A new technique for the cannulation of small lymph vessels

Inside-out cannulation of fine lymphatic trunks used to quantify coupling between transsynovial flow and lymphatic drainage from rabbit knees

The coupling of periarticular lymph flow to transsynovial flow from a joint cavity, i.e., fluid load, is essential to avoid periarticular edema, which is associated with arthritic morning stiffness. To study coupling in swollen joints, a new method, "inside-out" cannulation, which eliminates dead space, resistance and cutout, was used to collect lymph from fine femoral lymph trunks in anesthetised rabbits while the knee joint cavity was infused with Evans blue albumin (EVA) at controlled intraarticular pressure and transsynovial drainage rates. The amount of joint lymph in femoral lymph (volume fraction V(v)) was calculated by EVA analysis. Joint lymph flow and EVA clearance was 1.5 +/- 0.4 microl min(-1) (mean +/- SEM, n = 62) at mean trans-synovial flow, 23 microl min(-1), and increased with pressure. Volume fraction increased from 16% at 10 cmH(2)O to 43% at 41 cmH(2)O. The increase in lymph flow with pressure, 0.052 +/- 0.025 microl min(-1) cmH(2)O(-1) (n = 61) was much smaller than the increase in transsynovial flow (periarticular fluid load) with pressure, 0.71 +/- 0.14 microl min(-1) cmH(2)O(-1) (P < 0.001). Their ratio, the coupling coefficient, was only 0.06-0.11. Thus, although up to 43% of femoral lymph could stem from a single swollen joint, this drained away only a small fraction of the transsynovial filtrate. The study showed that joint lymphatic drainage is coupled to joint pressure and transsynovial flow; but the coupling is insufficient to prevent periarticular fluid accumulation under conditions of joint volume expansion and limb immobility. This may contribute to the periarticular edema of arthritis.

PGE2 concentrations in renal venous plasma and renal lymph during basal and stimulated conditions in the dog

PGE2 concentration (pg/ml + SEM) was measured in canine renal lymph (394 +/- 115), renal venous plasma (276 +/- 55), arterial plasma (172 +/- 34) and urine (1290 +/- 934). Control periods were followed by an infusion of the sodium salt of arachidonic acid (AA) (40 micrograms/kg min) into the renal artery to stimulate prostaglandin synthesis. During infusion of AA PGE2 concentrations increased significantly in renal lymph (672 +/- 155) renal venous plasma (549 +/- 123), and urine (6768 +/- 1420), but not in the arterial plasma (176 +/- 31). Concentrations in renal lymph and renal venous plasma were not significantly different under either condition. These findings indicate that PGE2 concentration in renal venous plasma is, by and large, representative of mean PGE2 concentrations in the cortical renal interstitium, although focal inhomogeneities in PGE2 concentration in the different areas of the renal interstitium cannot be excluded. Since flow rate of renal lymph is insignificant in comparison with renal venous plasma flow rate total renal PGE2 output can be estimated from measurements in renal venous plasma and urine.