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":"Genetic Study of HGF-MET Signaling Pathway in Primary Lymphedema Patients: Supporting Evidence for Loss of Function Variants in HGF.","authors":"R Kozacikova, D Veselenyiova, V Gelanova, I Belanova, G Bonetti, J Kaftalli, P E Maltese, A Macchia, C Micheletti, K Donato, L Ferrari, S Miertus, J Miertus, M Ricci, M Cestari, Si Michelini, Se Michelini, S Cecchin, M Bertelli, Sa Michelini","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The lymphatic system is composed of lymphatic vessels that connect lymphatic organs and play a critical role in draining lymph fluid from the intracellular environment. Disruptions in this system can lead to defects in lymphatic development and lymphedema which is characterized by chronic inflammation and fluid accumulation in tissues, finally resulting in swelling, pain, and fibrosis. If caused by genetic variants, this condition is referred to as primary lymphedema. This study explores the genetic basis of primary lymphedema in an Italian cohort retrospectively analyzing sequencing data and focusing specifically on genes involved in the HGF/MET signaling pathway. This pathway is crucial for lymphangiogenesis and lymphatic function, but the involved genes miss a clear association with lymphedema in clinical practice. The analysis identified 8 variants in three key genes, namely HGF, MET, and CBL, among 8 unrelated patients. Seven of these variants have never been reported in literature as associated with lymphedema. We performed molecular modeling studies to evaluate the effect of the three identified missense variants in MET, supporting the pathogenicity of two of them. The identification of these variants supports the significance of alterations in HGF/MET signaling pathway as possible causes of primary lymphedema.</p>","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"57 4","pages":"198-210"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051540","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: Jacques Aime Gruwez March 24, 1927-July 9, 2024; Vive le (ISL) Présidente!","authors":"M H Witte","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In Memoriam for Jacques Aime Gruwez who was the third president of the ISL March 24, 1927-July 9, 2024.</p>","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"57 3","pages":"169-170"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054618","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":"Characteristic Single Photon Emission Computed Tomography-Computed Tomography (SPECT-CT) Findings in Secondary Genital Lymphedema.","authors":"S M Ohki, H Sakai, T Miyazaki, R Tsukuura, T Yamamoto","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Diagnosis and evaluation of genital lymphedema (GL) is a challenging yet crucial step in the treatment of GL. Single photon emission computed tomography-computed tomography (SPECT-CT) is useful for lymph flow imaging, but its characteristic findings for GL are not clarified. The purpose of this study was to uncover characteristic SPECT-CT findings in secondary GL. Medical records of patients who underwent SPECT-CT and indocyanine (ICG) lymphography for evaluation of secondary lower extremity lymphedema (LEL) and/or genital lymphedema (GL) were reviewed. Characteristic SPECT-CT findings were identified based on timing, visibility, and extension of lymphatic enhancement in the lower abdominal, inguinal, genital, and pelvic regions. Patients were divided into either GL group with genital ICG lymphography stage I-V or control group with stage 0. Prevalence of each SPECT-CT finding was compared between the groups. Ten female patients were included; 7 (70%) were classified in GL group, and 3 (30%) in control group. Characteristic SPECT-CT findings included pauci-enhancement of inguinal lymph nodes (PEIL), genital dermal back flow, external iliac lymph nodes non-enhancement, common iliac lymph nodes non-enhancement, and periaortic lymph nodes non-enhancement. There was a statistically significant difference between GL and control groups for PEIL (100% vs. 0%, P = 0.002). Characteristic SPECT-CT findings in secondary GL were identified. Further studies are warranted to clarify usefulness of the findings for management of GL.</p>","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"57 4","pages":"211-218"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035662","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":"Current Role of Pneumatic Compression Therapy in Lymphedema Care: A Scoping Review of Persistent Debates and New Applications.","authors":"S K Pandy, B B Ozmen, S Morkuzu, Y Xiong, E Kemp, W F Chen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Access to trained lymphedema care providers remains limited making patient-driven management solutions essential. One such option, sequential intermittent pneumatic compression (IPC), has gained traction as a supportive tool for lymphedema management. While newer IPC devices and innovative applications are being introduced to the market, questions regarding the safety and efficacy of this technology persist. This underscores the importance of reviewing current literature to understand IPC's evolving role in lymphedema care and to identify existing knowledge gaps. A scoping review of literature was conducted across various databases using PRISMA-ScR guidelines. The eligibility criteria included articles published in English language from database's inception to June 2023, discussing IPC's safety, and/or efficacy, and/or optimal modes and settings for lymphedema management. Review articles and case reports and original studies with unclear outcome measures were excluded. The review identified 49 eligible studies from an initial pool of 614 articles, consisting of 12 randomized controlled trials, 25 cohort studies, and 12 experimental studies. Most studies (44) focused on limb lymphedema, while five examined non-limb regions. Sample sizes varied widely, ranging from 10 to 718 participants, reflecting differences in studies' power. Minor adverse events were reported in six studies, including transient skin irritation, paresthesia, and rare cases of genital edema. Efficacy data indicated that IPC, whether used with or without manual lymphatic drainage (MLD), improved limb volume, quality of life, and reduced infection rates, although results varied according to treatment protocols and limb type. The addition of IPC improved compliance of decongestive therapy and increased patient satisfaction. IPC sessions ranged from 45 to 120 minutes per day, conducted 3 to 7 days per week, with pressures set at 60 to 120 mmHg for lower limbs and 25 to 60 mmHg for upper limbs. Higher pressures were associated with more significant limb volume reduction in the lower limbs. A cost analysis indicated that IPC could potentially lead to healthcare savings by reducing infections and hospital admissions. IPC application also showed promising results in head and neck lymphedema, though results for trunk lymphedema were equivocal. Future research should aim to refine IPC protocols in different regions of the body and ascertain its long-term benefits.</p>","PeriodicalId":94343,"journal":{"name":"Lymphology","volume":"57 3","pages":"142-156"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054567","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}