Lymphology最新文献

{"title":"Classification of Breast Lymphedema in a Racially Diverse Cohort.","authors":"J G Chen, C B Perez, A Coogan, T Kim, L Sanchez-Johnsen, K Ohara, C Nelson, D M Rizzo, J Matt, E J Watson, M M Sowden, T P Ahern","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Breast lymphedema is a common sequela of breast conservation that delays healing and reduces quality of life. No rigorous classification system exists for this condition. We explored approaches for classifying breast lymph-edema based on breast ultrasound, physical exam, and patient-reported outcomes. We enrolled 80 patients from two institutions. Each site enrolled 30 invasive breast cancer patients treated with breast conservation and radiotherapy, and 10 control patients evaluated for benign breast complaints. All patients underwent bilateral breast ultrasound to measure dermal thickness and were assessed for physical signs of breast lymphedema. Patients reported quality of life impacts on standard questionnaires. We derived breast lymphedema classifiers using (1) a simple ultrasound-based metric of dermal thickness difference, and (2) a multiparameter machine learning classifier based on dermal thickness difference, physical exam, and patient-reported impacts. Ultrasound-defined breast lymphedema was present in 72% (95% CI: 59 to 82%) of invasive breast cancer patients. The multiparameter classifier identified three distinct patient groups: one with little evidence of breast lymph-edema, and two with increasingly severe breast lymphedema. A simple ultrasound-based measure and a novel multiparameter classifier both show promise for rigorous classification of breast lymphedema and warrant further development in larger patient cohorts.</p>","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"57 2","pages":"84-96"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635701","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}

{"title":"Looking Backward and Looking Forward: Revisiting \"Clinical Usefulness of Thoracic Duct Cannulation\".","authors":"M H Witte","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Over the past decade, there has been a resurgence of interest in the thoracic duct and central lymphatic system and its disorders, stimulated by advances in interventional magnetic resonance imaging techniques and urgent challenges in the clinical management of lymphatic malformations and lymphatic complications from congenital heart disease. The following chapter reprinted here written shortly after the formal founding of the discipline of lymphology and the International Society of Lymphology, describes early efforts, and also suggests future directions now being revisited and others yet to be explored (1).</p>","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"57 1","pages":"34-57"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485054","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}

{"title":"Brain Lymphatics: Rediscovery and New Insights into Lymphatic Involvement in Diseases of Human Brains.","authors":"M J Bartlett, R P Erickson, E B Hutchinson, R S Witte, M H Witte","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The brain's lymphatic system is comprised of a glymphatic-meningeal-cervical lymphatic vessel pathway. The study of its mechanism and pathophysiology in neurodegenerative disease has been one of the most exciting topics in basic and translational neuroscience of the last decade. However, while there has been some debate about when the meningeal lymphatics were discovered, it cannot be denied that studies in preclinical models and humans in this century represent a monumental step forward in our understanding of how the brain removes metabolic waste, the role this system plays in neurodegenerative disease, and, most importantly, its potential as a novel therapeutic target. This is a summary of the history, functional anatomy, and role of the brain's lymphatics in neurodegenerative disease.</p>","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"57 1","pages":"27-33"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485051","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}

{"title":"Author Response to Letter: BioBridge^TM Collagen Matrix for Lymphedema Therapy.","authors":"M Witt, A Ring","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Author's response to letter concerning article: Witt, M, A Ring: Handley's Thread Lymphangioplasty Vs. BioBridge^TM Collagen Matrix for Lymphedema Therapy-Old Wine in New Bottles? Lymphology 56 (2023) 110-120.</p>","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"57 2","pages":"107-115"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635618","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}

{"title":"Staging System of Three-Dimensional Non-Contrast Magnetic Resonance Lymphography in Secondary Lower Extremity Lymphedema.","authors":"T Kageyama, Y Shiko, Y Kawasaki, T Miyazaki, H Sakai, R Tsukuura, T Yamamoto","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Non-contrast magnetic resonance lymphography (NMRL) has been reported to be efficient for the evaluation of lymphedema. However, its characteristic findings and grading system are yet fully clarified. We retrospectively examined 48 patients with secondary lower extremity lymphedema (LEL) who underwent NMRL and indocyanine green lymphography (ICG-L). The lower extremity was divided into 5 areas for NMRL evaluation, and the prevalence of characteristic NMRL findings (Mist, Spray, and Inky) and the 3D NMRL stage that we proposed were compared according to the ICG-L stage. All characteristic NMRL findings increased in prevalence with the progression of the ICG-L stage (Mist, Spray, and Inky: P < 0.001, < 0.001, and < 0.001, respectively) Pre-dominant findings in each segment changed significantly from Mist in the ICG-L stage 0-Ⅱ, to the Spray in ICG-L stage Ⅲ-Ⅳ, to the Inky in ICG-L stage Ⅴ (P < 0.001). 3D NMRL stage significantly advanced with the progression of the ICG-L stage (rs = 0.72; P < 0.001). We believe this severity grading system is useful for efficient evaluation of fluid accumulation in LEL patients.</p>","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"57 2","pages":"59-70"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635704","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}

{"title":"In Memoriam: Dr. Alejandro Latorre Parra: Professor, and Passionate Lymphologist (1956-2023).","authors":"M H Witte","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We are sad to report the passing but will commemorate here the life and accomplishments of Alejandro Latorre Parra, MD, formerly Professor of the Medicine program at the Autonomous University of Bucaramanga - UNAB Faculty of Health Sciences and Director of the Escuela Colombiana de Linfologia.</p>","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"56 4","pages":"188-189"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116794","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}

