[Orthovoltage roentgenotherapy in the treatment of lymphorrhea after reconstructive operations on the lower extremities arteries]

After performance of 728 reconstructive-restoration operations on the lower extremities arteries in 58 (7.9%) patients a lymphorrhea from the wound have had occurred. While roentgenotherapy application for postoperative lymphorrhea treatment in 67% patients a good result was achieved. The number of the ray therapy procedures was determined in accordance with the clinical effect obtained.

Intraoperative mapping of renal lymphatic drainage: technique and application in a porcine model

BACKGROUND AND PURPOSE

The use of lymphadenectomy in renal-cell carcinoma (RCC) is controversial. Proponents argue that lymphadenectomy improves survival, whereas opponents challenge the procedure on the basis of its morbidity and the variable lymphatic drainage of the kidney. Intraoperative gamma probes have been used to guide resection of radiolabeled sentinel nodes in cancers of the breast, penis, and head and neck and in melanoma. Our goal in applying this technique to RCC is to improve detection and to limit sampling of lymph nodes during lymphadenectomy. This preliminary study in a porcine model evaluated the feasibility and transit time of radiolabeled tracer injected into the kidney.

MATERIALS AND METHODS

Data were collected on four 40-kg Yorkshire pigs. The right kidney was exposed through a flank incision. Using both blue dye and technetium-99m, mapping and resection of the sentinel lymph nodes was performed with the assistance of an intraoperative gamma probe (Neoprobe). Remote cervical lymph nodes were utilized as controls. Vascular counts along the carotid vessels were obtained to confirm that the radioisotope was not being dispersed systemically.

RESULTS

Within 10 minutes of renal injection of the tracer, excised sentinel lymph nodes demonstrated significant radioactive counts compared with controls. Vascular counts confirmed that radioisotope tracer did not enter the venous circulation.

CONCLUSIONS

Sentinel lymph node sampling using a gamma probe and blue dye appears to be feasible in the porcine kidney. Further studies using this technique in humans will evaluate the impact of selective lymphadenectomy on survival in RCC.

Improvement of macromolecular clearance via lymph flow in hamster gingiva by low-power carbon dioxide laser-irradiation

BACKGROUND AND OBJECTIVE

Although therapeutic effects of low-power laser-irradiation on periodontal disease have been reported, little is known about the biological effects of laser-irradiation in the gingiva. Recently we reported that topical warming stimulated macromolecular clearance via lymph flow in hamster gingiva. This study was conducted to investigate whether low-power laser-irradiation affects macromolecular clearance via the lymph flow in the gingiva.

STUDY DESIGN/MATERIALS AND METHODS

We injected 14C-methylated albumin into the mandibular gingiva of anesthetized hamsters followed by topical carbon dioxide (CO2) laser-irradiation (30 seconds, 0.5-1.5 W). We measured the clearance of radiolabeled albumin from the gingiva and its drainage into submandibular lymph nodes during 10 minutes.

RESULTS

The clearance of the radiolabeled albumin from the gingiva and the influx into the submandibular lymph nodes were increased by CO2 laser-irradiation.

CONCLUSION

Low-power CO2 laser-irradiation improves macromolecular clearance via the lymph flow in hamster gingiva.

[The effect of cystamine on the level of postradiation peroxidation products in the lymph of dogs]

The experiments on irradiated dogs with a drained pectoral lymph duct revealed an early accumulation of radiotoxins (diene conjugates and malonic dialdehyde) in the lymph and blood plasmas and; simultaneously, a lowering of water-soluble antioxidants. The prophylactic application of cystamine improved the drain-detoxifying function of the lymphatic system, lowered the level of radiotoxins, and aided in the antioxidant properties of lymph and blood plasmas.

[The effect of ionizing radiation on the vascular bed of the skin in ontogeny. The status of the lymph- and blood-microcirculatory beds of the skin in newborn white rats during sublethal irradiation]

Three-day rat pups were X-irradiated (5 Gy) and killed on days 3-4, 6-7, and 10-11. Using the microscopic, histological and morphometric methods it was found that the microcirculation channel was damaged to a greater extent than the hemocirculation one. This was followed up during the radiation sickness. The pathological changes were more pronounced in all structures of the derma papillary layer than in those of the reticular layer. Oedema and reduced cellularity were noted in the connective frame.

