Lymphatic research and biology最新文献

{"title":"Factors Predicting the Effect of a Complex Decongestive Therapy in Patients with Mild Lymphedema Following Mastectomy for Early Stage Breast Cancer.","authors":"Ju Hyeon Kim, Han Eum Choi, Jae Hyun Lee, Young-Joo Sim, Ho Joong Jeong, Ghi Chan Kim","doi":"10.1089/lrb.2023.0021","DOIUrl":"10.1089/lrb.2023.0021","url":null,"abstract":"<p><p><b><i>Background:</i></b> Complex decongestive therapy (CDT) is being used in breast cancer-related lymphedema (BCRL). The degree of initial edema and bioimpedance analysis (BIA) are known to be related with the therapeutic effect of CDT. D-dimer can indirectly reflect lymphangiogenesis because IL-6 regulates D-dimer and vascular endothelial growth factor, which is the most important lymphangiogenic factor. We assessed whether D-dimer could be used for the prediction of therapeutic effect of CDT, as well as BIA and initial edema. <b><i>Methods:</i></b> The participants were patients who took inpatient treatment for BCRL from July 2016 to May 2020. Percent excess volume (PEV) was calculated by dividing the difference in volume of both arms by the edema arm, and the difference in PEV before and after 2 weeks of CDT was defined as the CDT effect. BIA and D-dimer tests were performed before treatment. <b><i>Results:</i></b> The single frequency bioimpedance analysis (SFBIA) ratio and D-dimer showed significant correlations with β coefficients of 0.581 and 0.402 (<i>p</i> < 0.01), respectively, and the explanatory power of these models was confirmed to be 0.704.The areas under the curve of initial PEV, SFBIA ratio, D-dimer for determining the CDT effect were identified as 0.849, 0.795, and 0.725, respectively. <b><i>Conclusions:</i></b> Initial PEV, SFBIA ratio, and blood D-dimer levels could be used as predictors for CDT treatment effect. Their usefulness order was in the order of initial PEV, SFBIA ratio, and D-dimer. These factors could be used as predictors to establish therapeutic plan in patients with mild lymphedema.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Super-Microsurgery for Vessels with Diameters Smaller Than 0.5 mm.","authors":"Satoshi Onoda, Kahori Tsukura, Kyona Taki, Toshihiko Satake","doi":"10.1089/lrb.2024.0042","DOIUrl":"10.1089/lrb.2024.0042","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Among super-microsurgical techniques, the anastomosis of vessels smaller than 0.5 mm is very difficult to perform due to the small diameter and thinness of the blood and lymphatic vessel walls. In this article, we report on the main points of super microsurgery, particularly on the anastomosis of veins and lymphatic vessels with diameters smaller than 0.5 mm. <b><i>Methods and Results:</i></b> Details of anastomosis of vessels smaller than 0.5 mm. (1) The outer wall of the first blood vessel near the abrupt end hook with the tip of the needle in the needle holder. The entire abrupt end of the first blood vessel was supported by forceps in the surgeon's left-hand. (2) The surgeon decided the entry point and angle of the needle while moving the tip. After the needle was fixed, a force was applied so that the needle could pass through to the vascular wall. (3) After the needle passed through, the tip was confirmed to be located in the lumen of the first blood vessel. (4) The tip of the needle was inserted into the lumen of the second blood vessel, and the bite was adjusted while touching the second blood vessel through the endometrium. (5) Once the tip was properly positioned, counter-traction was applied by holding the entire outer wall with a left-hand forceps. (6) The needle was held near the tip and pulled out along its curvature. The anastomosis time was 11.35 minutes on average (9 to 14 minutes). The patency rate for all 20 anastomosis procedures was also 100%. <b><i>Conclusion:</i></b> The important points of LVA for lymphatic vessels and veins smaller than 0.5 mm were reported. Once the surgeons are familiarized with this anastomosis procedure, they can typically perform one anastomosis in about 10 minutes.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of Lymphedema and Subjective Symptoms in the Lower Abdomen and Genital Region.","authors":"Hisako Hara, Makoto Mihara","doi":"10.1089/lrb.2024.0032","DOIUrl":"https://doi.org/10.1089/lrb.2024.0032","url":null,"abstract":"<p><p><b><i>Background:</i></b> Lymphedema in the lower abdomen and genitals is unnoticeable and has no established diagnostic methods. In this study, we evaluated it using four examinations. <b><i>Methods:</i></b> We evaluated 25 patients with lymphedema in the legs, dividing the abdomen and genitals in four areas (right and left, upper and lower). The mean age was 58.6 years. In lymphoscintigraphy and indocyanine green (ICG) lymphography, we diagnosed lymphedema when dermal backflow was observed. ICG lymphography was performed in 13 patients. In ultrasonography, we determined the presence of edema when cobblestone pattern was observed. Subcutaneous fat thickness was also measured. The patients' subjective symptoms were