H Nakamura, A Ishizaka, M Sawafuji, T Urano, S Fujishima, F Sakamaki, K Sayama, M Kawamura, R Kato and K Kikuchi
Department of Medicine and Surgery, School of Medicine, Keio University, Tokyo, Japan.

We experienced a case of reexpansion pulmonary edema (RPE) after surgical treatment of pneumothorax. In this case, protein leakage and polymorphonuclear leukocyte (PMN) accumulation were observed in the reexpanded lung. Interleukin-8 and leukotriene B4 in edema fluid were increased at the onset of RPE. PMN elastase was also increased, though its peak was delayed. The plasma level of P-selectin, which mediates adhesion between PMN and endothelium, was elevated. We speculate that some of these fluid mediators may play important roles in chemotaxis and activation of PMN in the development of RPE.

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