Journals at the University of Arizona
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LYMPHOCYTE LOCOMOTION II. THE LYMPHOCYTE TRAFFIC OVER THE POST-CAPILLARY VENULES ANALYSED BY PHASE CONTRAST MICROSCOPY OF THIN SECTIONS OF RAT LYMPH NODES
No full textThin sections of lymph nodes from 14 rats were examined by phase contrast microscopy as regards direction of lymphocytes with amoeboid movement configuration (AMC) relative to the basement membrane of post-capillary high-endothelium venules (HE-venules). Out of 118 lymphocytes with AMC, 82 appeared to be on their way into the venule from the lymph node parenchyma. This observation suggests that the lymphocyte traffic over the HE-venules is bi-directional, with the main migratory stream of lymphocytes from the lymph node parenchyma into the post-capillary venules
CONSERVATIVE TREATMENT OF ACUTE AND CHRONIC LYMPHOEDEMA WITH BENZO-PYRONES
No full textGenerally, the success of conservative therapy is only limited to a transient reduction in oedema. Concomitant with this, subjective improvements such as a reduced feeling of heaviness, a lessening of pain and of the bursting feeling of the affected limb are frequently reported. Once the oedema is reduced, the reduction must be maintained by elevation, elastic compression bandages, and by careful attention to infection. A failure to observe these points results in a very rapid reformation of the oedema.Experimental results have shown the benzopyrones to be very useful in reducing high protein oedemas, particularly those of lymph and thermal oedema. They do this by enhancing the lysis and removal of the abnormal accumulated protein from the affected part. They also enhance glucose uptake by the various cells, thus allowing them to survive in a viable state in severe conditions such as those of metabolic acidosis characteristic of stagnant tissue fluids.Since the benzopyrones remove the excess protein, the tendency for further fibrotic tissue formation is reduced. In addition, like some other anti-inflammatory drugs, the benzopyrones may be able to enhance the removal of existing fibrotic tissue by causing its lysis. The cells involved in this action seem to be the macrophages.The remarkable reductions of lymph and thermal oedemas obtained in animal experiments with the benzopyrones have not been reported in many clinical trials. There seem to be two main reasons for this. Firstly much lower doses are used than have been shown to be optimal. Secondly, the follow up periods of observations have usually only been short. Some clinical trials even with these lower doses have however been very promising, and this is especially enlightening when it is considered that such doses in animals only result in minimal changes in the oedema volume. This may be the reason for the high proportion of "subjective improvement only" reports in clinical trials
X-Ray Contrast Presentation of the Thoracic Duct by Enterally Resorbed Iodized Oil Emulsions in Cats and Dog~
No full textIodized oils have been used in two completely different fields of clinical medicine:1. Fat resorption tests as a diagnostic approach to pancreatic disorders (e.g. Lipiodoltest of TTemoliere [ l]). The amount of resorbed fat may be assayed by quantitativeicdine analysis.2. Direct lymphography. This method has proved suitable especially for peripherallymphatics and lymph node presentation. It may also be used to demonstrate the thoracicduct. It is inconvenient, however, and direct lymphography with high doses (20-40 cerncontrast medium) comprises a relatively high rate of complications (2).In a number of experiments in cats and dogs we tried to combine the above modesof application in order to achieve contrast presentation of U1e thoracic duct with aphysiologic approach.The findings reported here comprise the combined resu lts of two series of tests, thefirst conducted between 1966 and 1968 in cats (see also 3, 4) and the second in 1968and 1969 in dogs (5). We intend to give a critical evaluation and comparison of thedifferent methods used to provide sufficienlly high concentrations of contrast mediumin •boracic duct lymph by means of increased or accelerated enteral resorption
Origin and Composition of Hepatic Lymph Proteins in the Dog
No full textPappenheimer (11) has shown that the walls of capillary vessels behaved as semipermeablemembranes. Applying this concept to the transcapillary transfer of macromolecules,Grotte ( 4) and Mayer son et al. (8) measured the permeability of the dog'scapillaries by means of the plasma versus lymph concentration ratios of dextran moleculesof graded molecular size, after intravenous injection of the substance. Both workersconcluded that capillary walls contained two kinds of pores of different size. The molecularsieve effect would be largely accounted for by a set of small pores having a radiusof about 40 A according to Grotte ( 4) or 110 A according to Mayer son et al. (8). The dataalso required the assumption of the existence of larger pores, of undefined diameter, whichwould allow free passage to particles of any molecular size up to a mo!. weight of 300 000.It was also shown that each type of tissue had its own characteristic capillary permeability,that of the liver being greater than that of the small bowel, and the latter in turnexceeding the capillary permeability of the limbs or cervical region. Such differenceswould arise both from regional variations in the distribution density of the pores andfrom shifts in the ratio of large versus small pores, the pore sizes remaining constant.The findings described above were all obtained by using dextran molecules, but intheory they could equally well have been derived from a study of the plasma versuslymph concentration ratio of endogenous plasma proteins. This presentation will beconcerned with an attempt in that direction, using as a model the plasma and hepaticlymph of the dog
Radiographic Features of Hodgkin's Disease*
