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      Lymph flow dynamics in exercising human skeletal muscle as detected by scintography

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          Abstract

          1. The effects of dynamic and isometric muscle contractions on the lymph flow dynamics in human skeletal muscle were studied with a scintographic method. 2. Radioactively labelled human serum albumin (99mTc-HSA) was injected bilaterally into the vastus lateralis muscles of eight men (n = 16), four of whom had had an endurance training background. The subjects performed 100 submaximal contractions in 10 min as (i) dynamic knee extensions (CONS), (ii) isometric contractions with the knees at full extension (IMExt), or (iii) isometric contractions with knees fixed at 90 deg angle flexion (IMFlex). The exercises were separated by 65 min periods in supine rest. The level of radioactivity at the injection site was monitored by a gamma-camera, and the clearance rate of radioactivity (CR) was calculated as the fractional decrease during the periods of interest (CR unit = % min-1). 3. The clearance rate was low during the rest periods (0.04 +/- 0.05% min-1), though higher in the trained than in the sedentary subjects (0.06 +/- 0.05 vs. 0.03 +/- 0.03% min-1; P = 0.008). Exercise increased the clearance rate three- to sixfold, to 0.16 +/- 0.16% min-1 during CONS, 0.20 +/- 0.15% min-1 during IMExt and 0.09 +/- 0.11% min-1 during IMFlex. There were no differences between the subject subgroups. 4. The higher clearance rate during IMExt than during IMFlex (P = 0.02) demonstrates the importance of muscle deformations on lymph propulsion and experimentally confirms the current concepts of lymph formation and propulsion in voluntarily active skeletal muscle. It is suggested that lymph propulsion by working muscle is most efficient when the muscle is able to shorten close to its minimum length.

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          Most cited references21

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          Microlymphatics and lymph flow.

          A careful review of several different organs shows that with the information available today the beginnings of the microlymphatics in the tissue consist of endothelialized tubes only. Lymphatic smooth muscle within the collecting lymphatics appears further downstream, in some organs only outside the parenchyma. This particular anatomic picture has been observed in many different mammalian organs and in humans. The nonmuscular, so-called initial, lymphatics are the site of interstitial fluid absorption that requires only small and transient pressure gradients from the interstitium into the initial lymphatics. A fundamental question concerns the mechanism that causes expansion and compression of the initial lymphatics. I presented several realistic proposals based on information currently on hand relevant to the tissue surrounding the initial lymphatics. To achieve a continuous lymphatic output, periodic (time variant) tissue stresses need to be applied. They include arterial pressure pulsations; arteriolar vasomotion; intestinal smooth muscle contractions and motilities; skeletal muscle contraction; skin tension; and external compression, such as during walking, running, or massage, respiration, bronchiole constriction, periodic tension in tendon, contraction and relaxation of the diaphragm, tension in the pleural space during respiration, and contractions of the heart. The nonmuscular initial lymphatic system drains into a set of contractile collecting lymphatics, which by way of intrinsic smooth muscle propel lymph fluid. The exact transition between noncontractile and contractile lymphatics has been established only in a limited number of organs and requires further exploration. Retrograde flow of lymph fluid is prevented by valves. There are the usual macroscopic bileaflet valves in the initial and collecting lymphatics and also microscopic lymphatic endothelial valves on the wall of the initial lymphatics. The latter appear to prevent convective reflow into the interstitium during lymphatic compression. Many of the lymph pump mechanisms have been proposed in the past, and most authors agree that these mechanisms influence lymph flow. However, the decisive experiments have not been carried out to establish to what degree these mechanisms are sufficient to explain lymph flow rates in vivo. Because individual organs have different extrinsic pumps at the level of the initial lymphatics, future experiments need to be designed such that each pump mechanism is examined individually so as to make it possible to evaluate the additive effect on the resultant whole organ lymph flow.(ABSTRACT TRUNCATED AT 400 WORDS)
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            Interstitial-lymphatic mechanisms in the control of extracellular fluid volume

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              New morphological evidence for a mechanism of lymph formation in skeletal muscle.

              A new mechanism of lymph formation associated with pulsation and vasomotion of arterioles is proposed in skeletal muscle. To provide evidence for this proposal, an investigation of the lymphatic vessels in the spinotrapezius muscle of the rat was undertaken. The lymphatics were visualized by microinjection of a contrast medium (Evans blue albumin), and histological sections of the muscle were prepared and examined with the light and the electron microscope. The studies indicated that lymphatics ranging in size from 20 to 200 micron in this skeletal muscle have no smooth muscle but only a thin lining of endothelium. All lymphatics lie in immediate proximity to the arcading and transverse arterioles and occasional muscular venules, and appeared to be wrapped around them. It was further observed that when the arterioles were dilated, the contiguous lymphatics were partially or completely collapsed, whereas lymphatics around contracted arterioles were wide open. No significant deformation of the adjacent skeletal muscle cells was observed. These results suggest that the contraction of vascular smooth muscle, as well as pulsatile elastic distension of arterioles, may cause periodic changes in lymphatic volume and thereby serve as peristaltic mechanisms for lymph transport. Vascular smooth muscle may thus influence not only blood flow in the microcirculation, but also water transport in the interstitium and into the lymphatics.
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                Author and article information

                Journal
                The Journal of Physiology
                Wiley
                00223751
                October 1997
                October 1997
                September 30 2004
                : 504
                : 1
                : 233-239
                Article
                10.1111/j.1469-7793.1997.233bf.x
                1159951
                9350633
                de54d18a-1215-4956-a388-760bc584c56f
                © 2004

                http://doi.wiley.com/10.1002/tdm_license_1.1

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