Lymphatic research and biology最新文献

{"title":"Effectiveness of Twice-Daily Complete Decongestive Therapy in Reducing Limb Volume in Children with Lymphedema: A Retrospective Study.","authors":"David Doubblestein, Deanne Fay, Sarah Brunskill, Betty Westbrook, Brittany Williams","doi":"10.1177/15578585251367334","DOIUrl":"https://doi.org/10.1177/15578585251367334","url":null,"abstract":"<p><p><b><i>Aim:</i></b> To determine whether a 4-day, twice-daily complete decongestive therapy (CDT) intervention effectively reduces limb volume in pediatric patients with primary and secondary lymphedema. <b><i>Methods:</i></b> A retrospective cohort study was conducted using rehabilitation records of children aged 5-17 years from Camp Watchme, a North American summer camp providing lymphedema interventions. <b><i>Results:</i></b> Over 4 years, 38 unique campers contributed 66 records for analysis. The majority were female (68.42%), with a mean age of 9.30 ± 2.66 years. Lower extremity limb volume demonstrated statistically significant reductions across all 4 years (2021, <i>p</i> = 0.011; 2022, <i>p</i> = 0.030; 2023, <i>p</i> < 0.001; 2024, <i>p</i> < 0.001). Cumulative analysis of upper extremities (<i>n</i> = 16) also showed significant volume reduction (<i>p</i> = 0.042, <i>r</i> = 0.50). Daily measurement tracking (<i>n</i> = 43) indicated consistent percent volume decreases, with confidence intervals supporting a meaningful change for lower extremity limb volume differences across 4 years. <b><i>Conclusion:</i></b> An intensive, short-duration CDT intervention significantly reduces limb volume in pediatric patients with lymphedema. Future research should explore long-term effects, optimize CDT protocols, and assess broader functional and psychosocial outcomes to enhance pediatric lymphedema management.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821946","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":"<i>Response to Letter:</i> Keith et al., Proposed Framework for Research Case Definitions of Lipedema, 22, 2: 93-105.","authors":"Helen E Eason, Elizabeth S Dylke","doi":"10.1177/15578585251362102","DOIUrl":"https://doi.org/10.1177/15578585251362102","url":null,"abstract":"","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789523","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":"Improving Precision of Bioimpedance Spectroscopic Analysis for Lymphedema and Lipedema Assessment.","authors":"Leigh C Ward, Katrina Gaitatzis, Belinda Thompson, Vincent Singh Paramanandam, Louise A Koelmeyer","doi":"10.1089/lrb.2024.0086","DOIUrl":"10.1089/lrb.2024.0086","url":null,"abstract":"<p><p><b><i>Background:</i></b> Bioimpedance spectroscopy (BIS) is commonly used for the detection and monitoring of lymphedema and potentially lipedema. BIS measures limb electrical resistance, which decreases with fluid accumulation in these conditions. R0, the index of extracellular fluid and lymph accumulation, is typically estimated using Cole modeling, but technical and biological factors can affect accuracy. <b><i>Methods:</i></b> Participants with clinically affirmed bilateral leg lymphedema, lipedema, self-ascribed swelling, and healthy controls were included in this study. Impedance measurements were taken using a stand-on BIS device, and R0 was estimated using both the Cole modeling method and a regression approach. Quality of data fitting was assessed visually and statistically. <b><i>Results:</i></b> Control participants were younger and lighter compared with the clinical groups. The regression method was able to analyze 100% of participant data, whereas the Cole method was successful in only 80%-88% of cases in the lymphedema and lipedema groups. Additionally, the regression approach provided better curve fitting accuracy for all participants. <b><i>Conclusion:</i></b> The regression method offers a robust alternative for estimating R0 values in BIS data, especially in lower limb assessments where data analysis is challenging. The small difference between methods in absolute R0 values (2.5%) has minimal practical implications, suggesting interchangeability in data analysis. The Cole method showed poorer performance, particularly in participants with lymphedema, possibly due to differences in water proportions and limb size. Overall, the regression method can be effectively used in clinical practice for estimating R0 values in BIS data, offering a more accurate and reliable approach than traditional Cole plotting methods.