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C H Chi

Publications and source records attributed to C H Chi.

30 records · Page 2Linked to original sources
PubMed1995

Gas composition in Clostridium septicum gas gangrene.

Clostridial gas gangrene (myonecrosis) is a rare but catastrophic condition that usually occurs in patients with underlying diseases. This paper reports a fatal case of spontaneous clostridial gas gangrene in a 60-year-old female diabetic patient. The composition of gas samples from the patient's damaged muscle was analyzed. The results showed 5.9% hydrogen, 3.4% carbon dioxide, 74.5% nitrogen and 16.1% oxygen. This gas composition supports the belief that such gas production occurs via glucose fermentation. This is the first time such an analysis has been performed in a clinical case of spontaneous clostridial gas gangrene.

Clostridium↗
PubMed1987

Metastatic adeno or undifferentiated carcinoma from an unknown primary site--natural history and guidelines for identification of treatable subsets.

Two hundred and eighty-six patients presenting with metastatic adenocarcinoma or undifferentiated carcinoma whose primary site was not identified by clinical history, physical examination and chest radiograph have been studied. Median survival from presentation was 22 weeks. Factors independently predicting improved survival were lymph node presentations, good performance status and body weight loss of less than 10 per cent. In 88 (31 per cent) patients the primary tumour site was subsequently identified, in 58 (20 per cent) during life. Lung cancer was the most frequently identified primary tumour, and in only 32 (11 per cent) of the patients was a 'treatable' primary tumour (i.e. germ cell, breast, ovarian, prostate, thyroid cancer or lymphoma) identified. Among the treatable primary tumours were those in eight out of 16 female patients presenting with axillary metastases who were subsequently shown to have primary breast cancer and four of 13 females presenting with ascites who were found to have primary ovarian cancer. Prostatic cancer was confirmed in five out of 13 men with raised serum acid phosphatase. Of 22 patients with elevated serum alphafoetoprotein (AFP) or beta-human chorionic gonadotrophin levels (beta HCG) 18 had some features of the 'atypical teratoma syndrome'. Of the total of 32 patients with treatable tumour types, 29 (90 per cent) were identified during life. Median survival for patients with treatable tumour types identified during life was 104 weeks, compared with 22 weeks for the group as a whole. Retrospective immunocytochemical staining of the original biopsy showed that prostatic specific antigen and antibodies to beta HCG and AFP were diagnostically useful, but a series of organ site non-specific markers of histogenesis or cellular differentiation (carcinoembryonic antigen, secretory component for IgA, peanut lectin binding, epithelial membrane antigen and keratin) showed no significant correlations with identified primary sites, responsiveness to empirical chemotherapy or survival. Metastatic undifferentiated carcinoma or adenocarcinoma from an unknown primary site represents 6.5 per cent of all referrals to the medical oncology unit, Royal Prince Alfred Hospital, Sydney. We offer guidelines for the rapid identification of the limited number of primary sites for which effective and specific forms of systemic treatment are available.

Adenocarcinoma↗
PubMed1979

Sensitive fluorescence assay for d,l-methadone.

d,l-Methadone forms a fluorophore when reacted with paraformaldehyde in concentrated sulfuric acid. Based on this reaction, a fluorescence assay suitable for quantitative d,l-methadone analysis from plasma and other tissues was developed. d,l-Methadone was extracted at pH 9.2 from the deproteinized filtrate of plasma or of aqueous tissue homogenate into an organic phase of 25% isobutanol in ethylene dichloride. After an aliquot of the organic phase was evaporated to dryness at 50--55 degrees with an air jet, paraformaldehyde (0.1%, in concentrated sulfuric acid) was added, and fluorescence was read at 450 nm with excitation at 275 nm. By this method, d,l-methadone can be assayed in the presence of its metabolites, morphine, diacetylmorphine (heroin), codeine, and cocaine; however, amphetamine, meperidine, and quinine interfere.

Animals↗
PubMed1977

The frequency and distribution of mitotic figures in dysplasia and carcinoma in situ.

The frequency and topographical (i.e. vertical and lateral) distribution of mitotic figures in normal cervical epithelium as well as in various degrees of dysplasia and in carcinoma in situ, was studied in punch biopsies and in subsequent cone specimens from 40 patients. The frequency of cells in mitosis in the whole thickness of the epithelium increased step-wise from normal epithelium to slight-moderate dysplasia, severe dysplasia and carcinoma in situ. A difference in the frequency of mitotic figures between slight and moderate dysplasia was recorded in the superficial cell layers of the epithelium. These findings, together with earlier reported differences in the frequency of DNA synthetizing cells between the various epithelial alterations support the validity of the histological classification of cervical atypias. Areas with mitosis alternated with areas without mitosis, supporting even here previous autoradiographical findings. The possible co-existence of proliferative and non-proliferative epithelial compartments in dysplasia and in carcinoma in situ of the uterine cervix is suggested.

Carcinoma in Situ↗
PubMed1977

Characterization of (+/-)-methadone uptake by rat lung.

