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PubMed1990

[Surgical thoracoscopy].

UNLABELLED: Thoracoscopic adhesiolysis since 1913 (Jacobaeus). Thoracoscopic targets: Sympathetic system, vagus system, lymphatic system, lung. INDICATIONS: Arterial circulation disturbances, posttraumatic reflexdystrophy ("Sudeck"), Hyperhidrosis syndromes, erythrodermy syndromes; pain syndromes: causalgiform, splanchnicotomy for chronic pancreatitis. For peptic jejunal ulcer thoracoscopic splanchnico-vagotomy. For bronchial asthma selective vagotomy of bronchial rami. Operative techniques. Hemostasis: low-frequency thermocoagulation, unipolar and bipolar high-frequency coagulation, with thermostabilisation. Videoendoscopy with minicameras. Electronic frame freezing for colour slides.

Electrocoagulation↗
PubMed2004

Development of the lymphatic vascular system: a mystery unravels.

The blood vascular and the lymphatic system play complementary roles in tissue perfusion and fluid reabsorption. Despite its critical role in mediating tissue fluid homeostasis, intestinal lipid absorption, and the immune response, the lymphatic system has not received as much attention as the blood vascular system, largely due to a lack of lymphatic-specific markers and to the dearth of knowledge about the molecular regulation of lymphatic development and function. A series of recent landmark studies now significantly has advanced our understanding of the lymphatic system. Based upon the discovery and characterization of lymphatic-specific growth factors, receptors, and transcriptional regulators, the mystery of lymphatic vascular system development begins to be unraveled. The successful isolation and cultivation of blood vascular and lymphatic endothelial cells has enabled comparative molecular and cellular analyses of these two genetically and developmentally closely related cell lineages. Moreover, studies of several genetic mouse models have set the framework for a new molecular model of embryonic lymphatic vascular development and have identified molecular pathways whose mutational inactivation leads to human diseases associated with lymphedema. Although these rapid advances already have led to development of the first lymphatic-targeted molecular therapies, there still remain many unanswered questions regarding almost every aspect of lymphatic vascular biology, making the lymphatic system a highly exciting and rewarding field of study.

Animals↗
PubMed1986

Lymph circulation: physiology, pharmacology, and biomechanics.

Lymph is the fluid in the lymphatic system. The lymphatic system, a complex network of vessels, is essentially a drainage system within the body which transports excess fluid and metabolic waste products from interstitial spaces into the blood circulatory system. Lymph flow is governed by extrinsic forces due to the movements of organs and skeletal muscles which exert external pressure on the lymphatic walls, and by the intrinsic forces due to rhythmic contractions of smooth muscle in the walls of the lymphatic vessels which play a major role in lymph circulation. Intensities of these lymphatic smooth-muscle contractions are modulated by several humoral mediators such as epinephrine, serotonin, and PGE1. These notions of lymphology, together with principles of mechanics, have been integrated into mathematical models of lymph circulation. Model analysis has revealed several interesting features of lymph circulation and lymphatic system design. Distention-induced enhancement of contractility is important in achieving significant increase in lymph flow during edema.

Animals↗
PubMed1989

[Problems of ecological lymphology].

Ecological influences, exercised on one the most important homeostatic systems - the lymphatic system - have been investigated extremely insufficiently. Nevertheless, in mechanisms of adaptogenesis interaction of the environmental effects with the lymphoid organs plays a rather essential role. Structural-functional response of the lymph nodes to the environmental effects possesses some features of stereotype, however, the stereotypic response is subjected to modulations in connection with the factor acting and functional specialization of the lymph node. Keeping this in mind, the lymph nodes (their morpho-functional status) can be considered as markers of the environmental pressing to the lymphatic system. When estimating the degree and stage of the phasic morpho-functional changes in the lymph nodes during their adaptation to the environmental influences, it is necessary to take into account the possibility of the environmental (in our case - cooling, chemicals) imprinting, in order to judge on the degree of individual stability of the organism to these effects. The morpho-functional rearrangements in the lymph nodes, under the environmental influences on the animal organism, reflect the dynamics of complex interorganic correlations both within the lymphatic system and at intersystemic level.

Adaptation, Physiological↗
PubMed1986

Lymphatics, lymph and lymphoid cells: an integrated immune system.

