Publications by authors named "Marta Cakala"

Background: In lymphedema, tissue fluid steadily accumulates in the subcutaneous space containing loose connective tissue. We documented previously that deformation of the structure of subcutaneous collagen bundles and fat by excess fluid leads to formation of "lakes" and interconnected channels with irregular shape. Since there is no force that could mobilize and propel stagnant fluid to the regions where lymphatics absorb and contract, this task should be taken over by external massage.

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Background: Physiotherapy of edema in cases with obstructed main lymphatics of lower limbs requires knowledge of how high external pressures should be applied manually or set in compression devices in order to generate tissue pressures high enough to move tissue fluid to nonswollen regions and to measure its flow rate.

Methods: We measured tissue fluid pressure and flow in subcutaneous tissue of lymphedematous limbs stages II to IV at rest and during pneumatic compression under various pressures and inflation timing. An 8-chamber sequential compression device inflated to pressures 50-120 mmHg, for 50 sec each chamber, with no distal deflation, was used.

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Background: The knowledge of where does excess tissue fluid accumulate in obstructive lymphedema is indispensable for rational physical therapy. However, it has so far been limited to that obtained from lymphoscintigraphic, ultrasonographic, and MR images. None of these modalities provide composite pictures of dilated lymphatics and expanded tissue space in dermis, subcutis, and muscles.

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Allografting with immunosuppression is accompanied by chronic rejection and continuing response of the host to infections. Upon first encounter with allogeneic and bacterial antigens the naive T and B cells react within days. Simultaneously cohorts of memory cells are created characterized by rapid response to the second antigenic stimulus.

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Transplantation of hands in humans has become an accepted therapeutic modality. A hand transplant is composed of various tissues of different degree of immunogenicity. In addition, skin contains own resident bacterial flora that may become virulent in the ischemic and rejecting graft.

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