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"229-238"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017331","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":"Effects of Forearm Bandaging Technique, Muscle Contraction, and Additional Compression Pad Use on Sub-Bandage Pressure.","authors":"Elif Sakizli Erdal, Miray Haspolat, Burak Erturk, Ilke Keser","doi":"10.1089/lrb.2025.0026","DOIUrl":"10.1089/lrb.2025.0026","url":null,"abstract":"<p><p><b><i>Background:</i></b> This study aimed to evaluate the effects of forearm bandaging techniques, muscle contraction, and additional compression pad use on sub-bandage pressure. <b><i>Methods and Results:</i></b> Thirty-one individuals (26 females, 5 males) with no chronic or lymphatic-related conditions participated in the study. Sub-bandage pressure was measured using the Kikuhime device, with a standardized protocol applied to the wrist extensor muscle belly. Participants were evaluated under rest and wrist extension conditions using two bandaging techniques: spiral and figure-of-eight. Variations included single and double layers, 1/2 and 1/3 overlaps, and the presence or absence of additional compression pads. Certified physiotherapists trained performed all bandaging applications using short-stretch compression materials. The figure-of-eight wrapping technique consistently produced significantly higher sub-bandage pressures compared to the spiral technique in all conditions. Double bandaging generated 1.4 times more pressure than single-layer applications, while 1/3 overlap resulted in greater pressure than 1/2 overlap. The addition of compression pads increased resting pressure by approximately 5 mmHg, and wrist extension further augmented pressure by 4-8 mmHg. The highest pressures were observed with the figure-of-eight technique, double bandaging, and 1/3 overlap combined (<i>p</i> < 0.05). <b><i>Conclusions:</i></b> These findings highlight the critical role of forearm bandaging technique, layering, and additional materials in determining sub-bandage pressure.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"239-243"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008940","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 Comparative Evaluation of Depression, Life Satisfaction, and Quality of Life Between Female Patients with Lipedema and Lymphedema.","authors":"Ayşegül Yaman, Pınar Borman, Esra Gizem Koyuncu, Ayşegül Balcan Aslan, Ayça Utkan Karasu, Cansu Şahbaz Pirinççi","doi":"10.1089/lrb.2024.0117","DOIUrl":"10.1089/lrb.2024.0117","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Lymphedema and lipedema are chronic conditions significantly impacting psychosocial status and quality of life (QOL). However, comparative studies on depression, life satisfaction, functional status, and QoL in these conditions are lacking. This study aims to fill this gap by providing a comparative evaluation of functional status, depression, life satisfaction, and QoL in patients with lymphedema and lipedema. <b><i>Method:</i></b> Over 12 months, 73 female patients diagnosed with pure lymphedema or lipedema were recruited according to inclusion/exclusion criteria. A range of demographic variables, including age, body mass index (BMI), disease duration, stage of disease, and exercise/smoking conditions, were recorded. The lower-extremity functional scale (LEFS), life satisfaction index (LSI), patient health questionnaire (PHQ-9), and Lymphedema QOL Questionnaire for Legs were used to assess functional status, life satisfaction, depression, and QoL, respectively, in both groups. The relationship between questionnaire scores and demographic variables was carefully evaluated. <b><i>Results:</i></b> Thirty-six individuals with lymphedema (mean age: 55.1 years) and 37 patients with lipedema (mean age: 50.7 years) were included in the study. Demographical variables were statistically similar between the groups (<i>p</i> > 0.05). Duration of disease was longer (mean: 159.3 months vs. 39.6 months) in a lipedema group than in lymphedema patients. PHQ-9 (mean:11.4 vs. 10.4) and overall QoL scores (mean: 5.06 vs. 5.47) were similar between groups, while LEFS (mean: 44 vs. 62) and LSI scores (mean: 11.5 vs. 14.3) were worse in patients with lymphedema than in a lipedema group. There were correlations between age and LEFS (<i>p</i> = 0.014, <i>r</i> = -0.40) and LSI (<i>p</i> = 0.013, <i>r</i> = -0.41) in the lymphedema group; and between BMI and LEFS (<i>p</i> = 0.013, <i>r</i> = -0.041) and QoL (<i>p</i> = 0.034, <i>r</i> = 0.37) scores; and duration of disease and PHQ-9 scores (<i>p</i> = 0.028, <i>r</i> = -0.41) in the lipedema group. <b><i>Conclusions:</i></b> Patients with lipedema have similar depression and impaired QoL as lymphedema patients. However, lymphedema patients experience more functional disability and less life satisfaction. As the BMI and duration of illness are correlated with depression and QoL, early diagnosis and early management are essential to improve disability and QoL in patients suffering from lipedema.