Lymphatics, lymph and lymphoid cells are still considered to be different entities and not parts of one integrated system. Surgeons working on the problems of lymphedema study lymph flow kinetics but neglect lymph humoral and cellular constituents. Immunologists study the problems of lymph cells but neglect lymph transport and chemical composition. This article describes the author's own views on the function of the lymphatics, lymph proteins and cells as one integrated immunoregulatory system. Data from own studies on the peripheral lymphatic system performed mostly in man are quoted.

B-Lymphocytes↗
PubMed1990

[Saccular initial segments of the lymphatic vessel system].

It is commonly said that the lymphatic system begins "blindly" as saccular outpocketings. In order to examine these saccular outpocketings, 120 injections into the conjunctival lymphatics of 60 bovine postmortem eyes were carried out, measuring the level of injection pressure and simultaneously documenting the various filling stages photographically. 20 trials were selected for further analysis. We recorded low initial pressures when the tip of the needle was situated close to a larger lymphatic vessel and the coloured solution (1% aqueous Berliner Blue) as possibly applied intravascularly. Higher initial pressures were seen on positioning inside fine networks of vessels. Extremely high initial pressures without any visible filling of vessels but in the presence of simultaneously increasing depots of dye were probably caused by absent or insufficient connection between the tip of the needle and a vessel. During lymphography numerous coarser and finer, tube-like projections (saccular outpocketings) filled, from which further progression of the coloured solution could only be observed when higher injection pressures were applied. We were able to prove that such segments had connections to neighbouring vessels as well as forming plexus of their own. Based on our findings we have reason to doubt the existence of tube-like initial segments in the lymphatic system. Rather in the conjunctiva of the bovine eye this system has the structure of a fine network where tube-like segments can be demonstrated as temporary filling stages.

Animals↗
PubMed2003

Functional anatomy of the lymphatic drainage system of the upper aerodigestive tract and its role in metastasis of squamous cell carcinoma.

BACKGROUND: Although there is a significant understanding of the vascular anatomy of the upper aerodigestive tract (UADT), there is less detailed knowledge of the architecture and drainage patterns of the lymphatic system. Detailed knowledge of the lymphatic system is critical for understanding the role of sentinal node identification in the management of different cancers. METHODS: We have combined microscopic techniques with in vivo and in vitro lymphographic studies to survey the architecture and drainage patterns of the lymphatic system of the UADT in 850 organ specimens. RESULTS: These studies show an interaction of superficial and deep lymphatic networks that vary in density but have a constant distribution characterized by predictable patterns of lymph drainage into the regional lymph nodes. CONCLUSIONS: Detailed knowledge of the lymphatic system of the UADT contributes to a better understanding of the patterns of metastatic spread of carcinomas of the UADT and provides a strong rationale for the practice of sentinel node identification in the management of these tumors.

Carcinoma, Squamous Cell↗
PubMed2006

New insights into the molecular control of the lymphatic vascular system and its role in disease.

The cutaneous lymphatic system plays an important role in the maintenance of tissue fluid homeostasis, in the afferent phase of the immune response, and in the metastatic spread of skin cancers. However, the lymphatic system has not received as much scientific attention as the blood vascular system, largely due to a lack of lymphatic-specific markers and to the dearth of knowledge about the molecular regulation of its development and function. The recent identification of genes that specifically control lymphatic development and the growth of lymphatic vessels (lymphangiogenesis), together with the discovery of new lymphatic endothelium-specific markers, have now provided new insights into the molecular mechanisms that control lymphatic growth and function. Moreover, studies of several genetic mouse models have set the framework for a new molecular model for embryonic lymphatic vascular development, and have identified molecular pathways whose mutational inactivation leads to human diseases associated with lymphedema. These scientific advances have also provided surprising evidence that malignant tumors can directly promote lymphangiogenesis and lymphatic metastasis, and that lymphatic vessels play a major role in cutaneous inflammation and in the cutaneous response to UVB irradiation.

Animals↗
PubMed1990

Nuchal cystic hygroma associated with massive lymphangiomatosis of the upper extremity and myocardium in a stillborn fetus: a case report.

