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Biomedical subjects

J F Winchester

Publications and source records attributed to J F Winchester.

At least 19 recordsLinked to original sources
PubMed1978

Solute, amino acid, and hormone changes with coated charcoal hemoperfusion in uremia.

This investigation assesses the effect of two-hour activated charcoal hemoperfusion using a column containing 300 g of acrylic hydrogel-coated activated charcoal either alone or combined with hemodialysis on small and "middle molecule" removal in uremic patients. Comparison was made with standard five-hour hemodialysis. Two patients with dialysis encephalopathy were treated with four-hour combined hemoperfusion/hemodialysis without beneficial clinical effects. Hemoperfusion increased the clearance rates of creatinine and urate when combined with dialysis. Hemoperfusion alone removed 1.3 +/- 0.6 g (mean +/- SD) of creatinine and 0.6 +/- 0.2 g of urate, while combined hemoperfusion/hemodialysis removed 1.7 +/- 0.6 g of creatinine and 1.0 +/- 0.5 g of urate in a two-hour period. Both treatment schedules removed less solute than standard five-hour hemodialysis but were associated with comparable "middle molecule" removal. Hemoperfusion accounted for additional amino acid removal when combined with hemodialysis, while hemoperfusion alone produced significant reduction only in the amino acid cystine. Changes in the hormones thyroxine, triiodothyronine, human growth hormone, and insulin were noted during the procedures. Acceptable falls in platelet counts and fibrinogen occurred with hemoperfusion. Coated charcoal hemoperfusion may prove to have a role in the management of uremic patients, although the acrylic hydrogel-coated charcoal hemoperfusion device requires combination with techniques allowing fluid and electrolyte removal.

Amino Acids↗
PubMed1978

Overdose.

Explore the source record for details and available documents.

Dopamine↗
PubMed1978

Polymer modification and blood compatibility.

Two procedures have been examined for altering the blood compatibility of copolymers of dimethylaminoethyl methacrylate, where blood compatibility has been measured by the recalcification time of platelet rich plasma. The improvement in blood compatibility of a copolymer of dimethylaminoethyl methacrylate and methyl methacrylate resulting from contact with heparin has been shown to be dependent on both copolymer composition and the method of polymerization. The hydrophilicity of a copolymer of dimethylaminoethyl methacrylate and acrylonitrile has been altered by reaction with ethylene oxide gas. The relationship between time of exposure to ethylene oxide gas. The relationship between time of exposure to ethylene oxide gas and clotting time indicates a dependence of compatibility on copolymer hydrophilicity.

Acrylonitrile↗
PubMed1978

Biochemical correlates of reversal of hepatic coma coated with charcoal hemoperfusion.

Ten patients in stage IV hepatic encephalopathy who had not responded to conventional therapy for at least 48 hrs were treated with one or more 4 hr periods of hemoperfusion. Nine (90%) awoke, and 4 (40%) are alive to date, the survivors having acutely toxic and infective hepatic lesions. Biochemical changes that occurred were a reduction in blood ammonia of 23%, a rise in the ratio of branched chain to aromatic amino acids in blood (1.08 +/- 0.3 to 1.3 +/- 0.4), and cerebrospinal fluid (0.26 +/- 0.02 to 0.32 to 0.03), and a rise in cerebrospinal fluid cAMP from 2.3 +/- 0.7 ng/ml to 3.4 +/- 1.29 ng/ml with hemoperfusion. Administration of platelets and fresh frozen plasma restored the reduction of platelet counts of 29% towards pretreatment values.

Adolescent↗
PubMed1977

Treatment of severe drug overdosage with charcoal hemoperfusion.

Mortality from severe poisoning remains excessively high in patients managed conservatively. In this report, charcoal hemoperfusion was used as a therapeutic aid to active drug removal in 10 patients (9 of whom were in Grade IV coma) intoxicated with a variety of drugs and a further 3 patients poisoned with the highly lethal herbicide, paraquat. All 10 patients who ingested drugs recovered. One of the 3 patients ingesting paraquat survived. The hemoperfusion treatments were associated with demonstrated drug removal. Complications associated with hemoperfusion were minor. Decreases in platelet levels were observed but were not accompanied by clinically important bleeding. The technique of hemoperfusion is simple and provides a therapeutic aid in the care of the severely poisoned patient.

Adolescent↗