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"255-262"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625229","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":"Enhanced Translational Activity Is Linked to Lymphatic Endothelial Cell Activation in Cutaneous Leishmaniasis.","authors":"Lucy Fry, Hayden Roys, Anne Bowlin, Gopinath Venugopal, Jordan T Bird, Alexx Weaver, Stephanie D Byrum, Tiffany Weinkopff","doi":"10.1089/lrb.2024.0080","DOIUrl":"10.1089/lrb.2024.0080","url":null,"abstract":"<p><p><i><b>Introduction:</b></i> Cutaneous leishmaniasis (CL) is a significant public health problem leading to permanently disfiguring skin lesions caused by <i>Leishmania</i> parasites. Lesion severity stems from an excessive host inflammatory response that prevents healing. <i><b>Materials and Methods:</b></i> Here, we characterized the transcriptional and translational responses of lymphatic endothelial cells (LECs) during murine CL using single-cell RNA sequencing data combined with flow cytometry and <i>in vivo</i> puromycin incorporation to assess translational activity. <i><b>Results:</b></i> We identified upregulation of antigen presentation pathways including MHC-I, MHC-II, and immunoproteasome transcripts in dermal LECs from <i>Leishmania major</i>-infected mice compared to naive controls. LECs also exhibited increased expression of guanylate binding proteins and interferon-inducible genes, indicative of immune activation. Moreover, our findings demonstrate that LECs in leishmanial lesions displayed heightened translational activity relative to LECs from uninflamed ears, and LEC translational activity was highest in activated LECs. Furthermore, LEC translational activity exceeded that of other cell types within the lesion microenvironment. Validating the transcriptomic data, LECs in lesions expressed elevated MHC-II and programmed death-ligand 1 (PDL-1), supporting their potential role in antigen presentation. Functional assays using DQ-ovalbumin confirmed that LECs from leishmanial lesions efficiently uptake and process antigens, highlighting their capability as antigen presenting cells in the inflamed dermal microenvironment. <i><b>Conclusion:</b></i> Overall, our study reveals the activation status of LECs in leishmanial lesions, shedding light on their potential role in shaping local immunity and inflammation in a variety of skin diseases.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"244-254"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006947","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.2025.0074","DOIUrl":"10.1089/lrb.2025.0074","url":null,"abstract":"","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"281"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310142","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":"Automated Measurement of Skin Thickness in Computed Tomography Images for Unilateral Lower Extremity Lymphedema.","authors":"Yukihiro Nomura, Hiroki Naganishi, Yuma Ando, Shinsuke Akita, Nobuyuki Mitsukawa","doi":"10.1089/lrb.2024.0075","DOIUrl":"10.1089/lrb.2024.0075","url":null,"abstract":"<p><p><b><i>Background:</i></b> Lower extremity lymphedema (LEL) is a common complication following gynecological cancer treatment, characterized by the accumulation of protein-rich fluid owing to lymphatic system insufficiency. This condition manifests as in skin thickening, soft tissue swelling, and other complications. Therefore, this study proposes an automatic method for measuring skin thickness in lower extremity computed tomography (CT) images and assessing its effectiveness in diagnosing LEL. <b><i>Methods and Results:</i></b> We selected 56 patients with unilateral LEL based on specific diagnostic criteria, including clinical evaluation, lymphoscintigraphy, indocyanine green lymphography, and a noncontrast CT scan, which included the entire lower extremities. The CT images had a pixel spacing ranging from 0.723 to 0.976 mm, with a slice thickness of 10.0 mm. Our skin thickness measurement method involves preprocessing, such as extracting the leg, bone, muscle, and subcutaneous fat regions, defining the target slice range, and measuring the skin thickness. The lower extremity was divided into eight subregions, and the skin thickness was measured across these subregions. The overall median skin thicknesses were 0.883 ± 0.201 and 1.536 ± 0.487 mm in normal and positive subregions, respectively. The classification of LEL was based on the <i>Z</i>-score calculated for each subregion, with the median skin thickness from normal legs serving as a reference. Our classification method demonstrated an overall accuracy of 0.839, sensitivity of 0.703, and specificity of 0.937. <b><i>Conclusions:</i></b> Our automated method for measuring skin thickness in CT images shows promise in diagnosing LEL, with high accuracy and specificity. This approach enables a comprehensive evaluation of the entire leg, potentially enhancing the diagnostic process for LEL.