Ciba Foundation Symposium 38 - Lung Liquids

332 Pages·1976·7.161 MB·English

Lung Liquids
The Ciba Foundution for the promotion of international cooperation in
medical and chemical research is a scientific and educational charity established by
ClBA Limited - now CIBA-GEIGY Limited - of Bade. The Foundation operates
independently in London under English trust law.
Cibu Foundation Sq’mposia are publhhed in collaboration with
Elsevier Scientific Publishing Compuny, Excerpta Medicu,
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Elsevier / Excerpta Medica / North-Holland, P.O. Box 21 I, Amsterdam
Lung Liquids
Ciba Foundation Symposium 38 (new series)
1976
Elsevier Excerpta Medica . North-Holland
+
Amsterdam . Oxford . New York
0 Copyright 1976 Ciha Foundation
All rights reserved. No part of this publication may be reproduced or transmitted in any
form or by any means, electronic or mechanical, including photocopying and recording,
or by any information storage and retrieval system, without permission in writing from the
publishers.
ISBN Excerpta Media 90 2 I9 4043 4
ISBN American Elsevier 0-444-15 204-0
Published in March 1976 by Elsevier/Excerpta Medica/North-Holland, P.O. Box 21 1,
Amsterdam, and
American Elsevier, 52 Vanderbilt Avenue, New York, N.Y. 10017.
Suggested series entry for library catalogues: Ciba Foundation Symposia
Suggested publisher's entry for library catalogues: Elsevier/Excerpta Medica/North-Holland.
Ciba Foundation Symposium 38 (new series)
Library of ConBress Cataloging in Publication Data
Symposium on Lung Liquids, London, 1975.
Lung liquids.
(Ciba Foundation symposium ; 38 (new ser.))
"Held at the Ciba Foundation, London, 22-24
April 1975."
Bibliography: p.
Includes indexes.
1. Lungs--Congresses. 2. Body fluids--Con-
gresses. 3. Biological transport--Congresses.
I. Title. 11. Series: Ciba Foundation. Sympos-
ium ; new ser., 38. [DNLM: 1. Body fluids--Phys-
iolcgy--Congresses. 2. Lung--Physiology--Con-
qresses. 3. Cell membrane permeabilitv--Conqresses.
W3 ClhlF v. 38 1975 / WF600 S987L 19751
QP121. S95 1975 621.2 76-870
ISBN 0-444-15204-0
Printed in The Netherlands by Van Gorcum, Assen
Contents
c. J. DICKINSON Introduction: goals of the meeting 1
E. E. SCHNEEBERGER Ultrastructural basis for alveolar-capillary permeability
to protein 3
Discussion 22
A. P. FISHMAN & G. G. PIETRA Permeability of pulmonary vascular endothelium
29
Discussion 38
L. B. STRANG The permeability of lung capillary and alveolar walls as deter-
minants of liquid movements in the lung 49
Discussion 58
B. A. WAALER & P. AARSETH Interstitial fluid and transcapillary fluid balance
in the lung 65
Discussion 7 1
A. c. GUYTON, A. E. TAYLOR, R. E. DRAKE & J. c. PARKER Dynamics of sub-
atmospheric pressure in the pulmonary interstitial fluid 77
Discussion 96
E. A. EGAN Effect of lung inflation on alveolar permeability to solutes 101
Discussion 11 0
General Discussion I 1 15
R. D. KEYNES Comparative aspects of salt and water transport across lung
epithelium 125
Discussion 128
VI CONTENTS
J. MAETZ Transport of ions and water across the epithelium of fish gills 133
Discussion 155
R. P. DURBIN Coupling of water to solute movement in isolated gastric
mucosa 161
Discussion 169
J. T. GATZY Ion transport across amphibian lung 179
Discussion 195
R. E. OLVER Ion transport and water flow in the mammalian lung 199
Discussion 209
T. M. ADAMSON & B. P. WAXMAN Carbonate dehydratase (carbonic anhydrase)
and the fetal lung 221
Discussion 23 1
L. E. FARHI, J. L. PLEWES & A. J. OLSZOWSKA Lung carbonate dehydratase
(carbonic anhydrase), CO, stores and CO, transport 235
Discussion 245
General Discussion II 251
N. c. STAUB, M. GEE & c. VREIM Mechanism of alveolar flooding in acute
pulmonary oederna 255
Discussion 263
E. D. ROBIN & J. THEODORE Intracellular and subcellular oedema and
dehydration 273
Discussion 284
General Discussion III 29 1
c. J. DICKINSON Clinical disorders of lung liquid 301
Discussion 305
c. J. DICKINSON Closing remarks 319
Index of contributors 323
Subject index 325
Part icipa nt s
Symposium on Lung Liquids held at the Ciba Foundation, London
22-24 April 1975
*c. J. DICKINSON (Chairman) Medical Unit, University College Hospita-
Medical School, Huntley Street, London WClE 655
T. M. ADAMSON Dept of Paediatrics, Monash University, Queen Victoria
Hospital, Melbourne, Victoria, Australia 3000
E. AGOSTONI Istituto di Fisiologia umana, Universith di Milano, Via
Mangiagalli 32, 20133 Milano, Italy
w. A. CROSBIE Chest Unit, Dept of Medicine, King’s College Hospital Medical
School, Denmark Hill, London SE5 8RX
P. DEJOURS Laboratoire de Physiologie Respiratoire, Centre National de la
Recherche Scientifique, 23 rue Becquerel, 67087 Strasbourg C, France
K. w. DONALD Dept of Medicine, University of Edinburgh, The Royal
