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At least 325 records · Page 18Linked to original sources
PubMed1988

Fetal thoracic duct lymph flow response to intravascular saline infusion.

The left thoracic lymph duct was catheterized at the base of the neck in the sheep fetus at 123-136 days of gestation, and the lymphatic catheter was connected to a jugular vein catheter so that the lymph could return to the fetus. Lymph flow was studied 5 days after catheter implantation in the unanesthetized fetus. Basal fetal thoracic duct lymph flow rate per unit body weight averaged three times adult sheep values. After an infusion of 20 ml/kg of warmed isotonic saline into a fetal vein over 5 min, lymph flow rate increased significantly to 161 +/- 15% of control, with a peak at 8 min after termination of the infusion, and flow declined thereafter. The increased lymph volume above baseline values over 30 min averaged 5.7% of the infused volume and is similar to the adult response. Plasma and lymph protein concentrations decreased as did the lymph-to-plasma protein concentration ratio. The latter is opposite to what occurs in the adult under the same conditions. Thus the present study shows that even though the fetus has a much higher basal thoracic duct lymph flow rate than the adult, the responsiveness of the fetal lymphatic system to intravascularly infused saline is similar to that of the adult. The decrease in the lymph-to-plasma protein concentration ratio suggests that there may be differences between fetal and adult vascular-interstitial-lymphatic protein kinetics.

Animals↗
PubMedDate not supplied

[Cannulation of the thoracic duct during central venous catheterization].

A case of inadvertent thoracic duct catheterization during transjugular central venous cannulation is reported. The clinical manifestations as well as the difficulties encountered in recognizing such a complication are analyzed. So, the necessity to obtain a radiographic confirmation of central venous catheter site is strengthened.

Aged↗
PubMed1988

Plasma apolipoprotein A-I levels and bile lipid secretion during thoracic duct drainage in the rat.

A large part of the circulating apolipoprotein A-I (apoA-I) is produced by the intestine. Yet the plasma levels of apoA-I are retained or even increased in rats with thoracic duct drainage (Johansson, B. and Nilsson, A, (1981) FEBS Lett. 130, 305-308 and Franzén, J. et al. (1987) Biochim. Biophys. Acta 918, 11-15). In this study we examined the effects of biliary drainage and of combined biliary and lymphatic drainage on the plasma apoA-I levels, and also the effects of lymphatic drainage on the output of biliary lipids in the rat. 63 h of biliary drainage caused a 40% decrease of the serum apoA-I concentration. In contrast the concentration in rats with combined thoracic duct and biliary drainage was 153% of that in control rats. The biliary secretion of bile acids, phosphatidylcholine and cholesterol declined to a lower level in rats with combined thoracic duct and biliary drainage, but increased at the later time intervals to the same levels as in rats with bile fistulas only. Intravenous chyle infusion 3-36 h after commencing the biliary drainage did not prevent the decrease in biliary lipid output. The study thus provided no evidence that the reduced hepatic inflow of apoB-containing lipoproteins during biliary drainage is of importance for the reduced biliary lipid output. The loss of all the chyle lipoproteins leads, however, to an even more pronounced decrease in the biliary lipid secretion. The drainage of all the chyle constituents also leads to an increased apoA-I synthesis that more than compensates for the apoA-I loss in chyle, whereas biliary drainage only lowers the plasma apoA-I levels.

Animals↗
PubMed1975

[Lymphocyte depletion through experimental anastomosis of the thoracic duct and cervical esophagus].

