Journals at the University of Arizona
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COMBINED MONITORING OF THORACIC DUCT AND LUNG LYMPH DURING E. COLI SEPSIS IN AWAKE SHEEP
No full textA thoracic duct lymph fistula in combination with a lung lymph fistula in the awake sheep was used to evaluate effects of thoracic lymph diversion during a septic insult and to monitor systemic and local changes in the lung and gastrointestinal tract. Live Escherichia coli 10(9) kg-1 b.w. were infused in 9 sheep. After sepsis, arterial pressure, cardiac output, partial pressure of oxygen, leukocytes and platelets decreased significantly compared to baseline values. Pulmonary arterial pressure increased significantly throughout the experiment with peak values at 44 +/- 4 mmHg after 15 minutes. Lung lymph flow (QL) (n = 6) increased from 23 +/- 0.5 to 11.2 +/- 2.4 ml/30 minutes after 60 minutes. QL then decreased but remained elevated. Lymph to plasma protein concentration ratio (L/P) in lung lymph decreased from 0.62 +/- 0.02 during baseline to 0.47 +/- 0.04 after 60 minutes. L/P then increased and was, after 150 minutes, no longer different from baseline. These lung lymph data favor increased pulmonary microvascular permeability during sepsis. Lymph flow in the thoracic duct (QT) (n = 9) increased from 34.2 +/- 6 to 58.3 +/- 9 ml/30 minutes during the first 30 minutes after bacterial infusion. QT was, after 90 minutes, back to baseline but then progressively increased. L/P in thoracic lymph steadily increased from 0.56 +/- 0.03 to 0.78 +/- 0.04. Thromboxane B2 and 6-keto PGF1 alpha in thoracic duct and lung lymph increased significantly after bacterial infusion and remained elevated thereafter. Combined monitoring of thoracic duct and lung lymph enabled comparison of systemic and pulmonary reactions in septic sheep
ISOTOPIC LYMPHANGIOGRAPHY TO EVALUATE LYMPHEDEMA BEFORE AND AFTER OPERATIVE TREATMENT
No full textISOTOPIC LYMPHANGIOGRAPHY TO EVALUATE LYMPHEDEMA BEFORE AND AFTER OPERATIVE TREATMEN
SCANNING ELECTRON MICROSCOPY OF THE INITIAL LYMPHATICS OF THE SKIN AFTER USE OF THE INDIRECT APPLICATION TECHNIQUE WITH GLUTARALDEHYDE AND MERCOX AS COMPARED TO CLINICAL FINDINGS, PART 1. THE NOMENCLATURE AND MICROTOPOGRAPHY OF THE INITIAL LYMPHATICS
No full textCertain phenomena in the region of the initial lymphatics during clinical examination (indirect lymphography and microlymphography)--namely build-up and course and filling and diffusion--have still to be elucidated. The glutaraldehyde and MERCOX methods were used to simulate indirect application conditions in clinical procedures in skin specimens (human and pig) which were then examined by scanning electron microscopy. The results presented include novel findings on the microtopography of these lymph vessels and the typology of filling refluxes which are of importance when indirect imaging techniques are employed. Various speeds of application were used and the function of the opening apparatus with previously undescribed structures (endothelial bridges and connective tissue trabeculae) was taken into consideration. Recommendations aimed at standardizing the nomenclature of parietal structures and sections of the lymphatics have been incorporated in the report
CONTRACTILE RESPONSE IN ISOLATED HUMAN GROIN LYMPHATICS
No full textLymphatics from the human superficial groin removed at operation in 21 patients (one with lymphedema) were examined in vitro. Histochemically no nerves were identified with either specific catecholamine fluorescence or immunoreactivity to tyrosine hydroxylase or dopamine beta-hydroxylase. Ring preparations of the lymphatics were mounted in tissue baths and isometric induced contractions were recorded after administration of K+ (124 mM), acetylcholine, selected amines and prostanoids. Noradrenaline (NA), adrenaline, dopamine, and acetylcholine had no or only weak contractile effects. In some segments, serotonin induced contractions. Prostaglandin E2 showed no contractile effect and prostaglandin F2 alpha induced contraction in most of the tested lymphatics. The prostaglandin-endoperoxide analogue U44069 uniformly elicited marked concentration-dependent contraction. In the lymphatic segment from the patient with lymphedema, a slightly greater contractile response to NA and serotonin was observed. The results overall suggest an absence of sympathetic innervation and contraction-mediating alpha adrenergic receptors in human superficial groin lymphatics, and support that certain prostanoids may be important regulators of human lymphatic contractility
CONTRASTING PATTERNS OF LYMPHATIC AND BLOOD CIRCULATORY DISORDERS
No full textCONTRASTING PATTERNS OF LYMPHATIC AND BLOOD CIRCULATORY DISORDER
NON-OPERATIVE THERAPY COMBINED WITH LIMITED SURGERY IN MANAGEMENT OF PERIPHERAL LYMPHEDEMA
No full textVigorous intermittent pneumatic compressioncombined with limited surgery for huge lymphedemaof the extremities is described. Thegoal of operation is primarily to restore thedistorted lymphedematous limb to a more normalshape to facilitate continued non-operative treat ment
LYMPHATIC CAPILLARIES IN RABBIT OVARIES DURING OVULATION: AN ULTRASTRUCTURAL STUDY
No full textThe fine distribution and ultrastructuralchanges of rabbit intraovarian lymphatics andblood vessels were compared in specimens obtainedat accurately timed intervals after theinjection of human chorionic gonadotropin(HCG).At four and six hours after HCG injection,edema was observed around blood capillarieswith a slight increase in the number of smallfenestrae in the theca intema. Edema aroundthe lymphatic capillaries in the theca extemaoccurred a little later. The lymphatic capillarieswere markedly dilated with occasional wideopenings between adjacent cells. At this stage,lysosome disappeared in the endothelial cells ofthe lymphatic capillaries, and macrophageswith numerous peculiar lysosomes appearedaround the lymphatic capillaries and some ofthem entered into the lumen. By eight hoursafter HCG injection, the edema around thelymphatic capillaries had disappeared. Theform and structure of the lymphatic capillariesresumed their pre-injection appearance, but theblood capillaries showed large gaps or perforationsin the endothelium.At 11 and 18 hours after HCG injection,blood capillaries had penetrated into the membranagranulosa, but lymphatic capillaries hadnot.Thus, the lymphatics appear to be modifiedat four and six hours after HCG injection andthese modifications are consistent with theremoval of edematous fluid
ARTERIOVENOUS SHUNTS IN PERIPHERAL LYMPHEDEMA: HEMODYNAMIC FEATURES AND ISOTOPIC VISUALIZATION
No full textThe hemodynamic characteristics ofperipheral lymphedema were studied in 28 patientswith uni- or bilateral leg swelling. Legblood flow was measured by venous isotopedilution (a technique for nutritive - capillaryblood flow) and arteriovenous shunts werevisualized by perfusion scintigraphy usingradiolabelled macroaggregated albumin.Arteriovenous communications were uniformlydetected in lymphedema, with a calculated"shunt flow" of 200 to 600 ml/min. Otherfeatures in the lymphedematous leg included anelevated limb blood flow rate and narrowedarteriovenous oxygen difference