Lymphology Pub Date : 2025-01-01

M Tsujita, Y Suzuki, T Kato, K Kishi

引用次数: 0

Feasibility and Potential Benefits of Moderate Intensity Cycling in People Living with Lower Limb Lymphedema: A Pilot Randomized Controlled Trial. 中等强度自行车运动对下肢淋巴水肿患者的可行性和潜在益处：一项随机对照试验。

Lymphology Pub Date : 2025-01-01

C Jonsson, K Johansson, M Bjurberg, C Brogardh

{"title":"Feasibility and Potential Benefits of Moderate Intensity Cycling in People Living with Lower Limb Lymphedema: A Pilot Randomized Controlled Trial.","authors":"C Jonsson, K Johansson, M Bjurberg, C Brogardh","doi":"","DOIUrl":"","url":null,"abstract":"The aim of this pilot randomized con-trolled trial (RCT) was to assess the feasibility of a moderate intensity cycling intervention in persons with lower limb lymphedema (LLL) and to explore its potential benefits. Thirty-three participants were included for an 8-week intervention of home-based exercise and randomized to an intervention group (IG) with cycling 3-5 times a week, 30-60 minutes, or to a control group (CG). Feasibility was assessed by recruitment and retention rates, adherence to training protocol, and adverse events. Potential benefits were physical fitness (submaximal bicycle ergometer test), volume, local tissue water, impedance of extracellular fluid, lymphedema-related disability (Lymph-ICF-LL) and health-related quality of life (Lymphedema Quality of Life Inventory). Assessments were performed at baseline and after 8 weeks. Non-parametric analyses were used. Twenty-seven participants (IG=16; CG=11), median age 63 years and time with LLL 9 years, completed the trial. Retention to group allocation was 82%, training protocol adherence was 81% and only one adverse event occurred. Significant between-group improvement was found for lymphedema-related disability favoring the IG. Within-group improvements regarding physical fitness, local tissue water and health-related quality of life were found in the IG, but not in the CG. In conclusion, this study shows that moderate intensity cycling is feasible with potential benefits in functioning and health-related quality of life for persons with chronic LLL.","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"58 1","pages":"11-22"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Does ICG have Time-Dependent Effects on the Lymphatic System in Women after Breast Cancer Surgery? ICG对乳腺癌术后女性淋巴系统有时间依赖性影响吗？

Lymphology Pub Date : 2025-01-01

P Bourgeois, M M Roman, C Karler, V Del Marmol

{"title":"Does ICG have Time-Dependent Effects on the Lymphatic System in Women after Breast Cancer Surgery?","authors":"P Bourgeois, M M Roman, C Karler, V Del Marmol","doi":"","DOIUrl":"","url":null,"abstract":"Near infrared fluorescence imaging (NIRFI) with Indocyanine Green (ICG) has been shown to detect lymph leakages and pat-terns in patients with complete axillary lymph node dissection (CALND) for breast cancer. However, ICG has also been demonstrated to have toxic effects in the ophthalmological field and limited data (in animal and human studies) suggest that it can alter functioning of the lymphatic system. The current study investigates pre-operative (Pre) and per-operative (Per) ICG administration and the volumes (V) of liquids collected in drains (Vd) and/or punctures (needle aspiration) (Vp) after breast cancer surgery. Fifty-five patients had one subcutaneous ICG injection in the ipsilateral hand either the day before (group Pre; n = 26) or the day of the surgery (group Per: n = 29). Vd, Vp and Vt (=Vd+Vp) were compared. The two groups did not differ statistically. We observed a statistical tendency (p=0.07) to find lower fluid volumes, overall (Vt) and in aspirations (Vp), when ICG was injected the day before the operation (Pre) compared with the same day (Per). When no fluorescence (no lymph leakage from the arm) was detected in the fluid collections, Vd and Vt were statisti-cally significantly lower in the pre-op group and in the whole group but not in the per-op one. Our correlation results add additional evidence to suggest that ICG may have a causative effect on the lymphatic system depending on the duration of its exposure as observed in the ophthalmological field. Although further study is needed to confirm, lymphologists, angiologists, lymphatic surgeons, vascular surgeons, and others who are using ICG for their NIRFLI evaluations should be aware of possible risks and complications associated with this procedure for use in patients with lymphedema.","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"58 2","pages":"66-76"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Genetic Variants in LZTR1, MAP2K1 and RAF1: Insights into the Role of RAS-MAPK Pathway in Primary Lymphedema. LZTR1、MAP2K1和RAF1基因变异：RAS-MAPK通路在原发性淋巴水肿中的作用

