bluuebunny/crossref_metadata_2025 huggingface dataset:
Double Filtration Plasmapheresis in the Treatment of Inflammatory Polyneuropathy
Authors: Chiu Hou‐Chang , Chen Wei‐Hung , Yeh Jiann‐Horng
Published: November 2007

Abstract: Twelve cases of recognized inflammatory polyneuropathy were treated by plasmapheresis (PP) at Shin‐Kong Wu Ho‐Su Memorial Hospital from November 1993 to November 1995. These include 6 cases of acute inflammatory demyelinating polyneuropathy (AIDP), 4 cases of chronic inflammatory demyelinating polyneuropathy (CIDP), one case of Fisher syndrome, and one case of Sjögren's syndrome with polyneuropathy. The patients chosen for PP met the inclusion criteria of severely disabled, i.e., Grade 4 (bed or chair bound) or Grade 5 (required assisted ventilation), or an unremittingly progressive course. Plasmapheresis was carried out by the double filtration method. Each patient received a standard course of at least 4 sessions of pheresis. All the patients receiving PP showed a beneficial response. The treatment for 10 patients was judged to be effective. The other 2 patients (one AIDP and one CIDP), though improved, were unable to reach Grade 2. Among the complications of PP, only 4 episodes of symptomatic hypotension were noted in a total of 73 sessions of PP. In conclusion, PP is safe and effective in treating inflammatory polyneuropathy.—
Plasmapheresis for Prevention of Recurrent Focal Segmental Glomerulosclerosis of Kidney Allograft in Adult Recipients
Authors: Iguchi Yasuhiro , Tanabe Kazunari , Yagisawa Takashi , Fuchinoue Syohei , Kawai Tatsuro , Kawaguchi Hiroshi , Takahashi Kota , Ito Katsumi , Toma Hiroshi , Agishi Tetsuzo , Ota Kazuo
Published: November 2007

Abstract: Nephrotic syndrome due to focal segmental glomerulosclerosis (FGS) frequently recurs even after renal transplantation and may cause renal allograft failure. From January 1983 though April 1995, 11 adult recipients with primary FGS received 11 kidney transplants at our institution, and 3 of them were treated with pretransplant plasma exchange (PE). Other patients did not receive any preoperative PE, and 4 patients lost their grafts due to recurrent FGS (50%). PE was completed 3 times before the transplantation to prevent posttransplant recurrence of FGS. Two recipients did not have any proteinuria or graft dysfunction without posttransplant PE. One patient had mild proteinuria immediately after transplantation, and histological examination showed recurrent FGS. The patient has been undergoing PE once a month (2 years posttransplant). Her renal function is excellent (sCr 1.2 mg/dl), and her FGS is being well controlled by PE. PE seems to be effective for the prevention of the recurrence of FGS following renal transplantation.—
Comparison of Acute Physiology and Chronic Health Evaluation III and II for Prediction of Mortality in Multiple Organ Failure Patients Treated by Plasma Exchange
Authors: Lin Kuo‐Juei , Kao Min‐Tsung , Liao‐Jen  , Hanasawa Kazuyosi , Tani Thoru , Kodama Masashi
Published: November 2007

Abstract: This study examined the efficacy of a different scoring system for multiple organ failure (MOF) patients treated by plasma exchange (PE). Twenty‐five patients with MOF resulting from fulminant hepatitis who had been treated by PE for a total number of 91 PEs in a consecutive period of 22 months were included in our study. Data were collected from each patient to compute acute physiology and chronic health evaluation (APACHE) II and APACHE (AP) III scores. The sensitivity, specificity, and correct prediction of outcomes were measured. The correct prediction of outcomes was 86.5%in AP III and 77.5% in AP II. For the prediction of patient mortality, the AP III system seems to be more reliable than AP II.—
Ability to Remove Immunoglobulins and Antiganglioside Antibodies by Double Filtration Plasmapheresis in Guillain‐Barré Syndrome: Is It Equivalent to Plasma Exchange?
Authors: Tagawa Yumi , Yuki Nobuhiro , Hirata Koichi
Published: November 2007

Abstract: The value of plasma exchange (PE) in Guillain‐Barré syndrome (GBS) is well established. In Japan, patients with GBS and related diseases often receive double filtration plasmapheresis (DFPP) as well as PE. No comparative trials between PE and DFPP, however, have been conducted. We compared their abilities to remove immunoglobulins and antiganglioside antibodies to find out whether DFPP is equivalent to PE. The ability to remove immunoglobulins and antiganglioside antibodies was compared between PE and DFPP using plasma samples from 41 patients with GBS and related diseases before and after each treatment session. The ability of DFPP to remove both IgGs and antiganglioside IgG antibodies were significantly inferior to those of PE. There is a less theoretical basis for selecting DFPP as the first choice of plasmapheresis for GBS and related disorders.—
Comparative Study of Clinical Effects Between Plasma Adsorption and Double Filtration Plasmapheresis in Patients with Myasthenia Gravis
Authors: Okada Hirokazu , Moriwaki Kenshi , Sugahara Souichi , Nakamoto Hidetomo , Hosokawa Takeshi , Hamaguchi Katsuhiko , Suzuki Hiromichi
Published: November 2007

