Journals at the University of Arizona
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VASCULAR REMODELING IN KAPOSI'S SARCOMA AND AVIAN HEMANGIOMATOSIS: RELATION TO THE VERTEBRATE LYMPHATIC SYSTEM
No full textVASCULAR REMODELING IN KAPOSI'S SARCOMA AND AVIAN HEMANGIOMATOSIS: RELATION TO THE VERTEBRATE LYMPHATIC SYSTE
THE IMPORTANCE OF VOLUMETRY, LYMPHSCINTIGRAGY AND COMPUTER TOMOGRAPHY IN THE DIAGNOSIS OF BRACHIAL EDEMA AFTER MASTECTOMY
No full textArm volumes of 360 patients with breast cancer were determined by a new optoelectronic technique. About 42% developed swelling of the arm after modified radical mastectomy which varied from mild (edema-volume 150-400 ml), moderate (400-800 ml), to severe (more than 800 ml) lymphatic edema. Lymphscintigraphy and computer tomography of the arms was also studied in different grades of lymphatic edema. Two years after operation and telecobalt-irradiation, one half of the patients without arm edema showed marked signs of a decreased capacity of lymphatic transport. In patients with severe lymphatic edema, the dynamic as well as the static evaluation of the lymphscintigrams revealed delayed transport, lack of radioisotope accumulation in the axillary region and notable congestion in the upper arm and forearm. Computerized tomography displayed a shift of fluid volume in the epifascial and subfascial tissue compartments and detected progressive structural changes in the soft tissue. Moderate edema not only increased the epifascial but also the subfascial compartments. In severe postmastectomy arm lymphedema, however, expansion of the epifascial space was paradoxically sometimes associated with a decrease in the subfascial compartment
CLINICAL USE OF INDIRECT LYMPHOGRAPHY IN DIFFERENT FORMS OF LEG EDEMA
No full textIndirect lymphography by subepidermal infusion of newly developed nonionic, dimeric contrast media (e.g., Iotrolan) opacifies peripheral lymphatics of the skin. Using this method we examined 159 patients with primary and secondary lymphedema, chronic venous insufficiency, and lipedema and compared the findings to normal individuals. A variety of characteristic patterns were uncovered. The technique causes little patient discomfort and takes on the average only 30 minutes
OIL CONTRAST LYMPHOGRAPHY AND RESPIRATORY FUNCTION
No full textWe reviewed our experience with direct oil contrast lymphography for pulmonary complications in more than 1500 lymphangiograms done since 1969. The vast majority of patients showed little subjective or objective (chest x-ray, pulmonary function test, and gas exchange) evidence of oil embolization even in those with mild to moderate cardiopulmonary disease. In 1% there was evidence on chest x-ray 24 hours after lymphography of tiny patchy infiltrates consistent with oil emboli. Although the indications for oil contrast lymphography have been sharply restricted with availability of newer imaging methods, it is nonetheless a safe and well-tolerated procedure even in patients with mild to moderate pulmonary dysfunction
TOPOGRAPHY AND ULTRASTRUCTURE OF KIDNEY LYMPHATICS IN SOME HIBERNATING BATS
No full textThe kidney lymphatic system of some bats consists of intraparenchymal (interlobar, arcuate, and interlobular) and extraparenchymal vessels (capsular and prehilar connective). These vessels drain lymph via precollecting and prenodal collecting lymphatics into a hilar lymph node. There are no lymphatics in the renal medulla. The lymphatic vasculature (precollecting vessels excluded) is characterized by an endothelial wall lacking basal lamina and fenestrations. The endothelial cells, mostly rectangular in shape, are joined together by overlapping, end-to-end, and complex interdigitating junctions. Cytoplasmic expansions profile and thickness, intercellular junctions and particularly the different categories of uncoated vesicles (free or opened on luminal or abluminal surface) show qualitative and quantitative seasonal variations. Luminal and abluminal cytoplasmic processes appear (when analyzed in tridimensional reconstructions) as "intraendothelial channels." The increased number of these structures during summer characterizes them as dynamic elements and supports the concept of an active role played by them in transendothelial transport. Nevertheless, the main functional role is still ascribed (in addition to membrane transport mechanisms) to the vesicular system, also defined as the "vesicular route." We did not find any open intercellular junctions
INTRAARTICULAR LYMPHOSCINTIGRAPHY OF THE HUMAN KNEE JOINT: A PRELIMINARY STUDY
No full textIntraarticular (knee) lymphoscintigraphy using 99mTc-nanocoll was performed in five patients with chronic synovitis. Scintigrams from the anterior and lateral view of the knee and of the iliac region were taken 1, 2, 4, and 22 hours after injection. The inguinal and iliac lymph nodes uniformly visualized in about 2 hours. Based on radioactivity in regional lymph nodes measured at prescribed time intervals, we were able to quantify lymph drainage from the knee joint. Lymphoscintigraphy is without complication and discomfort and is potentially useful to study synovial fluid reabsorption in joint diseases
THE REGULATION OF LYMPHATIC PUMPING
No full textAn important functional property of lymphatic vessels is their ability to pump fluid. To quantitate this activity in vivo, sheep mesenteric lymphatic segments were isolated from all lymph input and provided with lymph plasma or saline from a reservoir. Lymphatic pumping was controlled by transmural pressure with increases in pressure resulting in elevated fluid pumping followed by reductions in flow at high intraluminal pressures. With lymph input to the vessels denied, but with blood and nerve supply left intact, the pumping activity could be altered with systemic physiological perturbations including a major blood loss and the intravenous infusion of endotoxin. In each case, it was clear that the modulation of lymphatic pumping resulted from the direct effects of the test procedure on the 'lymph pump' and not from effects on vascular parameters or lymph formation