Infirmary, Edinburgh EH3 9YW
R. P. DURBIN Cardiovascular Research Institute, University of California
at San Francisco, San Francisco, California 94143, USA
E. A. LGAN Dept of Pediatrics, Division of Neonatology, College of Medicine,
University of Florida, Gainsville, Florida 326 10, USA
L. E. FARHI Dept of Physiology, State University of New York, Buffalo, New
York 14214, USA
A. P. FISHMAN Cardiovascular-Pulmonary Division, Dept of Medicine,
Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia,
Pennsylvania 19104, USA
* Present address: Dept of Medicine, St Bartholomew’s Hospital Medical College, West
Smithfield, London EClA 7BE
VIlI PARTICIPANTS
J. T. GATZY Dept of Pharmacology, The School of Medicine, The University
of North Carolina at Chapel Hill, North Carolina 27514, USA
A. c. GUYTON Dept of Physiology & Biophysics, The University of Mississippi
Medical Center, 2500 North State Street, Jackson, Mississippi 39216, USA
J. M. B. HUGHES Dept of Medicine, The Royal Postgraduate Medical School,
Hammersmith Hospital, Du Cane Road, London SE5 8RX
P. HUGH-JONES Dept of Medicine, Chest Unit, King’s College Hospital
Medical School, Denmark Hill, London SE5 8RX
R. D. KEYNES Physiological Laboratory, University of Cambridge, Downing
Street, Cambridge CB2 3EG
G. de J. LEE Cardiac Department, Radcliffe Infirmary, Oxford OX2 6HE
J. MAETZ Groupe de Biologie Marine, Dept de Biologie, Commissariat a
I’Energie Atomique, Station Zoologique, 06230 Villefranche-sur-mer,
France
c. c. MICHEL University Laboratory of Physiology, Parks Road, Oxford
OX1 3PT
I. c. s. NORMAND Dept of Child Health, University of Southampton, East
Wing, Room E. 159, Southampton General Hospital, Tremona Road,
Southampton SO9 4XY
R. E. OLVER Dept of Paediatrics, University College Hospital Medical School,
Huntley Street, London WClE 6BH
E. D. ROBIN Dept of Medicine, Stanford University School of Medicine,
Stanford, California 94305, USA
E. SCHNEEBFRGER Dept of Pathology, Harvard Medical School and Children’s
Hospital Medical Center, 300 Longwood Avenue, Boston, Massachusetts
02119, USA
N. c. STAUB Cardiovascular Research Institute and Dept of Physiology,
University of California School of Medicine, Third & Parnassus Avenues,
San Francisco, California 941 22, USA
L. B. STRANG Dept of Paediatrics, University College Hospital Medical
School, Huntley Street, London WClE 6DH
PARTICIPANTS IX
B. A. WAALER Institute of Physiology, University of Oslo, Karl Johans Gate,
47 Oslo 1, Norway
J. G. WIDDICOMBE Dept of Physiology, St. George's Hospital Medical School,
Tooting, London SW17 OQT
Editors: Ruth Porter (Organizer) and Maeve O'Connor
Lung Liquids
Ciba Foundatjon
Copyright 0 1976 Ciba Foundation
Introduction: goals of the meeting
C. J. DICKINSON
Medical Unit, University College Hospital Medical School, London’
Those who organize international symposia usually set out with the idea of
reviewing a well-defined and much-studied field-presumably in the hope that
a star-studded cast, abundant hospitality and an exotic venue will lead to a
synthesis of opposing views and to the advancement of knowledge. I am sure
that your experience is the same as mine: the synthesis usually proves elusive.
All the participants already know each other and each other’s opinions.
This symposium is different. We certainly have a star-studded cast; past
experience assures us of the Ciba Foundation’s abundant hospitality; and I
hope that, at least for those who do not live in a metropolis, Portland Place in
London can count as an exotic venue! The difference is in our subject. We
have one which is neither well defined nor often discussed, and which may
appear abstruse.
The human lungs when aerated in adult life contain only a few hundred
millilitres of liquid, and most of this is in blood vessels. But we can identify
at least three other actual or potential spaces for liquid: the interstitium, the
lining of the alveoli, and the pleural space. We may have to consider separately
the perivascular spaces and the liquid lining the larger air passages.
In health each of these compartments is small, but each has a characteristic
composition and pressure. This symposium will concern itself especially with
the endothelial membrane between blood vessels and interstitial space, and
with the epithelial membrane between interstitial space and alveolar fluid. We
are going to be looking at the differences between the properties of these two
membranes and at the effects of these differences on the composition ofdifferent
liquids and on the pressures in different spaces.
Although the symposium is concerned mainly with the lung, we have people
* Present address: Dept of Medicine, St Bartholomew’s Hospital Medical College, London.
1