Abstract: Plasma exchange (PE) has been one of the most powerful treatments for patients with myasthenia gravis (MG) since Pinching et al. reported its clinical usefulness in 1976, despite the need for supplemental human plasma. However, new apheresis techniques, e.g., plasma adsorption (PA) and double filtration plasmapheresis (DFPP), which do not need human plasma, were developed and have been introduced for clinical use in MG. We compared the effects of these plasma purification therapies in patients with MG and found that DFPP improved such subjective symptoms as chest compression and general fatigue better than PA while both of them could decrease the serum level of acetylcholine receptor (AChR) antibodies and relieve objective muscle weakness to a similar degree. It may be that DFPP can remove some circulating pathogenic factors other than AChR antibodies more efficiently than PA.—
Changes In Plasma Levels of Nitric Oxide Derivative During Low‐Density Lipoprotein Apheresis
Authors: Kojima Shunichi , Ogi Makoto , Sugi Toshihiko , Matsumoto Yuji , Yoshitomi Yuji , Kuramochi Morio
Published: November 2007

Abstract: The negative charges of dextran‐sulfate (DS) used for low‐density lipoprotein (LDL) apheresis activates the intrinsic coagulation pathway, in which plasma kallikrein acts on high‐molecular‐weight kininogen (HMWK) to produce large amounts of bradykinin. This study was undertaken to see whether bradykinin generated during DS LDL apheresis has some physiologic effects in vivo. The plasma levels of bradykinin and nitric oxide derivatives (NOx) were examined when either of 2 anticoagulants, heparin or nafamostat mesilate (NM), was used during DS LDL apheresis. Although anticoagulative action by NM depends on the inhibition of thrombin activity, this substance also inhibits the activity of plasma kallikrein. During apheresis using heparin, the marked increase in bradykinin levels (before apheresis, 18 ± 3 (mean ± SE, n = 5) pg/ml; after apheresis 470 ± 140, p < 0.01) was associated with the increase in NOx (before apheresis 50 ± 11 pg/ml; after apheresis 66 ± 15). Interestingly, these changes in bradykinin and NOx levels were suppressed during apheresis using NM. The changes in plasma NOx levels were negatively correlated with those in blood pressures. These findings suggest that bradykinin generated during apheresis exerts some physiologic effects by means of activation of endothelium‐derived relaxant factor (EDRF). Our results support the view that bradykinin produced during DS LDL apheresis has physiologic significance.—
Apheresis Techniques and Cellular Immunomodulation
Authors: Smith James W.
Published: November 2007

Abstract: Significant advances have been made in the capabilities to remove white blood cells (WBCs) from blood by both centrifugal and filtration techniques. New techniques have applications for both donor products (and their effects upon the recipients) and for selected disease therapeutics. The immunomodulatory effects of donor WBCs may be therapeutic, e.g., granulocytes harvested by apheresis may be used for the treatment of sepsis, or mononuclear cells collected by apheresis for peripheral blood progenitor (stem) cell transplantation or graft versus leukemia effect. In contrast, WBCs are removed from many transfusable components to decrease the immune effects in recipients. This has been accomplished primarily by the use of leukoreduction filters although newer adaptations of centrifugal equipment allow for the reduction of WBCs to target range of <1 times 106 WBCs/product. Therapeutic WBC removal by centrifuge has been used for treatment of the effects due to elevated levels of WBCs or platelets. More specific cellular immunotherapy has included lymphocytapheresis for the treatment of autoimmune diseases such as systemic lupus erythematosis (SLE). Various mononuclear cell fractions collected by apheresis have been used for lymphokine activated killer cells (LAK) and tumor infiltrating lymphocytes (TIL) cell therapy or autologous stem cell transplantation. The development of WBC adsorbent filters for therapeutic use has evolved as nonspecific filter materials have been demonstrated to show selective WBC removal, and filter columns permit therapeutic reductions in WBCs using online filtration therapy. Specific adsorption techniques, e.g., CD‐34 selection, are in use in vitro and indicate directions for further developments in cellular immunotherapy.
Efficacy of Filtration Leukocytapheresis on Rheumatoid Arthritis with Vasculitis
Authors: Hidaka Toshihiko , Suzuki Kimihiro
Published: November 2007

Abstract: The present study was designed to determine the efficacy of filtration leukocytapheresis (LCAP) in the treatment of rheumatoid arthritis (RA) with vasculitis. Nine RA patients with vasculitis were studied by the Malignant RA Collaborative Group formed by 8 clinical centers. A total of 7 filtration LCAP procedures using the Cellsorba column (Asahi Medical Co., Ltd., Tokyo, Japan) were performed with 1 week intervals between treatments. During each apheresis procedure, 3,000 ml of blood was filtered and returned to the patient at a flow rate of 50 ml/min for 60 min. In addition to the amelioration of arthritis, the improvement of extraarticular symptoms associated with rheumatoid vasculitis such as polyneuritis, skin ulcers, digital gangrene and rheumatoid nodules was obtained. In contrast, no improvement was observed in interstitial pneumonia or lung fibrosis. LCAP could be an optional modality for the treatment of RA with vasculitis.
Blood Purification for Critical Care Medicine: Endotoxin Adsorption
Authors: Kodama Masashi , Hanasawa Kazuyoshi , Tani Tohru
Published: November 2007

Abstract: Many kinds of blood purifying technologies have been applied to the treatment of critically ill patients since 1970 when plasma exchange with hollow‐fiber membranes was developed. These technologies have been applied not only to the removal of toxic substances, but also to the treatment of objective diseases and the removal of the factors relating to the associated inflammation. This article summarizes these methods and their efficacies for critically ill patients, especially those with severe sepsis. Attempts have been made to remove endotoxin, the main cause of sepsis, from the circulation using polymyxin B immobilized fiber, charcoal hemoperfusion, and plasma or whole blood exchange. Attempts have also been made to remove proinflammatory cytokines, eicosanoides, and coagulative factors from the circulation in the human body. Continuous hemofiltration or hemodiafiltration is the representative technology. The efficacy of these methods has been established, but several issues remain unresolved. All methods of the treatment of severe sepsis are discussed with reference to treatment indications, efficacy, and outcome parameters. In particular, the clinical results of endotoxin removal with polymyxin B immobilized fiber are summarized in this article.
Clinical Application and Effectiveness of Low‐Density Lipoprotein Apheresis in the Treatment of Coronary Artery Disease
Authors: Daida Hiroyuki , Yamaguchi Hiroshi
Published: November 2007