Lymphology Pub Date : 2025-01-01

I Belanova, D Veselenyiova, V Gelanova, R Kozacikova, G Bonetti, J Kaftalli, A Macchia, M C Medori, K Dhuli, G Guerri, S Miertus, J Miertus, M Ricci, M Cestari, B Amato, F Boccardo, G De Filippo, S I Michelini, S E Michelini, P E Maltese, M Bertelli, S A Michelini

{"title":"Genetic Variants in LZTR1, MAP2K1 and RAF1: Insights into the Role of RAS-MAPK Pathway in Primary Lymphedema.","authors":"I Belanova, D Veselenyiova, V Gelanova, R Kozacikova, G Bonetti, J Kaftalli, A Macchia, M C Medori, K Dhuli, G Guerri, S Miertus, J Miertus, M Ricci, M Cestari, B Amato, F Boccardo, G De Filippo, S I Michelini, S E Michelini, P E Maltese, M Bertelli, S A Michelini","doi":"","DOIUrl":"","url":null,"abstract":"The lymphatic system, a complex physiological network of lymphatic organs and vessels, is essential for maintaining fluid homeostasis. Dysfunction of lymphatic system can lead to lymphedema, a pathology characterized by the accumulation of interstitial fluid in peripheral tissues. This study aimed to identify novel genetic variants in genes within the RAS/ MAPK pathway and assess their potential association with lymphedema onset. We conducted a retrospective analysis of the genetic and clinical data from 408 patients diagnosed with primary lymphedema. These patients were previously tested using a next-generation sequencing panel that included 28 diagnostic genes and 71 candidate genes. The analysis revealed five genetic variants in the genes LZTR1, RAF1 and MAP2K1. Among the identified variants, four of them have never been reported in the literature. In silico analysis and molecular modelling supported the possible pathogenicity of one missense variant in RAF1 (c.1344T>G; p.Ile448Met), which could affect protein activation by phosphorylation. The results of this study highlight the genes involved in the RAS/MAPK signaling pathway as potential diagnostic targets for primary lymphedema.","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"58 2","pages":"46-55"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lymphspiration: Systemic Echoes - Can Lymphatic Reconstruction Surgery Extend its Therapeutic Reach from Limbs to Head. 淋巴：全身回声-淋巴重建手术能将其治疗范围从四肢延伸到头部吗？

Lymphology Pub Date : 2025-01-01

W F Chen, S Kukreja-Pandey, M Salman

{"title":"Lymphspiration: Systemic Echoes - Can Lymphatic Reconstruction Surgery Extend its Therapeutic Reach from Limbs to Head.","authors":"W F Chen, S Kukreja-Pandey, M Salman","doi":"","DOIUrl":"","url":null,"abstract":"This case series highlights potential systemic effects of lymphaticovenular anastomosis (LVA) with conventional treatment in patients with primary lymphedema of the lower limb, with a particular focus on its implications for cerebral lymphatic function. We present two cases in which LVA performed on a lower limb led to interesting systemic improvements extending beyond the treated regions, including alleviation of preoperative cognitive symptoms. The first case involves a 37-year-old woman with diffuse body swelling, including facial edema. LVA in her left leg resulted not only in re-duction of swelling but also in marked improvement in speech and mentation. The second case describes a 62-year-old woman who, following LVA in her right leg, experienced resolution of limb and facial edema, relief of oropharyngeal symptoms, and improvement in cognitive function. Although these cranial improvements were not objectively assessed due to lack of measurement before the LVAs, they were subjectively perceived by the patients post-operatively. These reports indicate the systemic nature of primary lymphedema and interestingly suggest that peripheral lymphatic surgery and treatment may positively influence cerebral lymphatic dynamics.","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"58 2","pages":"77-82"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Upper Arm Lymphosome: Watershed of Upper Arm Lymphatic Pathways Evaluated with Indocyanine Green Lymphography. 上臂淋巴体：用吲哚菁绿淋巴造影评价上臂淋巴通路的分水岭。