{"title":"The Diagnosis and Treatment of Peripheral Lymphedema: 2023 Consensus Document of The International Society of Lymphology.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;p&gt;This International Society of Lymphology (ISL) Consensus Document is the latest revision of the 1995 Document for the evaluation and management of peripheral lymphedema (1). It is based upon modifications: [A] suggested and published following the 1997 XVI International Congress of Lymphology (ICL) in Madrid, Spain (2), discussed at the 1999 XVII ICL in Chennai, India (3), and considered confirmed at the 2000 (ISL) Executive Committee meeting in Hinterzarten, Germany (4); [B] derived from integration of discussions and written comments obtained during and following the 2001 XVIII ICL in Genoa, Italy as modified at the 2003 ISL Executive Committee meeting in Cordoba, Argentina (5); [C] suggested from comments, criticisms, and rebuttals as published in the December 2004 issue of Lymphology (6); [D] discussed in both the 2005 XX ICL in Salvador, Brazil and the 2007 XXI ICL in Shanghai, China and modified at the 2008 Executive Committee meeting in Naples, Italy (7,8); [E] modified from discussions and written comments from the 2009 XXII ICL in Sydney, Australia, the 2011 XXIII ICL in Malmo, Sweden, the 2012 Executive Committee Meetings (9); [F] discussions at the 2013 XXIV ICL in Rome, Italy, and the 2015 XXV ICL in San Francisco, USA, as well as multiple written comments and feedback from Executive Committee and other ISL members during the 2016 drafting (10); informal discussions at the XXVI ICL in Barcelona, Spain; [G] discussions at a dedicated, focused Post-Congress session at the XXVII ICL in Iguazu, Argentina (2019) followed by additional written comments from the Executive Committee and others (11); and [H] discussions and written comments from the XXVIII ICL in Athens, Greece (2021), and the XXIX ICL in Genoa, Italy (2023). The document attempts to amalgamate the broad spectrum of protocols and practices advocated worldwide for the diagnosis and treatment of peripheral lymphedema into a coordinated proclamation representing a \"Consensus\" of the international community based on various levels of evidence. The document is not meant to override individual clinical considerations for complex patients nor to impede clinical treatment or research progress. It is not meant to be a legal formulation from which variations could be used to describe or define medical malpractice. The Society understands that in some clinics the method of treatment derives from national standards while in others access to medical equipment, technical expertise, and supplies is limited; therefore, the suggested assessments and treatments might be impractical. Adaptability and inclusiveness do come at the price that members can rightly be critical of what they see as vagueness or imprecision in definitions, qualifiers in the choice of words ( e.g., the use of \"may ... perhaps ... unclear\", etc.) and mentions (albeit without endorsement) of treatment options supported by limited hard data (few randomized control trials). Most members are frustrated by the reality tha","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"56 4","pages":"133-151"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116796","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}

{"title":"Diagnostic Comparability of Ratio of Tissue Dielectric Constant (TDC) Between Patients with Lipedema and Those with Lower Limb Lymphedema (LLL): A Prospective Observational Study.","authors":"A Tugral, Y Bakar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Lipedema is usually thought of as a dis-ease of women. Potentially diagnostic comparative data is needed between patients with lip-edema and those with lower limb lymphedema (LLL). Since there is no gold standard to diagnose lipedema, some promising modalities such as Tissue Dielectric Constant (TDC) need to be investigated among patients with lipedema and lymphedema. This study was completed with a total of 26 patients (14 lipedema, 12 LLL). Local tissue water was assessed with Moisture MeterD compact (DelfinTech, Kuopio, Finland) according to the TDC method at 300 MHz within a 2.5 mm tissue penetration depth via the following reference points: Thigh, calf (20 cm upper and lower point of knee level, respectively), and malleoli (5 cm upper point of medial malleolus). Patients with LLL showed significantly higher TDC values and interlimb TDC ratios in all affected points and unaffected malleolus points compared to patients with lipedema. No significant difference was achieved between genders with LLL in all reference points. The area under the curve (AUC) for thigh, calf, and malleolus reference points were found as 0.851 (95%CI .678-1.00), 0.801 (95% CI 0.612-0.989) and 0.786 (95%CI 0.596-0.976), respectively. Patients with LLL showed significantly higher TDC values compared to patients with lipedema, these differences should be carefully interpreted in patients with bilateral LLL and those with lipo-lymphedema.</p>","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"56 4","pages":"168-177"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116792","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}

{"title":"In Memoriam: Hugo Partsch: Phlebolylmphologist Extraordinaire 1938-2023.","authors":"M H Witte","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We are sad to report the passing but will commemorate here the life and accomplishments of Hugo Partsch, MD, formerly Professor of Dermatology at the University of Vienna and Head of the Dermatological De-partment at the Wilhelminen Hospital in Vienna.</p>","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"56 3","pages":"131-132"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428647","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}

{"title":"Aselli Award Winner 2023: The Life and Times of a Lymphomaniac.","authors":"D G Jackson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Winning a scientific prize is always a welcome honor and receiving the Aselli Award in 2023 was a particularly pleasant surprise. The following text provides a brief summary of the research carried out by my group in Oxford that led to the discovery of the lymphatic endo-thelial marker LYVE-1 and its emerging role as a pivotal receptor controlling the entry of immune cells and metastatic tumor cells to lymphatic capillaries in peripheral tissues. As a basic scientist and relatively late comer to the field of lymphology, my hope is that a closer partnership of basic and clinical research will help explain the intricate workings of the lymphatics and improve the picture for patients suffering from much neglected lymphatic disorders.</p>","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"56 3","pages":"92-98"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428645","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}