identified on an interview. We compared the results among the examinations. <b><i>Results:</i></b> The positivity rates for lymphedema based on lymphoscintigraphy, ICG lymphography, ultrasonography, and subjective symptoms were 45.0%, 42.3%, 8.0%, and 34.0%, respectively. Two of the 13 patients who underwent all examinations complained of subjective symptoms of edema in areas that showed no abnormalities in the examinations. In contrast, 14 of the 25 patients had areas where they had no subjective symptoms despite having abnormalities in at least one of the tests. Those with subjective symptoms of edema tended to have thinner abdominal fat in both the upper and lower abdomen, but no significant difference was observed. <b><i>Conclusion:</i></b> Large differences were observed in the positive rate of edema in subjective symptoms and examinations of lymphedema in the lower abdomen and genitals. It is not important to determine which examination is best but rather to combine multiple examinations.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relation Between Characteristics of Indocyanine Green Lymphography and Development of Breast Cancer-Related Lymphedema.","authors":"Sarah Thomis,Sophie Ronsse,Beate Bechter-Hugl,Inge Fourneau,Nele Devoogdt","doi":"10.1089/lrb.2024.0009","DOIUrl":"https://doi.org/10.1089/lrb.2024.0009","url":null,"abstract":"Background: Breast cancer-related lymphedema (BCRL) is a disabling and frequently occurring condition after treatment for breast cancer. Studying lymph anatomy by means of indocyanine green (ICG) lymphography is a promising tool to help better understand BCRL. The aim of this study is to investigate the relation between ICG lymphography characteristics and the risk of developing BCRL. Methods and Results: Patients scheduled for breast surgery with either unilateral axillary lymph node dissection or sentinel lymph node biopsy between November 2017 and May 2019 were included. Patients were assessed at baseline and up to 36 months postsurgery. BCRL was defined as an increase of ≥5% relative arm volume difference compared with the presurgical difference. In total, 128 patients were included. During 36 months of follow-up, 45 patients (35.2%) developed BCRL. The number of lymph vessels before surgery was not a statistically significant risk factor for developing BCRL (p = 0.8485). However, an increase in the number of lymph vessels compared with baseline was a significant protective factor for developing BCRL (odds ratio = 0.8). An increase of one lymph vessel corresponds to a 19% relative risk reduction of developing BCRL. The presence of lymph nodes at baseline and the change in the presence of lymph nodes compared with baseline were no predictors for the development of BCRL (p = 0.0986 and p = 0.8910, respectively). Conclusions: An increase in the number of lymph vessels visualized by ICG lymphography compared with baseline is a protective factor for developing BCRL. Therapies with the ability to increase the number of lymph vessels can thus possibly decrease the risk of developing BCRL.","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142201242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Different Lymphedema Assessment Tools in Women with Breast Cancer After Mastectomy.","authors":"Rocío Abalo-Núñez, Iria Da Cuña-Carrera, Alejandra Alonso-Calvete, Eva M Lantarón-Caeiro, Mercedes Soto-González","doi":"10.1089/lrb.2024.0004","DOIUrl":"10.1089/lrb.2024.0004","url":null,"abstract":"<p><p><b><i>Background:</i></b> Lymphedema is a common complication after mastectomy in women with breast cancer. Several methods have been described to assess and diagnose lymphedema, one of the most studied being the perimeter and ultrasonography. However, the reliability of these methods and the correlation between them are still controversial. The aim of this study was to analyze the reliability of cytometry and ultrasound imaging in the assessment of lymphedema after mastectomy in women with breast cancer and to study the correlation between them. <b><i>Methods and Results:</i></b> A cross-sectional study was conducted in 29 women with mastectomy after breast cancer. Lymphedema in the arm was measured both with cytometry and ultrasonography. Reliability was calculated with intraclass correlation coefficient. The correlation between the two methods was carried out with the Pearson correlation coefficient. Both cytometry (M1: α = 0.999, ICC = 0.996; M2: = α = 0.998, ICC = 0.994) and ultrasonography (M1: α = 0.992, ICC = 0.976; M2: = α = 0.991, ICC = 0.973) are reliable methods to assess lymphedema in the arm. No significant correlation was found between them (<i>p</i> > 0.05). <b><i>Conclusions:</i></b> Cytometry and ultrasonography appear to be adequate for the measurement of edema in women with breast cancer after mastectomy. However, for an accurate measurement of lymphedema, these measurements should not be used interchangeably.