Lymphatic research and biology最新文献

{"title":"Efficacy of Therapeutic Ultrasound Added to Complex Decongestive Therapy in Breast Cancer-Related Lymphedema.","authors":"Mihriban Cağlı, Burcu Duyur Çakıt, Secil Pervane","doi":"10.1089/lrb.2023.0019","DOIUrl":"10.1089/lrb.2023.0019","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To determine the efficacy of therapeutic ultrasound (TUS) added to complex decongestive therapy (CDT) in patients with breast cancer-related lymphedema (BCRL). <b><i>Materials and Methods:</i></b> Thirty female volunteer patients who developed stage 2-3 BCRL were included in the study. The patients were randomly assigned to one of two groups: standard treatment with CDT alone and CDT + TUS. Before the study, both groups were given a training and home program consisting of remedial exercises and skin care. All patients received 15 sessions of treatment over 3 weeks. Circumferential and ultrasonographic (USG) measurements of all patients were performed before and after treatment. Treatment efficacy was evaluated based on extremity volume and soft tissue thickness. <b><i>Results:</i></b> The demographic data and volume measurements of the patients were similar at the beginning of treatment. There was a statistically significant decrease in the affected extremity in both groups in posttreatment circumferential measurements. However, the reductions in volume difference and volume difference percentage were significantly higher in the CDT + TUS group (<i>p</i> = 0.001 and <i>p</i> = 0.002, respectively). In the USG measurements, a greater decrease was observed in the soft tissue thickness below the elbow in the CDT + TUS group compared with the CDT alone group (<i>p</i> = 0.003). <b><i>Conclusion:</i></b> In the treatment of BCRL, TUS added to CDT resulted in a reduction in lymphedema. We consider that when added to CDT, TUS can increase the efficacy of treatment by reducing lymphedema in stages 2 and 3 lymphedema cases.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"272-280"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557295","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 the Treatment Process with Home Exercise Program and Telerehabilitation in Patients with Breast Cancer-Related Lymphedema: A Case-Control Study.","authors":"Merve Demirci, Canan Şanal","doi":"10.1089/lrb.2024.0038","DOIUrl":"10.1089/lrb.2024.0038","url":null,"abstract":"<p><p><b><i>Background:</i></b> This study aimed to evaluate and compare the effectiveness of telerehabilitation (TR) and home exercise program (HEP) in patients with breast cancer-related lymphedema and the patients' compliance with these treatment processes. <b><i>Methods and Results:</i></b> 23 patients were prospectively included in the HEP group and 22 patients in the TR group, who were followed up in the Lymphedema Outpatient Clinic of the Department of Physical Medicine and Rehabilitation of a University Hospital. These patients were randomized. The volume difference between the extremities of the patients was calculated with the truncated cone formula, before and after treatment. The patients' pain, tightness, heaviness, and stiffness symptoms associated with lymphedema were questioned using a numerical scale. The patients' functionality and participation in daily life activities were evaluated with disabilities of arm, shoulder, and hand Quick Questionnaire (Quick-DASH) and the Lymphedema Life Impact Scale (LLIS). Patients' treatment satisfaction and compliance with treatment were questioned using Likert scales. A total of 45 patients were included in the study. The mean age and body mass index were similar between the groups (<i>p</i> ≥ 0.05). In the evaluations performed, no significant differences were observed within groups or between groups in terms of volume difference, quick DASH, pain, tightness, heaviness, stiffness, and LLIS scores (<i>p</i> ≥ 0.05). Patient satisfaction was significantly higher in the TR group (<i>p</i> ≤ 0.001). During treatment follow-up, only one person from the TR group missed the 5th-week checkup (4.5%), whereas five patients from the HEP missed the 5th-week checkup and three missed the 8th-week checkup. Overall, eight patients discontinued treatment (34%). <b><i>Conclusion:</i></b> Although there were no significant differences in clinical assessments between TR and HEP groups, patient satisfaction, and treatment adherence were significantly higher in the TR group.