MATERIALS AND METHODS

Studies were performed in 25 randomly selected male volunteers aged 19-65; 12 were normal healthy individuals and 13 were patients with solid tumors not affecting the lower extremities. Two had small varices in lower legs but no past history of deep thrombophlebitis. There was no clinically detectable edema of the feet or calves nor inflammatory changes in the skin. Subcutaneous lymph vessel of the leg was cannulated against the direction of lymph flow, according to the techniques described previously (4, 5, 2l). This lymphatic drained lymph from the skin, subcutaneous tissue, and perimuscular fascia of the foot and anterior aspect of lower leg. The approximate area of drainage was estimated previously on autopsy specimens. No collaterals bypassing the site of lymph collection were expected to occur at that level. Lymphangiograms performed by us in a large group of patients revealed several small lymph vessels merging into collecting trunks, but only very infrequently dividing and running as solitary vessels toward the knee (unpublished observations). The approximate diameter of the cannulated lymph vessel ranged between 0.1 and 0.4 mm. A polyethylene PE-60 Adams Clay cannula, with the tip adjusted in each case to the diameter of the vessel, was inserted into the lumen. The vessel was ligated with 6-O silk thread over the inserted part of the cannula.

In 12 cases both the distal and proximal parts of the same vessel were cannulated and their ends connected by an externally placed T-piece. All tubings had diameters larger than the cannulated vessels to provide the least possible resistance to lymph flow. The length of tubing did not exceed 12 cm. The volunteers were allowed to perform their normal daily activities. Studies were performed on days 2 and 5 after cannulation when the operative wound had already partially healed. Lymph was collected continuously into calibrated containers. No anticoagulant was given systemically. For pressure measurement the external end of the cannula or the side arm of the T-piece was connected to a pressure transducer AE 840 (Solid State Products) and the amplified signals