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"223-228"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795423","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":"Children and Young People with Lymphedema: The Education Need of Health Care Professionals.","authors":"Rhian Noble-Jones, Melanie Thomas","doi":"10.1089/lrb.2024.0043","DOIUrl":"10.1089/lrb.2024.0043","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The education need of health care professionals (HCP) to provide good quality care to children and young people with lymphedema (CYPwL) was unknown. While understanding of pediatric lymphedema grows, families still report delays in accessing appropriate treatment and HCP have reported being ill-prepared. <b><i>Methods:</i></b> A questionnaire was designed by phased process of literature search, focus group, and online consensus with international experts. The online survey, available in six languages, was distributed to HCP working with CYPwL by professional groups. <b><i>Results:</i></b> Questionnaires were received from 507 responders from 33 countries. Specific education on the treatment of CYPwL is needed, even when HCP are adult lymphedema trained according to 80% of respondents. Greatest consensus on best practice was that a multidisciplinary team (MDT) with specialist knowledge is required to treat CYPwL, but almost one in five HCP working with CYPwL have no, or rare, access to such a team. Reducing infections and adapting compression/treatment for age and development were deemed most essential. A variety of learning resources are needed including films, videos, and webinars from clinical experts. <b><i>Discussion and Conclusion:</i></b> This is the first international survey of the education need of HCP regarding CYPwL which include pathology, treatment, psychosocial care, and education of other professionals. Uppermost was knowing how to reduce infections and adapt compression and other treatments for age and development. Access to an experienced MDT was considered essential to support good clinical decision-making. Multimodal approaches are needed to address identified education need. Further research in individual countries and professions is recommended.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"215-222"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094307","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":"Evaluation of Elastographic Parameters in Patients with Breast Cancer-Related Lymphedema and Examination of Their Relationship with Clinical Data.","authors":"Merve Demirci, Canan Sanal, Ilker Yagcı, Gulseren Akyuz","doi":"10.1089/lrb.2024.0088","DOIUrl":"10.1089/lrb.2024.0088","url":null,"abstract":"<p><p><b><i>Background:</i></b> To evaluate the stiffness of the skin and subcutaneous tissues of the arm and forearm of patients with breast cancer-related lymphedema using shear-wave elastography (SWE) and to investigate the relationship between the patients' symptoms. <b><i>Methods and Results:</i></b> Both lymphedematous and unaffected upper extremities of 72 patients (72 lymphedematous and 72 unaffected extremities) and 72 upper extremities of 36 controls (72 healthy extremities) were included in the study. The stiffness of the skin and subcutaneous tissues of all extremities was evaluated with SWE. The patients' pain, tension, weight, and stiffness symptoms associated with lymphedema were questioned using a numerical scale. The patients' functionality and participation in daily life activities were evaluated. The skin stiffness of the affected extremity was higher and the subcutaneous tissue stiffness was lower in patients than in controls (<i>p</i> < 0.05). The skin stiffness of the affected forearm was higher and the subcutaneous tissue stiffness of the affected arm and forearm was lower than their healthy extremities (<i>p</i> < 0.05). Quick Disabilities of Arm, Shoulder, and Hand and Life Impact Scale; were negatively correlated with arm and forearm subcutaneous tissue stiffness and positively correlated with forearm skin stiffness. The decrease in subcutaneous tissue stiffness of the arm was associated with heaviness sensation, the increase in skin stiffness of the forearm was associated with tightness, and the decrease in subcutaneous tissue stiffness of the forearm was associated with tightness, heaviness, and stiffness sensations. <b><i>Conclusion:</i></b> The results of this study suggest that SWE measurements can be useful for diagnosis and follow-up of patients.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"263-271"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557311","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}