Reda S Saad

Summary

Affiliation: Sunnybrook Health Sciences Centre
Country: Canada

Publications

  1. doi request reprint P16INK4a expression in undifferentiated carcinoma of the uterus does not exclude its endometrial origin
    Reda S Saad
    Department of Pathology, Sunnybrook Health Sciences Center, University of Toronto, ON, Canada
    Int J Gynecol Pathol 31:57-65. 2012
  2. doi request reprint CDX2, cytokeratins 7 and 20 immunoreactivity in rectal adenocarcinoma
    Reda S Saad
    Department of Pathology, Sunnybrook Health Science Center, University of Toronto, Toronto, Ontario, Canada
    Appl Immunohistochem Mol Morphol 17:196-201. 2009
  3. doi request reprint Respiratory cytology: differential diagnosis and pitfalls
    Reda S Saad
    Department of Pathology, Sunnybrook Health Sciences Center University of Toronto, Toronto, Ontario, USA
    Diagn Cytopathol 38:297-307. 2010
  4. doi request reprint Lymphatic vessel density as a prognostic marker in clinical stage I endocervical adenocarcinoma
    Reda S Saad
    Department of Pathology, Sunnybrook Health Sciences Center University of Toronto, Ontario Canada
    Int J Gynecol Pathol 29:386-93. 2010
  5. doi request reprint Distribution of basal/myoepithelial markers in benign and malignant bronchioloalveolar proliferations of the lung
    Reda S Saad
    Drexel University College of Medicine, Department of Pathology, Allegheny General Hospital, Pittsburgh, PA, USA
    Appl Immunohistochem Mol Morphol 18:219-25. 2010
  6. ncbi request reprint Usefulness of Cdx2 in separating mucinous bronchioloalveolar adenocarcinoma of the lung from metastatic mucinous colorectal adenocarcinoma
    Reda S Saad
    Department of Pathology, Allegheny General Hospital, Pittsburgh, PA, USA
    Am J Clin Pathol 122:421-7. 2004
  7. ncbi request reprint Endoglin (CD105) and vascular endothelial growth factor as prognostic markers in esophageal adenocarcinoma
    Reda S Saad
    Department of Pathology, Allegheny General Hospital, Drexel University College of Medicine, Pittsburgh, PA 15213, USA
    Hum Pathol 36:955-61. 2005
  8. doi request reprint Lymphatic vessel density as prognostic marker in esophageal adenocarcinoma
    Reda S Saad
    Department of Pathology, Allegheny General Hospital
    Am J Clin Pathol 131:92-8. 2009
  9. ncbi request reprint Lymphatic microvessel density as prognostic marker in colorectal cancer
    Reda S Saad
    Department of Pathology, Allegheny General Hospital Drexel University College of Medicine, Pittsburgh, PA 15213, USA
    Mod Pathol 19:1317-23. 2006
  10. ncbi request reprint Diagnostic value of CDX-2 and TTF-1 expressions in separating metastatic neuroendocrine neoplasms of unknown origin
    Xiaoqi Lin
    Department of Pathology, Allegheny General Hospital, 320 East North Avenue, Pittsburgh, PA 15212, USA
    Appl Immunohistochem Mol Morphol 15:407-14. 2007

Collaborators

Detail Information

Publications47

  1. doi request reprint P16INK4a expression in undifferentiated carcinoma of the uterus does not exclude its endometrial origin
    Reda S Saad
    Department of Pathology, Sunnybrook Health Sciences Center, University of Toronto, ON, Canada
    Int J Gynecol Pathol 31:57-65. 2012
    ..Distinction between undifferentiated endometrial carcinoma and endocervical adenocarcinoma, both of which can share diffuse p16 expression, should rely on detection of human papilloma virus in the latter...
  2. doi request reprint CDX2, cytokeratins 7 and 20 immunoreactivity in rectal adenocarcinoma
    Reda S Saad
    Department of Pathology, Sunnybrook Health Science Center, University of Toronto, Toronto, Ontario, Canada
    Appl Immunohistochem Mol Morphol 17:196-201. 2009
    ..It can be helpful in cases with metastatic rectal carcinoma, especially those with CK7+/CK20+ or CK20-/CK7- immunophenotype. In this study, CDX2 expression was not influenced by the grade (differentiation) of rectal adenocarcinoma...