No full textI. Radiographic morphology and morphometry of retroperitoneal lymph nodes has beendescribed in patients with each of the common presenting histological subtypes of Hodgkin'sDisease.2. In addition to well known lymphographic features of Hodgkin's Disease many less floridchanges have been described in the radio-opaque images of pelvic and retroperitoneal lymphglands. Such non-specific findings have been seen in the absence of histological evidence ofHodgkin's Disease in the same nodes, and may be related to abnormal lymphoreticular functionpreceding or concurrent with early neoplastic changes (19). Their significance with respect toimmune mechanisms is not yet known.3. Because of current ignorance of the basic pathogenesis of Hodgkin's Disease, in vivo lymphographicstudy of contrast containing intranodal sinusoids of many glands, and in vitro histologicalstudy of individual lymph node samples obtained at biopsy or laparotomy evaluatedifferent parameters of abnormality, and are at present complementary.4. In this series lymph node architecture and the topography of adenopathy suggest twodistinct patterns of involvement in Hodgkin's Disease.5. A practical method of dividing the majority of new patients with Hodgkin's Disease intotwo groups for further study is described
The Influence of the Spleen on Thoracic Duct Lymph in Schistosomat Hepatic Fibrosis
No full text1. Splenectomy was found to cause a marked decrease in the thoracic duct lymph flow and pressurein patients with schistosomal fibrosis.2. There was no direct correlation between the drop in thoracic duct lymph flow and the drop inportal pressure produced by removal of the spleen.3. The splenic lymphatics were found to be increased in number and distended.4. In some patients, the splenic lymphatics contained intact red blood cells.5. Removal of the spleen caused immediate disappearance of red blood cells from thoracic ductlymph.The pathogenesis of ascites in schistosomal hepatic fibrosis remains unclear. In a previouscommunication from our center, we reported increased flow and pressure in thethoracic duct of patients with schistosomal hepatic fibrosis where portal hypertensionis characterized by presinusoidal obstruction (7).In Laennec's cirrhosis, excess thoracic duct lymph originates from both the liver andextrahepatic portal bed (3, 8, 9). These authors also suggest that, in "early" cases, theliver is the major source of increased thoracic duct lymph, whereas in "late cases excessextrahepatic portal lymph combines with hepatic lymph to overload the thoracic duct.On the other hand, in schistosomal hepatic fibrosis with presinusoidal block, the extrahepaticportal bed is probably the sole source of excess thoracic duct lymph.The observation by Dumont et al. (4) that in patients with hepatic cirrhosis or congestive'heartfailure the splenic pedicle contains a number of dilated lymphatics, is similarto that previously described by Baggenstoss and Cain (1) and Baggenstoss (2), atthe hilus of the liver. This finding suggests that part of the excess extrahepatic lymphoriginates from the spleen. To evaluate this possibility, the present study was undertakento determine the role played by the spleen in excess lymph production in patientswith schistosomal hepatic fibrosis, a disorder characterized by presinusoidal portal block
Studies on the Lymph Node-Venous Communications 111. The Presence of Saccular Sinuses and their Possible Function*
No full textFrom analysis of serial sections of the canine medial retropharyngeal lymph node, sinuses with asaccular configuration have been delineated. Maximum dimensions of the saccular sinus analyzedvaried from 13-25 μ through the depth of the serial sections, a distance of approximately 0.5 mm.The saccular sinus opened at either end into a normal, irregularly-shaped sinus. Continuity was observedbetween a distinctly separate tubular vessel and the saccular sinus. The vessel appears toarise obliquely from the saccular sinus and is first seen as an evagination, approximately 100 μ inlength, of the endothelial border of the saccular sinus. At the region of continuity, the vessel wasapproximately 10 μ in diameter and increased to approximately 25 μ in diameter where fully separatedfrom the saccular sinus. Approximately 20 μ from the region of vessel-saccular sinus continuity,endothelial strands projected across the vessel lumen. Reconstructions of approximately36 μ of this area disclosed that these strands were tricuspid and arch-shaped in structure and couldfunction as a valve. These structw:es are discussed in relationship to the direct lymph node-venoustransfer of tracer substances.When the lymphatic duct becomes obstructed as a result of either induced or pathologicalobstacles, functional extranodal lymphaticovenous communications appear toact as a bypass mechanism (1-8). Experimental evidence has demonstrated the presenceof lymph node-venous communications, has shown that short-tenn, rapid passage oftracer substances and cells may be pressure related, and has suggested that certain anatomicalstructures may serve as a mixing chamber with two possible exits (9, 10). Histologicalevidence is presented herein to document the presence of a system of anatomicalstructures which may serve as the morphological pathway for intranodal pressurerelatedtransfer from lymph node sinuses directly to the venous system
SYSTEMIC CHLAMYDIAL INFECTION ASSOCIATED WITH GENERALIZED LYMPHEDEMA AND LYMPHANGIOSARCOMA
No full textA Chlamydial agent was isolated repeatedly from a variety of body fluids in a Negro adolescent boy with a fatal progressive lymphedema and widespread lymphangiosarcoma. The hybrid Chlamydial organism cultured resembled closely Chlamydia trachomatis. The exact relationship of the infection to the lymphedema and lymphangiosarcoma in this patient remains to be clarified
THE EFFECT OF ARTERIO-VENOUS FISTULA ON THE LYMPHATICS
No full textAlterio-venous fistulae were made in young growing pigs and lymphography was performed before and at regular intervals after operation. Animals were sacrificed at periods of two to six months. Small but consistent increases in limb growth resulted, but there was no change in the lymphatic vessels or nodes on lymphography or histological examination