MARCELLO IZZO* **, LUIGI NAPOLITANO**, VINCENZO COSCIA ^ *, ANTONIO LA GATTA*, FABRIZIO MARIANI*, VINCENZO GASBARRO* °
* Research Centre “Mathematics for Technology”, VasaeTech workgroup.
^ Department of Mathematics, University of Ferrara.
° Department of Surgery, Anaesthesiology and Radiology, Vascular Surgery Unit,
University of Ferrara – Interuniversity Center of Study and Education in Phlebology.
** Oedema Center – Nola (NA).
INTRODUCTION
Lymphoedema represents a chronic pathology, that renders
patients physically and psychologically disabled, it is not easy to
control, and shows a marked tendency to spontaneously set in
complications. For such reasons lymphoedema demands for a
novel early, targeted and lasting diagnostic and therapeutic
approach (1).
So far it is frequently claimed, in a completely misleading manner,
that nor the lymphoedema physiopathology is clear or the
corresponding treatment is satisfactory. Nevertheless, though the
pathogenetic details are still an open question, the general
principles of the disease’s physiopathology are well known.
On one side, the main disorder may be characterized by a “low
output failure” of the lymphatic system, that is, a general
decreasing of the lymphatic flow. Such a disorder can be due to a
congenital lymphatic dysplasia (primary lymphoedema) or to an
anatomic obliteration, for example caused by a radical surgical
resection or by radiotherapy, or again as a consequence of repeated
lymphangitis with lymphangiosclerosis or, finally, produced by a
functional insufficiency such that due to lymphangiospasm,
paralysis and valvular insufficiency (secondary lymphoedema). In
any case, the common feature is a disorder in the lymphatic
transport mechanism, that decrease below the minimum capability
required by the microvascular filtrate, that includes plasmatic
proteins and cells that normally come out from the haematic
network entering the interstice.
On the other side, the “high output failure” of lymphatic
circulation occurs when an excess of capillary haematic filtrate
overcomes the normal transport capability of the lymphatic system
as for example happens in the liver cirrhosis (ascites), in the
nephrosic syndrome (anasarca) and in the inferior limbs deep
venous insufficiency (post-thrombophlebitic syndrome) and the
severe phlebostasis (2). The lymphatic injury, both moneygram charges for transfer primitive and
THE EUROPEAN JOURNAL
OF lymphology
and related problems
VOLUME 21 • No. 61 • 2010
INDEXED IN EXCERPTA MEDICA
THE ROLE OF DIAMAGNETIC PUMP (CTU mega 18)
IN THE PHYSICAL TREATMENT OF LIMBS LYMPHOEDEMA.
A CLINICAL STUDY
MARCELLO IZZO* **, LUIGI NAPOLITANO**, VINCENZO COSCIA ^ *, ANTONIO LA GATTA*,
FABRIZIO MARIANI*, VINCENZO GASBARRO* °
* Research Centre “Mathematics for Technology”, VasaeTech workgroup.
^ Department of Mathematics, University of Ferrara.
° Department of Surgery, Anaesthesiology and Radiology, Vascular Surgery Unit,
University of Ferrara – Interuniversity Center of Study and Education in Phlebology.
** Oedema Center – Nola (NA).
secondary, worsen in time due to the creation of a vicious circle:
LYMPHATIC DISORDER ? INCREASE OF PROTEIN RICH
INTERSTITIAL LIQUID ? DECREASE OF PROTEOLYTIC
CAPABILITY ? INCREASE OF INTERSTITIAL
CONNECTIVE ? FIBROSIS (3). In the subcutaneous tissue of
patients affected by lymphoedema an increase of the amount of
interstitial liquid, rich in proteins,is observed. To the increase a
chronic phlogosis is associated (the monocyte-macrophage system
and the fibroblast are activated), with a growth of the interstitial
matrix. The lymph accumulates in the fascia, forming “holes” or
“lymphatic lakes” and the three-dimensional retinaculum structure
addresses molecules and lymph toward the cutis surface. The
hydrophobic adipose lobules keep the water component off, so that
it accumulates along the retinaculum. Finally, we observe an
upsetting of the subcutaneous tissue, with the appearance of
“comb” picture (4).
PULSED LOW-FREQUENCY ELECTROMAGNETIC
FIELDS: The pulsed low-frequency (< 50 Hz) electromagnetic
fields (5) belong to he class of non ionizing radiations, that is, they
are characterized by an associated energy below 12 eV (electron-
Volt). Such an energy is insufficient both to turn on ionization
phenomena in molecules and to break even very weak chemical
bonds. For this reason in the last decades these radiations have not
been considered able to interact with biological systems and, as a
consequence, the studies on this subject were scarce and
information poor, especially when compared with the great
amount of knowledge concerning the interactions among ionizing
radiations and biological systems (6). Only recently, due to the
more and more common use of electromagnetic fields of different
intensity and frequencies (7), a vast research activity (8-9-10-11-12-13-14-15)
has started, addresses to the definition of their main biological and
therapeutic effects, on which are based the exposition thresholds
currently recommended (Tab. 1):