  3. doi request reprint Respiratory cytology: differential diagnosis and pitfalls
    Reda S Saad
    Department of Pathology, Sunnybrook Health Sciences Center University of Toronto, Toronto, Ontario, USA
    Diagn Cytopathol 38:297-307. 2010
    ..In addition, some specific challenging and difficult aspects in classification of pulmonary malignancies will be discussed. Guidelines and clues are presented to avoid such pitfalls...
  4. doi request reprint Lymphatic vessel density as a prognostic marker in clinical stage I endocervical adenocarcinoma
    Reda S Saad
    Department of Pathology, Sunnybrook Health Sciences Center University of Toronto, Ontario Canada
    Int J Gynecol Pathol 29:386-93. 2010
    ..Our study showed that both angiogenesis and lymphangiogenesis play an important role in the progression of endocervical adenocarcinoma, and that peritumoral D2-40 LVD is an independent predictor of lymph node metastasis...
  5. doi request reprint Distribution of basal/myoepithelial markers in benign and malignant bronchioloalveolar proliferations of the lung
    Reda S Saad
    Drexel University College of Medicine, Department of Pathology, Allegheny General Hospital, Pittsburgh, PA, USA
    Appl Immunohistochem Mol Morphol 18:219-25. 2010
    ..The staining pattern of basal cells in bronchioloalveolar carcinoma supports that these neoplasms may actually be carcinoma in-situ...
  6. ncbi request reprint Usefulness of Cdx2 in separating mucinous bronchioloalveolar adenocarcinoma of the lung from metastatic mucinous colorectal adenocarcinoma
    Reda S Saad
    Department of Pathology, Allegheny General Hospital, Pittsburgh, PA, USA
    Am J Clin Pathol 122:421-7. 2004
    ..Our results demonstrated Cdx2 as a sensitive and specific marker for differentiating metastatic colorectal adenocarcinoma from mucinous bronchioloalveolar adenocarcinoma...
  7. ncbi request reprint Endoglin (CD105) and vascular endothelial growth factor as prognostic markers in esophageal adenocarcinoma
    Reda S Saad
    Department of Pathology, Allegheny General Hospital, Drexel University College of Medicine, Pittsburgh, PA 15213, USA
    Hum Pathol 36:955-61. 2005
    ..Endoglin staining also showed prognostic significance with positive correlation with the presence of angiolymphatic invasion, LN metastases, tumor stage, and survival...
  8. doi request reprint Lymphatic vessel density as prognostic marker in esophageal adenocarcinoma
    Reda S Saad
    Department of Pathology, Allegheny General Hospital
    Am J Clin Pathol 131:92-8. 2009
    ..Our study showed that angiogenesis and lymphangiogenesis have important roles in the progression of esophageal adenocarcinoma...
  9. ncbi request reprint Lymphatic microvessel density as prognostic marker in colorectal cancer
    Reda S Saad
    Department of Pathology, Allegheny General Hospital Drexel University College of Medicine, Pittsburgh, PA 15213, USA
    Mod Pathol 19:1317-23. 2006
    ..Immunostaining with D2-40 enhances the detection of lymphatic invasion relative to H&E staining and the endothelial marker, CD31...
  10. ncbi request reprint Diagnostic value of CDX-2 and TTF-1 expressions in separating metastatic neuroendocrine neoplasms of unknown origin
    Xiaoqi Lin
    Department of Pathology, Allegheny General Hospital, 320 East North Avenue, Pittsburgh, PA 15212, USA
    Appl Immunohistochem Mol Morphol 15:407-14. 2007
    ....
  11. ncbi request reprint Endoglin (CD105) and vascular endothelial growth factor as prognostic markers in prostatic adenocarcinoma
    Yasser M El-Gohary
    The Department of Pathology, Allegheny General Hospital, Pittsburgh, PA 15212, USA
    Am J Clin Pathol 127:572-9. 2007
    ..A high endoglin microvessel count and VEGF expression correlated with shorter survival. Endoglin is a more specific and sensitive marker for tumor angiogenesis than CD31 and may serve as a prognostic marker for prostatic adenocarcinoma...