In 25 dogs, a short segment of the left subclavian vein, adjacent to the connection of the thoracic duct, was dissected free with its jugular branch and ligated. An end-to-side anastomosis, using interrupted sutures was performed in two layers, between the side of the cervical esophagus and the proximal part of the jugular vein. This vein, acting as a reservoir, remains connected to the thoracic duct by the isolated segment of the subclavian vein. The original aspect, of our technique is the use of a catheter placed into a branch of the vein near the site of the anastomosis and through which a saline solution with heparin (1 mg/kg) and penicillin (40.000 U/kg) is injected daily. The catheter emerged on top of the dog's neck, and continuous perfusion was provided by a chronofusor. The catheter was removed after one month. In 30% of the dogs, the anastomosis was found patent after more than 6 weeks. This has been proved by fibro-esophagoscopy after injection of a solution of patent blue in the jugular catheter ; lymphangiograms obtained by direct injection of radio-opaque material through the jugular catheter, and a decrease in lymphocyte counts to 4% of the total white blood cell count, compared to 30% in the controls. There was no significant loss of weight in the surviving dogs.

Animals↗
PubMed2001

Life-threatening anomalies of the thoracic duct: anatomic delineation dictates management.

Congenital anomalies of the thoracic duct are rare, poorly characterized, and difficult to manage. The spectrum of pathophysiologic perturbations, presenting symptoms, radiographic findings, and interventions performed in 4 patients are shown. Accurate anatomic delineation of the malformation was only possible by direct injection contrast lymphangiography. Therapies tailored to address the anatomic aberrations included intralesional sclerotherapy, surgical excision and ligation, lymphovenous anastomosis, and omental interposition to interrupt dysfunctional collateral lymphatics to the lung. Accurate anatomic diagnosis of central lymphatic channel anomalies by contrast lymphangiography facilitates an individualized multidisciplinary approach to repair.

Adolescent↗
PubMed2000

[Thoracoscopic clipping of thoracic duct in a woman with persisting chylothorax].

A 78-year-old female had chest pain, radiating to the back, caused by a thoracic aneurysm of the aorta. A vascular prosthesis was sutured into place through a left-sided thoracotomy. Six days after the operation she developed chylothorax on the right side. Following 14 days of conservative management, chyle leakage persisted at a rate of 1500 ml per 24 hours. By thoracoscopy the thoracic duct was dissected and clipped, which stopped the chyle leakage. The patient recovered moderately well. Conservative measures, such as adjusted nutrition, are successful in 50% of patients. Clipping of the thoracic duct by thoracoscopy is a definitive and minimally invasive procedure to treat persistent chyle leakage.

Aged↗
PubMed1997

Characteristics of thoracic duct lymph in multiple organ dysfunction syndrome.

OBJECTIVE: To investigate the presence of endotoxin, bacteria, and potential humoral and cellular mediators in thoracic duct lymph and peripheral blood in patients with severe refractory multiple organ dysfunction. DESIGN: Convenience sample. SETTING: General intensive care unit of a university hospital. PATIENTS: Two men and 2 women were studied after a mean of 7.25 days (range, 6-9 days) of multiple organ dysfunction syndrome. The primary injury was thoracic in 1 patient and abdominal in 3 patients. INTERVENTION: The thoracic duct was cannulated with a 7F catheter and samples of lymph and peripheral blood were obtained. MAIN OUTCOME MEASURES: Simultaneous lymph and serum levels of lipopolysaccharide, tumor necrosis factor alpha, interleukin-1 beta, and interleukin-6, and activation markers on T lymphocytes. RESULTS: Lipopolysaccharide and cytokine levels were low in lymph and serum, except for a mean lymph-to-serum ratio of 53.4 for interleukin-1 beta. There was phenotypical evidence of intense polyclonal T-lymphocyte activation in both lymph and peripheral blood with increased lymph-to-peripheral blood ratios. Increased percentages in lymph of CD45RA + CD45RO + lymphocytes were observed. In 1 patient, Proteus mirabilis grew simultaneously in lymph, pancreatic necrosis fluid, and a central venous catheter tip. All simultaneous blood cultures were negative. CONCLUSIONS: Our results provide evidence of the participation of the gut-associated lymphatic tissue in the pathogenesis of the multiple organ dysfunction syndrome, suggesting that T-cell activation and cytokine production occur at the gut level. Future studies are needed to confirm and extend our findings.

Female↗
PubMed2000

[Variants in the organization of the cervical portion of the human thoracic duct in prenatal ontogeny].

