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E Tejada

Publications and source records attributed to E Tejada.

At least 19 recordsLinked to original sources
PubMed2000

Synovial sarcoma of the upper digestive tract: a report of two cases with demonstration of the X;18 translocation by fluorescence in situ hybridization.

Two cases of synovial sarcoma that arose in the upper digestive tract are reported. One case was a polypoid mass that arose at the gastroesophageal junction; the other was a large intramural mass that arose in the wall of the stomach. Both cases had a classic biphasic pattern. In the stomach tumor, the biphasic morphology was focal and there was an abrupt transition to poorly differentiated synovial sarcoma. The tumors had immunohistochemical features that were consistent with synovial sarcoma. Ultrastructural evaluation of the gastroesophageal tumor supported the diagnosis. The diagnostic X;18 translocation was demonstrated by fluorescence in situ hybridization on sections from paraffin-embedded tissue in 86% and 50% of interphase nuclei from the gastroesophageal and gastric tumor, respectively. The translocation was present in equal frequency in the epithelial and spindle cells in the biphasic areas and the poorly differentiated areas of the gastric tumor, indicating that the development of the more aggressive subclone was probably due to genetic mutations not encompassing the SYT-SSX gene fusion product. We are aware of only five reported cases of synovial sarcoma arising in the digestive tract, all in the proximal esophagus. These cases are the first reported arising in the gastroesophageal junction and stomach and the only cases of synovial sarcoma of the digestive tract in which the diagnostic translocation was demonstrated. Sarcomatoid carcinoma (carcinosarcoma) and gastrointestinal stromal tumor are the main differential diagnoses for synovial sarcoma in this site. Synovial sarcoma of the digestive tract may be underdiagnosed, and its recognition may have important clinical implications. Fluorescence in situ hybridization is helpful in making this distinction.

Chromosomes, Human, Pair 18↗
PubMed1997

p53 immunostaining of surgical margins as a predictor of local recurrence in squamous cell carcinoma of the oral cavity and oropharynx.

Local and regional recurrence is the principal reason for treatment failure in squamous cell carcinoma (SCC) of the head and neck. The conventional method of evaluating surgical margins for cellular atypia does not always predict risk of local recurrence accurately. Immunostaining of surgical margins for tumor markers may provide a more precise evaluation of risk of local recurrence. Paraffin-embedded tissue blocks of surgical margins from 24 patients with oral cavity and oropharyngeal squamous cell carcinoma were immunostained for p53 protein. Fifty-eight percent of the patients had at least one margin stain positive for p53, including eight of ten patients whose SCC recurred locally. The sample odds ratio test predicted a 5.333 times higher chance of local recurrence with at least one p53 positive surgical margin. The implications of these results for patient management and further investigations will be discussed.

Adult↗
PubMed1994

Severe life-threatening cholera associated with blood group O in Peru: implications for the Latin American epidemic.

A household survey in 1991, at the onset of the Latin American cholera epidemic, investigated high attack rates in Trujillo, Peru, and determined the association between blood group O and severe cholera. Of 463 persons in 69 households, 173 (37%) reported diarrhea, 21% required rehydration therapy, and 4% were hospitalized; these treatment requirements greatly exceeded estimates based on other populations. Elevated vibriocidal or antitoxic antibody titers were present in 52% of 321 from whom serum was obtained; 73% were blood group O. Blood group O was strongly associated with severe cholera: Infected persons had more diarrheal stools per day than persons of other blood groups, were more likely to report vomiting and muscle cramps, and were almost eight times more likely to require hospital treatment. Since prevalence of blood group O in Latin America may be the world's highest, estimates of treatment requirements should be increased to prevent unnecessary deaths.

ABO Blood-Group System↗
PubMed1992

Waterborne transmission of epidemic cholera in Trujillo, Peru: lessons for a continent at risk.

The epidemic of cholera that began in Peru in January, 1991, marked the first such epidemic in South America this century. Subsequently, over 533,000 cases and 4700 deaths have been reported from nineteen countries in that hemisphere. We investigated the epidemic in Trujillo, the second largest city in Peru. Trujillo's water supply was unchlorinated and water contamination was common. Suspect cholera cases were defined as persons presenting to a health facility with acute diarrhoea between Feb 1, and March 31, 1991. We studied a cohort of 150 patients who had been admitted to hospital and conducted a matched case-control study with 46 cases and 65 symptom-free and serologically uninfected controls; we also carried out a water quality study. By March 31, 1991, 16,400 cases of suspected cholera (attack rate 2.6%), 6673 hospital admissions, and 71 deaths (case-fatality rate 0.4%) had been reported in the province of Trujillo. 79% of stool cultures of patients with diarrhoea presenting to a single hospital yielded Vibrio cholerae O1. In the case-control study, drinking unboiled water (odds ratio [OR] 3.1, 95% confidence interval [CI] 1.3-7.3), drinking water from a household water storage container in which hands had been introduced into the water (4.2, 1.2-14.9), and going to a fiesta (social event) (3.6, 1.1-11.1) were associated with illness. The water quality study showed progressive contamination during distribution and storage in the home: faecal coliform counts were highest in water from household storage containers and lowest in city well water. V cholerae O1, biotype El Tor, serotype Inaba, was isolated from three city water samples. Cholera control measures in Trujillo should focus on treatment of water and prevention of contamination during distribution and in the home. Trujillo's water and sanitation problems are common in South America; similar control measures are needed throughout the continent to prevent spread of epidemic cholera.

