01: Lymphology Then and Now
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8:15 am -10:30 am Session 1: Lymphology Then and Now: A Historical Panorama of 50 Years of Pioneers, Questions, Discoveries and the Evolution of Lymphology in Health and Disease
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01: Lymphology Then and Now
- 1. WELCOME!
- 2. Session 1: Lymphology Then and Now: A Historical Panorama of 50 Years of Pioneers, Questions, Discoveries and the Evolution of Lymphology in Health and Disease Marlys Witte, MD and Many Others
- 4. “LYMPHA” and
- 5. 1. Discovery of the chyliferous vessels and “lymphatic imaging" - Asellius, 1627 - 2. Lymph as the milieu interieur - Claude Bernard, 1878 3. Transcapillary exchange of liquid, lymph formation and edema - Starling, 1895 4. Embryology and phylogeny of lymphatic system - Sabin, Kampmeier-1903, 1909- 5. Transcapillary protein movement/lymph absorption– Krogh, Drinker, Mayerson, Courtice, 1925 - 6. Lymphangiogenesis in vivo, 1932- and in vitro, 1984- 7. Lymphocyte migrant streams - J Yoffey, B Morris, J Gowans, 1939 - 8. Lymphatic imaging/classification - J Kinmonth, M Servelle, F Kaindl, 1950 - 9. Intrinsic contractility and distinctive ultrastructure of lymphatics - J Hall, I Roddie, J Casley-Smith, L Leak 1962 – 10. Lymphostatic disorders /edematous states - I Rusznyak, G Szabo, M & E Foldi, W Olszewski, A Dumont, M & C Witte, 1960 – 11. Lymphscintigraphy including sentinel node mapping, 1970- 12. Highly specific molecular/histochemical markers- 5’ nucleotidase, Lyve-1, Prox-1, Podoplanin, VEGFR-3, 1990- 13. Lymphatic/vascular growth remodeling factors/genetics – N. Ferrara, 1989, K. Alitalo, 1996, G. Yancopoulos 2001; teams U Pittsburgh, U Conn - St George, U Az/U Mich, 1998-, U Leuven, 2003 Giant Steps in Lymphology Crystallization of Lymphology and birth of the ISL in the 1960’s ISL
- 6. Manuel Viamonte, MDAlois Ruttimann, MD
- 8. prescience [presh-uh ns, -ee-uh ns, pree-shuh ns, -shee-uh ns] Noun 1. knowledge of things before they exist or happen; foreknowledge; foresight.
- 9. Lymphatic System is a Vasculature…
- 11. …and a route
- 12. . . .and the Immune System
- 14. ISL Presidents
- 15. 25 International Congresses of Lymphology (1966-2015) 1 …and many more affiliated international, national, and regional courses, symposia, task forces, and meetings, and ISL members from 42 nations 25 26
- 16. Online Congress Proceedings I-XXIV Lymphology Journals Vols. 1-48 Seminal Texts by ISL Members 1956-2015 and many more ISL affiliated Proceedings, national/regional journals, and texts by ISL members/leaders
- 17. W. Olszewski Liu et al. 2010 Goldberg et al 20081 US/Microbubbles PA/ICG Roach et al 2011 SPECT-CT Multimodal Imaging Lymphatic System Imaging LAGLAS MRL IHC/ Confocal
- 18. Combined Physiotherapy / Pumps Multimodal Management Options Prevention Support Networks Liposuction/Other Microsurgery Debulking L-V Shunt L-L Auto transplantL-V-L Anastomosis LN-Venous Shunt LN Transplantation
- 20. "Knowledge is like a sphere, the greater the volume, the larger its contact with the unknown." Mathematician Blaise Pascal Ignorance Paradox and Paradigm: The more you know ( ! )… the more you don't know ( ? )
- 21. Types of Questions 1) Basic Science 2) Clinical 3) Societal Progress of Questions Beginning Ending Qs (Ignorance Reports/ Conferences)
- 22. Mobile Medical Ignorance App (MoMIA) Is there an outcome difference in transport of neonatal patients performed by specialized neonatal services vs pediatric or general CCT teams? How frequently does a neonatal transport provider revise specific treatment protocols? What can be the role of neonatal transport industry to promote research in the field? It is possible a centralization to improve transport and triage decisions? Should EU states have specific qualification requirements for licensed operators of neonatal transport services? Should states have specific financial budgets to sustain certified neonatal transport services? How well do human neonatal patient simulators train neonatal transport crews? Does neonatal patient simulation testing develop skills which reduce medical errors? Regarding “back transport” after infant cared for and stable, how do you get the infant back to the country/jurisdiction of origin or if the parents do not accept? How do you encourage the foreign country or jurisdiction of origin to handle at least some of the neonatal transport requests? When do you use whole body cooling in babies with acute encephalopathy in the context of chronic deprivation of oxygen? How do you decide whether or not to transport very low weight infants in extremis with minimal chance of survival? In low birth weight infants where thermoregulation is challenging, how can you counteract the low thermogenesis capacity with IV solutions?
- 23. Smartphone App Questionarium - and now for the Lymphologists http://questions.curiosityforall.org/lymph
- 30. Presidents (1966-2015) ? ? ? A. E. Dumont
- 31. Presidents (1966-2015) ? ? ? J. R. Casley-Smith
- 32. Presidents (1966-2015) ? ? ? M. H. Witte
- 50. Saskia and the NLN
- 51. ISL Presidents
- 52. Lymphology Past Lymphology Now ? ? Lymphology Future Lymphology Abandoned (Blind Orion Searching for the Rising Sun by Nicolas Poussin 1658 adapted for Lymphology) Standing on the Shoulder of the Giants of Lymphology ? ? ?
- 56. Personalized Lymphology Practice in the Imagined World what's wrong with the lymphatic system? what gene/protein/omic defect is responsible? what management options will be available? Omo/genotypingPhenotyping Translation Gene Therapy Lymphangiomodulators Stem Cells/Cloning Tissue Engineering/ Artificial Lymphatics DNADNA Surgicogenomics etc Prevention Networking Targeted Therapy Robotics ? ? ? ? ?