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Lymphatic Research and Biology

Christopher J Coroneos, Franklin C Wong, Sarah M DeSnyder, Simona F Shaitelman, Mark V Schaverien
BACKGROUND: Bioimpedance spectroscopy (BIS) is an established tool for the measurement of extracellular fluid in lymphedema. This study assesses the validity of BIS measurements using the l-Dex® for evaluating the effectiveness of interventions to treat lymphedema. Measurements are correlated with limb volume, assessment of pitting edema, physiologic measures of lymphatic function, and response to surgical intervention. Three l-Dex BIS metrics are compared. METHODS AND RESULTS: This retrospective study of prospectively collected data identified consecutive patients with lymphedema...
November 2, 2018: Lymphatic Research and Biology
Sheila H Ridner, Jennifer K Doersam, Deonni P Stolldorf, Mary S Dietrich
BACKGROUND: Lymphedema is a chronic, incurable condition that occurs most commonly in lower limbs (legs and feet). Increased morbidity is seen with this form of lymphedema, but there are few studies and even fewer tools intended to assess symptom burden in patients impacted by this condition. A questionnaire, the Lymphedema Symptom Intensity and Distress Survey-Lower Limb (LSIDS-L), was developed to fill this gap. The measure is composed of several clusters of symptoms thought to characterize lower limb lymphedema...
October 24, 2018: Lymphatic Research and Biology
Shan Liao, Echoe M Bouta, Linda M Morris, Dennis Jones, Rakesh K Jain, Timothy P Padera
BACKGROUND: Metastatic tumor cells spread through lymphatic vessels and colonize draining lymph nodes (LNs). It is known that tumors induce lymphangiogenesis to enhance lymphatic metastasis and that metastatic cancer cells are carried by lymph flow to LNs. METHODS AND RESULTS: Here, we investigated the molecular and cellular regulation of collecting lymphatic vessel contraction in vessels draining a metastatic tumor using intravital microscopy. In tumor-draining collecting lymphatic vessels, we found vessel contraction was suppressed...
October 24, 2018: Lymphatic Research and Biology
Joël Visser, Michel van Geel, Anouk J M Cornelissen, René R W J van der Hulst, Shan Shan Qiu
BACKGROUND: Secondary lymphedema is a complication following breast cancer therapy and constitutes the main form of lymphedema in the western world. The purpose of the current study was to provide a clear overview of the genetic predisposition and secondary lymphedema. METHODS AND RESULTS: A systematic search was performed between February and June 2017 in MEDLINE and Embase. Search terms included Genes, Genetic Predisposition to Disease, Lymphedema, Breast Cancer Lymphedema, Secondary Lymphedema, Breast Cancer-Related Lymphedema, and Humans...
October 24, 2018: Lymphatic Research and Biology
Emma Underwood, Mary Woods, Katie Riches, Vaughan Keeley, Anita Wallace, Jennifer Freeman
BACKGROUND: More research is needed in lymphedema management to strengthen the evidence base and ensure patients receive clinically and cost-effective treatment. It is critical that patients and clinicians are involved in prioritizing research to ensure that it reflects their needs and is not biased by commercial interests. This study aimed to set the research priorities for lymphedema management in the United Kingdom, through collaboration with patients, carers, and clinicians. METHODS AND RESULTS: Following the James Lind Alliance's methodology, a national survey was conducted to identify unanswered questions about lymphedema management from the perspective of patients, carers, and clinicians...
October 24, 2018: Lymphatic Research and Biology
F Figen Ayhan, Melek Aykut, Hakan Genç, Başak Mansız Kaplan, Atilla Soran
BACKGROUND: Multilayer bandaging used in complex decongestive therapy (CDT) may increase tissue pressure resulting in nerve entrapments. The aim of this study was to discover if median nerve damage is a consequence of CDT in patients with breast cancer-related lymphedema (BCRL). METHODS AND RESULTS: Eighty-two arms of 41 patients with BCRL were included. Mean age was 56.05 (8.16) years and all stages of lymphedema were equally included. Fifteen sessions of CDT was applied to all patients...
October 24, 2018: Lymphatic Research and Biology
J Jane Phillips, Susan J Gordon
BACKGROUND: Pneumatic compression has been used for more than 40 years in the management of lymphedema (LE). Modes of application have evolved with little consensus regarding optimal treatment parameters or dosage. The aim of this systematic review was to report the evidence for dosage of intermittent pneumatic compression (IPC) for people with LE and, particularly, that for upper versus lower limbs or child versus adult dosage. METHODS: Medline, Embase, CINAHL, PubMed, and Scopus were searched with terms, including LE and IPC devices, with no restriction on time...