  12. ncbi request reprint Prognostic significance of HER2/neu, p53, and vascular endothelial growth factor expression in early stage conventional adenocarcinoma and bronchioloalveolar carcinoma of the lung
    Reda S Saad
    Department of Pathology, Allegheny General Hospital, Pittsburgh, PA, USA
    Mod Pathol 17:1235-42. 2004
    ..This immunostaining pattern suggests that conventional adenocarcinoma has different molecular abnormalities than bronchioloalveolar carcinoma...
  13. doi request reprint Diagnostic and prognostic utility of molecular markers in synchronous bilateral breast carcinoma
    Reda S Saad
    Department of Pathology, Allegheny General Hospital Drexel University College of Medicine, Pittsburgh, PA 15212, USA
    Mod Pathol 21:1200-7. 2008
    ..In this study, synchronous bilateral breast cancers represent two independent primaries rather than metastatic events...
  14. ncbi request reprint Diagnostic utility of CDX-2 expression in separating metastatic gastrointestinal adenocarcinoma from other metastatic adenocarcinoma in fine-needle aspiration cytology using cell blocks
    Reda S Saad
    Department of Pathology, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA
    Cancer 102:168-73. 2004
    ..The objective of the current study was to investigate the diagnostic value of CDX-2 to separate metastatic gastrointestinal adenocarcinoma from other metastatic adenocarcinomas in fine-needle aspiration cytology (FNAC)...
  15. ncbi request reprint Fine needle aspiration biopsy of vertebral lesions
    Reda S Saad
    Department of Pathology, Allegheny General Hospital, 320 East North Avenue, South Tower, 3rd Floor, Pittsburgh, Pennsylvania 15212, USA
    Acta Cytol 48:39-46. 2004
    ..To evaluate the accuracy of fine needle aspiration biopsy (FNAB) in the diagnosis of vertebral lesions...
  16. ncbi request reprint Endoglin (CD105) and vascular endothelial growth factor as prognostic markers in colorectal cancer
    Reda S Saad
    Department of Pathology, Louisiana State University Health Science Center, New Orleans, LA 70112, USA
    Mod Pathol 17:197-203. 2004
    ..Endoglin staining also showed prognostic significance with positive correlation with angiolymphatic invasion and metastases to lymph nodes and liver...
  17. ncbi request reprint Expression of cytokeratin by malignant meningiomas: diagnostic pitfall of cytokeratin to separate malignant meningiomas from metastatic carcinoma
    Yulin Liu
    Department of Pathology and Laboratory Medicine, Allegheny General Hospital, Pittsburgh, PA 15212, USA
    Mod Pathol 17:1129-33. 2004
    ..3 and CD-15, and vimentin may be needed to separate malignant meningioma from metastatic carcinoma. Cytokeratin expression can be a potential pitfall for confusing a malignant meningioma with a metastatic carcinoma...
  18. ncbi request reprint Clinical significance of cytologic diagnosis of atypical squamous cells, cannot exclude high grade, in perimenopausal and postmenopausal women
    Reda S Saad
    Department of Pathology, Allegheny General Hospital and Drexel University College of Medicine, Pittsburgh, PA 15212, USA
    Am J Clin Pathol 126:381-8. 2006
    ..The diagnosis of ASC-H in postmenopausal women usually is associated with LSIL or a negative diagnosis on follow-up, suggesting a less aggressive surveillance and treatment regimen is needed for postmenopausal women with ASC-H...
  19. doi request reprint Fine-needle aspiration biopsy of breast adenomyoepithelioma: a potential false positive pitfall and presence of intranuclear cytoplasmic inclusions
    Reda S Saad
    Department of Pathology, Sunnybrook Health Sciences Center University of Toronto, Toronto, ON, Canada
    Diagn Cytopathol 40:1005-9. 2012
    ..Cytopathologists should be familiarized with this entity to avoid a misdiagnosis of carcinoma...