1. By use of a sensitive and specific fluorescence assay procedure it was shown that after subcutaneous administration to rats, (+/-)-methadone was concentrated in the lung. Lung to serum ratios ranging from 25 to 60 were obtained indicating that the rat lung tissue was capable of extracting (+/-)-methadone against a concentration gradient. 2. This phenomenon was investigated in vitro with rat lung slices incubated in Krebs-Ringer phosphate buffer (pH 7.4). The uptake was expressed in terms of tissue to medium concentration ratios (T/M ratio). 3. The principal observations were: (i) Studies on the time-course of the uptake showed that the T/M ratios of (+/-)-methadone increased rapidly during the first 60 min of incubation and then more slowly, with a plateau occurring at 180 min; (ii) The T/M ratio of (+/-)-methadone progressively increased from 9.5 to 17 as the pH of the incubation medium was varied from 6.2 to 7.5; (iii) When the concentration of (+/-)-methadone in the incubation medium was varied from 0.005 to 0.5 mM, the T/M ratio decreased rapidly suggesting self-saturation of the transport process. Beyond the medium concentration of 0.5 mM, the T/M ratio declined very slowly. 4. These results suggested that at low concentrations, (+/-)-methadone was transported predominantly by a self-saturable process while at higher concentrations it was transported by a process of simple diffusion. 5. At low concentrations (0.01 mM) the uptake of (+)-methadone was higher than that of (-)-isomer indicating stereo-specificity of the uptake process. The uptake of (+/-)-methadone at low concentration (0.01 mM) was significantly inhibited by low temperature, lack of O2, lack of glucose, lack of Na+ in the incubation medium, and by exposure of the tissue to high temperature (approximately 100 degrees C). The uptake was also inhibited by relatively high concentration of iodoacetate (1.0 mM) and of naloxone (1.0 mM). 6. Kinetic analysis of data showed that the diffusion constant for (+/-)-methadone was 5.0 (h-1) and the Vmax of the active transport process was 6.5 micronmol g-1h-1.

Animals↗
PubMed1976

Cysticercosis in otolaryngology.

Cysticercosis is not likely to be the first diagnosis the otologist has in mind when regarding tumors in the head and neck area. The fact that this disease may present a diagnostic and therapeutic problem is illustrated by three cases, appearing in the tongue, buccal mucosa, and midline of the neck, respectively. The local finding of a soft nontender mass, the typical calcifications in the soft tissues visible on roentgenograms, and the histopathological findings are described and illustrated. Attention is drawn to the fact that cerebral cysticercosis, which is a very grave disease, may cause tinnitus, nystagmus, and hearing disturbances.

Adult↗
PubMed1976

Autopsy findings in leukaemia.

Out of 38 leukaemic cases only 16 had extensive leukaemic infiltration at death. 15 patients had slight or moderate and 7 no infiltration at all. 12 of the 15, and 5 of the 7 died with septicaemia. The latter patients must have died of complications rather than of the leukaemia itself. Although it has been possible to reduce the incidence of septicaemia during life, terminal septicaemia does not yet seem to be preventable. Septicaemia was revealed at autopsy in 27 of 38 patients; 25 of these also had clinical signs of septicaemia before death. Necrotizing gastrointestinal lesions may cause endogenous infection. In the present material, almost every second patient had fungal septicaemia. Out of 7 patients having oral candidiasis in vivo 5 had systemic candidiasis at autopsy, but only half of the patients with systemic candidiasis had visible oral growth. Modern treatment of leukaemia seems to be able to prevent intracranial haemorrhage in 90% of the cases. On the other hand, vacuolization of muscle and liver tissue was a frequent finding in leukaemia. It is suggested as being caused by fatty degeneration. Vacuolization of myocardial cells was found in 7 out of 13 cases. Among these 7, 4 had had intermittent hypokalaemia.

Acute Disease↗
PubMedDate not supplied

A three-day course of intravenous omeprazole plus antibiotics for H. pylori-positive bleeding duodenal ulcer.

BACKGROUND/AIMS: This prospective trial aimed to test the efficacy of 3-day intravenous omeprazole plus antibiotics for Helicobacter pylori (H. pylori) eradication rate, and to see whether individualized response to omeprazole in intragastric pH elevation will alter the success of eradication. METHODOLOGY: One hundred and thirty-eight cases with H. pylori-positive duodenal ulcer bleeding were randomized into four therapy groups: Group 1 (n = 32) received a 3-day course of intravenous omeprazole (80 mg loading then 40 mg q 9 am & 9 pm) plus ampicillin/salbactum (1.5 gm i.v. loading then 750 mg q 9 am, 3 pm, & 9 pm); Group 2 (n = 35) followed protocol as for Group 1 except the antibiotics were metronidazole and erythromycin (both 500 mg i.v. q 9 am, 3 pm, & 9 pm). Group 3 (n = 31) followed protocol as for Group 1 and further added with erythromycin (both 500 mg i.v. q 9 am, 3 pm, & 9 pm). Group 4 served as a control group (n = 40) receiving oral dual therapy after leaving the emergency room (omeprazole 20 mg and amoxycillin 1 g bid x 2 weeks). In each case, three gastric biopsies were done for total histologic density of H. pylori (THPD) (range: 0-15) before, 1 day and 6 weeks after completion of therapy. Except for the control group, the 24-hour ambulatory intragastric pH meter (MIC Inc, Gastrograph Spark III, Swiss) was inserted as possible on the 2nd day of therapy. RESULTS: The 3-day intravenous regimens achieved high clearance rates of H. pylori (Group 1: 93.8%; Group 2: 93.9%; Group 3: 100%). The eradication rates of H. pylori in Groups 1-4 were 43.8%, 57.1%, 58.1%, and 72.8%, respectively. In Groups 1-3, the H. pylori-eradicated cases had lower pre-treatment THPD than non-eradicated cases (6.01 vs. 9.24, p < 0.001). Among 72 cases with pH meter insertion, the percentage of intragastric pH > 5.3 during 24-hour was not different among 35 H. pylori non-eradicated and 37 eradicated cases (78.7 vs. 76.7%, p > 0.05). CONCLUSIONS: The 3-day intravenous regimens may achieve clearance of H. pylori quickly. However, they were not so effective for eradication, especially in cases with higher bacterial loads. The interindividual response to omeprazole in intragastric pH elevation under the study dosage had insignificant variations to alter the success of eradication.

Adult↗