October 19, 2018: Lymphatic Research and Biology
Gülbin Ergin, Ertan Şahinoğlu, Didem Karadibak, Tuğba Yavuzşen
BACKGROUND: Complex decongestive physiotherapy (CDP) is an effective treatment for patients with breast cancer-related lymphedema (BCRL). Bandaging is an important component of CDP. Although the literature suggests that bandages must be kept on for about 24 hours, some patients cannot tolerate keeping them on for this length of time. Also, it has been observed that limb volume decreased in patients who did not keep bandages on for 24 hours in clinical trials. But there is no evidence that this reduction in time is statistically significant...
October 19, 2018: Lymphatic Research and Biology
Katarzyna Ochalek, Hugo Partsch, Tomasz Gradalski, Zbigniew Szygula
BACKGROUND: In a previous randomized controlled trial it has been demonstrated that arm compression sleeves worn immediately after breast cancer surgery, including axillary lymph node removal in addition to physical therapy are able to reduce the occurrence of early postoperative swelling and of arm lymphedema up to 1 year and to improve quality of life. The aim of the present investigation was to check the further development of the arm swelling in patients using compression sleeves or not, and to compare the quality of life in women treated due to breast cancer 2 years after surgery...
October 19, 2018: Lymphatic Research and Biology
Harvey N Mayrovitz
BACKGROUND: Tissue dielectric constant (TDC) measurements as an index of local tissue water are useful in a range of applications most notably to characterize and assess lymphedema. Once a measuring device is applied to skin and a result is obtained in less than 10 seconds, but multiple sites may be required and use of the standard triplicate measurements may be time prohibitive. Thus, this study's goal was to provide data from which informed judgments could be made as to the impact of making a single measurement to reduce expended clinic time...
October 19, 2018: Lymphatic Research and Biology
Yaqi Zhang, Yingnan Bai, Qing Jing, Juying Qian
Cardiac lymphatic vessels play a vital role in maintaining cardiac homeostasis both under physiological and pathological conditions. Clearer illustration of the anatomy of cardiac lymphatics has been achieved by fluorescence exhibition comparing to dye injection. Besides, identification of specific lymphatic markers in recent decades paves the way for researches in development and regeneration of cardiac lymphatics, such as VEGF-C/VEGFR-3, EphB4/ephrin-B2, Prox-1, Podoplanin, and Lyve-1. Knocking out each of these markers in mice model also reveals the signaling pathways instructing the formation of cardiac lymphatics...
October 19, 2018: Lymphatic Research and Biology
Brenda J Svensson, Elizabeth S Dylke, Leigh C Ward, Sharon L Kilbreath
BACKGROUND: Bioimpedance spectroscopy (BIS) is commonly used in the assessment and monitoring of lymphedema. This study investigated electrodes as a source of variability that could impact the accuracy of BIS in the clinic and determined if Ag/AgCl electrocardiograph (ECG) electrodes could be used as an alternative to instrument-specific electrodes. METHODS AND RESULTS: Two types of Ag/AgCl electrodes were studied: instrument-specific bioimpedance electrodes (bioimpedance) and single tab ECG electrodes (cardiac)...
October 6, 2018: Lymphatic Research and Biology
Lena Trinh, Pernilla Peterson, Håkan Brorson, Sven Månsson
BACKGROUND: In patients with arm or leg lymphedema, more fat has been found in the epifascial compartment of the edematous limb compared to the healthy limb. However, not much is known about subfascial fat accumulation in these patients. This study aims to investigate the intramuscular and intermuscular fat and muscle/water volume in lymphedema patients. The excess of intramuscular and intermuscular fat volume was also compared to the excess epifascial fat volume, the excess limb volume, and the duration of lymphedema...
October 6, 2018: Lymphatic Research and Biology
Burcu Duyur Cakıt, Secil Pervane Vural, F Figen Ayhan
BACKGROUND: The aim of this prospective clinical study was to compare the long-term efficacy of complex decongestive therapy (CDT) in obese and nonobese patients with breast cancer-related lymphedema (BCRL). MATERIALS AND METHODS: A total of 59 patients (29 obese patients group 1, 30 normoweight overweight patients group 2) with unilateral BCRL were enrolled. All patients underwent CDT that included manual lymphatic drainage, intermittent pneumatic compression pump, multilayer compression bandaging, lymphedema exercises, and skin care...