Abstract: The Low‐Density Lipoprotein Apheresis Coronary Atherosclerosis Prospective Study (L‐CAPS) examined whether or not combined low‐density lipoprotein (LDL) apheresis and drug therapy apheresis could induce the regression of coronary atherosclerotic lesions in patients with familial hypercholesterolemia. Twenty‐eight patients treated with LDL apheresis and drugs and 11 patients treated with drugs alone underwent sequential coronary angiography 2.5 years apart. The frequency of cases with regression or no change was significantly higher for the apheresis group than for the control group (p = 0.004). The LDL apheresis Angioplasty Restenosis Trial (LART) investigated the hypothesis that high plasma lipoprotein (a) (Lp[a]) levels were associated with increased incidences of restenosis after coronary angioplasty. Two days before and 5 days after angioplasty, 66 patients underwent LDL apheresis. The restenosis rates were 21% in the 42 patients whose Lp(a) levels were reduced 50% and 50% in the 24 patients whose Lp(a) levels were reduced < 50% (p < 0.05). LDL apheresis is effective in the prevention of the progression of coronary atherosclerosis. Its potential application in restenosis prevention should be further investigated.
The Retardation of Progression, Stabilization, and Regression of Coronary and Carotid Atherosclerosis by Low‐Density Lipoprotein Apheresis in Patients with Familial Hypercholesterolemia
Authors: Koga Nobuhiko
Published: November 2007

Abstract: The long‐term effects of low‐density lipoprotein (LDL) apheresis (LA) on the progression and regression of atherosclerosis were evaluated by angiographic and pathological findings as well as ultrasonography based studies, and the clinical significance of the treatment was evaluated. We studied 11 patients with familial hypercholesterolemia (FH), 2 with homozygous FH and 9 with severe heterozygous FH who received combined LA and drug therapy for a mean of 7.7 years. During the treatment period, the mean time‐averaged level of LDL cholesterol was 181 ± 52 mg/dl. According to the coronary angiographic results, 3 patients showed regression, 6 patients showed progression, and 2 patients showed no change. Cardiac events occurred in 6 patients. We pathologically examined at autopsy the coronary arteries of 1 FH patient who had received long‐term LA therapy before death. The results revealed the process of scarring of atheromatous plaque, suggesting pathological regression correlated with the angiographic regression shown in serial angiograms taken during LA treatment. It was further suggested that the formation of an eccentric thick end wall lesion rich in collagen fiber prevented atheromatous plaque from tearing off. However, the annual progression rate of the mean maximal intima‐media thickness in the common carotid artery was 0.0002 mm/year in the LA group, which was significantly lower than the mean of 0.251 mm/year seen in the control group (drug therapy only group). In the patients with heterozygous FH (9 patients), the annual progression rate was lowered to 0.0023 mm/year, suggesting regression. The findings of the present study indicate that patients with severe FH refractory to drug treatment may benefit from more aggressive cholesterol lowering treatments such as LA combined with cholesterol lowering drug therapy. The progression of atherosclerosis may be prevented, plaque may be stabilized (regressed), and clinical events may be reduced as seen with patients with non‐FH hypercholesterolemia.
Further Examination of Various Administration Protocols of Pegylated Recombinant Human Megakaryocyte Growth and Development Factor on Thrombocytopenia in Myelosuppressed Mice
Authors: Akahori Hiromichi , Ozai Masako , Ida Masumi , Shibuya Kazunori , Kato Takashi , Miyazaki Hiroshi
Published: November 2007

Abstract: Thrombopoietin (TPO) is the recently isolated lineage‐dominant hematopoietic factor that plays a pivotal role in the regulation of megakaryocytopoiesis and throm‐bopoiesis. In vivo studies have shown that daily multiple injections of pegylated human megakaryocyte growth and development factor (PEG‐rHuMGDF), a truncated molecule related to human TPO, modified with polyethylene glycol, greatly improve thrombocytopenia and in most cases anemia and neutropenia in myelosuppressed animal models. In this study, we further examined various administration protocols of PEG‐rHuMGDF on thrombocytopenia in mice treated with a combination of irradiation and carboplatin. After the myelosuppressive treatment on Day 0, mice received the same amount of PEG‐rHuMGDF be ginning on Day 1 by a single, 3 times (on alternate days), or 7 day daily administration. A single injection of PEG‐rHuMGDF significantly reduced the severity and duration of thrombocytopenia and anemia with a concomitant accelerated recovery of megakaryocytic and erythroid progenitors in the bone marrow, similar to the 2 other administration protocols. As the start of a single injection of PEG‐rHuMGDF was delayed, its therapeutic effects were attenuated. These results indicate that an administration of PEG‐rHuMGDF at an earlier time after the myelosuppressive treatment is necessary to improve thrombocytopenia and anemia.
Short‐Term and Long‐Term Effects of Low‐Density Lipoprotein (LDL) Apheresis on Restenosis after Percutaneous Transluminal Coronary Angioplasty (PTCA): Is Lowering Lp(a) by LDL Apheresis Effective on Restenosis after PTCA?
Authors: Kanemitsu Seiyu , Takekoshi Noboru , Matsui Shinobu , Tsugawa Hiroichi , Ohkubo Shinji , Kitayama Michihiko , Matsuda Takeshi , Senma Junji , Masuyama Kazuhiko , Yamagata Toshirou , Murakami Eiji
Published: November 2007