Nuchal cystic hygromas may be encountered in stillborn fetuses as part of a spectrum of a more generalized abnormality of the lymphatic system. These lymphatic system abnormalities may be accompanied by various visceral anomalies, especially in Ullrich-Turner Syndrome (UTS) (45,X0) but also in non-45,XO fetuses. We present unique autopsy findings in the case of a stillborn female fetus with a nuchal cystic hygroma associated with massive lymphangiomatosis of the upper extremity as well as myocardium. While previous descriptions of abnormal cardiac lymphatics associated with nuchal cystic hygroma have focused on dilated lymphatics surrounding the root of the aorta and pulmonary artery, the present case extends the spectrum of possible findings to include subtotal replacement of the ventricular myocardium by dilated lymphatics.

Cardiomegaly↗
PubMed1990

[Historical notes on the lymphatic vascular system].

The history of the progress in the knowledge of the lymphatic system can be divided in three main periods. The first one spans Egyptian. Greek and Roman civilizations until III century after Christ: the earliest topographical reports on collectors, major trunks and regional groups of lymph nodes date back to this age. The second period begins with Renaissance and extends until the end of XIX century. The scientific knowledge is no longer accepted as a collection of "unquestionable truths" but rather new discoveries are confirmed by painstaking descriptions and detailed pictures. We owe to Aselli (1622) the scientific description of lacteals. The new techniques of maceration (Malpighi, 1628) and of injection of different substances (water, air, mercury, cinnabar) allowed a strict check of the acquired knowledge and an accurate description of the superficial and deep lymphatic networks in different organs (kidney, heart). The documentation of the vascular lymphatic system culminates in the matchless work "Vasorum Lymphaticorum Corporis Humani..." by Paolo Mascagni (1755-1815) which Susini (1773-1814) immortalized in ceroplastic statues. The third phase covers the XX century. The studies deepen with the demonstration of lymphatic capillaries, endothelial cells. Macro- and microtopographical relationships between lymphatic and blood networks are described in detail and lymphatic vessels are studied at microscopic level. In the last decades ultrastructural and immunocytochemical researches develop in order to investigate the processes involved in lymph genesis and transendothelial transport of fluids, macromolecules and cells.

Anatomy↗
PubMed1987

Comparison of fluid transport systems in lymphatics and veins.

In the anesthetized sheep, pressure pulses generated in the feet are transmitted downstream in the veins but not in the lymphatics at normal intralymphatic pressure. When the sheep is tilted on a tilt table, gravitational changes occur in venous pressure but not in the pressure in adjacent lymphatics. These results suggest that in limb lymphatics, unlike limb veins, the column of fluid is incomplete. This makes extrinsic pumping less effective for propelling fluid in lymphatics than in veins. At normal intralymphatic pressures, intrinsic pumping seems to be mainly responsible for lymph propulsion. The incompleteness of the fluid column in lymphatics might also protect these vessels against the hydrostatic problems experienced by veins during gravitational stress.

Animals↗
PubMed2006

Histology of selected tissues of the leopard seal and implications for functional adaptations to an aquatic lifestyle.

The microscopic anatomy of the cardio-respiratory system, digestive system, kidney, lymphatic system and integument was investigated in the leopard seal, Hydrurga leptonyx, by examining histological sections of tissues collected from leopard seals in Antarctica and New South Wales, Australia. The majority of the tissues had similar histological features to those described in terrestrial mammals and other pinniped species, particularly phocid seals. Differences noted included readily identifiable Purkinje cells within the endocardium, muscular rather than cartilaginous reinforcement of the smaller airways, a single capillary layer within the alveolar septa, limited and variable keratinization of the oesophageal epithelium, few lymphoid follicles within the lamina propria of the gastrointestinal tract, and an absence of a sporta perimedullaris musculosa described in the kidney of cetaceans and some pinniped species. Adaptations of the lung, spleen and integument, similar to those described in other pinnipeds, including reinforcement of the pulmonary terminal airways, prominent pulmonary interlobular septa, ample smooth muscle in the capsule and trabeculae of the spleen, increased thickness of the epidermis, well-developed dermal sebaceous glands, and a thick blubber layer, appear to confer upon the leopard seal advantages related to its aquatic lifestyle.

Adaptation, Physiological↗
PubMed2006

Lymph, lymphocytes, and lymphatics.

This is a summary of recent developments regarding the role of the lymphatic system in immune responses. Emphasis is on physiological considerations from experiments in sheep. Cell- and tissue-specific lymphocyte traffic patterns measured over several days are considered. Particular attention is given to recent data on the relationship between the central nervous system and the lymphatic system, to cell labeling in situ, and to the entry of immune cells into afferent lymph from the interstitial tissues.

Animals↗