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During fluid absorption induced by amphotericin B, the lateral intercellular spaces (LIS) of the dog tracheal epithelium were widely dilated as compared to untreated time controls. When fluid absorption was inhibited by ouabain, or by replacement of luminal Na by choline, amphotericin B failed to cause dilation of the LIS. These data suggest that, as in other epithelia, a significant amount of transepithelial fluid flow passes down the LIS, and that these spaces may provide the local osmotic compartment which is responsible for linking transepithelial fluid movement to active ion transport.

Under short-circuit conditions, vasoactive intestinal peptide (VIP) did not alter net Na+ movement but selectively stimulated net Cl- secretion across dog tracheal epithelium with a high affinity (Km congruent to 10(-8) M). The increase in Cl- secretion was not different from the rise in short-circuit current (Isc). However, stimulation of Cl- secretion was not maximal, because the addition of isoproterenol (10(-6) M) to VIP-treated tissues further increased the Isc by 54%. The effect of exogenous VIP was not blocked by a combination of atropine, phentolamine, propranolol (10(-5) or 10(-6) M), or tetrodotoxin (10(-6) M). Under open-circuit conditions, VIP caused an increase in the net secretion of Cl- and Na+, but the changes did not reach statistical significance. We conclude that VIP acts directly on receptors on the surface of epithelial cells to stimulate active Cl- secretion. The abundance of VIP nerves in the submucosa suggests that VIP may be important in regulation of fluid movement across the epithelium.

Ion fluxes or fluid flow were measured across sheets of dog tracheal epithelium mounted in Ussing chambers or a special apparatus, respectively. Under short-circuit conditions, luminal amphotericin B (3 X 10(-5) M) caused an inhibition of net Cl secretion and an increase in net Na absorption across paired tissues. In paired tissues under resting open-circuit conditions, there was no significant net transepithelial flux of either Cl or Na. Amphotericin B induced significant net fluxes of both Cl and Na toward the serosal side. In separate tissues from the same animals, there was no significant transepithelial fluid movement under resting conditions. Amphotericin B caused a net absorption of fluid. The absorption of salt and fluid in amphotericin B-treated tissues was abolished by ouabain. We conclude that stimulation of active Na transport by amphotericin B leads to fluid absorption. In vivo, the movement of fluid across the dog tracheal epithelium may be dependent on a balance between active Cl secretion and active Na absorption.

Exercise tolerance and cardiorespiratory adjustments at peak work capacity (PWC) were determined in 20 patients with cystic fibrosis (CF) during progressive cycle ergometry. The results were related to resting lung function tests, expressed by a pulmonary function score (PFS) that ranged from 0 (no pulmonary dysfunction) to 18 (extreme dysfunction). Patients with CF with no (PFS less than 3), mild (PFS 3-7), or moderate (PFS 8-12) pulmonary dysfunction exercised as well as normal subjects. When the PFS exceeded 12, PWC was reduced on the average by 51%, peak heart rate (PHR) was reduced by 15%, and peak ventilation (PVE) was reduced by 39%. Severely affected patients developed arterial desaturation at PWC (-7.3%), CO2 retention (end-tidal PCO2 + 5 mmHg), and an increase in the PHR/PWC ratio. In most patients with CF the PVE/PWC ratio was elevated, suggestion wasted VE and a probable increase in dead space ventilation. The results indicate that whenever pulmonary disease in CF is advanced, there are decreases in exercise tolerance and cardiorespiratory reserves, exercise-induced ventilation-perfusion abnormalities, arterial desaturation, and alveolar hypoventilation. In view of the abnormal physiological adaptations to exercise in patients with CF with advanced lung disease (PFS greater than 12), they should engage in exercise training programs and strenuous physical activity with caution and only after their cardiorespiratory reserves and adjustments to exercise have been objectively evaluated.

The "loop" diuretics MK-196, bumetanide, piretanide, and furosemide are all potent inhibitors of Cl transport by the dog's tracheal epithelium. In short-circuited tissues, the drugs caused significant decreases in both unidirectional Cl fluxes and in the net flux of Cl toward the lumen; the change in net Cl flux was not significantly different from the change in short-circuit current. The drugs had no effect on active Na absorption. All drugs caused a significant fall in tissue conductance. All drugs, except MK-196, were more potent from the serosal bath; MK-196 was equipotent from either side of the tissue. In experiments with isolated cells, the diuretics caused no significant changes in intracellular Na and K concentrations, a fall in intracellular Cl concentration, and approximately equal falls in Na and Cl influxes. These results suggest that the site of action of these drugs is on a basolateral linked Na-Cl entry process. Additional evidence for such a linked entry process was provided by experiments in which removal of Cl reduced Na influx and removal of Na reduced Cl influx.

for a short time following ligation of the duct. Our histologic studies have shown the presence of marked edema of the separated tail for the first two weeks, later followed by a gradual atrophy of the glands of external secretion. In this series of experiments we have attempted to correlate our morphologic observations with values for diastase in the blood. The purpose of this study was to establish with a simple test whether ligation of the tail would cause an increased absorption of pancreatic diastase. It was undertaken to establish the duration of the pancreatitis following ligation of the tail. As clinical experience has repeatedly shown, acute pancreatitis will cause a marked rise in diastase in the blood. In ninety-seven cases of acute necrosis of the pancreas collected by Schmieden and Sebening,5 seventy-eight cases (80 per cent) showed abnormally high figures. At the fifty-first German Surgical Congress,6