Abstract: It has been reported that serum lipoprotein(a) (Lp[a]) levels in patients with restenosis after percutaneous transluminal coronary angioplasty (PTCA) were significantly higher than in patients without restenosis. In this study, we evaluated the preventive effect of LDL apheresis on restenosis after PTCA in patients with hypercholesterolemia. For 10 patients who had shown a serum cholesterol level of more than 220 mg/dl despite treatment with antihypercholesterolemic drugs, LDL apheresis was conducted every 2 weeks after a successful PTCA until restenosis could be checked. In 4 patients, LDL apheresis was conducted for 2 years. LDL apheresis significantly reduced serum cholesterol from 248 ± 22 mg/dl to 135 ± 26 mg/dl and Lp(a) from 42 ± 34 mg/dl to 21 ± 16 mg/dl. The average degree of stenosis in the 11 lesions undergoing PTCA was 92 ± 6% before PTCA, 35 ± 10% immediately after PTCA, and 38 ± 19% at 3 to 4 months after PTCA. Restenosis was observed in only 1 lesion. In 4 patients who received LDL apheresis for 2 years, restenosis did not occur in any of the 4 lesions treated. We concluded that LDL apheresis was an efficacious therapy to prevent restenosis after PTCA in patients with hypercholesterolemia.
Present Status of Apheresis Technologies: Part 4. Leukocyte Filter
Authors: Sueoka Akinori
Published: November 2007

Abstract: This article is the fourth of a 4 part series describing the currently available apheresis devices and technologies. The sections include the following: Part 1, Membrane Plasma Separator (published in Vol. 1, No. 1); Part 2, Membrane Plasma Fractionator (published in Vol. 1, No. 2); Part 3, Adsorbent (published in Vol. 1, No. 3); and Part 4, Leukocyte Filter.
Leukocyte Removal Filter‐Passed Lymphocytes Produce Large Amounts of Interleukin‐4 in Immunotherapy for Inflammatory Bowel Disease: Role of Bystander Suppression
Authors: Noguchi Mitsunori , Hiwatashi Nobuo , Hayakawa Tomohiko , Toyota Takayoshi
Published: November 2007

Abstract: To determine immunosuppression by leukocy‐tapheresis, we studied the immune profiles of filter‐passed lymphocytes (FPLs) in patients with ulcerative colitis. These patients were treated with a leukocytapheresis (LCAP) filter of granulocyte apheresis (GCAP) column. Cytokine profiles or FPLs and peripheral blood mononuclear cells (PBMCs) were examined using interleukin (IL)‐4 and interferon‐gamma (IFN‐7) immunoassay with lectin stimulation. The IL‐4 production of LCAP FPLs was significantly higher than in prefilter PBMCs and GCAP column‐passed lymphocytes (median: 540 pg/ml 106 cells versus 4.7 and 2.9, respectively, p = 0.001). IL‐4 production in PBMCs was increased after LCAP. IFN‐γ production was not increased in the FPLs. The IL‐4 immune deviation was not shown in the patients treated with GCAP. LCAP FPLs showed increased CD4+DR‐ cells and decreases CD4+DR+ cells in comparison to PBMCs. LCAP FPLs could produce IL‐4 and may lead to bystander suppression.
Complications of Leukocytapheresis
Authors: Nagase Kazuko , Sawada Koji , Ohnishi Kunio , Egashira Akimitsu , Ohkusu Kazunobu , Shimoyama Takashi
Published: November 2007

Abstract: Recently leukocytapheresis (LCAP) has attracted attention as a new therapy for ulcerative colitis. We reviewed the complications associated with LCAP carried out in our department during the period from December 1992 to September 1997. There were side effects during 195 (9.9%) of the 1,978 sessions performed, involving 47 (51.1%) of the 92 patients treated. Moderate reactions, which caused considerable discomfort to the patients and required the transient interruption of the administration or some medical treatment depending on the state, occurred during 31 (1.6%) of all therapy sessions, involving 15 (16%) patients. All patients recovered soon and never fell into a life‐threateningly severe state. They also did not have any symptoms afterwards. The common side effects were nausea, vomiting, fever, chills, and nasal obstruction. Reactions such as palpitations, respiratory distress, or chest oppressions were common, especially when heparin sodium (HS) was used as the anticoagulant. The type and frequency of side effects depended somewhat on the length of the therapy series or the duration of one session. Other complications such as clotting in the leukocyte removal filter and/or blood line during administration were encountered frequently. These latter problems occurred during 46% of all sessions, but most of them had little significance. Sessions in which HS was used as the anticoagulant showed more severe clotting than those in which nafamostat mesilate (NM) was used. In our series, we experienced a relatively low rate of serious complications. We require, of course, careful observation during and after each session.
Bilirubin Adsorbent Column for Plasma Perfusion
Authors: Takenaka Yoshinori
Published: November 2007

Abstract: To eliminate protein‐bound toxic substances, plasma exchange was introduced. In the case of fulminant hepatitis or other hepatic failure, the supply of coagulation factors is usually necessary; therefore, plasma exchange is a suitable method for the elimination of protein‐bound toxins, for example, bilirubin. However, plasma exchange needs fresh frozen plasma or another protein fraction from humans, and virus contamination or other infectious facrs are a serious problem. In the case of bilirubin, anion exchange resin was used to try to eliminate this toxic substance from the patient's blood or plasma. In Japan a bilirubin adsorption column for plasma perfusion has been put to practical use. This review outlines the characteristics of this bilirubin adsorbent.
A Study of the Efficacy of Plasmapheresis for the Treatment of Drug Induced Toxic Epidermal Necrolysis
Authors: Yamada Hiromichi , Takamori Kenji , Yaguchi Hitoshi , Ogawa Hideoki
Published: November 2007