Adolescent↗
PubMed1992

Outbreak of human rabies in the Peruvian jungle.

Transmission of rabies to man by vampire bats has been known for 60 years but there have been few reports of the features of rabies transmitted in this way. These aspects of the disease were investigated during an outbreak in Peru in early 1990. Between Jan 1 and April 30, 1990, 29 (5%) of 636 residents of the two rural communities in the Amazon Jungle in Peru acquired an illness characterised by hydrophobia, fever, and headache and died shortly thereafter. A census in one of the two towns revealed that the proportion affected was significantly higher for 5-14 year olds (17%) than for other age-groups (p less than 10(-5). Interviews conducted with 23 of the patients or their families revealed that 22 (96%) had a history of bat bite, compared with 66 (22%) of 301 community members who remained healthy (p less than 10(-6). A rabies virus strain identical to those isolated from vampire bats (Desmodus rotundus) was isolated from the brain of the only person on whom necropsy could be done. Because of the extreme isolation of this and other communities affected by bat-transmitted rabies, preventive measures should be directed at decreasing the risk of nocturnal exposure to bats by bat proofing dwellings or use of mosquito nets and at prompt wound care. Rabies pre-exposure or postexposure vaccination is clearly indicated, but may not be feasible in these isolated populations.

Adolescent↗
PubMed1991

Malignant myxoid emboli as the presenting feature of primary sarcoma of the aorta (myxoid malignant fibrous histiocytoma): a case report and review of the literature.

Primary sarcomas of the aorta are rare vascular tumors. About 26 cases have been reported between 1973 and 1989. They are seldom diagnosed antemortem. The present report describes a patient with a myxoid malignant fibrous histiocytoma arising in the intima of the lower thoracic aorta, which was diagnosed premortem in metastatic peripheral emboli. The clinical and pathologic features of this patient along with a summary of the 29 primary aortic tumors previously reported (26 malignant and 3 benign) are discussed. Although few of these tumors have been described histologically as benign, all of them behave as malignant tumors.

Aged↗
PubMed1991

Prostatic stromal hyperplasia with bizarre nuclei.

Prostatic stromal hyperplasia with bizarre nuclei is an uncommon variant of nodular hyperplasia that may be confused with mesenchymal malignancy but that can usually be distinguished by the degenerative character of the nuclear changes, absent to negligible mitotic rate, and relatively sparse cellularity. We report a case in a 73-year-old man and review six other cases, which, to our knowledge, are the only ones that have been reported previously.

Aged↗
PubMed1990

Two unusual manifestations of aortic aneurysms.

Pain and pulsation are common presenting features of aortic aneurysms. Massive hematemasis and ureteral obstruction represent rare clinical presentations. This report describes a patient with massive hematemesis in whom a thoracic aneurysm ruptured into the esophagus, and a second patient in whom a large abdominal aortic aneurysm caused bilateral ureteral obstruction.

Aorta, Abdominal↗
PubMed1989

Ectopic or heterotopic liver (choristoma) associated with the gallbladder.

A 43-year-old man with a history and symptomatology of hereditary spherocytosis underwent splenectomy and cholecystectomy for treatment of his underlying disease and of cholelithiasis. The removed gallbladder showed a serosal encapsulated nodule, supported by a short mesentery, measuring 11 x 6 x 4 mm, that histologically was an ectopic or heterotopic functioning liver. This nodule did not have any connection with the main liver. It is because of the comparative rarity of this anatomic anomaly that we are presenting a new case; a simple classification of these aberrant liver tissues, which are found in the wall of the gallbladder; the embryological development; and a complete review of the literature. We also stress the need to restore the term choristoma, now in disuse.

Adult↗
PubMed1988

Simple cyst of the rete testis.

We report a case of a simple cyst in the upper pole and connected to the mediastinum testis at the rete testis. The cyst appeared to arise from a dilated rete duct, and it was spherical, smooth-walled and filled with clear fluid. The epithelium was lined with a single layer of cuboidal or flattened cells, with no evidence of squamous differentiation.

Aged↗
PubMed1987

Hereditary amyloidosis: description of a new American kindred with late onset cardiomyopathy. Appalachian amyloid.

A family with hereditary amyloidosis characterized by peripheral neuropathy and cardiomyopathy is described. Lack of eye involvement sets their disease apart from the Indiana/Swiss familial amyloidotic polyneuropathy type II. The disease is of late onset; affected members die of cardiomyopathy after age 60. The late onset and lack of clinically significant neuropathy in several family members has led to misdiagnosis of the cardiomyopathy. Immunohistochemistry using antiprealbumin antiserum showed staining of amyloid deposits in nerve and heart.

Adult↗
PubMed1986

Malignant melanoma in Meckel's diverticulum.

Meckel's diverticulum is a vestigial remnant of the omphalomesenteric duct, which is rarely affected by neoplasia. The authors report the first case of malignant melanoma in Meckel's diverticulum in a middle-aged man without skin or ocular lesions. Five other Meckel's diverticuli were evaluated histologically and by immunoperoxidase technics for neural crest elements, which could have given rise to this lesion.

Humans↗