Age, site of the tumor, and degree of cellular differentiation were the only independent variables affecting survival. Eleven of 14 patients younger than 1 year were alive 5 or more years after diagnosis. Cervical, thoracic, and pelvic tumors had a better prognosis than abdominal tumors. Other factors affecting survival were the stage and the mode of therapy. Infants with stage IV-S congenital neuroblastoma had a very poor prognosis. The initial urinary VMA level as well as the presence or absence of calcifications within the tumor had no bearing on prognosis.
A case of perforated neonatal appendicitis in a surviving premature infant is presented. An up-dated review of the English literature on this subject is included. Of 111 cases with adequate documentation, 29 neonates had the inflamed appendix located within the inguinal hernial sac and survived after operation. In contrast only 24 (29%) of the remaining 82 patients with intra-abdominal acute appendicitis survived. The operative mortality rate in this review since 1901 with and without appendiceal perforation was 61% and 41% respectively. The diagnosis of acute appendicitis since 1976 was made at laparotomy in all patients except one, whereas it was made at necropsy in 57% of the cases of abdominal appendicitis that were reported previously.
Five patients with extensive traumatic shoulder and arm defects in whom successful repair with the latissimus dorsi island myocutaneous flap are presented. The ease and speed of elevation of the flap, its wide skin surface, large size, and long pedicle make it an ideal flap for reconstruction of such defects.
Twelve of 80 patients suffering from neuroblastoma who were treated during a 21-year period had intraspinal involvement. Mediastinal tumors have a greater tendency to extend to the spinal canal; however, distant spread of the tumor is rare in patients presenting with intraspinal extension. Patients with intraspinal extension also survive longer than those without. Other factors affecting survival are age, stage of disease, duration of neurological symptoms, degree of histologic differentiation, and mode of therapy. In the absence of osseous metastasis, total excision of the primary lesion and its intraspinal components is usually followed by a favorable outcome; residual neurological deficits among survivors, however, are relatively common.
The effect of intravenous administration of prostaglandin E1 on bile flow in the rat was investigated. PGE1 infused at concentrations of 4.5, 7.5 and 15 micrograms/kg body weight/min caused an initial increase in bile acid-independent bile flow rate which peaked within 30 min and was followed by a significant decrease (p less than 0.01) below the control value. However, PGE1 administered intravenously at an infusion rate of 15 micrograms X kg-1 X min-1 showed a significant decrease (p less than 0.01) in bile acid-dependent bile flow rate.
Data on 100 consecutive non-emergency coronary artery bypass (CABG) patients were analyzed retrospectively. Sixty-nine patients received no homologous blood (Group I). Thirty-one patients received a total of 118 units of blood products averaging 2.23 units of red cells (Group II). The average red cell transfusion rate for all patients was 0.7 units per patient. The median age for Group I was 61 and Group II was 68 years (p less than 0.05). The average number of grafts was the same for both (3 per patient) with 75% of Group I and 58% of Group II receiving internal mammary artery (IMA) grafts (p less than 0.05). Twelve of the Group II patients who received intraoperative transfusions on cardiopulmonary bypass to maintain adequate hemoglobin levels were older and had lower admission hematocrits: 36 +/- 0.8% compared to 41 +/- 0.5% for all other patients (p less than 0.05). Average postoperative blood loss was 889 +/- 38 ml for Group I and 1077 +/- 104 ml for Group II (p less than 0.05). Increased hemorrhage was correlated with bypass time and IMA use but not with preoperative heparin administration, pre-existing risk factors (diabetes, hypertension, etc.), bleeding time, post-bypass clotting time, age or number of grafts. Two patients in Group II and none in Group I required exploration for excessive postoperative hemorrhage. Mortality rate was 2% (both in Group II, neither transfusion related). Discharge hematocrits were the same for all at 29.4 +/- 0.4%. Among anemia-related postoperative symptoms, only sinus tachycardia was significantly higher in Group I (20%) compared to Group II (6.5%).(ABSTRACT TRUNCATED AT 250 WORDS)
Between April 1980 and June 1986, 274 patients underwent mitral valve replacement (MVR) with the Björk-Shiley (BS) standard disc mitral valve prosthesis at the American University of Beirut Medical Center (AUBMC). Eleven patients (3.9%) presented 6-41 months after surgery with prosthetic valve dysfunction due to thrombosis. Inadequate control of anticoagulation was the major factor predisposing to thrombosis in all except one. All patients had documented rheumatic valvular disease. Nine patients were operated on an emergency basis and two died before any surgical intervention was possible. Thrombectomy was performed on six patients with four survivors and MVR in three with two survivors. Two patients died intraoperatively (22%). Three pregnant patients underwent mechanical declotting; pregnancy was terminated by abortion in 2 and by caesarean section and live birth in one. We conclude that implantation of the BS mitral valve prosthesis mandates emphasis on anticoagulation and the difficulty encountered with continuous anticoagulant therapy in pregnancy.
Seven patients with gastric leiomyosarcoma (LMS) and leiomyoblastoma (LMB) were seen at the American University of Beirut Medical Center in the period 1970-1983. The natural history, clinical presentation, radiologic findings, histopathologic features and treatment modalities of these patients are discussed. The anatomic location of the tumor had no relation to the occurrence and number of mucosal ulcers. Ulcerations were more frequent with endogastric than exogastric tumors. Histologic pattern, cell shape and number of mitotic figures were the basic morphological criteria for differentiating between LMS and LMB. Maintenance of a reasonable gastric reservoir and avoidance of total or near total gastrectomy are important factors affecting long term morbidity following surgical resection.