Abstract: The efficacy of plasmapheresis for the treatment of toxic epidermal necrolysis (TEN) in our patient and related reports in the literature were examined. The patient, a 41‐year‐old female, was diagnosed as having drug (Sedes‐G [isopropylantipyrin, arylisopropylacetou‐reid, and phenacetinum]) induced TEN. Upon admission to our hospital, extensive corticostroid therapy was initiated. After 6 days, because more than 90% of the patient's body surface was affected by TEN, it was concluded that the patient was unresponsive to corticosteroid therapy. Double filtration plasmapheresis (DFPP) was therefore begun. After 2 sessions of DFPP, extensive reepithelial‐ization rapidly occurred, and after 3 sessions of DFPP, the improvement was dramatic. The patient's condition had almost healed during 1 month's hospitalization. It has been reported in the literature that 22 patients with drug induced TEN have been treated with plasmapheresis. The mortality rate of 23 patients, including our patient, was 17.4%. The rate of effectiveness of plasmapheresis on drug induced TEN is 82.6%. It appears that some kind of necro‐lytic factors were removed by the plasmapheresis. This suggests that plasmapheresis may be an effective treatment for drug induced TEN.
Immusorba TR and Immusorba PH: Basics of Design and Features of Functions
Authors: Yoshida Makoto , Tamura Yuichi , Yamada Yukihiro , Yamawaki Naokuni , Yamashita Yasuhiko
Published: November 2007

Abstract: Immusorba was reported by Yamazaki et al. to be the world's first practical immunoadsorbent in 1982. Since then, this immunoadsorbent has accumulated an abundance of clinical achievements. Immusorba has such unique functions that it is used in treating various diseases and holds possibilities for application to more diseases. Immusorba was designed as an artificial receptor for rheumatoid factor (RF) based on structural analysis of heat‐denaturated globulin. Subsequently, new substances that it can adsorb have been found as seen in reports on the adsorption performance of Immusorba to anti‐acetylcholine receptor antibodies (anti‐AChR Abs) and antiganglioside antibodies. Along with this, Immusorba has been used in treating a wide range of diseases. The greatest characteristic of Immusorba is that its adsorption capability is selective rather than specific, making it effective against a great number of diseases.
Lipoprotein (a) Immunapheresis in the Treatment of Familial Lipoprotein (a) Hyperlipoproteinemia in a Patient with Coronary Heart Disease
Authors: Straube Richard , Kingreen Helmut
Published: November 2007

Abstract: This paper reports 2 years' experience with lipoprotein (a) (Lp[a]) immunapheresis which was successfully handled on a now 40‐year‐old patient with familial Lp(a) hyperlipoproteinemia inducing severe coronary heart disease with 2 myocardial infarctions and diffuse coronary sclerosis. Continued treatment by Lp(a) immun‐absorption with specific sheep antibodies reduced stenosis in coronary vessels more than 50% and stopped the progression of coronary heart disease. A special apheresis technique and the results of continued absorption effects are described.
Changes in Plasma Levels of Cyclic Nucleotides During Low‐Density Lipoprotein Apheresis
Authors: Kojima Shunichi , Yoshitomi Yuji , Sugi Toshihiko , Matsumoto Yuji , Yano Michiko , Kuramochi Morio
Published: November 2007

Abstract: The negative charges of dextran sulfate (DS) used for low‐density lipoprotein (LDL) apheresis activate the intrinsic coagulation pathway, accompanied by the production of bradykinin. This study was undertaken to see whether cyclic nucleotide plasma levels are affected by DS LDL apheresis. Previously, we showed the rise in plasma levels of prostaglandins and nitric oxide derivatives accompanied by the rise in bradykinin levels. The physiologic effects of prostaglandins and nitric oxide become manifest through the intracellular signal of cyclic nucleotides. The plasma levels of the cyclic nucleotides (cyclic adenosine monophosphate [cAMP] and cyclic guanosine monophosphate fcGMP]) were examined when either of 2 anticoagulants, heparin or nafamostat mesilate (NM), was used during DS LDL apheresis. The plasma levels of cAMP during LDL apheresis using heparin were 9.2 ± 0.3 (mean ± SE) 12.4 ± 0.6, 12.0 ± 0.5, and 12.1 ± 0.3 pmol/ml, respectively, at the 0,1,000,2,000, and 3,000 ml stages. The rise in cAMP levels was suppressed during apheresis using NM. There were no significant increases in cGMP during apheresis with heparin or with NM. There were significant negative correlations between changes in cAMP and those in the blood pressure. These findings suggest that bradykinin generated during apheresis exerts some physiologic effects via activation of the adenylate cyclase dependent pathway.
A Comparative Study of a New, Fully Automated Procedure and the Standard Mononuclear Cell Program Using the Cobe Spectra for Peripheral Blood Stem Cell Collection
Authors: Hiruma Kiyoshi , Nakayama Shin , Okuyama Yoshiki
Published: November 2007