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Combination of Functional and Anatomical Assessment Represents the New Frontier in Lymphedema Assessment.","authors":"Michaela Cellina","doi":"10.1089/lrb.2024.0034","DOIUrl":"10.1089/lrb.2024.0034","url":null,"abstract":"","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Matters.","authors":"","doi":"10.1089/lrb.2024.532987.wr","DOIUrl":"10.1089/lrb.2024.532987.wr","url":null,"abstract":"","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Matters.","authors":"","doi":"10.1089/lrb.2024.0026","DOIUrl":"10.1089/lrb.2024.0026","url":null,"abstract":"","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantification of Lymphangiogenesis in the Murine Lymphedema Tail Model Using Intravital Microscopy.","authors":"Ganesh Mohan, Imran Khan, Stephanie M Diaz, Malgorzata M Kamocka, Luci A Hulsman, Shahnur Ahmed, Colby R Neumann, Miguel D Jorge, Gayle M Gordillo, Chandan K Sen, Mithun Sinha, Aladdin H Hassanein","doi":"10.1089/lrb.2023.0048","DOIUrl":"10.1089/lrb.2023.0048","url":null,"abstract":"<p><p><b><i>Background:</i></b> Lymphedema is chronic limb swelling resulting from lymphatic dysfunction. It affects an estimated five million Americans. There is no cure for this disease. Assessing lymphatic growth is essential in developing novel therapeutics. Intravital microscopy (IVM) is a powerful imaging tool for investigating various biological processes in live animals. Tissue nanotransfection technology (TNT) facilitates a direct, transcutaneous nonviral vector gene delivery using a chip with nanochannel poration in a rapid (<100 ms) focused electric field. TNT was used in this study to deliver the genetic cargo in the murine tail lymphedema to assess the lymphangiogenesis. The purpose of this study is to experimentally evaluate the applicability of IVM to visualize and quantify lymphatics in the live mice model. <b><i>Methods and Results:</i></b> The murine tail model of lymphedema was utilized. TNT was applied to the murine tail (day 0) directly at the surgical site with genetic cargo loaded into the TNT reservoir: TNT_pCMV6 group receives pCMV6 (expression vector backbone alone) (<i>n</i> = 6); TNT<i>_Prox1</i> group receives pCMV6-<i>Prox1</i> (<i>n</i> = 6). Lymphatic vessels (fluorescein isothiocyanate [FITC]-dextran stained) and lymphatic branch points (indicating lymphangiogenesis) were analyzed with the confocal/multiphoton microscope. The experimental group TNT<i>_Prox1</i> exhibited reduced postsurgical tail lymphedema and increased lymphatic distribution compared to TNT_pCMV6 group. More lymphatic branching points (>3-fold) were observed at the TNT site in TNT<i>_Prox1</i> group. <b><i>Conclusions:</i></b> This study demonstrates a novel, powerful imaging tool for investigating lymphatic vessels in live murine tail model of lymphedema. IVM can be utilized for functional assessment of lymphatics and visualization of lymphangiogenesis following gene-based therapy.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11310576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristic Single Photon Emission Computed Tomography-Computed Tomography Findings in Lower Extremity Lymphedema: Comparison to Indocyanine Green Lymphography.","authors":"Hayahito Sakai, Toko Miyazaki, Maya Kanasaki, Reiko Tsukuura, Takumi Yamamoto","doi":"10.1089/lrb.2023.0051","DOIUrl":"https://doi.org/10.1089/lrb.2023.0051","url":null,"abstract":"Introduction: Evaluation of lymph circulation is significant in lower extremity lymphedema (LEL) management. Single-photon emission computed tomography-computed tomography (SPECT-CT) has been introduced for lymphedema evaluation, but its characteristic findings are yet fully clarified. The purpose of this study was to reveal typical SPECT-CT findings in secondary LEL by contrasting with indocyanine green (ICG) lymphography findings. Methods: This is a single-center retrospective case-control study. Medical charts of cancer survivors who underwent SPECT-CT and ICG lymphography for secondary LEL were reviewed. Lymphedematous limbs were defined as ICG lymphography stage I-V and non-lymphedematous limbs were defined as ICG lymphography stage 0. Characteristic SPECT-CT findings were identified in early phase and delay phase, and prevalence of the findings was compared between lymphedematous limbs and non-lymphedematous limbs. Results: Thirty-four limbs of 17 patients were included in this study; 6 (17.6%) non-lymphedematous limbs and 28 (82.4%) lymphedematous limbs. Four characteristic SPECT-CT findings were identified; delayed enhancement of the main lower leg lymphatic pathway (DML), few delayed inguinal lymph nodes enhancement (FDN), early phase discontinuous enhancement of the main lymphatic pathway (EDM), and nonenhancement of the deep lymphatic pathways in early phase (NDE). Between lymphedematous and non-lymphedematous limbs, there were statistically significant differences in FDN (64.3% vs. 0%, p = 0.004) and EDM (67.9% vs. 0%, p = 0.002). Conclusions: FDN and EDM are characteristic SPECT-CT findings in secondary LEL.","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140656459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}