Capillary Permeability In Patients Research Articles

A prospective pilot study of the effect of neutrophil elastase on the pulmonary vascular permeability in patients with pneumonia

Some cases of pneumonia may lead to hypoxemia with acute respiratory failure, acute lung injury (ALI) or acute respiratory distress syndrome (ARDS), which may require intensive management. Neutrophil elastase is thought to be one of the causes of ALI/ARDS, because it raises the pulmonary capillary permeability, lyses of pulmonary connective tissue proteins, and produces leukocyte chemotactic factors. However, a causal relationship between the plasma neutrophil elastase level and changes in the pulmonary capillary permeability has not been established in patients with pneumonia, one of the most serious diseases underlying ALI/ARDS. Therefore, the objective of this study was to determine whether an increase in plasma neutrophil elastase is related to elevation of the pulmonary capillary permeability in patients with pneumonia.

Decreased capillary permeability and capillary density in patients with systemic sclerosis using large-window sodium fluorescein videodensitometry of the ankle

Local capillary permeability in patients with SSc has been reported increased when assessed by nail-fold capillaroscopy. We measured capillary permeability at a clinically less affected site by using large-window fluorescein videodensitometry of the ankle. We hypothesized that increased capillary permeability or leakage is a generalized phenomenon in SSc. Large-window videodensitometry with sodium fluorescein was performed in 38 SSc patients and 20 healthy controls. Capillary permeability was expressed as the average relative light intensity over the first 7 min [I(av)(7)] after appearance of fluorescein in skin capillaries. Capillary permeability, expressed as I(av)(7) was significantly decreased in patients with SSc (47.3 +/- 15.0% vs 57.6 +/- 9.4% in controls, P = 0.007), as was capillary density (12 +/- 6/mm(2) vs 26 +/- 11/mm(2), P < 0.001). Adjustment for capillary density in multivariate regression analysis demonstrated that differences in I(av)(7) between SSc patients and controls were related to differences in capillary density, BMI and high density lipoprotein cholesterol. At the level of the ankle decreased capillary permeability was found in SSc patients, related to decreased capillary density. Microvascular involvement in SSc is widespread, but no evidence was established for increased capillary permeability at the level of individual capillaries as a generalized phenomenon.

In vivo and in vitro effects of salbutamol on alveolar epithelial repair in acute lung injury

Background: Acute lung injury is an important cause of respiratory failure in the critically ill patient. It is caused by damage to the alveolar barrier with subsequent alveolar flooding leading...

ANECORTAVE ACETATE TREATMENT FOR RETINAL ANGIOMATOUS PROLIFERATION

The purpose of this study was to evaluate anecortave acetate treatment of retinal angiomatous proliferation (RAP), a neovascular form of age-related macular degeneration, with specific regard to inhibition of neovascularization and maintenance of vision. Thirty-four patients with RAP with any stage of neovascularization were randomized 1:1:1 for treatment with three different quantities (30 mg, 15 mg, 3 mg) of anecortave acetate sterile suspension for juxtascleral administration. Best-corrected visual acuity (Early Treatment Diabetic Retinopathy Study chart), intraocular pressure measurement, biomicroscopy, funduscopy, digital fluorescein, and indocyanine green angiography were recorded at baseline and at 3 months. A 6-month retreatment interval was established for this study with a follow-up of 12 months. In selected patients optical coherence tomography was performed. The outcomes were mean changes in visual acuity and lesion size at 1 year. The detachment of the neurosensory retina and retinal pigment epithelium improved in all eyes, but all neovascular lesions increased in size. Vision loss occurred in the majority of study eyes (22 out of 34 eyes, 64.7%) independent of the concentration administered. The results suggest that a posterior juxtascleral injection of anecortave acetate reduces capillary permeability in patients with RAP. However, in spite of improvement of the exudation there is a progression of neovascularization and a significant loss of vision in all these patients. Like other monotherapeutic methods used to treat this variant of neovascular age-related macular degeneration, anecortave acetate alone does not appear to benefit these patients. Future studies should investigate a combination form of therapy.