Abstract: Recently, a completely automated procedure, the AutoPBSC program for the COBE Spectra cell separator, has been developed for peripheral blood stem cell harvest (PBSCH). We compared the performance of the AutoPBSC program with the standard mononuclear cell (MNC) program in the same patients and in a donor. Peripheral blood stem cells (PBSC) were collected from 3 patients or a donor alternately using the MNC program and the AutoPBSC program in a course of PBSC mobilization. Equal blood volume was processed from each patient (200 ml/kg) and a donor (150 ml/kg). We used a harvest volume of 3 ml and a chase volume of 7 ml in all AutoPBSC procedures. The procedure duration was almost equivalent for both programs. The volume of products was significantly lower in the AutoPBSC program (71′± 13 ml) than in the MNC program (183 ± 30 ml). MNC yields were fewer, and total nucleated cell (TNC) and MNC collection efficiency was less for the AutoPBSC program compared to the MNC program. The CD34 + cell collection efficiency was less for the AutoPBSC program (26.5 ± 13.7%, compared with 77.7 ± 60.6%; p > 0.05). The contamination of platelets and red cells was significantly less in the AutoPBSC program than in the MNC program. In conclusion, we consider that the collection efficiency in the new program should be improved by modification of parameters because there exist great advantages to automated procedures.
Elevated Bradykinin and Decreased Carboxypeptidase R As a Cause of Hypotension During Tryptophan Column Immunoabsorption Therapy
Authors: Tsuboi Yoshio , Takahashi Mitsuo , Ishikawa Yasushige , Okada Hidechika , Yamada Tatsuo
Published: November 2007

Abstract. Tryptophan column immunoabsorption therapy is beneficial to the patient with a neuroimmunological disease, but some complications have been attributed to this treatment. There have been some instances of an abrupt shock state along with severe decreases in blood pressure. In regards to this shock state, it has been reported that plasma bradykinin levels increase during tryptophan column immunoabsorption therapy. In this study, we examined the correlation between plasma bradykinin levels and either blood pressure or the levels of its degrading enzymes, angiotensin converting enzyme (ACE) and carboxypeptidase R (CPR) in 6 patients. Increased concentrations of bradykinin were present in the latter half of the therapeutic interval, and plasma bradykinin levels were found to be inversely correlated to CPR activity. The decreased CPR level could augment the activities of bradykinin. We speculate that bradykinin could be responsible for the hypotension occurring in patients during tryptophan column immunoabsorption therapy and that the metabolism of bradykinin could be caused by the decreased activity of CPR.
Autologous Blood Donation Preceding Coronary Artery Bypass Graft Operation in a Hemodialysis Patient
Authors: Shinoda Toshio , Shirai Toshizumi , Takenaka Michiko , Fujiwara Hitoshi , Takayama Masanobu , Ootsuka Masakazu , Nakajima Ken‐ichi , Sakai Takahiro
Published: November 2007

Abstract: A 67‐year‐old male hemodialysis patient with abdominal aortic aneurysm and triple vessel coronary heart disease required autologous blood donation because of his blood type of Rh(‐) before cardiovascular surgery. We performed autologous red blood cell and plasma collection by the switch back method with recombinant human erythropoietin therapy during the 5 weeks before the operation. Autologous platelet collection was also made the day before the operation. These autologous blood donations were safely and successfully performed along with hemodialysis. There was some caution taken for these pro cedures. The ultrafiltration rate had to be adjusted for blood collection or blood transfusion during hemodialysis in order not to disturb fluid balance. It was necessary to monitor the hyperkalemia of the stored autologous packed red blood cells. For platelet collection, blood in the extracorporeal circuit had to be concentrated because of the presence of renal anemia. Coronary artery bypass graft was safely and successfully performed with the autologous blood only.
A Computational Method for Planar Kinematic Analysis of Beam Pumping Units
Authors: Bhagavatula Ramkamal , Fashesan Olu A. , Heinze Lloyd R. , Lea James F.
Published: November 2007

A generalized computational method for planar kinematic analysis of pumping units is presented in this study. In this method, a local coordinate system is assigned to each body with respect to a fixed global coordinate system. The position of each point in a body is determined by specifying the global translational coordinates of the local coordinate system origin and its rotational angle relative to the global coordinate system. Constraint equations of motion are developed using the vector of coordinates of the connected bodies. These equations are solved to yield the position, velocity, and acceleration of the individual linkages at each instance of time. Both rotational and translational types of joints are considered in the analysis. The translational joint analysis is not discussed in this paper as they are not applicable for beam pumping units. This method can be used as an effective tool for pumping unit design and optimization. An example is provided to show the application of this method.
Transient Optimization in Natural Gas Compressor Stations for Linepack Operation
Authors: Abbaspour M. , Krishnaswami P. , Chapman K. S.
Published: November 2007

One of the key factors in the operation of a natural gas pipeline network is the linepack in the network. The desired operation of the network as derived from estimated receipts and deliveries is expressed in terms of the desired linepack profile that must be maintained. The compressor stations in the pipeline network are then operated in a manner that generates this linepack profile. Generally, the operating points selected for the units in the compressor stations are based on experience and experimentation and are therefore not optimal. In this paper, we present a systematic approach for operating the units of a compressor station to meet a specified linepack profile. The first step in developing this approach is the derivation of a numerical method for analyzing the flow through the pipeline under transient nonisothermal conditions. We have developed and verified a fully implicit finite difference formulation that provides this analysis capability. Next, the optimization of the compressor stations is formulated as a standard nonlinear programing problem in the following form: Find the values in the design variable vector denoted by b=[b1,b2,…,bn]T, to minimize a given objective function F(b), subject to the constraints gj(b)⩽0, j=1,…,m. Here, n is the number of operational parameters whose optimal value is to be determined, while m is the number of operational constraints that must be enforced. In our formulation, the design variables are chosen to be the operating speeds of the units in the compressor stations, while the objective function is taken to be the average fuel consumption rate over the interval of interest, summed over all units. The constraint functions gj(b) are formulated suitably to ensure that operational limits are met at the final solution that is obtained. The optimization problem is then solved using a sequential unconstrained minimization technique (SUMT), in conjunction with a directed grid search method for solving the unconstrained subproblems that are encountered in the SUMT formulation. The evaluation of the objective function and constraint functions at each step of the optimization is done by using the fully implicit analysis method mentioned above. A representative numerical example has been solved by the proposed approach. The results obtained indicate that the method is very effective in finding operating points that are optimal with respect to fuel consumption. The optimization can be done at the level of a single unit, a single compressor station, a set of compressor stations, or an entire network. It should also be noted that the proposed solution approach is fully automated and requires no user involvement in the solution process.
Modeling of Chemical Processes in a Diesel Engine With Alcohol Fuels
Authors: Yilmaz Nadir , Donaldson A. Burl
Published: November 2007