[Ultraviolet irradiation of lymphoplasma in combination with lymphocytapheresis in the treatment of patients with diseases of the blood system]

The article describes results of treatment of 8 patients with diseases of blood system complicated by autoimmune processes with the use of lymphocytopheresis in combination with the ultraviolet irradiation of lymphoplasm for its sterilization before autotransfusion. It was shown that ultraviolet rays (254-330 nm) gave a stable most pronounced lymphoplasm-sterelizing effect in addition to the increased immunosuppressive action due to lymphocytophoresis in the external drainage of the thoracic lymphatic duct.

[Reaction of lymph and blood coagulation systems to gamma radiation at high altitudes]

A study was made of coagulation and cellularity of blood and lymph of thoracic duct of dogs exposed to 2.5 Gy radiation at the altitudes of 760 m and 3200 m above sea level after one-month adaptation. Irrespective of the irradiation conditions coagulation of blood decreased and that of lymph increased. Radiation-induced changes in the cellularity of both blood and lymph were less pronounced in conditions of natural hypoxia than at the altitude of 760 m.

Successful treatment of autoimmune disease in (NZB/NZW)F1 female mice by using fractionated total lymphoid irradiation

Adult female (NZB/NZW)F1 hybrid mice with documented autoimmune glomerulonephritis resembling systemic lupus erythematosus were treated with fractionated total lymphoid irradiation (TLI), a modification of the radiotherapeutic regimen currently used for the treatment of Hodgkin disease. After TLI, proteinuria subsided in all mice that had undergone radiotherapy, and the mean survival increased from 359 days in untreated controls to 545 days. It is suggested that TLI should be further investigated as a new approach for immunoregulation of autoimmune disorders.

Effects of irradiation of cervical lymph nodes

The effects of irradiation upon the functional integrity of lymph nodes were studied in the isolated cervical region of the dog. After 6000 rads were applied in one dose plan, the measure of lymph flow was determined by the migration of radiogold from the larynx to the associated primary lymphatic terminals at intervals of 2, 4, and 12 weeks, and six months post-irradiation. Interference with lymph flow was identified by radionuclide stasis in the injection depot; alteration in the direction of flow was identified by relative concentration of the tracer item in the associated nodal terminals. The lymph flow was minimally distorted by irradiation in the test period unless secondary damage to the associated lymphatic channels intervened. The relative migration was consistent with the normal data in 52%, depressed in 13% and increased in 35% of the cases studied. Major obstruction and rerouting of lymph flow contralaterally was evident in 19% of the subjects due to fibrosis secondary to local infection.

Changes of the antiheparin activity of the blood plasma and lymph in dogs after total irradiation

An increase was demonstrated of the antiheparin activity in the blood of rats after their total exposure to 200, 500 and 800 R and dogs exposed to 400 R. In the rats the increase of the antiheparin activity was directly dependent of the exposure used. The antiheparin activity increased up to 180 min after the exposure. In the irradiated dogs, there was also a strong increase in the antiheparin activity with a certain decrease 24 hrs after irradiation. A secondary increase was observed on the 7th, 10th and 13th days of the experiment. In the lymph of the irradiated dogs, the increase of the antiheparin activity was steeper than that in the blood itself. The results achieved could serve as a starting point for further investigations to answer the question of possible using these changes for diagnostic estimation of the biological degree of the radiation damage under different conditions.

Extracorporeal irradiation of thoracic duct lymph as immunosuppressive treatment in rheumatoid arthritis

Thoracic duct drainage and re-infusion of the irradiated lymph was carried out as immunosuppressive treatment in 2 patients with progressive, therapy-resistant rheumatoid arthritis. In both patients, a marked clinical improvement was achieved even during the first days of treatment. A reduced number of T cells in the blood was seen 3 days after onset of drainage, whereas no significant change in the number of B cells was observed. No recirculation of the infused cells could be detected, nor was the radiation removal of T cells accompanied by rapid proliferation of "new" T cells. As clinical improvement and reduction in T cells occurred simultaneously, there is probably a connection between these two events. The beneficial clinical response and the achievement of T cell suppression by thoracic duct drainage--the result of irradiation and re-infusion of irradiated lymph--encourage further clinical trials with this type of treatment in severe therapy-resistant rheumatoid arthritis.