Lymphology Pub Date : 2025-01-01

H Sakai, T Miyazaki, R Tsukuura, T Yamamoto

{"title":"The Upper Arm Lymphosome: Watershed of Upper Arm Lymphatic Pathways Evaluated with Indocyanine Green Lymphography.","authors":"H Sakai, T Miyazaki, R Tsukuura, T Yamamoto","doi":"","DOIUrl":"","url":null,"abstract":"Understanding lymphatic anatomy of the upper extremity is necessary for treatment of upper extremity lymphedema (UEL). This study aimed to clarify the watershed of upper arm lymphosomes using fluorescent lymphography with multi-site injection of indocyanine green (ICG). Limbs contralateral to breast cancer treatment side of breast cancer survivors were included to evaluate upper arm lymphosomes. 0.1ml of ICG was injected intra-dermally at these 3 points in the mid-lateral upper arm: at the level of one (U1), two (U2), and three quarters (U3) from the lateral edge of the acromion to the lateral epicondyle of the humerus. Fluorescent images were obtained to determine the upper arm lymphatic pathway patterns. An injection site with multiple lymphatic pathways was evaluated as a watershed point. A total of twenty-one limbs were included. The lymphatic pathways from the U1/ U2/ U3 were anteromedial patterns in 20/13/6 (95.2%/90.5%/28.6%), and posterolateral pat-terns in 3/13/19 (14.3%/61.9%/90.5%), respectively. Both patterns were identified in 2/12/5 (9.5%/57.1%/23.8%), and no pattern in 0/1/1 (0%/4.8%/4.8%). Based on study results, the true watershed was determined as an approximate line from the posterolateral side of the lateral edge of the acromion to the anteromedial side of the lateral epicondyle of the humerus rather than a mid-arm line.","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"58 3","pages":"145-152"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145777114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment Strategies and Effectiveness in Lymphatic Malformations: A 10-Year Retrospective Study. 淋巴畸形的治疗策略和疗效：一项10年回顾性研究。

Lymphology Pub Date : 2025-01-01

M Shiraishi, M Narushima, C H Banda, Y Moriwaki, K Kojima, K Yamagata, C Kondo, K Mitsui, K Hashimoto, K Danno, K Hosomi, R Ishiura, M Kurita, I Koshima

{"title":"Treatment Strategies and Effectiveness in Lymphatic Malformations: A 10-Year Retrospective Study.","authors":"M Shiraishi, M Narushima, C H Banda, Y Moriwaki, K Kojima, K Yamagata, C Kondo, K Mitsui, K Hashimoto, K Danno, K Hosomi, R Ishiura, M Kurita, I Koshima","doi":"","DOIUrl":"","url":null,"abstract":"Recurrence is a major challenge in treatment of lymphatic malformations (LMs) world-wide. The objectives of the current study were to investigate risk factors associated with LM recurrence and to compare effectiveness of surgical and endovascular treatments. A multi-center 10-year retrospective chart review was conducted on all consecutive patients treated for LMs from 2009 to 2019. Data collected included post-treatment size, symptoms, and recurrence. Stepwise multiple regression analysis was used to identify risk factors and to compare treatment modalities. A total of 13 patients with 20 treatment cases were included. No significant difference was observed in size reduction and symptom alleviation between the treatment groups. Resection showed the highest recurrence rate of 36.4% (p=0.04) and lymphaticovenular anastomosis (LVA) presented excel-lent results in post-treatment size, symptoms, and recurrence despite lack of statistical significance. Microcystic type of LMs was identified as an independent risk factor for recurrence. Both surgery and sclerotherapy are effective in improving size and symptoms of LMs. This data will help physicians and patients choose the optimal treatment and potentially predict progression.","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"58 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lymphangiosarcoma, a Rare Complication of Lymphostasis: An Observational Study on the Role of the Physiotherapist in Early Recognition and Medical Referral. 淋巴管肉瘤，一种罕见的淋巴淤积并发症：物理治疗师在早期识别和转诊中的作用的观察研究。

