[Lymphedema and lymphangioscintigraphy]. / Lymfødem og lymfangioscintigrafi.

INTRODUCTION: The diagnoses of lymphoedema is generally based on clinical examination. Sometimes supplementary laboratory techniques are required. MATERIAL AND METHODS: A practical lymphangioscintigraphic method is described based on a survey of the literature and trial and error in a series of about 40 patients. The method gives an excellent picture of lymphatic pathology and the lymph stasis present in most lymphoedema patients. RESULTS: The use of the method in 48 patients is reported. An abnormal scintigraphic pattern was seen in 25 patients. In 20 cases with a well established clinical diagnose, the lymphangioscintigram was positive in 15 cases. INTERPRETATION: Lymphangioscintigraphy is a non-invasive method recommendable as first choice in supplementary examination of lymphoedema.

Improvement of physical capacity after long-term training in patients with chronic active hepatitis.

A training program was started in nine patients with chronic active hepatitis in clinical remission while receiving immunosuppressive therapy. The patients were examined before and after a training period of 4-5 weeks and 10-12 weeks, respectively. The calculated oxygen consumption increased by 19% and 29%, and the estimated work load capacity improved. No change occurred in alanine aminotransferase, aspartate aminotransferase, alkaline phosphatases, gamma-glutamyl-transpeptidase, serum bilirubin, or prealbumin, whereas creatine kinase and lactate dehydrogenase increased significantly. The clinical condition did not worsen in any patient, and most of the patients felt that their physical performance capacity had improved. We conclude that long-term regular physical training is well tolerated by patients with chronic active hepatitis in clinical remission and that training leads to improvement in the oxygen consumption and the estimated work load capacity in such patients.

Plasma exchange in motor neuron disease. A controlled study.

In vitro studies seem to indicate that a serum factor may be involved in the pathogenesis of motor neuron disease. If so, plasmaphoresis might influence the course of amyotrophic lateral sclerosis (ALS) favorably. In the present study, therefore, ALS patients were subjected to weekly 21 plasma exchanges, using a Haemonetics blood separator. Seven other ALS patients, matched as closely as possible with the treatment group regarding age, sex, duration of symptoms as well as degree of involvement, served as control group. The progression of the disease was followed by an arbitrary grading system, assessment of muscular power by Zadig's dynamometer, and by tests for motor speed, coordination and for pulmonary function. Duration of treatment was from 6 to 15 months. Monthly evaluations indicated that the rate of deterioration was approximately the same in treatment and control groups. Plasmaphoresis carried out in this way does thus not alter the downhill course of ALS.