Journals at the University of Arizona
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INFLUENCE OF A LYMPHAGOGUE, CLS 2210, ON REGIONAL CARDIAC LYMPHATICS AND THE ELECTROCARDIOGRAM AFTER CORONARY ARTERY OCCLUSION IN THE DOG
No full textTo examine the role of cardiac lymphaticdrainage in myocardial infarction, we quantifiedthe effect of a lymphogogue, CLS 2210, on thenumber and appearance of myocardial lymphaticsas well as the electrocardiogram followingcoronary occlusion in the dog. Thirty minutesand six hours after intravenous administration ofthe benzenesulfonate compound, (CLS 2210)cardiac lymphatics in the distribution of the leftanterior descending coronary artery (LAD) weredetermined and further delineated bypostmortem cardiac lymphangiograms. Theresults were compared with treated and untreateddogs without and with descending coronaryartery ligation including the non infarctedzone; that is, myocardium within the distributionof left circumflex coronary (LCC) artery. After30 minutes in dogs receiving CLS 2210 withoutLAD ligation, number of lymphatics (pointcountlcmZ, see Methods) were respectively -LAD zone: 2.62 ± 0.11 or 10.9% of left ventricular(LV) surface; LCC zone: 2.87 ± 0.10,whereas after six hours-LAD zone 8.04 ±0.03 or 32.3% LV surface; LCC zone-8.13 ±0.06 compared with untreated controls-LADzone 1. 71 ± 0.11 or 6.6% of LV surface; LCCzone 1.65 ± 0.12 (p 0.0001). At similar intervalsin dogs with LAD ligation, the findingswere at 30 minutes LAD zone 0.78 ± 0.07 or3.1 % of LV surface and at 360 'minutes was0.80 ± 0.08 or 3.3% of LV surface. In conjunctionwith CLS 2210 administration, however,LAD zone showed at 30 minutes 2.50 ± 0.12or 10% of LV surface (p .01) and at 360minutes was 10.34 ± 0.03 or 35.1% of LV surface.Moreover, in dogs with LAD ligation andCLS 2210 administration, electrocardiogram at six hours showed diminished ST-segment elevatio
ENDOLYMPHATIC APPLICATION OF BLEOMYCIN OIL SUSPENSION IN DOG MODEL
No full textTo explore the potential usefulness of a cytostaticagent deposited directly in lymph nodes, 4mlBleomycin oil suspension (Oil-Bleo) was injected overone hour into hind leg lymphatics of seven dogs. Fiveof these dogs received a second, identical dose oneweek later into lymphatics of the contralateral hindleg.Peak serum concentration of Oil-Bleo after thefirst injection (7 dogs) was 12.3 g/ml but after thesecond injection (5 dogs) was slightly lower (10.8g/ml). Maximum level of Oil-Bleo in blood was12% of the endolymphatic dose and represented the"spillover" from lymph transport. In a control experiment,in which 60mg of aqueous Bleomycin wasinjected, the serum spillover was one-third higher.Large amounts of Oil-Bleo were stored inpopliteal and retroperitoneal lymph nodes for severalweeks. Twenty-four hours after injection the weightof "treated" lymph nodes was 73% greater than"untreated" nodes and one month later treatedlymph nodes were still 37% heavier. After 24 hours,4.7% of Oil-Bleo instilled was distributed within extractedlymph nodes, and one month later 0.12%was still detectable. By contrast, after aqueousBleomycin infusion, only 0.05% was detected inthese lymph nodes after only six hours. In general,lymph nodal architecture was preserved after OilBleo.Together the findings suggest that Bleomycinoil suspension may be a useful agent for treatment oflymph nodal metastases by endolymphatic infusion
A TISSUE TONOMETER FOR USE IN THE FIELD
No full textA robust tissue tonometer is described which is suitable for use in the field
CHYLOPERICARDIUM: A RARE CAUSE OF PERICARDIAL EFFUSION
No full textA 21 year old man presented with asymptomatic, isolated chylopericardium. Despite echocardiography, radionuclide-angiography, computer tomography, and chemical analysis of the chylous effusion, the etiology remained obscure. After patent blue dye infusion into peripheral soft tissues, the appearance of coloring material in the effusion at 4 hours suggested direct communication of the pericardium with an apparently large thoracic duct. Fifteen months later, cardiomegaly persists in site of medium-chain triglyceride dietary restriction
