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Biomedical subjects

J G Caya

Publications and source records attributed to J G Caya.

At least 19 recordsLinked to original sources
PubMed1998

Massive hemoperitoneum from endometriosis of the fallopian tube. A case report.

BACKGROUND: Endometriosis is a common gynecologic disease that usually presents with pelvic pain and infertility in the reproductive years. It can be complicated by bleeding, such as hematuria or hemoptysis; however, acute massive hemoperitoneum caused by tubal endometriosis without any concomitant disorder has not been reported previously. CASE: An unusual case of massive hemoperitoneum led to preshock as a result of bleeding from a tubal endometriosis implant in a previously healthy 29-year-old woman without previous history suggesting endometriosis. CONCLUSION: Although the most common gynecologic cause of hemoperitoneum in a reproductive-age woman is ruptured ectopic pregnancy, endometriosis should also be considered, especially after exclusion of pregnancy.

Adult↗
PubMed1991

Hyperplastic gastropathy. Clinicopathologic correlation.

Assessment of gastric histology in patients with hyperplastic gastritis is now possible using new endoscopic biopsy techniques that obtain a full-thickness gastric mucosal biopsy. Thirty-one patients with hyperplastic gastropathy and full-thickness gastric mucosal biopsies or gastric resections were seen during a 13-year period. Six patients had Zollinger-Ellison syndrome (ZE) with gastric gland hyperplasia; six had Menetrier's disease with foveolar hyperplasia and gland atrophy; and a single patient with hyperplastic hypersecretory gastropathy (HHG) was seen. The majority of patients, 18 of 31 with large folds, had peptic disease. The enlarged gastric folds were due to edema and inflammation. Discordant clinical findings and gastric pathology were seen in four patients: three of the 18 patients with peptic disease had histology typical of ZE (two patients) or Menetrier's disease. None of the three patients have developed a syndrome on follow-up ranging up to 5 years. Also, the patient with HHG had the gastric histology seen in Menetrier's disease. One patient with Menetrier's disease had areas of atrophic gastritis interspersed between the hyperplastic gastritis. In summary, the majority of patients with endoscopic hyperplastic gastropathy had gastritis on histologic examination. Most patients with a clinical syndrome associated with hyperplastic gastritis showed histology typical for the syndrome; however, clinical-histologic concordance was not absolute. In a small minority of cases, a patient with one clinical syndrome had the histology typical of another.

Adult↗
PubMed1991

Accuracy of breast frozen section diagnosis in the community hospital setting: a detailed analysis of 628 cases.

The author presents a detailed analysis of 628 breast frozen sections performed at Columbia Hospital over a 35-month period. These 628 frozen sections came from a total of 574 females and 13 males (mean age 55.3 years and range 20.1 to 95.0 years). Frozen section diagnosis was deferred in 18 cases (2.8%) and diagnostic accuracy for presence or absence of malignant neoplasia was 99.2%; one false positive case (pathologist judgement error) and four false negative cases (two sampling errors and two pathologist judgement errors) were detected. Strict diagnostic accuracy for this series was 98.7%. Fifty-three of 223 positive frozen sections (23.8%) were immediately followed by completion mastectomy. The author discusses the philosophy of frozen section technique and concludes that breast frozen section analysis in a busy community hospital setting can meet and even exceed the accuracy level attained at large academic medical centers.

Adult↗
PubMed1990

Lung cancer treated on the basis of cytologic findings: an analysis of 112 patients.

The authors studied 112 patients who received definitive radiotherapy/chemotherapy solely on the basis of positive cytologic findings in the appropriate clinical context. Eighty patients (71.4%) were treated on the basis of one or more positive sputum studies, while the remainder had at least one positive bronchial cytologic preparation. Eighty-six patients (76.3%) received radiotherapy alone; 19 received both radiotherapy and chemotherapy; only 7 were exclusively given chemotherapy. The utilization of stringent verification criteria revealed that none of our patients was falsely positive for malignancy. For those patients categorized as having malignant disease by verification criteria I-IV, there were no significant disparities between histologic and cytologic diagnoses. This study demonstrated, in a systematic fashion, that patients can be reliably and definitively treated for lung cancer on the basis of positive respiratory cytology findings without tissue corroboration.

Adult↗
PubMed1990

Laboratory identification of conditions predisposing to thrombosis.

The 5-year experience with a panel of laboratory tests designed to identify patients with high risk of thromboembolism was reviewed. This panel included an activated partial thromboplastin time and reptilase time as well as specific assays for antithrombin III, protein C, protein S, and plasminogen. One hundred and nine patients were evaluated by this panel. Conditions predisposing to thrombosis were identified in 24 of these patients and these conditions included: dysfibrinogenemia, lupus anticoagulant, and deficiencies of antithrombin III, protein C and protein S. The limitations of this panel are also discussed.

Adolescent↗
PubMed1989

Preoperative coagulation indices in patients with morbid obesity.

Preventive measures against venous thromboembolism are used frequently in surgical patients with morbid obesity because the risk has been claimed to be higher than usual. We addressed this risk in 81 morbidly obese patients by measuring preoperative plasma proteins associated with coagulation and by correlating variations in these indices to excess weight, liver histology, patient sex, tobacco use and serum triglycerides. Plasma levels of antithrombin III and plasminogen were normal in these patients. Plasma fibrinogen concentrations were elevated in 34 percent of patients; the values did not relate to excess weight and they correlated negatively (P less than 0.04) with increasing serum triglycerides and grades of liver fat content. Premenopausal women had higher plasminogen and fibrinogen levels than menopausal women or men, although their mean levels were normal. Smokers had lower plasminogen levels than nonsmokers (P less than 0.01). However, none of the measured levels of preoperative coagulation proteins identified increased risk for venous thrombosis in cohorts of this population, and the coagulation indices were not different from those reported in normal weight patients.