  20. doi request reprint The diagnostic utility of CK5/6 and p63 in fine-needle aspiration of the breast lesions diagnosed as proliferative fibrocystic lesion
    Hatem Al-Maghraby
    Department of Pathobiology and Laboratory Medicine, University of Toronto, Toronto, Ontario, Canada
    Diagn Cytopathol 40:141-7. 2012
    ..In conclusion, CK5/6 may enhance the ability to differentiate between benign and malignant epithelial proliferations in breast FNABs. In fibroepithelial lesions, p63 may be more useful than CK5/6...
  21. doi request reprint Postradical vaginal trachelectomy follow-up by isthmic-vaginal smear cytology: a 13-year audit
    Zeina Ghorab
    Department of Pathology, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada M4N 3M5
    Diagn Cytopathol 37:641-6. 2009
    ..This study summarizes our experience, emphasizing the role of isthmic-vaginal smears for early detection of central recurrence and highlighting the role of LUSEC and reactive changes as potential overcall pitfalls...
  22. ncbi request reprint The diagnostic utility of D2-40 for malignant mesothelioma versus pulmonary carcinoma with pleural involvement
    Reda S Saad
    Department of Pathology, Drexel University College of Medicine, Allegheny General Hospital, 320 East North Avenue, Pittsburgh, PA 15212, USA
    Diagn Cytopathol 34:801-6. 2006
    ..Conversely, to differentiate between MM and PSCC, p63 and WT-1 are the best available markers. We recommend a panel of CK5/6, p63, D2-40, and WT-1 to differentiate MM from pulmonary carcinomas in effusion cytology specimens...
  23. doi request reprint Is routine appendectomy at the time of primary surgery for mucinous ovarian neoplasms beneficial?
    Tomer Feigenberg
    Division of Gynecologic Oncology, University of Toronto, Toronto, Ontario, Canada
    Int J Gynecol Cancer 23:1205-9. 2013
    ..Removal of the appendix in the setting of mucinous histologic type is primarily driven by the existing challenge to distinguish between primary ovarian mucinous neoplasm and metastatic appendiceal carcinoma to the ovary...
  24. ncbi request reprint Clinical implications of the diagnosis "atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion" in pregnant women
    Kazuya Onuma
    Department of Pathology, Magee Womens Hospital of the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
    Cancer 108:282-7. 2006
    ..The objective of this study was to investigate the clinical implications and pathologic significance of ASC-H in pregnant women, so that these patients will be managed appropriately...
  25. doi request reprint Immunophenotyping of serous carcinoma of the female genital tract
    Sharon Nofech-Mozes
    Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
    Mod Pathol 21:1147-55. 2008
    ..HER2/neu was exclusively overexpressed in serous carcinomas of endometrial origin...
  26. doi request reprint Immunohistochemical characterization of primary and recurrent adult granulosa cell tumors
    Sharon Nofech-Mozes
    Department of Anatomic Pathology, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada
    Int J Gynecol Pathol 31:80-90. 2012
    ....
  27. ncbi request reprint Significance of loss of heterozygosity in predicting axillary lymph node metastasis of invasive ductal carcinoma of the breast
    Xiaoqi Lin
    Department of Pathology, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
    Appl Immunohistochem Mol Morphol 20:116-23. 2012
    ..Detection of LOH in IDC is not only useful in studying oncogenesis, but also predicting aggressiveness and ALN metastasis...
  28. ncbi request reprint Clinical significance of a cytologic diagnosis of atypical glandular cells, favor endometrial origin, in Pap smears
    Reda S Saad
    Department of Pathology, Louisiana State University, School of Medicine, New Orleans, USA
    Acta Cytol 50:48-54. 2006
    ..To evaluate the significance of a diagnosis of atypical glandular cells, favor endometrial origin (AGC-EM), using cytohistologic correlation...
