Mácula equimótica sobre lesión pigmentada tras traumatismo / Ecchymotic Macule on a Pigmented Lesion Following Trauma

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[The valvular apparatus and tissue organization of the endothelium of the thoracic duct]. / Klapannyi apparat i tkanevaia organizatsiia éndoteliia grudnogo protoka.

The structure of ostial valves and valves located along the thoracic duct and of its branches ostial valves and right lymphatic duct ostial valves were studied in 30 experimental outbred dogs and 46 cats. Cryodestruction of thoracic duct was performed in 28 outbred cats. 1, 3, 7 and 14 days later perfusive fixation with intercellular borders impregnation was carried out with simultaneous examination of intact regions of intravalvular segments, cisterna chyli and area of thoracic duct trunks connection with valvular surfaces. Tissue organization in ageing was studied using the intervalvular segment of old animals. Specimens were studied by means of scanning electron microscopy and film preparations of endothelium. Valves, located along the thoracic duct length are bicuspid formations, while ostial ones are falciform and cuneiform respectively in 80 and 20%. Endotheliocytes of cuspids are characterized with high content of microfilaments bundles in the cytoplasm and low content of microvesicles. Cells of the valvular free margin cross the cuspid edge and have adaptive changes preventing their desquamation: fusiform shape, long basal processes and bundles of microfilaments in the cytoplasm. Peculiar "pericyte-like" cells alike with myofibroblasts lie deep in the cuspid thickness close to the sinusal venous side. Fascicles of the duct smooth myocytes reach the base of the valve. Besides, in the ostial valve stroma there is elastic membrane, better displayed along the cuspid venous side. Increased polymorphism and changes of the endotheliocytes metric characteristics were demonstrated in the zones of turbulent lymph flow. Analysis of the newly formed endothelium tissue mosaics allows to reveal mechanisms of monolayer repair: spreading and migration of endotheliocytes on the first day, their proliferation within three days, desquamation of newly formed endotheliocytes and spreading of adjacent cells on later stages.

Are peripheral lymphatics damaged by high pressure manual massage?

Massage of the foot in men and the hindpaw in dogs was performed by applying external pressures of 70-100 mmHg for a period of one, three, five, and ten minutes with a frequency of 25 strokes per minute. This protocol was performed on individuals without edema, on dogs with experimental lymphedema and men with post-thrombotic venous edema. After ten minutes of forceful massage, focal damage of lymphatics was present. In a group of dogs with lymphedema and men with post-thrombotic venous edema, the alteration of lymphatics was greater than in normal individuals and evident only after 3 to 5 minutes of massage. At first, the forceful massage affected the endothelial lining of the initial lymphatics. Alterations of lymphatic collectors were visible later. The fluid in lymphedema was translocated by massage using high pressure from the interstitium into the lumen of lymphatics by means of the open junctions and by artificial cracks that develop from injury to the lymphatic wall. Vigorous massage in lymphedema also produces loosening of subcutaneous connective tissue, formation of large tissue channels and release of lipid droplets that enter the lymphatics. By this mechanism, massage helps reduce the amount of fat cells in the lymphedematous leg.