Effect of prior statin therapy on capillary permeability in the lungs after cardiac or vascular surgery

Cholesterol-lowering statins can ameliorate severe forms of vascular hyperpermeability in experimental studies, and may thereby ameliorate acute lung injury and sepsis. It is unknown whether this also applies to humans. This study aimed to define whether or not prior statin therapy reduces mild post-operative increases in pulmonary capillary protein permeability associated with acute lung injury after cardiac or major vascular surgery. A prospective observational study was performed in an intensive care unit of a university hospital on 64 patients, 37 after elective cardiac and 27 after major vascular surgery, of whom 68 and 44%, respectively, had received prior statin therapy. A mobile probe system was used to measure the pulmonary leak index (PLI), i.e. the transvascular transport rate of gallium-67-radiolabelled transferrin. For all of the patients together, the mean PLI did not differ between the statin and control groups (22.9 versus 24.4 x 10(-3) min(-1)). The prevalence of an elevated PLI was 57% in the statin and 59% in the control group. Subgroup analysis did not reveal significant differences caused by statins in the PLI of these patients. Prior statin therapy neither has an adverse effect on mildly increased pulmonary capillary permeability in patients after cardiac or major vascular surgery nor does it ameliorate this increased capillary permeability.

Short-term aggressive LDL-lowering, endothelial-mediated arteriolar vesodilatation and capillary permeability in patients with atherosclerotic vascular disease

Short-term aggressive LDL-lowering, endothelial-mediated arteriolar vesodilatation and capillary permeability in patients with atherosclerotic vascular disease

Bedside measurement of pulmonary capillary permeability in patients with acute lung injury What have we learned?

Bedside measurement of pulmonary capillary permeability in patients with acute lung injury What have we learned?

Improvement of Capillary Permeability in Patients with Venous Hypertension After Treatment with TTFCA

The VSC (vacuum suction chamber) device, a new system to evaluate local capillary permeability, was used with laser Doppler flowmetry to study variations of permeability and of the microcirculation in 10 normal subjects; in 22 patients with moderate, superficial venous hypertension; and in 12 patients with postphlebitic limbs and severe venous hypertension. All these patients had distal (ankle and foot edema) in the evening. After a first assessment these subjects were studied again after two weeks without treatment and after two weeks' treatment with total triterpenic fraction of centella asiatica (TTFCA), tablets, 60 mg, tid. The VSC produces a wheal on the skin of the perimalleolar region that disappears (in average) in less than sixty minutes in normal subjects. The disappearance time (DT) is greater in conditions of increased capillary filtration and permeability. The three groups of subjects (normal and those with superficial and severe venous hypertension) had significantly different, increasing disappearance time of the wheals at the first observation. There were no significant changes after two weeks' observation, but after 2 weeks' treatment with TTFCA, there was a significant decrease of DT both in limbs with superficial and with deep venous incompetence. The improvement (decrease) of the abnormally increased capillary permeability was associated with a significant improvement of the microcirculation and symptoms (studied by an analogue scale line). In conclusion this study showed a combined improvement of the microcirculation and capillary permeability after treatment with TTFCA and the possibility of using the VSC to evaluate the effects of drugs (or other treatment) on local capillary permeability in patients with venous hypertension.

A Study of Capillary Permeability in Patients with Venous Hypertension by a New System: The Vacuum Suction Chamber (VSC) Device — A Preliminary Report

A Study of Capillary Permeability in Patients with Venous Hypertension by a New System: The Vacuum Suction Chamber (VSC) Device — A Preliminary Report

A new method for evaluating an increased general capillary permeability in patients.

The difference between total plasma volume determined with a substance which escapes from vascular beds in the presence of an increase of general capillary permeability and that determined with a substance which is confined to blood even in the presence of an increased capillary permeability may reflect the degree of an increase of general capillary permeability. The total plasma volume was determined by simultaneous injections of 131I-HSA and 51Cr tagged red cells. The capillary permeability was evaluated by calculating the difference (deltaTPV) between total plasma volume determined with 131I-HSA and that determined with 51Cr tagged red cell. deltaTPV in patients with systemic lupus erythematosus, idiopathic thrombocytopenic purpura, chronic active hepatitis, liver cirrhosis and subacute baterial endocarditis was larger than that of controls, averaging 204ml/m2, 178 ml/m2, 82 ml/m2, 131 ml/m2 and 179 ml/m2, respectively. The increase of deltaTPV was considered to indicate the increase of capillary permeability in these patients. A permeability increasing factor was present in serum of patients with an elevated deltaTPV. There was a significant correlation between deltaTPV and the titer of serum capillary permeability increasing factor in these patients.