Evaluation of different perfusion durations in direct hemoperfusion with polymyxin B-immobilized fiber column therapy for acute exacerbation of interstitial pneumonias.

BACKGROUND: Recently, the potential therapeutic effect of direct hemoperfusion with a polymyxin B-immobilized fiber column (PMX-DHP) has been reported for acute exacerbation of interstitial pneumonia (AE-IP), a highly morbid clinical event; however, there is no consensus on the appropriate procedure for PMX-DHP. We examined the appropriate perfusion duration of PMX-DHP for AE-IP. METHODS: AE-IP patients receiving PMX-DHP were divided into two groups: short-duration group (≤6 h) (n = 5) and long-duration group (12 h) (n = 12). RESULTS: ThePaO(2)/FiO(2) (P/F) ratio increased immediately after PMX-DHP in the two groups. In the long-duration group, the P/F ratio continued to increase over the following 7 days, while, in the short-duration group, the P/F ratio declined again 3 days after therapy. The survival rate 30 days after PMX-DHP was significantly higher in the long-duration group than in the short-duration group. CONCLUSIONS: A long perfusion duration of PMX-DHP is more efficacious for AE-IP than a short perfusion duration.

CuF-chemiluminescent reaction and plasma switching by laser ablation in the gaseous Cu-CF(4) system and their interactions with magnetic field.

In view of new metal catalysis reactions, CuF-chemiluminescent and plasma reactions in a gaseous Cu-CF(4) system are studied as well as their interactions with a magnetic field. As for the chemiluminescent reaction, the spectroscopic analysis of the CuF chemiluminescence in the reaction of CF(4) with Cu emitted by laser ablation with a fundamental beam of a Nd(3+):YAG laser indicates that the rotational, vibrational, and translational temperatures of the product CuF are rather similar, suggesting the simple heating mechanism. In this mechanism, the high translational energy of the reactant Cu atom will be used to go over the early barrier. The mechanism is evidenced by experimentally observing that the reaction barrier decreases with an increase in the translational energy of the reactant Cu by an increase in the laser power for ablation. On the other hand, in the further study, we find that Cu emitted by laser ablation can switch the plasma in an electric field less than that necessary for the direct discharge in dc-plasma and call it PLASLA (plasma switching by laser ablation). In PLASLA, the plasma is formed by the first ablation, quenched by the second ablation, formed by the third ablation, quenched by the fourth ablation, and so on. Thus PLASLA will be a promising new metal catalysis process for materials science. In particular, the cooperation of the ablation laser with the laser for photoreactions will be significant as a new technique. The studies on the mechanism of PLASLA with metals of Cu, Al, Ag, Zn, Co, Ni, Ti, Mo, and W indicate that the metals are classified into three groups. It is of great interest that the classification agrees with the classification by their electronic configurations. PLASLA is found to be formed rather easily and stable with Al, Ag, Cu, and Zn of group I. Species such as C, C(+), C(2+), and C(2) are observed in the time-resolved spectra of PLASLA luminescence at 0.5 mus after laser ablation, suggesting carbon polymers as the final product. In fact, the TOF (time-of-flight) mass spectrometric analysis of the product material confirms it. Furthermore, PLASLA and the CuF-chemiluminescent reaction are studied in a magnetic field. In the chemiluminescent reaction, we propose that the field switches the reaction paths by mixing the singlet and triplet potential surfaces at level crossing by breaking the spin selection rule. The field affects PLASLA through the MHD (magneto-hydrodynamic) processes such as E x B drifts and cyclotron circulation, as well as the singlet-triplet mixing.

Possible therapeutic effect of direct haemoperfusion with a polymyxin B immobilized fibre column (PMX-DHP) on pulmonary oxygenation in acute exacerbations of interstitial pneumonia.

BACKGROUND AND OBJECTIVE: Acute exacerbations of interstitial pneumonias (IP) can occasionally occur, and have an extremely poor prognosis. Recently, direct haemoperfusion with a polymyxin B immobilized fibre column (PMX-DHP) was shown to have a beneficial effect in acute exacerbations of IPF. However, little is known about the efficacy of PMX-DHP in acute exacerbations of other IP. This study investigated the effectiveness and safety of PMX-DHP in acute exacerbations of IP. METHODS: The study subjects consisted of five patients with an acute exacerbation of IP, including three with IPF, one with idiopathic interstitial pneumonia (IIP) with atypical radiological findings of IPF, and one with myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA)-related IP. The patients were treated with two courses of 3-12 h each of PMX-DHP, concurrently with corticosteroids alone or plus cyclophosphamide. RESULTS: After two courses of PMX-DHP, the PaO(2)/fraction of inspired oxygen (FiO(2)) (P/F) ratio increased rapidly from an average of 93 to 260 mm Hg, and there was radiological improvement in all patients. However, one patient treated for 3 h each time eventually died of respiratory failure, and two patients treated for 6 h each time died from respiratory infections. The other two patients were treated for 12 h each time, and the therapeutic effects lasted longer, with both surviving longer than 48 days. No adverse effects were detected apart from thrombocytopaenia. CONCLUSION: PMX-DHP therapy was safe and effective in improving oxygenation in acute exacerbations of IPs, either with corticosteroids alone or plus cyclophosphamide, and may be beneficial for the treatment of this condition.