Lymphology Pub Date : 2025-01-01

A Maccio, M Quattro, L Biava, C Palmero, T Galli, S Caruso

{"title":"Lymphangiosarcoma, a Rare Complication of Lymphostasis: An Observational Study on the Role of the Physiotherapist in Early Recognition and Medical Referral.","authors":"A Maccio, M Quattro, L Biava, C Palmero, T Galli, S Caruso","doi":"","DOIUrl":"","url":null,"abstract":"Lymphangiosarcoma is a rare, malignant angiosarcoma that primarily develops in limbs with chronic lymphedema and presents with dermal lesions. Due to a 5-year survival rate of 22.4%, early detection and treatment are critical for improving prognosis. This study assessed physiotherapists' skills in recognizing suspicious dermal lesions in lymphedema patients with a focus on lymphangiosarcoma. An 11-question online survey was created using Google Forms that included academic training, practical experience, frequency of lymphatic treatments, ability to recognize suspicious dermal lesions, referral frequency to specialists, and opinions on specific training needs. The study was conducted from 9 February to 30 March, 2024 and it targeted Italian physiotherapists who manage patients with lymphedema. Responses were received from 170 physiotherapists. Only 12.9% had university education on dermal lesions in lymphedema patients, while 70.6% had postgraduate training. Additionally, 57.6% felt unable to recognize lymphangiosarcoma. Postgraduate education was correlated with the ability to recognize the pathology (p=0.047). Clinical experience and frequency of lymphatic treatments was associated with recognition and reporting of suspected cases (p<0.05). Findings suggest the need for increased awareness and specialized training among physiotherapists to improve early detection and treatment of lymphangiosarcoma in lymphedema patients. Enhanced postgraduate education and clinical experience may lead to better patient outcomes.","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"58 1","pages":"34-41"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lymphspiration: The Mind-Body Connection in Lymphedema: Harnessing Placebo and Mitigating Nocebo for Better Care. 淋巴：淋巴水肿的身心联系：利用安慰剂和减轻反安慰剂以获得更好的治疗。

Lymphology Pub Date : 2025-01-01

R Tedeschi

引用次数: 0

Minimal Clinically Important Difference of the Lymphedema Quality of Life Scale in Upper Limb Lymphedema after Breast Cancer Surgery. 乳腺癌术后上肢淋巴水肿患者生活质量量表的微小临床重要差异。

Lymphology Pub Date : 2025-01-01

O Ozkutlu, C Sahbaz Pirincci, U Duzlu Ozturk, M Dalyan, D Celik

{"title":"Minimal Clinically Important Difference of the Lymphedema Quality of Life Scale in Upper Limb Lymphedema after Breast Cancer Surgery.","authors":"O Ozkutlu, C Sahbaz Pirincci, U Duzlu Ozturk, M Dalyan, D Celik","doi":"","DOIUrl":"","url":null,"abstract":"This study aimed to determine the mini-mal clinically important differences (MCID) for the Lymphedema Quality of Life Questionnaire (LYMQOL) in breast cancer-related lymphedema (BCRL). LYMQOL was used to evaluate quality of life (QoL) with four do-mains: function, body image, symptoms, and mood. All patients received a standardized three-week program of combined complex de-congestive therapy. An anchored-based (response to a satisfaction question at post treatment) method was used to estimate MCIDs. The optimal cut-off points were calculated. The study included 67 patients with a mean age of 54.3±9.73 years and a BMI of 32.6±6.80 kg/m². Significant statistical improvements were observed in all domains of the LYMQOL after treatment, including function (p=0.001), body image (p=0.001), symptoms (p<0.001), and mood (p=0.012) with the overall QoL score increasing from 6.31±1.93 to 6.81±1.45 (p=0.004). The MCID values for LYMQOL were 0.31 for function, 0.5 for body image, 0.31 for symptoms, and 0.33 for mood, with corresponding MCID change percentages of 10.33%, 16.66%,10.33%, and 11%, respectively. This study's MCID values for QoL provide valuable insights to enhance clinical decision- making and improve patient outcomes in BCRL.","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"58 4","pages":"179-189"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lymphology最新文献