LOCAL SKIN COOLING AS AN AID TO THE MANAGEMENT OF PATIENTS WITH BREAST CANCER RELATED LYMPHEDEMA AND FIBROSIS OF THE ARM OR BREAST
No full textBased on preliminary observations that topical cooling appeared to soften lymphedematous and fibrotic tissue, our goal was to systematically and quantitatively evaluate this effect. For this purpose, topical cooling was used as part of treatment of lymphedematous and fibrotic skin of women with breast cancer related lymphedema (BCRL) and localized fibrosis. Skin tissue hardness was assessed via the force required to indent skin to 4 mm (F4.0) and 1.3 mm (F1.3) and skin water was assessed by measurements of tissue dielectric constant (TDC). Measurements were done before cooling, after cooling, and after a single treatment session in 20 women with arm involvement and in 12 women with breast involvement. Pre-cooled arm and breast skin temperatures (mean ± SD) of 32.4 ± 1.4̊C and 33.8 ± 1.0̊C were reduced to 23.7 ± 2.0̊C and 24.7 ± 1.6̊C respectively via application of cold washcloths. Cooling was associated with a significant (p0.001) decrease in F4.0 and F1.3 at arm and breast sites. At arm sites, force reductions ranged from 24% to 28% depending on indentation depth. Although the precise mechanism linking cooling to softening is as yet not fully understood, the fact that tissue is softened carries with it many potential benefits to patient and therapist. The near immediate tissue softening is associated with less pressure on underlying nerve endings and less input to sensory nerves thereby interrupting the pain cycle resulting in rapid pain relief. The rapidly softened tissue and decreased perception of pain offers the patient hope and encouragement in their therapeutic journey to reclaiming functional use of their affected body. Further, because softer tissue becomes more pliable, myofascial lengthening, scar tissue releasing, and other aspects of treatment are easier to perform thereby reducing treatment time and effort while achieving improved functional mobility
DIFFERENTIAL DIAGNOSIS OF LYMPHEDEMA AFTER INDIRECT LYMPHOGRAPHY WITH IOTASUL
No full textIndirect lymphography with lotasul (interdigital, intradermal infusion) was performed in 32 patients with lymphedema. No side effects were observed.Opacification of the peripheral lymph vessels reveals two distinct patterns:1. No, few, or only very small-calibre lymph vessels ("hypoplasia"): 17 patients (primary lymphedema in 14 cases, secondary in 3).2. Many large-calibre (dilated) lymph vessels ('"hyperplasla") : 15 patients (primary lymphedema in 2 cases, secondary in 13).An occasional finding in '"hypoplasia" is drainage of the contrast material in the region of the adventitia of vessels, and a network of extremely fine lymph vessels apparently corresponding to the dermal plexus is sometimes observed.Because it leads to the opacification of barely perceptible lymph vessels in the extreme periphery which were previously inaccessible to radiology, indirect lymphography offers a genuine gain in information and improves the differential diagnosis. When administered correctly, lotasul invariably enhances the peripheral lymph vessels without making any great demands of the patient or investigator
APLASIA OF SUPERFICIAL LYMPHATIC CAPILLARIES IN HEREDITARY AND CONNATAL LYMPHEDEMA (MILROY'S DISEASE)*
No full textFour patients with hereditary lymphedema present at birth (Milroy's disease) have been studied by fluorescence microlymphography (1, 7). The videomicroscopytechnique failed to visualize any lymphatic capillary in the edematous part of their legs. In sporadic primary lymphedema with late manifestation, however, a well developed superficial capillary network is detected (1, 6) . Three family members without lymphedema had normal microlymphatics.Milroy 's disease, at least in the family presented, is characterized by aplasia or extreme hypoplasia of both lymphatic capillaries and collectors whereas in the usual sporadic form of primary lymphedema aplasia or hypoplasia is confined to the larger trunks