October 3, 2018: Lymphatic Research and Biology
Myriam Preuß, Renee Killaars, Andrzej Piatkowski de Grzymala, Marcel Binnebösel, Ulf Neumann
BACKGROUND: In the past, measurement of upper limb lymphedema was done by water displacement (WD), which is frequently cited as the gold standard. For various reasons, however, the use of WD is restricted in clinical settings. A more precise and easy-to-use method would be favorable. The high precision of three-dimensional (3D) imaging in comparison to WD has already been reported for healthy subjects. The aim of this study is to determine the validity and reliability of 3D imaging by comparing it to the WD method in women with unilateral upper limb lymphedema...
October 3, 2018: Lymphatic Research and Biology
Marzanna T Zaleska, Waldemar L Olszewski
BACKGROUND: Evaluation of intermittent pneumatic compression (IPC) in lymphedema is classically based on measurements of circumferences and volume of the edematous limb. However, although important, it provides only a general information without insight into what proceeds under the skin with respect to hydromechanical and structural changes. AIM AND METHODS: We present the multimodal evaluation of the effectiveness of IPC device in limb edema by measuring tissue stiffness, fluid pressure, and flow volume, and lymphoscintigraphic and near-infrared fluorescence (NIRF) indocyanine green (ICG) lymphography imaging of edema fluid movement, before and after one 45-60 minute compression cycle in over 50 patients with lymphedema stage II and III...
October 3, 2018: Lymphatic Research and Biology
Megan L Steele, Monika Janda, Dimitrios Vagenas, Leigh C Ward, Bruce H Cornish, Robyn Box, Susan Gordon, Melanie Matthews, Sally D Poppitt, Lindsay D Plank, Wilson Yip, Angela Rowan, Hildegard Reul-Hirche, Andreas Obermair, Sandra C Hayes
BACKGROUND: Bioimpedance spectroscopy detects unilateral lymphedema if the ratio of extracellular fluid (ECF) between arms or between legs is outside three standard deviations (SDs) of the normative mean. Detection of bilateral lymphedema, common after bilateral breast or gynecological cancer, is complicated by the unavailability of an unaffected contralateral limb. The objectives of this work were to (1) present normative values for interarm, interleg, and arm-to-leg impedance ratios of ECF and ECF normalized to intracellular fluid (ECF/ICF); (2) evaluate the influence of sex, age, and body mass index on ratios; and (3) describe the normal change in ratios within healthy individuals over time...
October 2, 2018: Lymphatic Research and Biology
Jeremy A Goss, Reid A Maclellan, Arin K Greene
BACKGROUND: Primary idiopathic lymphedema is an uncommon condition that typically affects the lower extremities. Patients have a malformed lymphatic system that causes subcutaneous fluid and adipose deposition. Rarely, the disease also has been described in the upper extremities. The purpose of this study was to investigate a cohort of patients with primary arm lymphedema to better understand the disease. METHODS: Patients evaluated in our Lymphedema Program between 2008 and 2018 were reviewed for individuals with upper extremity primary lymphedema...
October 2, 2018: Lymphatic Research and Biology
Zhi Zheng, Kun Ren, Xiaoshan Peng, Xiao Zhu, Guanghui Yi
Many basic and clinical studies have demonstrated that atherosclerosis is a chronic inflammatory disease. Although there are many factors affecting atherosclerosis, the role of lymphatic vessels in this disease has been neglected. Traditionally, lymphatic vessels have been considered to be passages for transporting interstitial fluid to the blood circulation. However, as early as the last century, researchers found that there are numerous lymphatic vessels surrounding sites of atherosclerosis; however, the relationship between lymphatic vessels and atherosclerosis is not clear...
September 29, 2018: Lymphatic Research and Biology
Zeynep Erdogan Iyigun, Filiz Agacayak, Ahmet Serkan Ilgun, Filiz Elbuken Celebi, Cetin Ordu, Gul Alco, Alper Ozturk, Tomris Duymaz, Fatma Aktepe, Vahit Ozmen
BACKGROUND: Early detection of lymphedema gives an opportunity for effective and successful treatment of lymphedema. However, the current diagnosis methods, except the bioimpedance analysis, perometry, and indocyanine green lymphography, have limitations in detecting early stage lymphedema. Sonoelastography is a diagnostic ultrasound technique that provides an opportunity to estimate soft tissue stiffness. Shear wave elastography (SWE) is a brand new elastography technique. Unlike strain elastography, this method is conducted automatically, that is, independently of user's manual tissue compression...
September 13, 2018: Lymphatic Research and Biology
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