Methanol utilization in a compression ignition engine has held tentative promise for a number of years, and, in fact, the concept has seen large scale field trials intended to demonstrate this option as a precursor to commercial implementation. However, results from those tests have identified some of the practical problems encountered with this fuel, namely, (1) its difficulty of vaporization and (2) its high autoignition temperature. Luminosity promoting additives, which facilitate radiative transport as a component of flame spread (because pure alcohol burns with little luminosity, continuum radiation as a reaction transport mechanism is essentially absent), intake air heating, active and passive heat sources, etc., represent some of the attempts to overcome limitations of these two factors. Except for intake air preheat, these augmentation methods have been noted to result in poor off-load thermal cycle efficiency. Focusing on the case of intake air preheat (which can be achieved by elevated compression ratio), and to model the chemical reaction kinetics, the partially stirred reactor model in CHEMKIN was used. This approach provided examination of the chemistry and reaction rates associated with an actual trial in which methanol was the fuel under study. To initiate this simulation, literature available reaction mechanisms were obtained, and then the experimental cylinder pressure history was matched by control of heat release rate via the partially stirred reactor model. This is represented within the reactor model by changing the turbulent mixing intensity factor. The overall reaction sequence, which models cylinder pressure, and attendant extent of reaction were the major focus. The minor focus included production of emission gases, e.g., the aldehydes and unburned fuel. Not only are the model results consistent with actual findings, they also support a method for addressing causes of off-load inefficiency and engine failures due to engine oil dilution with fuel.
Enhancement of structural and magnetic properties in sputtered half-metallic Fe3O4 films
Authors: Tang Xiao-Li , Zhang Huai-Wu , Su Hua , Zhong Zhi-Yong , Jing Yu-Lan
Published: November 2007

Polycrystalline Fe3O4 films grown on different thicknesses of Fe underlayers were prepared by dc reactive-magnetron sputtering in an Ar+O2 gas mixture and annealing under an infrared-lamp furnace system. Analyses of structural and magnetic properties revealed that a 15nm Fe underlayer can be oxidized to Fe3O4 by increasing the oxygen flow rates during initial Fe3O4 layer growth. These analyses also confirmed the stoichiometry and high-crystallographic quality of grown Fe3O4. Adopting this method, Fe3O4 films can be grown without any other elemental buffer layers.
High-flux ion irradiation with energy of ∼20eV affecting phase segregation and low-temperature growth of nc-TiN∕a-Si3N4 nanocomposite films
Authors: Li Z. G. , Wu Y. X. , Miyake S.
Published: November 2007

Ti 0.8 Si 0.2 N films were synthesized by an inductively coupled plasma-assisted magnetron sputtering at deposition temperature lower than 200°C. The effects of the incident ion to Ti+Si flux ratio (0.14⩽Ji∕JTi+Si⩽10), with the ion energy constant at ∼20eV, on film growth, microstructure, and morphology were investigated by x-ray diffraction, x-ray photoelectron spectroscopy, and field emission scanning electron microscope. All films have slightly higher than 50at.% of N content. The film deposited by only magnetron sputtering with Ji∕JTi+Si=0.14 is amorphous with a columnar structure. With the addition of inductively coupled plasma, the as-deposited films become crystalline. The preferred orientation evolves from (111) to (200) with the increase in Ji∕JTi+Si. The film grown with Ji∕JTi+Si=10 exhibits a pure (200) preferred orientation with a fine dense-grained globular structure. The lattice constant of this film is about 0.4244nm, nearly equal to that of monolithic TiN. The binding energy of Si 2p of this film is 101.7eV, consistent with that of amorphous silicon nitride. The low-temperature growth of a nc-TiN∕a-Si3N4 nanocomposite structure is believed to be due to the enhancement of kinetic surface migration induced by high-flux low-energy ion irradiation.
Molecular dynamics simulations of Ar+ bombardment of Si with comparison to experiment
Authors: Humbird David , Graves David B. , Stevens A. A. E. , Kessels W. M. M.
Published: November 2007

The authors present molecular dynamics (MD) simulations of energetic Ar+ ions (20–200eV) interacting with initially crystalline silicon, with quantitative comparison to experiment. Ar+ bombardment creates a damaged or amorphous region at the surface, which reaches a steady-state thickness that is a function of the impacting ion energy. Real-time spectroscopic ellipsometry data of the same phenomenon match the MD simulation well, as do analogous SRIM simulations. They define positional order parameters that detect a sharp interface between the amorphous and crystalline regions. They discuss the formation of this interesting feature in the simulation, and show that it provides insight into some assumptions made in the analysis of experimental data obtained by interface-sensitive surface spectroscopy techniques.
Selection of SHV Extended-Spectrum-β-Lactamase-Dependent Cefotaxime and Ceftazidime Resistance in
Klebsiella pneumoniae
Requires a Plasmid-Borne
bla
SHV
Gene
Authors: Hammond David S. , Harris Tegan , Bell Jan , Turnidge John , Giffard Philip M.
Published: November 2007