Anastomosis, Roux-en-Y↗
PubMed1988

The diagnosis of pulmonary small-cell anaplastic carcinoma by cytologic means: a 13-year experience.

This article reports on a series of 432 patients with positive respiratory (sputum and bronchial) cytology and proven malignant respiratory tract disease as corroborated by detailed verification criteria; 54 of these patients were diagnosed as having small-cell anaplastic carcinoma (SCAC). None of the 31 patients with autopsy-and/or biopsy-proven disease had false-positive results for SCAC. Typing accuracy for SCAC versus non-SCAC was 97.7% in the 263 patients with histologic confirmation of their respiratory tract disease. Twenty-three of the 54 patients (42.6%) were treated for SCAC solely on the basis of positive cytology in the context of compatible clinical data. This finding underscores the great importance of proper specimen preparation, quality control procedures, and diligent clinical follow-up in an era of heightened cost-containment awareness when many patients with pulmonary SCAC will be treated on the basis of positive cytology not immediately confirmed by histologic methods.

Bronchi↗
PubMed1988

Respiratory epithelial cyst of the orbit.

An 88-year-old woman presented with a longstanding superomedial cyst of the orbit complicated by recurrent acute infection. Despite a clinical picture typical for a sino-orbital mucocele, no sinus abnormality was demonstrated. Histopathologic examination revealed a respiratory epithelial lining similar to that of the paranasal sinuses. Possible pathogenetic mechanisms are discussed.

Aged↗
PubMed1988

Pityrosporum folliculitis after bone marrow transplantation. Clinical observations in five patients.

A skin rash in marrow graft recipients often poses difficult diagnostic problems because multiple causes may be implicated, and clinical and histopathologic findings may be nonspecific. Five recipients of allogeneic bone marrow transplants had pityrosporum folliculitis diagnosed by skin biopsy in the early weeks (less than 18 days) after transplantation. In all cases, patients were febrile and leukopenic (granulocyte count, less than 500 cells/mm3), and were receiving broad-spectrum antibiotics at onset of the skin rash. Erythematous macules and papules were distributed primarily over the chest, shoulders, and upper back, and pustules and crusts developed in some cases. Granulocyte counts of more than 500 cells/mm3 were associated with resolution of the rash. Pityrosporum infection should be considered in the differential diagnosis of skin rashes in marrow graft recipients.

Adult↗
PubMed1987

Intraocular Echinococcus multilocularis.

Alveolar hydatid disease, caused by the organism Echinococcus multilocularis, is a potentially lethal helminthic infection. After initial hepatic infestation, the organism may spread locally and hematogenously to distant sites. Death occurs secondary to hepatic failure, local extension into vital structures, or metastasis to the brain or lungs. A 67-year-old male Alaskan Eskimo developed decreased visual acuity secondary to a choroidal mass in the right eye eight years after an initial diagnosis of alveolar hydatid disease and four years before the development of symptomatic cerebral metastasis. A pathologic examination disclosed characteristic parasitic membranes involving the posterior pole of the right eye. To our knowledge, this is the first report of ocular involvement in alveolar hydatid disease.

Aged↗
PubMed1986

Clostridial septicemia complicating the course of leukemia.

The authors report an analysis of 47 leukemia patients (including 9 from our own medical center) whose courses were complicated by 48 episodes of clostridial septicemia. There were 36 adults and 11 children; acute myelogenous leukemia and acute lymphoblastic leukemia accounted for 61.7% and 14.9% of cases, respectively. All patients for whom remission status was known were in leukemic relapse. Fever was a presenting complaint in at least 36 patients whereas neutropenia, thrombocytopenia, and gastrointestinal lesions were noted in 100%, 90.9%, and 87.9%, respectively, of the patients for whom information on these parameters was available. Overall mortality from clostridial septicemia was 78%; none of the children and none of the patients with intravascular hemolysis survived. Overall, antibiotic therapy resulted in a 40% survival rate. However, among patients receiving beta lactam and/or chloramphenicol therapy, 57% survived their episode of clostridial septicemia. Prompt initiation of appropriate antimicrobial therapy offers the best chance of survival in leukemia patients with clostridial septicemia.

Adolescent↗
PubMed1986

The morphologic spectrum of large gastric folds: utility of the snare biopsy.

The differential diagnosis of large gastric folds is diverse, and endoscopic biopsies are often too small to permit adequate morphologic evaluation. This article describes the morphology of large gastric folds obtained by electrosurgical endoscopic snare biopsy in a series of 52 patients. The great majority of patients with enlarged rugae presented with peptic ulcer symptoms. This series included 16 patients with hyperplastic gastropathies, 15 with chronic nonspecific gastritis, seven with gastric polyposis, three with adenocarcinoma, five with benign lymphoid hyperplasia, and the remainder with miscellaneous conditions. In all cases, the snare biopsy provided a full thickness mucosal biopsy adequate to fully evaluate the enlarged rugae.

Biopsy↗