Search PubMedSearch

Biomedical subjects

E Chirito

Publications and source records attributed to E Chirito.

13 recordsLinked to original sources

Long-term clinical assessment of combined ACAC hemoperfusion-ultrafiltration in uremia.

ACAC hemoperfusion was used in series with a small fluid removal system for a clinical trial in the treatment of uremia. A 22-month trial included a pretest control period, test period and a post-test control period. The most significant observations from this trial are: 1) the predialysis body weight of the patient could be maintained closer to the patient's dry weight; 2) there was a significant increase in hematocrit; and 3) there was insufficient removal of urea. With the development of an effective urea removal system, a more compact artificial kidney than any presently available will become feasible.

Blood Chemical Analysis

Biochemical, hematological and histological changes in a fulminant hepatic failure rat model for artificial liver assessment.

Galactosamine-induced fulminant hepatic failure rats have been used as a model for statistical assessment of liver support systems. The present study reports in detail the biochemical, hematological and histological changes in these animals. They have been used to study statistically the effects of ACAC charcoal hemoperfusion, cross-circulation and liver perfusion on long-term survival in fulminant hepatic failure.

Animals

Artificial liver: the effect of ACAC microencapsulated charcoal hemoperfusion on fulminant hepatic failure.

Control trials and statistical analysis were carried out to assess the effects of albumin-collodion microencapsulated activated charcoal (ACAC) hemoperfusion on fulminant hepatic coma. A rat model of galactosamine induced fulminant hepatic coma was used. Rats which did not recover died at 3.0+/-0.6 days after galactosamine injection. Those which survived this period recovered. Forty-eight hours after galactosamine injection, a test group of 21 rats were treated with 1 hour hemoperfusion and compared with an untreated group of 23 rats. 71.4% of the treated group survived as compared to 30.4% of the untreated rats. Statistical analysis (t test) shows a significant increase in recovery for the treated group (less than 0.01). Biochemical and histological results will be discussed.

Albumins

Microencapsulated charcoal hemoperfusion: a possible therapeutic adjunct in digoxin toxicity.

Attempts to remove substantial quantities of digoxin by either peritoneal or hemodialysis, have been unsuccessful due to their low clearance rate. The present study determined the in-vivo clearance rate for digoxin of a single microcapsule of 300 gm of activated charcoal. The clearance rate was 55 +/- 5 ml/min (mean +/- SEM) in the first hour and 48.4 +/- 4 ml/min in the second; these values are approximately five-fold higher than with other dialysis techniques. No evidence of a post-dialysis rebound increase in serum digoxin levels was found, implying that peripheral tissues can rapidly release digoxin to the diminishing serum pool. Preliminary data obtained suggest a beneficial effect on arrhythmias and lowering of the myocardial to serum rate of digoxin after hemoperfusion.

Animals

Clinical evaluation of the clearance profiles of a portable, compact, dialysate-free system incorporating microencapsulated charcoal hemoperfusion for blood purification with ultrafiltration for fluid removal.

A total of 30 procedures have been carried out in two patients using a new portable, compact, dialysate-free system formed by combining 300 gms of albumin--cellulose nitrate microencapsulated activated charcoal (ACAC) in series with a small Amicon ultrafiltrator. Blood passing through the ACAC hemoperfusion system is purified of waste metabolites and toxins. Fluid removal is carried out with the hydrostatic pressure of the blood passing through the dialysate-free ultrafiltrator. Since ACAC hemoperfusion is much more efficient than hemodialysers for blood purification, the combined system with the ultrafiltrator results in a very efficient system for blood purification and fluid removal. Typical clearance data for the combined systems include: 75 ml/min for 2000--5000 MW; 112.7 ml/min for 300--1500 MW; 235 ml/min for creatinine; 240 ml/min for uric acid; 2500--2700 ml/2 hours for water removal; and 17--18 gm/2 hours for NaCl removal. Guanidines, mercaptans, and PTH are also cleared very efficiently.

Charcoal

Studies of the electrical potential difference in rat proximal tubule.

The electrical potential difference (PD) in the rat proximal convoluted tubule was investigated in vivo as a function of distance from the glomerulus. The PD was found to be invariably negative (up to -4.5 mV) in the earliest segments (less than 0.5 mm from the glomerulus) and rose to positive values (+2 to +4) in the later segments (1 mm beyond the glomerulus). This change in PD correlated with the bubule fluid-to-plasma (TF/P) chloride ratios, which rose from unity in the early segments to approximately 1.3 in the late. Corresponding changes in PD and chloride ratios could be elicited by single-nephron stop-flow techniques in the early segments. Luminal perfusion techniques demonstrated a direct relationship between PD and tubule fluid chloride concentration. Acetazolamide was found to significantly reduce both late proximal PD (less than +2 mV) and TF/P chloride ratios (less than 1.06). Split-drop studies demonstrated that the negative PD in the early proximal tubule was dependent on the presence of glucose and alanine and the absence of a chloride gradient, whereas in the late proximal tubule under the same conditions the PD was not significantly different from zero. In this segment of the nephron the positive PD in free flow appeared to result from the chloride diffusion potential generated by preferential HCO3 reabsorption. These results provide further demonstration of intrinsic differences in the transport properties along the length of the proximal convoluted tubule.

Acetazolamide