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"169-177"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046781","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":"Relationship Between 25-Hydroxyvitamin D and Vitamin B12 Levels and Neuropathic Pain in Patients Diagnosed with Lipedema.","authors":"Gulcan Ozturk, Pinar Akpinar, Duygu Silte Karamanlioglu, Feyza Akan Begoğlu, Feyza Unlu Ozkan, Ilknur Aktas","doi":"10.1089/lrb.2024.0083","DOIUrl":"10.1089/lrb.2024.0083","url":null,"abstract":"<p><p><b><i>Background:</i></b> Pain is a prevalent symptom in patients with lipedema predominantly impacting the lower extremities. This study aimed to evaluate the relationship between 25-hydroxyvitamin D [25(OH)D] and vitamin B12 levels and neuropathic pain (NP) in patients diagnosed with lipedema. <b><i>Methods and Results:</i></b> A total of 243 patients with lipedema who had 25(OH)D and B12 levels measured in the past 6 months were included in this study. Participants were divided into two groups: Group 1 (<i>N</i> = 78) with NP scores ≥13 and Group 2 (<i>N</i> = 165) with NP scores <13. The Turkish version of the painDETECT questionnaire was used to assess the patients' NP symptoms. Pain levels were measured using the Visual Analog Scale (VAS) and pain threshold through algometric measurement. Group 1 had significantly higher palpation and spontaneous VAS scores, and pain threshold through algometric measurements than Group 2 (<i>p</i> < 0.05). No statistically significant difference was found between the groups regarding vitamin D levels being below 30 ng/mL or vitamin B12 levels being below 400 pg/mL (<i>p</i> > 0.05). <b><i>Conclusions:</i></b> No association was found between NP and 25(OH)D or B12 levels in patients with lipedema.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"203-211"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024547","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.2025.0043","DOIUrl":"10.1089/lrb.2025.0043","url":null,"abstract":"","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"213"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030951","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":"A New Secondary Chronic Lymphedema Rat Model Improved by High-Fat Diet.","authors":"Chan Xing, Jie Sun, Yaqian Liu, Jialin Zhou, Xue Bai, Jun Li, Haidong Zhao","doi":"10.1089/lrb.2024.0051","DOIUrl":"10.1089/lrb.2024.0051","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Secondary chronic lymphedema is a complication that seriously affects the quality of life of cancers survivors which is urgent to be studied. However, the current animal models generally have some defects such as short duration that affect the research process. To acquire an animal model which is easier to accomplish as well as higher success rate is the main goal of our experiment. <b><i>Methods:</i></b> The hind limb model of rats with secondary chronic lymphedema was established by near infrared fluorescence-guided lymphatic system destruction combined with high-fat diet innovation. The model was evaluated by limb circumference, volume, near-infrared fluorescence imaging of lymphatic vessels, and a series of histopathological staining. <b><i>Results:</i></b> The model was successfully established by operation combined with a high-fat diet and kept persistent effective lasting up to 16 weeks. Compared with the normal diet group, the high-fat group received a higher success rate (77.77% vs. 55.55%), a more obvious degree of limb swelling, and a more significant level of subcutaneous inflammatory factor infiltration at the edema site. Based on it, we kept research and found out that there was no significant difference in the process of subcutaneous fibrosis between the two groups. <b><i>Conclusions:</i></b> High-fat diet may improve secondary chronic lymphedema rat model success rate as well as effectiveness by changing the level of inflammatory infiltration in the site of lymphedema.