Lymph Stasis

Waldemar L. Olszewski, M.D., Ph.D. is Professor of Surgery and Director of the Department of Surgical Research and Transplantology at the Medical Research Center, Polish Academy of Sciences in Warsaw, Poland. Dr. Olszewski graduated from the Medical Faculty, Medical Academy in Warsaw, receiving his M.D. degree in 1954 and Ph.D. degree in 1962. He obtained his surgical training in the Surgical Division, Warsaw City Hospital and then Department of Surgery, Medical Academy, Warsaw. He served as an Assistant Professor at the Medical Academy and the Medical Research Center from 1962 to 1968 and as Associate Professor from 1968 to 1978. In 1978 he became Professor of Surgery. From 1962 to 1975 he was Deputy Director of the Department of Surgical Research, Medical Research Center and in 1975 he assumed the position of Director. Since 1974 he has been associated with the Laboratory of Hematology and Lymphology, Norwegian Radium Hospital, in Oslo, Norway., Dr. Olszewski was a Research Fellow at the Royal Postgraduate Medical School in London from 1962 to 1963 and at the Peter Bent Brigham Hospital, Harvard Medical School, Boston, in 1968 and 1969. Dr. Olszewski is a member of the European Society for Surgical Research, International Lymphological Society, International Microsurgical Society, and the International Transplantation Society. He served as President of the European Society for Surgical Research from 1977 to 1978 and as a member of the Executive Committee until 1982. He was elected President of the International Society of Lymphology for the term 1989–1993. He is Associate Editor of Lymphology, Zeitschrift für Experimentelle Chirurgie, Transplant International, Angiology International , and Immunologia Polska. He is also Honorary Member of the Brazilian Vascular Society and the Korean Medical Association. Recently he founded the Polish-Japanese Surgical Society, and started cooperation in treatment of lymphedema with the National Lymphedema Network of America and Thanjavur University, India., Dr. Olszewski is the author of more than 250 papers on lymph and lymphoid tissue, transplantation immunology, vascular problems, and has been the author or editor of 6 books, among them Handbook of Microsurgery, Peripheral Lymph: Formation and Immune Function , and In vivo Immune Cell Migration. His major clinical interests relate to vascular and lymphatic surgery, and research interests in the physiology of the lymphoid organs and immunoregulation., Thomas H. Adair, Ph.D. Professor, Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi, Knut Aukland, M.D. Professor, Department of Physiology, University of Bergen, Bergen, Norway, James A. Barrowman, M.D., Ph.D. Professor, Department of Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada, Rüdiger G. H. Baumeister, M.D. Professor, Department of Surgery, University of Munich, Munich, Germany, Joseph Beninson, M.D. Director, Leg Ulcer Clinic and Peripheral Vascular Disease, Department of Dermatology, Henry Ford Hospital, Detroit, Michigan, Tom Bergan, M.D. Professor and Chief, Department of Microbiology, University of Oslo, Oslo, Norway, Josef Bruna, M.D. Professor, Department of Radiology, Charles University of Prague, Prague, Czechoslovakia, Corradino Campisi, M.D. Associate Professor, Department of General and Emergency, Surgery — Microsurgery Unit, University of Genoa School of Medicine and Surgery, Genoa, Italy, Ian Carr, M.D., Ph.D. Professor, Department of Pathology, University of Manitoba, Winnipeg, Manitoba, Canada, A. Castenholz, M.D. Professor, Department of Human Biology, University of Kassel, Kassel, Germany, Ti-Sheng Chang, M.D. Professor, Department of Plastic Surgery, Ninth Peoples’ Hospital, Shanghai, Peoples’ Republic of China, Robert V. Cluzan, M.D. Head, Lymphology Unit, Hôpital Cognacq-Jay, Paris, France, Mario Degni, M.D. Professor, Department of Surgery, Pontìficia Universidade, Católica de Campinas, Campinas, Sao Paulo, Brazil, Allan E. Dumont, M.D. Professor Emeritus, Department of Surgery, New York University School of Medicine, New York, New York, Arfinn Engeset, M.D. Det Norske Radiumhospitalet, Oslo, Norway, Ethel Földi, M.D. Medical Chief Superintendent, Földi Clinic, Hinterzarten, Germany, Michael Földi, M.D. Director, Földi-Klinik and Földi-Schulen, Freiburg, Munich, Berlin, Germany, Umberto Fox, M.D. Professor, Department of Surgery, University of Milan, Milan, Italy, Ji-Liang Gan, M.D. Department of Plastic Surgery, Ninth Peoples’ Hospital, Shanghai, Peoples’ Republic of China, Peter Hirnle, M.D. Department of Gynecology and Obstetrics, University of Tübingen, Tübingen, Germany, Alf Kolbenstvedt, M.D. Professor, Department