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[Angiogenesis of cervix carcinoma. Contrast enhanced dynamic MRI, histologic quantification of capillary density and lymphatic system infiltration].

PURPOSE: It was the aim of this project to examine (i) the relationships between contrast-enhanced dynamic MR imaging derived characteristics and histologic microvessel density counts--a recognized surrogate of tumor angiogenesis--from tumors in patients with primary or recurrent cancer of the uterine cervix, and (ii) to correlate these parameters with lymphatic involvement (i.e. lymphatic channels) to assess tumor biological aggressiveness in terms of lymphatic spread. MATERIAL AND METHODS: Pharmacokinetic MR imaging parameters (amplitude A, exchange rate constant k21) were derived from contrast-enhanced dynamic MR imaging in thirty-three patients with biopsy proven cancer of the uterine cervix. The pharmacokinetic MR imaging characteristics were correlated to histologic capillary density counts obtained from whole mount specimen. In addition, these data were correlated to the angiogenic activity as a marker for lymphatic system involvement. RESULTS: Pharmacokinetic MR imaging derived parameters (A, k21) showed a weak but significant (p < 0.05) correlation with microvessel density counts. Lymphatic involvement was more comprehensively assessed by the pharmacokinetic parameter k21 compared with histologic microvessel density, resulting in a significantly (p < 0.05) higher overall accuracy (85% vs. 64%), sensitivity (83% vs. 54%), and comparable specificity (89% vs. 89%), respectively. CONCLUSION: Our first results show that the signal-time curves measured by contrast-enhanced MR imaging are only in part influenced by microvessel density. In addition, MR imaging derived characteristics may assess tumor biological aggressiveness in terms of lymphatic spread (i.e. lymphatic channels) more comprehensively than histologic microvessel density in patients with primary or recurrent cancer of the uterine cervix.

Adult↗

Ancillary tests of the cardiovascular and lymphatic system.

Clinical signs of cardiovascular or lymphatic disease may not be specific. Even such signs as edema, cardiac murmur, or cyanosis require further investigation to make a final diagnosis, determine prognosis, or assess treatment response. This article describes indications, description, and interpretation of the electrocardiogram, echocardiogram, phonocardiogram, arterial blood gases, pericardiocentesis, cardiac catheterization, lymph node aspirate or biopsy, indirect blood pressure determination, and other tests associated with the investigation of cardiovascular or lymphatic disease of food animals.

Animals↗

Whole-body lymphangioscintigraphy: preferred method for initial assessment of the peripheral lymphatic system.

In 20 patients with congenital and acquired lymphedema in either upper or lower extremities and in four patients without extremity edema, human serum albumin labeled with technetium-99m was injected intradermally into a digital web space of the hand or foot. With a digital gamma camera that permitted a "sweep" of the torso, serial extremity and whole-body lymphagioscintigraphy (LAS) of the peripheral lymphatic system was performed. In 11 patients with acquired lymphedema, a well-defined obstructive pattern was seen, characterized by discrete peripheral lymphatic trunks, delayed or absent depiction of regional nodes, and delayed but extensive soft-tissue tracer extravasation. Five of nine patients with congenital lymphedema showed hypoplasia characterized by poorly defined lymphatic trunks, delayed depiction of regional nodes, and early and extensive extravasation of tracer. The other four patients showed aplasia, with absence of trunks, no depiction of nodes, and little or no tracer extravasation. LAS is technically simple to perform and requires no special training. Radiation exposure is minuscule, and the procedure is safe and without apparent side effects. For these reasons, whole-body LAS should be the preferred method for the initial assessment of congenital or acquired lymphedema.

Adolescent↗

[Effect of ultrasonic stimulation of the lymphatic system on changes in subpopulations of peripheral blood lymphocytes in multiple sclerosis].

In the years 1977-1979 after publication of the experiences of German authors a trial was undertaken of treating 63 patients with multiple sclerosis by means of ultrasonic stimulation of the lymphatic system. It was the purpose of the present work to check the effect of this method on the subpopulations of peripheral blood lymphocytes in 20 patients. These investigations were carried out using rosette tests EAC, AE, E which were performed three times in each case: before the onset of treatment, after the first procedure and after the last procedure. These investigations demonstrated significant differences between the mean values of EAC and EA rosettes before and after the treatment--a rise in the number of lymphocytes B (EAC rosettes) and a fall of lymphocytes T (EA rosettes).

Adult↗

A case of liver cirrhosis with chylous ascites and multiple cystic dilatation of the abdominal lymphatic system.

A 51-year-old male suffering from abdominal distension and diagnosed by laparoscopic and histological examination as a liver cirrhosis patient, had a chylous ascites with a negative Gordon test. The content of chylomicron in ascites decreased by restriction of dietary fat, although the ascites retention was resistant to salt restriction, diuretics and intravenous re-infusion of ascites. Lymphangiography revealed dysplasia of the retroperitoneal lymphatic system and dilatation of the thoracic duct. Main autopsy findings were liver cirrhosis (post-necrotic type) without malignancy and marked cystic dilatations of the lymphatic duct. The lymph congestion in the intestine was more remarkable in the subserosal space and the leakage of the chyle into the abdominal cavity was also proved by histological examination.

Abdomen↗