Using macro- and microscopic methods stages of formation, forms of spatial and temporal organization and definitive variants of cervical part of human thoracic duct were studied in 49 5-8 wks old embryos, 120 8.5-36 wks old embryo and 10 human newborns. Variability of structure of thoracic duct cervical part is a reflection of parameters characterizing magistralization of jugular prevertebral lymphatic plexus: its depth (maximum, medium, minimum), topographic variant (medial, lateral, combined) and length (small, moderate, significant). With the aspect genetic 3 types of its organization were distinguished: jugular (51%), subjugular (11.3%) and combined (37.7%). In prematurely born children and newborns jugular type of the duct cervical part is the most favourable for the drainage.

Fetus↗
PubMed1977

Inadvertent thoracic duct catheterization during transjugular central venous cannulation. A case report.

An aberrant placement of a central venous catheter into the upper part of the thoracic duct with loop formation in the left innominate vein was observed on catheterizing via the left internal jugular vein. The misplacement, which did not have any deleterious effects, was caused by the atypical insertion site of the thoracic duct at the dorsocaudal wall of the left innominate vein and, possibly, by its incompetent closing valve. The stiffness of the nylon catheter used may also have been a contributory factor. The possible causes of this complication of central venous catheterization are discussed. The preferential use of the right internal jugular vein is stressed.

Catheterization↗
PubMedDate not supplied

[The development of the thoracic duct lymphangions in the prenatal period of human ontogeny].

This paper concerns structural and functional organization of the human lymphatic system during the prenatal period. For the first time the data is presented on the development of thoracic duct based on the concept of lymphangion as a structural and functional unit of a lymphatic vessel. The formation of the duct is considered in connection with structural changes of its wall and variants of duct roots fusion. The following stages are distinguished in the development of the thoracic duct: valval segment stage, protolymphangion, and lymphangion.

Gestational Age↗
PubMed1995

Ligation of the thoracic duct without thoracotomy as an effective treatment for postoperative chylothorax: a newly designed surgical procedure.

We describe herein a newly designed surgical procedure for ligating the thoracic duct to treat postoperative chylothorax, without performing a thoracotomy. This technique was successfully performed on a 50-year-old man who developed chylothorax following resection of carcinoma of the esophagus whose case is briefly presented. The advantages of this procedure include the following: the integrity of the thorax is maintained, there is less traumatization, the need for a drainage tube is eliminated, shorter hospitalization is required, and the thoracic duct is much more easily exposed than by conventional transthoracic approaches. No similar report was found in our research of the literature.

Chylothorax↗
PubMed2003

Flow-mediated release of nitric oxide from lymphatic endothelial cells of pressurized canine thoracic duct.

We examined the effects of flow on lymphatic endothelial cells by using conventional cascade preparations of isolated coronary arteries without intact endothelium. The pressurized thoracic ducts were intraluminally perfused at a constant flow rate ranging from 0.5 to 2.0 ml/min. A linear relationship was observed between the flow rate and the normalized amount of relaxing substance(s) released from the lymphatic endothelial cells. Thus the flow rate of 2.0 ml/min produced approximately 39% of sodium nitroprusside (SNP)-produced maximal relaxation in the cascade arterial rings. The acetylcholine (ACh, 10(-5) M)- and flow-induced relaxations of the cascade arterial rings were completely reduced by the mechanical rubbing of lymphatic endothelial cells in the pressurized lymph vessels. Pretreatment with 5 x 10(-5) M N(G)-nitro-L-arginine methyl ester (L-NAME) on the lymphatic endothelial cells caused a significant reduction of the ACh- and flow-induced vasodilations of the cascade arterial rings. Pretreatment with 10(-5) M indomethacin on the lymphatic endothelial cells produced no significant effect on the ACh- and flow-induced vasodilations. These findings suggest that lymphatic endothelial cells of canine thoracic ducts can produce and release endogenous nitric oxide by stimulation of flow (approximately 2.0 ml/min).

Acetylcholine↗