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"194-202"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449152","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 Intermittent Pneumatic Compression Influences Edema Fluid Movement and Promotes the Compensatory Drainage Pathways in Patients with Breast Cancer Related Lymphedema.","authors":"Marzanna T Zaleska, Natalia E Krzesniak","doi":"10.1089/lrb.2024.0061","DOIUrl":"10.1089/lrb.2024.0061","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Upper limb lymphedema is the most common complication after breast cancer therapy. Suddenly disturbed lymphatic transport in the affected arm causes tissue fluid accumulation in tissue spaces, limb enlargement, and secondary changes in tissue. Early compression therapy is necessary. We aim to evaluate the effectiveness of intermittent pneumatic compression (IPC) in fluid movement along the limb and the possibility of creating compensatory drainage pathways. <b><i>Methods and Results:</i></b> We investigated 25 patients with Breast Cancer Related Lymphedema (BCRL) stages II and III. Indocyanine green observation and measurement of skin water concentration and skin and subcutaneous tissue stiffness were done before and after a single 45-minute session of IPC. After IPC, we observed the movement of edema fluid upper in the arm (92%) and in three main directions not seen before IPC: to the ipsilateral supraclavicular lymph node (30%), to the ipsilateral axilla (22%), and to the axilla, chest, and scapula (26%). We noticed two changes in fluorescent intensity along the entire limb: a decrease in the hand and forearm, an increase in the arm (64%), and a decrease along some parts or the entire limb (36%). Skin and subcutaneous tissue stiffness decreased at all limb levels. The highest, statistically significant reduction of subcutaneous tissue stiffness was noticed in the middle forearm and elbow (36.4% and 33.4%, respectively). <b><i>Conclusions:</i></b> IPC can effectively move edema fluid from the distal to the proximal part of the limb, promote compensatory drainage pathways, and decrease tissue stiffness. This compression type should be applied even in the early stages to prevent limb enlargement and secondary tissue changes.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"160-168"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046925","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":"Usefulness of Tapered Cutting Needles for Lymphaticovenular Anastomosis.","authors":"Satoshi Onoda, Kahori Tsukura, Kyona Taki, Toshihiko Satake","doi":"10.1089/lrb.2024.0057","DOIUrl":"10.1089/lrb.2024.0057","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> We report the usefulness of a tapered cutting needle, which has a polyhedral tip similar to that of a square needle and transitions to a round tip in the middle, for super-microsurgery. <b><i>Methods:</i></b> We have performed more than 500 lymphaticovenular anastomoses (LVAs) using tapered cutting needles. Therefore, we investigated the caliber of the anastomosed lymphatic vessels and veins, characteristics of the lymphatic vessels, the time required to perform the anastomosis, damage to the lymphatic vessels and veins during anastomosis, and patency of 30 recently performed consecutive anastomoses. <b><i>Results:</i></b> The mean caliber of the anastomosed lymphatic vessels was 0.68 mm (range, 0.4-1.2 mm), and the mean caliber of the veins was 0.87 mm (range, 0.5-1.5 mm). Regarding the progression of fibrosis, 14 cases were classified as no degeneration, 13 cases were classified as mild degeneration, 2 cases were classified as moderate degeneration, and 1 case was classified as severe degeneration. The average time required to perform the anastomosis was 10.53 minutes (range, 8-13 minutes). No cases of lymphatic or venous injury or laceration occurred during the anastomosis procedure. After the anastomosis was created, intraoperative patency was observed in all patients. <b><i>Conclusion:</i></b> The tapered cutting needle is useful for LVAs because of its excellent thread-ability and protective properties for blood vessels. Furthermore, the tapered cutting needle is useful for short anastomoses, regardless of the diameter or condition of the lymphatic vessels. In the future, the tapered cutting needle is expected to become the needle of choice for LVAs.