Keiko Inatomi

Sequential Changes of Perivascular Edema Cuffs in Models of Permeability and Hemodynamic Pulmonary Edema

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.

A case of small cell carcinoma of the lung with neurological symptoms due to intramedullary metastasis.

65才男性.左下肢しびれ感と筋力低下で発症し, 下半身麻痺へと進行した.左中肺野に腫瘤影を認め, 皮下腫瘤の生検で低分化の癌細胞を検出したが, 下半身麻痺との関係は不明であった.剖検では, 左肺S4原発の中間細胞型小細胞癌の腰髄内転移を認めた.脊髄内転移は極めて稀であり, その転移症状が初発症状であったことは興味がある.肺癌に神経症状を伴う時, 脊髄内転移の可能性も念頭に置くべきである.