[The changes of blood gas analysis values and platelet aggregability on acute phase in the experimental model of pulmonary embolism prepared by sephadex G-75 (SG-75) injection].

To study pathophysiologic phenomena in acute pulmonary embolism, we injected sephadex G-75 (SG-75) into rabbit auricular veins and measured the changes in blood gases and in platelet aggregability. Severe hypoxemia developed within 10 minutes of SG-75 injection. Microscopic examination of samples taken 120 minutes after SG-75 injection pulmonary artery had been embolized by the SG-75 particles, and that thrombin had formed around the particles. The lowest platelet counts were measured 10 minutes after SG-75 injection. The rates of platelet aggregation induced by adenosine diphosphate and by platelet-activating factor were abnormally low until 40 minutes after SG-75 injection. These results suggest that platelets were activated by anoxia and that the activated platelets moved around the emboli after obstruction of the pulmonary artery. We conclude that decreases in PaO2 and changes in platelet aggregability exacerbate the pathophysiologic processes in acute pulmonary embolism.

[Pneumonitis in a patient who inhaled a fibrinolysin-deoxyribonuclease mixture].

A 56-year-old man was transferred to our department from the department of oral surgery, with a high fever and a cough. He had inhaled a fibrinolysin-deoxyribonuclease mixture (Elase) to treat inflammation in the oral cavity after resection of an oral tumor. A chest X-ray film showed diffuse patchy shadows in both lung fields. Bronchoalveolar lavage fluid had an abnormally high number of lymphocytes and transbronchial lung biopsy revealed interstitial infiltration by lymphocytes and histiocytes, with granulomatous lesions. The patient was treated with steroids, and his clinical condition improved markedly. He accidentally inhaled the drug again, and the coughing and fever began again. The drug lymphocyte stimulation test was positive only for the fibrinolysin-deoxyribonuclease mixture. Based on these findings, we diagnosed pneumonitis induced by this fibrinolysin-deoxyribonuclease mixture. To our knowledge, this is the first reported case of pneumonitis caused by this fibrinolysin-doxyribonuclease mixture.

[Two cases of pulmonary alveolar proteinosis with increased CEA].

Two cases of pulmonary alveolar proteinosis (PAP) with increased CEA were reported. Case 1 was a 62-year-old male with suspected pulmonary fibrosis, who was transferred to our hospital. Laboratory findings on admission revealed 31.3 ng/ml of CEA. Because he had severe dyspnea, lung biopsy was not carried out. His condition gradually deteriorated and he died of respiratory failure. Autopsy revealed he had PAP and no malignancy. Case 2 was a 48 year-old male referred to our hospital because of dyspnea. Serum CEA was 52.8 ng/ml. Microscopic examination of a transbronchial lung biopsy showed PAP. The level of CEA in bronchoalveolar lavage fluid was 151 ng/ml. Unilateral whole lung lavage was performed twice. With the improvement of chest X-ray findings, serum levels of CEA fell to normal level. The molecular weight of CEA in bronchoalveolar lavage fluid was 180,000. Immunochemical staining of CEA in lung revealed nonspecific findings.