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"178-183"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066642","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":"Assessment Tools to Quantify the Physical Aspects of Lipedema: A Systematic Review.","authors":"Helen E Eason, Sharon L Kilbreath, Nicola Fearn, Elizabeth S Dylke","doi":"10.1089/lrb.2024.0102","DOIUrl":"10.1089/lrb.2024.0102","url":null,"abstract":"<p><p>Lipedema diagnosis is heavily reliant on patient history. Various objective assessments have been suggested; however, a standardized measurement process is lacking. A systematic review was undertaken to identify which imaging and measurement tools are used in lipedema quantification and to review their protocols. Six databases were searched with two reviewers screening citations for inclusion. Full peer-reviewed publications that included defined lipedema diagnosis criteria, no male cases within comparative cohorts, and used an imaging or measurement tool to quantify lipedema were included. Twenty studies met the inclusion criteria using 13 different tools to quantify individual physical lipedema characteristics to either enable differential diagnosis, and/or quantify treatment effect: tape measure, perometry, durometry, tonometry, bioimpedance spectroscopy, tissue di-electric constant, ultrasound, Dual-Energy X-ray Absorptiometry, magnetic resonance imaging (MRI), noncontrast MRI lymphangiography, Indocyanine green lymphography, lymphoscintigraphy, and dynamic lymphangiography. Eight imaging and five measurement tools assessed lymphatic transport disturbances (<i>n</i> = 8), limb size/volume (<i>n</i> = 4), adipose tissue thickness/mass/volume (<i>n</i> = 3), and tissue fluid presence (<i>n</i> = 2). Multiple tools were only used in studies completed in 2020 or later. A lack of consistency exists in tool protocols, measurement locations, and outcome analysis. Limited reporting of clinimetrics with data derived from small cohorts and heterogenous populations impacted the ability to recommend tools for clinical practice and research. Various tools were used for objective lipedema assessment; however, consistency in approach was lacking. Further investigations are required to establish the validity and reliability of measurement and imaging tools, protocols, measurement points, and outcome reporting/interpretation to quantify the physical attributes of lipedema.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"139-159"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557294","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.2025.0020","DOIUrl":"10.1089/lrb.2025.0020","url":null,"abstract":"","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"212"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649706","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":"Hypoxia Impairs Migration of Human Dermal Lymph Endothelial Cells: Implications for Lymphedema Pathogenesis.","authors":"Chihiro Matsui, Hiroshi Koide, Hatan Mortada, Reiko Tsukuura, Toko Miyazaki, Hayahito Sakai, Hiroshi Mizuno, Takumi Yamamoto","doi":"10.1089/lrb.2024.0019","DOIUrl":"10.1089/lrb.2024.0019","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Lymphedema, characterized by abnormal lymph circulation, is a chronic debilitating condition often associated with chronic inflammation and hypoxia in lymphedematous tissue. Previously, using videocapillaroscopy, we found that the severity of lymphedema damages vasa vasorum vessels on the surface of lymph vessels, significantly compromising the oxygen supply environment to lymph endothelial cells. While previous research has indicated the inhibitory effects of hypoxic conditions on the proliferation of human dermal lymph endothelial cells (HDLECs), the impact on HDLEC migration remains unclear. This study aims to investigate the migration ability of HDLECs under hypoxic conditions, shedding light on the potential mechanisms underlying lymphedema progression and offering insights into therapeutic strategies. <b><i>Materials and Methods and Results:</i></b> Purchased HDLECs were cultured under normoxic (2% O₂) and hypoxic (1% O₂) conditions. Migration assays were performed using a scratch assay to assess the migratory capabilities of HDLECs. The experiment monitored cell migration over a period of 6 hours. Experiments were performed in triplicate. HDLECs were cultured to full confluence before the scratch assay. The results revealed a significant reduction in HDLEC migration under hypoxic conditions compared to normoxic conditions after 6 hours (<i>p</i> < 0.001). This suggests that hypoxic environments directly impair HDLEC migration. <b><i>Conclusion:</i></b> Hypoxia negatively affects HDLEC migration, potentially exacerbating lymphedema. Protecting vasa vasorum may preserve HDLEC migration and lymphangiogenesis. Further exploration of hypoxia-HDLEC interactions is crucial for understanding lymphedema pathogenesis and developing therapies.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"184-187"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391291","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}