In
Klebsiella pneumoniae
, it is common for plasmid-located and chromosome-located
bla
SHV
copies to coexist within single cells. The plasmid-borne genes are mainly derived from two separate IS
26
-mediated mobilizations of
bla
SHV
. The objective of this study was to test the hypothesis that the presence of a non-extended-spectrum β-lactamase (non-ESBL) encoding plasmid-borne form of
bla
SHV
facilitates the cefotaxime (CTX)-mediated selection of ESBL-expressing mutants, even when there is a chromosomal copy of the same gene. Twenty-one diverse ESBL-negative,
bla
TEM
-negative
K. pneumoniae
clinical isolates were tested for the IS
26
insertions characteristic of the two mobilization events. The isolates were then tested for their ability to be selected for ESBL-mediated CTX resistance by serial subculturing with a doubling of the CTX concentration at every subculture. Fourteen isolates possessed neither of the IS
26
insertions. None of these became ESBL positive, and all died during the course of the experiment, despite possessing chromosomal
bla
SHV
copies. The other isolates all became ESBL positive and grew abundantly up to a CTX concentration of 128 μg/ml. Similar results were obtained with ceftazidime. ESBL expression was associated with the appearance of the expected G→A mutation at position 1 of codon 238 and also with
bla
SHV
copy number amplification. It was concluded that plasmid-borne
bla
SHV
greatly facilitates the selection of ESBL expression, even when the same gene is on the chromosome, and that gene dosage effects are likely to contribute to this phenomenon.
Daptomycin Activity against
Staphylococcus aureus
following Vancomycin Exposure in an In Vitro Pharmacodynamic Model with Simulated Endocardial Vegetations
Authors: Rose Warren E. , Leonard Steven N. , Sakoulas George , Kaatz Glenn W. , Zervos Marcus J. , Sheth Anjly , Carpenter Christopher F. , Rybak Michael J.
Published: November 2007

Recently, the emergence of reduced susceptibility to daptomycin has been linked to the reduced vancomycin susceptibility that occurs after vancomycin exposure in
Staphylococcus aureus
in vivo and in vitro. This study evaluated this propensity in clinical isolates of
S. aureus
using an in vitro pharmacokinetic/pharmacodynamic model with simulated endocardial vegetations over 8 days. Five clinical isolates (four methicillin-resistant
S. aureus
isolates and one methicillin-susceptible
S. aureus
[MSSA] isolate), all of which were reported to have become nonsusceptible to daptomycin, were evaluated. The following regimens were evaluated: vancomycin 1 g every 12 h for 4 days followed by daptomycin 6 mg/kg of body weight daily for 4 days and daptomycin 6 mg/kg daily for 8 days. If nonsusceptibility was detected, the following regimens were evaluated: no treatment for 4 days followed by daptomycin 6 mg/kg daily for 4 days, vancomycin 1 g every 12 h for 4 days followed by daptomycin 10 mg/kg daily for 4 days, and daptomycin 10 mg/kg daily for 8 days. The emergence of daptomycin nonsusceptibility (12- to 16-fold MIC increase) was detected only with the MSSA isolate with daptomycin 6 mg/kg daily for 4 days after vancomycin exposure. However, the bactericidal activity of daptomycin was maintained and the MIC increases of these isolates, which had no
mprF
or
yycG
mutations, were unstable to serial passage on antibiotic-free agar. Subsequent regimens did not demonstrate nonsusceptibility to daptomycin. These findings suggest that reduced daptomycin susceptibility can be a strain-specific and unstable event. Further evaluation of the susceptibility relationship between daptomycin and vancomycin is necessary to understand the factors involved and their clinical significance.
The Mechanism of Action of β-
d
-2′-Deoxy-2′-Fluoro-2′-
C
-Methylcytidine Involves a Second Metabolic Pathway Leading to β-
d
-2′-Deoxy-2′-Fluoro-2′-
C
-Methyluridine 5′-Triphosphate, a Potent Inhibitor of the Hepatitis C Virus RNA-Dependent RNA Polymerase
Authors: Murakami Eisuke , Niu Congrong , Bao Haiying , Micolochick Steuer Holly M. , Whitaker Tony , Nachman Tammy , Sofia Michael A. , Wang Peiyuan , Otto Michael J. , Furman Phillip A.
Published: November 2007

β-
d
-2′-Deoxy-2′-fluoro-2′-
C
-methylcytidine (PSI-6130) is a potent inhibitor of hepatitis C virus (HCV) RNA replication in an HCV replicon assay. The 5′-triphosphate of PSI-6130 is a competitive inhibitor of the HCV RNA-dependent RNA polymerase (RdRp) and acts as a nonobligate chain terminator. Recently, it has been shown that the metabolism of PSI-6130 also results in the formation of the 5′-triphosphate of the uridine congener, β-
d
-2′-deoxy-2′-fluoro-2′-
C
-methyluridine (PSI-6206; RO2433). Here we show that the formation of the 5′-triphosphate of RO2433 (RO2433-TP) requires the deamination of PSI-6130 monophosphate and that RO2433 monophosphate is subsequently phosphorylated to the corresponding di- and triphosphates by cellular UMP-CMP kinase and nucleoside diphosphate kinase, respectively. RO2433-TP is a potent inhibitor of the HCV RdRp; however, both enzymatic and cell-based assays show that PSI-6130 triphosphate is a more potent inhibitor of the HCV RdRp than RO2433-TP.