Increase of microvascular permeability is one of the most important pathological events in the pathogenesis of trauma and burn injury. Massive leakage of fluid from vascular space leads to lose of blood plasma and decrease of effective circulatory blood volume, resulting in formation of severe tissue edema, hypotension or even shock, especially in severe burn injury. Fluid resuscitation has been the only valid approach to sustain patient's blood volume for a long time, due to the lack of overall and profound understanding of the mechanisms of vascular hyperpermeability response. There is an emerging concept in recent years that some so-called barrier stabilizing mediators play a positive role in preventing the increase of vascular permeability. These mediators may be released in response to proinflammatory mediators and serve to restore endothelial barrier function. Some of these stabilizing mediators are important even in quiescent state because they preserve basal vascular permeability at low levels. This review introduces some of these mediators and reveals their underlying signaling mechanisms during endothelial barrier enhancing process.
Burns ; Capillary Permeability ; Fluid Therapy ; Humans ; Permeability

Immune cells (leukocytes or white blood cells) move actively and sensitively based on body conditions. Despite their important role as protectors inside the body, it is difficult to directly observe the spatiotemporal momentum of leukocytes. With advances in imaging technology, the introduction of two-photon microscopy has enabled researchers to look deeper inside tissues in a three-dimensional manner. In observations of immune cell movement along the blood vessel, vascular permeability and innate immune cell movements remain unclear. Here, we describe the neutrophil extravasation cascade, which were observed using a two-photon intravital imaging technique. We also provide evidence for novel mechanisms such as neutrophil body extension and microparticle formation as well as their biological roles during migration.
Blood Vessels ; Capillary Permeability ; Cell Movement ; Leukocytes ; Microscopy ; Neutrophils*

No abstract available.
Angiotensin II* ; Angiotensins* ; Capillary Permeability ; Female ; Ovarian Hyperstimulation Syndrome

BACKGROUND: Exposure to hyperoxia causes extensive injury to lung tissue, which resembles the pathologic changes of the adult respiratory distress syndrome. To observe the relationship between the pulmonary oxygen toxicity and duration of exposure to oxygen, 100% oxygen was exposed to Wistar rats. METHODS: 35 rats were partitioned into 5 groups (n=7 in each group). Gr. I breathed room air. Gr. II, III, IV and V were exposed to 99~100% oxygen for 24 hrs, 48 hrs, 60 hrs and 72 hrs. Wet lung/body weight (WW/BW), dry lung/body weight (DW/BW), wet/dry lung weight (WW/DW) and I-albumin flux ratio were measured in each group. RESULTS: After exposure for 72 hrs in Gr. V, 3 rats were dead. WW/BW in Gr. I was 0.69+/-0.04 and increased to 1.10+/-0.28 in Gr.II (P<0.05), which was maintaind until 60 hrs. It showed marked increase in Gr. V; 2.16+/-0.60. DW/BW, WW/DW and I-albumin flux ratio increased after 48 hrs of hyperoxia. WW/BW and DW/BW in Gr. V and I-flux ratio in Gr. IV showed significant increase compared with Gr. I, II and III. CONCLUSIONS: The results suggest that pulmonary capillary permeability begins to change after 24 hrs of hyperoxia and that definite permeability change to albumin and fluid accumulation in the lung are demonstrable from 48 hrs-exposure to 99~100% oxygen and aggravated by duration of oxygen exposure.
Animals ; Capillaries* ; Capillary Permeability* ; Hyperoxia ; Lung ; Oxygen* ; Permeability ; Rats* ; Rats, Wistar ; Respiratory Distress Syndrome, Adult

The epithelium, including the respiratory system, acts as a selective gate between the outside environment and underlying tissue. Epithelial cells are polarized due to the formation of the apical junctional complex, which includes adherent junctions and tight junctions. Endothelial cells are one of the most important cellular constituents of blood vessels. Endothelial junctional proteins play important roles in tissue integrity as well as in vascular permeability, leukocyte extravasation, and angiogenesis. This review focuses on the apical junctional complex in respiratory diseases.
Blood Vessels ; Capillary Permeability ; Endothelial Cells ; Epithelial Cells ; Epithelium ; Leukocytes ; Permeability ; Respiratory System ; Tight Junctions

Systemic capillary leak syndrome (SCLS) is a condition that's caused by the shift of fluid and protein from the intravascular space to the interstitial space as a result of repetitive episodes of capillary hyperpermeability. The pathogenesis of SCLS is still unclear, but there's recently been a report showing this syndrome in association with monoclonal gammopathy. This syndrome can be a fatal disease because cardiovascular collapse can occur in the initial capillary leak phase. Although theophylline, diuretics, terbutaline, steroids, calcium antagonist, Ginkgo biloba extracts and plasmapheresis have been suggested as medication, none of them have been proven to be effective. Considering that this disease is self-limiting, conservative treatment in the acute phase is believed to be very important. Because hypoalbuminemia is very a common manifestation of SCLS, Pentastarch, which has a higher molecular weight than albumin, could be efficient to prevent cardiovascular collapse. We used 10% Pentastarch during the acute SCLS attacks of 2 patients and the patients both showed a dramatic response. Pentastarch may be helpful to treat SCLS in its initial capillary leak phase by the elevating blood pressure, and this might contribute to somewhat decreasing the acute mortality of SCLS.
Adult ; Capillary Leak Syndrome/diagnosis/*drug therapy/etiology ; Capillary Permeability ; Female ; Hetastarch/*therapeutic use ; Humans ; Plasma Substitutes/*therapeutic use