  29. ncbi request reprint Cytomorphologic analysis and histological correlation of high-grade squamous intraepithelial lesions in postmenopausal women
    Reda S Saad
    Department of Pathology, Magee Womens Hospital at UPMC, Pittsburgh, Pennsylvania, USA
    Diagn Cytopathol 34:467-71. 2006
    ..Granular background, nuclear enlargement, abnormal chromatin pattern, and hyperchromasia can be seen in reactive changes, and may lead to inaccurate interpretation...
  30. ncbi request reprint Prognostic significance of thyroid transcription factor-1 expression in both early-stage conventional adenocarcinoma and bronchioloalveolar carcinoma of the lung
    Reda S Saad
    Department of Pathology, Allegheny General Hospital Drexel University College of Medicine, Pittsburgh, PA, USA
    Hum Pathol 35:3-7. 2004
    ..Although nonmucinous BAC patients showing strong positive staining had longer survival, the difference was not statistically significant, which is probably related to the overall good survival of patients with early-stage BAC...
  31. doi request reprint Detection of HPV-DNA by a PCR-based method in formalin-fixed, paraffin-embedded tissue from rare endocervical carcinoma types
    Sharon Nofech-Mozes
    Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
    Appl Immunohistochem Mol Morphol 18:80-5. 2010
    ..Our observation is particularly significant in cervical cancer prevention as we enter the HPV vaccination era...
  32. doi request reprint Peritumoral lymphatic vessel density as a prognostic parameter in endometrial carcinoma: an immunohistochemical study
    Hala K Maghraby
    Department of Pathology, MRI Alex University, Toronto, ON, Canada
    Indian J Pathol Microbiol 53:465-9. 2010
    ..Lymphatic invasion and nodal metastasis play a major role in the spread and prognosis of endometrial adenocarcinoma (EC)...
  33. ncbi request reprint Diagnostic value of HepPar1, pCEA, CD10, and CD34 expression in separating hepatocellular carcinoma from metastatic carcinoma in fine-needle aspiration cytology
    Reda S Saad
    Department of Pathology, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, USA
    Diagn Cytopathol 30:1-6. 2004
    ..An IHC panel consisting of pCEA, CD10, HepPar1, and CD34 is useful for confirming HCC in FNAC of the liver...
  34. ncbi request reprint The diagnosis of malignancy in effusion cytology: a pattern recognition approach
    Telma C Pereira
    Department of Pathology and Laboratory Medicine, Allegheny General Hospital, Pittsburgh, PA 15212, and Drexel University College of Medicine, USA
    Adv Anat Pathol 13:174-84. 2006
    ..An algorithmic approach to the workup of serous effusions as well as pitfalls for false-positive diagnosis are discussed...
  35. ncbi request reprint The value of epithelial membrane antigen expression in separating benign mesothelial proliferation from malignant mesothelioma: a comparative study
    Reda S Saad
    Department of Pathology, Allegheny General Hospital, Pittsburgh, PA 15212, USA
    Diagn Cytopathol 32:156-9. 2005
    ..EMA clone E29 was negative in all cases of RM and positive in 75% of MM and therefore is a reliable immunocytochemical marker for differentiating RM from MM...
  36. ncbi request reprint Sclerosing papillary lesion of the breast: a diagnostic pitfall for malignancy in fine needle aspiration biopsy
    Reda S Saad
    Department of Pathology, Magee Womens Hospital at University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
    Diagn Cytopathol 34:114-8. 2006
    ..In conclusion, FNA cytology of this proliferative lesions may be highly cellular and may display cellular atypia similar to breast carcinoma and thus leads to false-positive interpretation...
  37. ncbi request reprint Endoglin (CD105) expression in endometrial carcinoma
    Reda S Saad
    Department of Pathalogy, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, USA
    Int J Gynecol Pathol 22:248-53. 2003
    ..Endoglin staining also had prognostic significance, with positive correlation with angiolymphatic invasion, lymph node metastases, and tumor stage...
  38. ncbi request reprint Role of cytology in the diagnosis of Barrett's esophagus and associated neoplasia
    Reda S Saad
    Department of Pathology, Allegheny General Hospital Drexel University College of Medicine, Pittsburgh, Pennsylvania 15212, USA
    Diagn Cytopathol 29:130-5. 2003
    ..Our results support the high degree of diagnostic accuracy of cytology for the diagnosis of Barrett's-associated HGD and/or carcinoma, and moderate sensitivity for BE...
