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Biomedical subjects

H W Asbach

Publications and source records attributed to H W Asbach.

8 recordsLinked to original sources

Long-term results in children following dialysis and renal transplantation.

Since 1966, 93 children in end-stage renal disease, aged between 5 and 16 years were treated by a combined programme of dialysis and transplantation. In 91 patients treatment of uraemia was started either as hospital or home haemodialysis, until now covering more than 90 dialysis years. Forty-one children were transplanted. Twenty children died during dialysis treatment, 7 after renal transplantation. Sixty-six children are currently alive, 25 with a functioning graft, 28 are treated by hospital dialysis, 13 by home haemodialysis. Eighty-three per cent of the patients on hospital dialysis are classified in rehabilitation category 2 according to the EDTA categories, and all children on home dialysis and those with functioning grafts, category 1.

Adolescent

Lipid hemodialysis versus charcoal hemoperfusion in imipramine poisoning.

Previous experimental results have demonstrated the possibility of eliminating imipramine (14 C-IP) by hemodialysis. A simultaneous uptake of the substance by the polyvinyl chloride extracorporeal blood lines could be shown. Based on these results the imipramine absorption capacity of the blood lines and of the artificial kidney (Hollow Fiber Artificial Kidney, HFAK, Model 4) were studied. Imipramine (IP) absorption capacity of a usual blood-line set (arterial and venous, surface area 86,000 mm) was estimated to be 43 mg, and that of the HFAK to be 207 mg. Charcoal hemoperfusion (300 gm of coated activated coconut charcoal) eliminated more than 90% of IP from the blood within 3 hr if the initial IP blood concentration was 2 mg/ml. In comparison, lipid hemodialysis using 20% soybean oil as dialysate eliminated 95% of IP from the blood when the initial IP blood concentration was 1 mg/ml and 98% when the initial IP blood concentration was 2 mg/ml. In vivo studies on the elimination of IP by lipid (10%) hemodialysis demonstrated a substantial removal of the substance. Within 2 hr of treatment, 12% of the administered dose (75% of the LD50) was eliminated.

Adsorption

Haemodialysis in imipramine poisoning? An experimental study.

In the last several years an increasing number of severe imipramine intoxications have been observed. Though standard principles for the treatment of acute tricyclic poisoning have been established, nonetheless there still exists doubt on the most effective method of tricyclic removal in cases of massive overdose. Haemodialysis was successfully employed until now but has not found general acceptance as only insignificant amounts of imipramine could be recovered from the dialysate. An experimental clearance study was undertaken using radiolabelled imipramine (14C-I) to obtain insight into the usefullness of haemodialysis in imipramine poisoning. 14C-I clearances which were calculated in a closed circuit dialysis system ranged between 18 ml/min and 48 ml/min depending on the constitution of the dialysate, i.e. aqueous or lipid solution. Surprisingly a rapid and significant uptake of imipramine by the plastic material (polyvinylchloride) of the extracorporeal blood line system was detected. This escape of imipramine from the blood into the tubings explains the poor recovery of tricyclics from the dialysate, which discredited haemodialysis as a therapeutical method in imipramine poisoning. The results of our experiments may offer a new method of rapid tricyclic elimination in severe imipramine intoxications.

Absorption

Indolic tryptophan metabolism in uraemia.

Tryptophan and some indolic metabolites were studied in urine, plasma and dialysate of uraemic patients using thin-layer- and high-pressure liquid chromatography. Some new metabolites: indole-3-carboxylic acid, indole-3-carbaldehyde, indolelactic acid and N-acetyltryptophan were detected. Levels of the latter two metabolites in urine, dialysate and especially plasma suggest increased transamination of tryptophan and a possible defect in renal amino acid acylase in uraemia.

Aldehydes

[The effects of extreme cold on major blood vessels. An experimental study (author's transl)].

In 10 beagles cryogenic experiments were performed to study the effects of freezing the iliac artery and vein. The histological tissue reaction after cold exposure in major pelvic vessels was early inflammation and followed by a rapidly progressing reparative process. Long-term microscopic changes were proliferations of the vessel intima and focal splitting on the elastic membrane. No evidence of thrombosis, aneurysm fomation and rupture of the vessel was found. Vascular function as a blood conduit was undisturbed.

Angiography