BACKGROUND: Rhinovirus infection of the airways results in increased permeability of the airway vascular endothelium with the influx of plasma proteins, including lipids such as LDL. In vitro studies on the effect of oxLDL on leukocytes has shown many proinflammatory effects on multiple leukocytes. We hypothesized that oxLDL is one mechanism for recruiting granulocytes to the airways during a RV infection. Therefore, chemotaxis and transendothelial migration, in response to nLDL, was determined for these granulocytes. METHODS: nLDL was oxidized with 5mM Cu2SO4 for 20-24 hours. 3-5×10(5) cells were loaded into the Transwell filter while the chemotatic agonists were placed in the lower well for chemotaxis. Confluent monolayers on HPMEC were grown on Transwell filters for transendothelial migration. The filters were washed and eosinophils and neutrophils loaded on to the filter with the chemotatic agonist was were placed in the lower well. The wells were incubated for 3 hours. The number of migrating cells was counted on a hemocytometer. RESULTS: OxLDL, but not nLDL, is chemotatic for eosinophils and neutrophils. The level of granulocytes chemotaxis was dependent on both the concentration of LDL and its degree of oxidation. OxLDL stimulates eosinophil and neutrophils migration across HPMEC monolayers (±IL-1β preactivation) in a dose dependent manner. CONCLUSION: Increased vascular permeability during a RV infection may lead to the influx and oxidation of LDL. The resulting oxLDL. is one possible mechanism for the recruitment of neutrophils and eosinophils to the airway interstitial matrix. Once in the airways, granulocytes can further interact with oxLDL to promote airway inflammation.
Blood Proteins ; Capillary Permeability ; Chemotaxis ; Endothelium, Vascular ; Eosinophils* ; Granulocytes ; Inflammation ; Leukocytes ; Neutrophils* ; Permeability ; Rhinovirus ; Transendothelial and Transepithelial Migration

The endothelial glycocalyx (EG) is a gel-like layer lining the luminal surface of healthy vascular endothelium. Recently, the EG has gained extensive interest as a crucial regulator of endothelial funtction, including vascular permeability, mechanotransduction, and the interaction between endothelial and circulating blood cells. The EG is degraded by various enzymes and reactive oxygen species upon pro-inflammatory stimulus. Ischemia-reperfusion injury, oxidative stress, hypervolemia, and systemic inflammatory response are responsible for perioperative EG degradation. Perioperative damage of the EG has also been demonstrated, especially in cardiac surgery. However, the protection of the EG and its association with perioperative morbidity needs to be elucidated in future studies. In this review, the present knowledge about EG and its perioperative implication is discussed from an anesthesiologist's perspective.
Blood Cells ; Capillary Permeability ; Endothelium, Vascular ; Glycocalyx* ; Oxidative Stress ; Permeability ; Phenobarbital ; Reactive Oxygen Species ; Reperfusion Injury ; Thoracic Surgery

Acute bilateral reexpansion pulmonary edema after pleurocentesis is a rare complication. In one case, bilateral reexpansion pulmonary edema after unilateral pleurocentensis in sarcoma was reported. Verious hypotheses regarding the mechanism of reexpansion pulmonary edema include increased capillary permeability due to hypoxic injury, decreased surfactant production, altered pulmonary perfusion and mechanical stretching of the membranes. Ragozzino et al suggested that the mechanism leading to unilateral reexpansion pulmonary edema involves the opposite lung when there is significant contralateral lung compression. Here we report a case of bilateral reexpansion pulmonary edema and acute respiratory distress syndrome after a unilateral pleurocentesis of a large pleural effusion with contralateral lung compression and increased interstitial lung marking underlying chronic liver disease.
Capillary Permeability ; Liver Diseases ; Lung ; Membranes ; Perfusion ; Pleural Effusion ; Pulmonary Edema* ; Respiratory Distress Syndrome, Adult ; Sarcoma

Currently, hemodynamic monitoring system is developing rapidly, with many different devices now available, which makes anesthesiologists feel somewhat confused by the various possibilities and issue of noninvasiveness. By the order of degree of invasiveness, these devices can be classified into the highly invasive pulmonary artery catheter and the completely noninvasive bioimpedance/bioreactance technique and Doppler echocardiography. Recently, trans-cardiopulmonary thermodilution-derived hemodynamic parameters, such as global end-diastolic volume, global ejection fraction, cardiac function index, extravascular lung water, pulmonary vascular permeability index and its cardiac output, are available in anesthetic practice by PiCCO(R)(Pulsion Medical Systems) and VolumeView(R) (Edwards Life Sciences). This article provides objective review of the monitoring systems, as well as the advantages and limitations, in order to offer better management of the critically ill patients undergoing surgery.
Capillary Permeability ; Cardiac Output* ; Catheters ; Critical Illness ; Echocardiography, Doppler ; Extravascular Lung Water ; Hemodynamics* ; Humans ; Pulmonary Artery