of Diagnostic Radiology, Rikshospitalet, Oslo, Norway, Sanford E. Leeds, M.D. Associate Chief, Department of Experimental Surgery, Mount Zion Medical Center of the University of California San Francisco, California, Hans Henrik Lien, M.D. Department of Diagnostic Radiology, Norwegian Radium Hospital, Oslo, Norway, Michael T. Lotze, M.D. Professor of Surgery, Molecular Genetics and Biochemistry, Associate Director for Surgical Oncology, Pittsburgh Cancer Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, Noel G. McHale, Ph.D. Reader in Physiology, School of Biomedical Science, The Queen’s University of Belfast, Belfast, Ireland, Jean-Pierre Montani, M.D. Associate Professor, Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi, Walter Montorsi, M.D. Professor and Chairman, Department of Surgery, University of Milan, Milan, Italy, L. Mosca, M.D. Professor and Chairman, Department of Pathology, University of Milan, Milan, Italy, Moriya Ohkuma, M.D. Professor, Department of Dermatology, Kinki University School of Medicine, Osaka, Japan, Waldemar L. Olszewski, M.D., Ph.D. Chief, Department of Surgical Research and Transplantology, Medical Research Center, Polish Academy of Sciences, Warsaw, Poland, and, The Norwegian Radium Hospital, Laboratory for Hematology and Lymphology, Oslo, Norway, Hugo Partsch, M.D. Professor and Head, Department of Dermatology, Wilhelminen Hospital, Vienna, Austria, Alain M. Pecking. M.D. Head, Nuclear Medicine, René Huguenin Center, Saint Cloud, France, Carl Fredrik Petlund, M.D. Department of Physical Medicine, Rikshospitalet, Oslo, Norway, Norman M. Pettigrew, M.D. Department of Pathology, University of Manitoba, Winnipeg, Manitoba, Canada, Neil B. Piller, Ph.D. Associate Professor, School of Nursing Studies and Department of Primary Health Care, Flinders University of South Australia, Bedford Park, Australia, Rolf K. Reed, M.D. Professor, Department of Physiology, University of Bergen, Bergen, Norway, Giuliano Romagnoli, M.D. Department of Surgery, University of Milan, Milan, Italy, Wilhelm Schneider, M.D. Department of Dermatology, University of Tübingen, Tübingen, Germany, E. Trabucchi, M.D. Associate Professor, Department of Surgery, University of Milan, Milan, Italy, Herman N. Uhley, M.D. Associate Chief, Department of Medicine, Mount Zion Medical Center of the University of California, San Francisco, California, Terence P. Wade, M.D. Assistant Professor, Department of Surgery, St. Louis University Medical Center, St. Louis, Missouri, Charles L. Witte, M.D. Professor, Department of Surgery, University of Arizona College of Medicine, Tucson, Arizona, Marlys H. Witte, M.D. Professor, Department of Surgery, University of Arizona College of Medicine, Tucson, Arizona

INTRODUCTION. Lymphology and the Lymphatic System. STRUCTURE OF LYMPHATICS, LYMPH FORMATION AND FLOW. Structure of Initial and Collecting Lymphatic Vessels. Interstitial Edema-Preventing Mechanisms. Dynamics of Lymph Formation and Its Modification. Influence of Autonomic Nerves on Lymph Flow. Lymph Pressure and Flow in Limbs. Dermal Lymph and Lymphatics. Pulmonary Lymph and Lymphatics. Gastrointestinal Lymphatics. CHEMICAL AND CELLULAR COMPOSITION OF LYMPH. Chemistry of Lymph. Cells in Lymph. PATHOLOGICAL FACTORS AFFECTING LYMPH FLOW. Injury of Lymphatics. Lymphangitis. Lymph Stasis After Lymph Node Dissection. Lymphatic Spread of Cancer. Thoracic Duct: Conditions Affecting Function. Pathophysiology of Lymphatic Insufficiency and Principles of Treatment. CLINICAL PICTURE OF LYMPH STASIS IN LIMBS. Clinical Picture of Lymphedema. Histological and Ultrastructural Evaluation of the Crural Lymph Nodes in Primary Lymphedema of the Lower Limbs. Malformations of the Lymphatic System. DIAGNOSTIC PROCEDURES. Radionuclide Lymphography. Computerized Tomography, Xeroradiography, Lymphography and Xerolymphography in Diagnosis of Lymph Stasis. Indirect Lymphangiography. Volumetry of Limbs. Diagnosis of Lymphatic Invasion by Tumors. TREATMENT OF LYMPHEDEMA. Conservative Treatment of Lymphedema. Postmastectomy Lymphedema-Medical Therapy Using Intermittent Compression and a Pressure Gradient Prosthesis. Heating and Bandaging in the Treatment of Chronic Lymphedema of the Extremities. Pharmacological Treatment of Lymph Stasis. Surgical Lympho-Venous Anastomoses for Treatment of Lymphedema. A Technique of Lymphatic Vessel-Vein Anastomosis for the Treatment of Lymphedema of Limbs. Microsurgical Autologous Lymph-Vessel Grafting. The Autologous Vein Grafts in Reconstructive Microsurgery for Lymph Stasis. Drug Penetration to Peripheral Lymph in Man. Endolymphatic Therapy. Collection of Peripheral Lymph in Man.