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    PATHOGENSISI OF AIDS- ASSOCIATED KAPOSI'S SARCOMA

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    Kaposi's sarcoma presents the oncologist with a myriad of unanswered questions. What accounts for the genesis, distribution, and natural history of this tumor? How could a tumor with such a singular histologic appearance occur in such diverse clinical circumstances? What accounts for the unusual geographic, ethnic, and demographic features of Kaposi's sarcoma? Clearly, the answers to these questions will involve a multifactorial etiology, and may only be arrived at by methodical, piecemeal dissection of each question

    MOLECULAR, BIOLOGIC, IMMUNOHISTOCHEMICAL, AND ULTRASTRUCTURAL ASPECTS OF LYMPHATIC SPREAD OF THE HUMAN IMMUNODEFICIENCY VIRUS

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    RETROSTERNAL HEMORRHAGE: AN EXPERIMENTAL MODEL FOR STUDY OF LYMPHATIC LEAKAGE

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    Courtice and colleagues observed that blood injected into the peritoneal cavity of rats occasionally leaked from retrosternal lymphatics. The present work shows that this leakage is determined by volume as well as dose of inoculum. The uniform occurrence of visible retrosternal hemorrhage after injection of diluted blood suggests its use as a model for lymphatic leakage. Leakage was prevented when the blood was instilled during the healing phase of a chemical peritonitis

    THE LYMPHOGOGUE ACTION OF CALCIUM BOBESILATE ON THE FLOW OF LYMPH FROM THE THORACIC DUCT OF ANESTHETIZED AND MOBILE GUINEA PIGS

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    Calcium dobesilate increases thoracic duct lymph flow in both anesthetized and mobile guinea pigs. The marked lymphogogue action of this drug may explain in part the improvement in tissue survival with ischemic insult

    TWENTY YEARS OF THE ISL

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    IS

    LYMPHATIC SYSTEM OF THE THYROID GLAND IN THE RAT

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    Intraglandular thyroid lymph vessels in the rat were studied by qualitative and quantitative analyses in order to obtain information regarding their structure, distribution, relationships, and possible mechanisms of lymph formation. Ultrastructurally, the lymphatic vessels were similar to those described in other organs. The volume density of the lymphatic vessels was 0.007, the profile density 5.68 mm2 and the maximum diameter 17.87 nm. Ultrastructurally, visible transport pathways across the vessels appear to be represented by intracytoplasmic vesicles and channels between endothelial cells. The mean maximum diameter of the vesicles was 96 nm and they occupied 6.9% of the cytoplasm. They were equally distributed between luminal, abluminal, and intracytoplasmic positions. Open junctions (greater than 30 nm) were not seen between endothelial cells, but dilations along part of the length of interdigitating and overlapping contacts were frequent. It was concluded that the mechanism of lymph formation in the thyroid is similar to that in the kidney and liver, but differs from that in the dermis or diaphragm. However, the volume density of the vesicles of the thyroid was twice that of the liver and more than twice that of the kidney. This finding is consistent with an increase in transendothelial vesicular transport of macromolecules

    FINE STRUCTURE AND MORPHOMETRIC ANALYSIS OF LYMPHATIC CAPILLARIES IN THE DEVELOPING CORPUS LUTEUM OF THE RABBIT

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    The fine distribution and ultrastructural changes in the intraovarian lymphatics were studied in the developing corpus luteum of rabbits. Three days after human chorionic gonadotropin (HCG) injection, lymphatic capillaries were observed among theca lutein but not granulosa cells. This distribution persisted even on day 14. Edema appeared around the lymphatic capillaries, corresponding to dilatation of blood capillaries surrounding the membrana granulosa. The diameter and perimeter of the latter vessels were about 5 times greater than before HCG injection. Lymphatic capillaries were slightly dilated and about 2 times their original diameter and perimeter. Flocculent material migrated into the lumen of the lymphatics through the open junctions. Lysosomes and rough endoplasmic reticulum were increased in number in the lymphatic endothelial cells. Five and 7 days after HCG injection macrophages and sometimes loose, degenerated lutein cells were observed in the lymphatic capillaries. Fourteen days after HCG injection, the dilatation of blood capillaries disappeared, although lymphatic capillaries remained slightly dilated after day 3. Some lymphatic but not blood vascular endothelial cells began to degenerate. The results suggest that lymphatic capillaries function to absorb and transport excess fluid and "hormones" in association with changes in ultrastructure

    PANEL DISCUSSION: PATHOPHYSIOLOGY AND IMMUNOLOGY

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    PANEL DISCUSSIO

    PARENTAL EXPERIENCE OF PRENATAL DIAGNOSIS OF LYMPHATIC MALFORMATION

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    Lymphatic malformations (LM) are adevelopmental anomaly arising from a somaticmutation in the lymphatic endothelial cells.This study investigated parental experiencesassociated with prenatal diagnosis of LM.Parents of 5 children diagnosed prenatallywith LM were recruited from the VascularAnomalies Clinic at the Royal Children’sHospital, Melbourne. Ten in-depth semistructuredinterviews were conducted witheach parent separately to explore theirexperiences and views at the time of diagnosisand immediately after childbirth. Transcribedinterviews were coded and thematicallyanalyzed. Parents experienced prenatal diagnosisof LM as an unexpected and traumaticevent. The lack of adequate information andclear care pathway created confusion andadded to the difficulty of understanding theimpact of LM on the unborn child and whatto expect after the child was born. Parentsused the internet as the primary source ofadditional information; however, some parentsfound that information distressing. Differencesbetween mothers and fathers were noted interms of roles that each parent played andtheir emotional responses during pregnancyand the prenatal diagnosis. Closer connectionbetween obstetric centers and specializedtreatment clinics are suggested to facilitatebetter understanding of the LM impact on theunborn child and available treatment optionsafter birth

    QUANTITATIVE APPROACHES TO THE STUDY OF LYMPHATIC CONTRACTILE ACTIVITY IN VITRO AND IN VIVO: POTENTIAL ROLE OF THIS DYNAMIC 'LYMPH PUMP' IN THE RE-EXPANSION OF THE VASCULAR SPACE FOLLOWING HEMORRHAGE

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    Few investigators have considered adynamic role for the lymphatic vessel inregulating the movement of fluid and proteinfrom the interstitium back to the bloodstream.This view is based on the assumption that lymphaticsare passive conduits and thathydrostatic pressure gradients and external compressionforces acting on the vessels are primarilyresponsible for the movement of lymph.However, it is becoming increasingly evidentthat the intrinsic contractile capabilities of lymphaticvessels provide a major part of the propulsiveforce. Lymphatics have noradrenergicinnervation and respond to a variety ofhumoral factors and inflammatory mediatorssuggesting that the pumping activity is centrallyregulated and in addition, may respond to localfactors. In this article, we will discuss what isknown of the regulation of this 'lymph pump'.Techniques that permit analysis of contractileactivity and fluid pumping in vitro and invivo will be reviewed. Of particular interest isa sheep model that allows the quantitation ofpumping activity in vivo without the complicationof variable lymph inputs. While there islittle information available at this time concerningthe potential role of the 'lymph pump' inpathophysiological states, some preliminary experimentsfrom our own laboratory suggest thatan independently regulated 'lymph pump' mayplay an important role in hemorrhagic shock

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