No abstract
The areas of perivascular edema cuffs surrounding pulmonary arteries and veins were sequentially measured as an index of the fluid transport unit in lung interstitium (FTULI) in epinephrine-induced and oleic acid-induced pulmonary edema in rats. The former edema represents a model of hemodynamic edema and the latter, permeability pulmonary edema, respectively. In epinephrine-induced pulmonary edema, both the ratio of edema cuff area to cross-sectional area of the pulmonary artery (Rr) and the ratio of lung weight to body weight (L/B) were increased in parallel, reached maximum levels at 0.5 h after the treatment, and returned to the control levels after 3 h. In oleic acid-induced pulmonary edema, the changes in Rr and L/B were not parallel, and the maximum levels were reached at different times, Rr at 3 h and L/B at 1.5 h. Rr returned close to the control level in 24 h but L/B remained elevated so that rate of recovery was delayed. The cuffs around the veins appeared similar to those around the arteries, but were very slight in both models. The difference in the time course of Rr and L/B in the two models may suggest that the recruitment of FTULI is insufficient in oleic acid-induced pulmonary edema; this limitation seems to be an important factor which makes the permeability edema refractory to treatment, together with the damage to the blood gas barrier
Artificial pleural fluids, containing plasma protein from 0.1 to 9.0 g per 100 ml, indocyanine green (ICG) and para-aminohippurate (PAH), were injected into the pleural cavity of dogs. The concentration of these two indicators were measured at a regular time interval, and the lymphatic and non-lymphatic flows and PAHclearance were calculated by Stewart's and Takashina's equations. Whenthe protein concentration in the pleural fluid was less than 4 g per 100 ml, the pleural fluid volume decreased at a rate of 0.20 ml/kg/hour. The decrease was due to pleural fluid drainage by the lymphatic flow, because the inward and outward non-lymphatic flows due to hydro-oncotic forces balanced each other and the net non-lymphatic flow was essentially zero. Whenthe protein concentration was 6 g per 100 ml or more, the decrease of pleural fluid was remarkably attenuated, because of an increase of the inward non-lymphatic flow due to an increase of protein concentration in the pleural fluid. Even in these situations, the lymphatic flow was kept at the rate of 0.20 ml/kg/hour, similarly with the former conditions. From these results, it may be concluded that the lymphatic system is a principal factor, and that factors governed by hydro-oncotic elements have additive effect to that of the lymphatic system in the regulation of pleural fluid dynamics.Key Words: Lymphatic flow, Non-lymphatic flow, PAH clearance, Pleural fluid Pleurisy due to various causes is not uncommonand in fact such cases may be increasing nowadays because of an increase in the incidence of malignant pulmonary diseases. Despite the frequency of pleurisy, our understanding of pleural fluid dynamics is not sufficient. It is generally believed that the formation and the absorption of pleural fluids are controlled by hydro-oncotic forces acting in and around the pleural space. However, the role played by the lymphatic system in the regulation of pleural fluid has remained obscure.The object of this experiment is to study pleural fluid drainage patterns through lymphatic and non-lymphatic routes, by changing pleural fluid protein concentration over a wide rangefrom O.i to 9.0gper 100ml-in dogs. pentobarbital sodium (25 mg/kg, iv), and ventilated with room air delivered by a positive pressure ventilator through a cuffed endotracheal tube at a respiratory rate of 20 times per minute and 15 ml/kg tidal volume. A femoral artery was catheterized to measure systemic blood pressure, and a femoral vein, for continuous infusion of physiological saline solution at a rate of 3 ml/kg/hour.
Not only healthcare professionals but also local governments must have knowledge of infectious disease in order to maintain the health of disaster victims. We conducted a survey to determine local government awareness and response to infection prevention. In total 611 surveys (64.8) were returned. We found a link between two items:``Being able to respond adequately at the time of disaster'' and``Knowledge of infectious disease.'' Therefore, local governments consider it is di‹cult to respond adequately without knowledge of infectious diseases. It is clear that knowledge of infectious diseases is necessary for the person in charge of disaster prevention.
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