  39. ncbi request reprint Utility of immunohistochemistry in separating thymic neoplasms from germ cell tumors and metastatic lung cancer involving the anterior mediastinum
    Reda S Saad
    Allegheny General Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania 15212, USA
    Appl Immunohistochem Mol Morphol 11:107-12. 2003
    ..An IHC panel consisting of CD5, CK5/6, PLAP, TTF-1, and CD57 is useful for the separation of thymic neoplasms from other epithelial malignancies involving the mediastinum...
  40. pmc Idiopathic hypertrophic pyloric stenosis in an adult, a potential mimic of gastric carcinoma
    Alireza Zarineh
    Department of Pathology and Laboratory Medicine, Allegheny General Hospital Drexel University College of Medicine, 320 East North Avenue, Pittsburgh, PA 15212, USA
    Patholog Res Int 2010:614280. 2010
    ..The recent advances in understanding the pathogenesis of IHPM are discussed...
  41. doi request reprint Multiple neuroenteric cysts at cerebello-pontine angle and foramen magnum: a case report and review of the literature
    Alireza Zarineh
    Department of Pathology and Laboratory Medicine, Allegheny General Hospital Drexel University College of Medicine, 320 East North Avenue, Pittsburgh, PA 15212, USA
    Neuropathology 29:318-22. 2009
    ..The MIB-1 proliferation index was < 1%. One-year follow-up has shown no recurrence. The differential diagnosis and a brief review of the literature are also presented...
  42. ncbi request reprint Diagnostic value of microtubule-associated protein-2 (MAP-2) for neuroendocrine neoplasms
    Yulin Liu
    Department of Pathalogy and Laboratory Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, USA
    Adv Anat Pathol 10:101-6. 2003
    ..This report details the diagnostic value of MAP-2 on tumors with neuroendocrine differentiation and neoplasms derived from the neural crest...
  43. ncbi request reprint Pathologic variables predictive of breast events in patients with ductal carcinoma in situ
    Edwin R Fisher
    National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, USA
    Am J Clin Pathol 128:86-91. 2007
    ..The similar predictive role of comedo necrosis in this study and that reported previously from NSABP B-17 (total of 2,079 patients) strongly supports its role as a simple high-risk predictor for ipsilateral breast tumor recurrences...
  44. pmc CDX2 as a marker for intestinal differentiation: Its utility and limitations
    Reda S Saad
    Reda S Saad, Zeina Ghorab, Mahmoud A Khalifa, Department of Pathobiology, Sunnybrook Health Sciences Center, University of Toronto, Ontario, ON M4N 3M5, Canada
    World J Gastrointest Surg 3:159-66. 2011
    ..Limitations with its use as the sole predictor of a gastrointestinal origin of metastatic carcinomas are also discussed...
  45. ncbi request reprint Atypical squamous metaplasia of seromas in breast needle aspirates from irradiated lumpectomy sites: a potential pitfall for false-positive diagnoses of carcinoma
    Reda S Saad
    Allegheny General Hospital, MCP Hahnemann University, Pittsburgh, PA 13212, USA
    Diagn Cytopathol 26:104-8. 2002
    ..The squamous metaplastic cells in aspirates of these cystic lesions may display significant cellular atypia that can potentially result in a false-positive diagnosis of malignancy...
  46. doi request reprint Ovarian adenosarcoma arising from benign cystadenoma and associated intraoperative consultation pitfalls
    Zhongchuan Will Chen
    Department of Pathology, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, Canada
    Int J Gynecol Pathol 29:415-8. 2010
    ..This case also shows the challenges in differentiating adenosarcoma from a benign counterpart on both frozen and permanent sections...
  47. ncbi request reprint Pathologic quiz case: A localized pulmonary consolidation in a young woman
    Reda S Saad
    Department of Pathology and Laboratory Medicine, Allegheny General Hospital, Pittsburgh, PA 15212 4772, USA
    Arch Pathol Lab Med 127:e49-50. 2003