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Lymphatic Research and Biology

Paloma Triana, Miriam Miguel, Mercedes Díaz, Marta Cabrera, Juan Carlos López Gutiérrez
BACKGROUND: Mechanistic target of rapamycin (mTOR) inhibitors are being used off-label showing promising results in patients with vascular anomalies. Children with lymphatic malformations (LMs) involving the airway benefit from sirolimus therapy soon after birth, reducing the need of tracheostomy. Available information about efficacy and side effects in neonates remains poor. We present seven newborns with severe head and neck LM showing response to sirolimus with no significant toxicity...
April 13, 2019: Lymphatic Research and Biology
Marzanna T Zaleska, Waldemar L Olszewski
OBJECTIVES: Linforoll is a device composed of handpiece with roller and pressure sensor connected wireless to the computer displaying the pressure curve of the applied force. In a previous study, we proved it to regulate the applied force according to the hydromechanic conditions of the massaged tissues. Standardization of massage based on applied force was repeatable in the same patient; it decreased limb volume and provided evident increase in tissue elasticity. AIM: In this study, we measured additional parameters useful for the understanding of tissue and fluid events and approval of the device for general practice...
March 27, 2019: Lymphatic Research and Biology
Jeremy A Goss, Reid A Maclellan, Arin K Greene
BACKGROUND: Primary lymphedema results from the anomalous development of the lymphatic system that typically presents during infancy, childhood, or adolescence. Adult-onset primary lymphedema is rare and has not been studied. The purpose of this investigation was to characterize patients with primary lymphedema that developed after the pediatric time period to better understand the condition. STUDY DESIGN: Patients treated in our Lymphedema Program between 2009 and 2018 were reviewed...
March 27, 2019: Lymphatic Research and Biology
Elizabeth K Eady, Helen D Brasch, Jennifer de Jongh, Reginald W Marsh, Swee T Tan, Tinte Itinteang
AIM: To investigate the expression of embryonic stem cell (ESC) markers in microcystic lymphatic malformation (mLM). METHODS AND RESULTS: Cervicofacial mLM tissue samples from nine patients underwent 3,3'-diaminobenzidine (DAB) immunohistochemical (IHC) staining for ESC markers octamer-binding protein 4 (OCT4), homeobox protein NANOG, sex determining region Y-box 2 (SOX2), Krupple-like factor (KLF4), and proto-oncogene c-MYC. Transcriptional activation of these ESC markers was investigated using real-time polymerase chain reaction (RT-qPCR) and colorimetric in situ hybridization (CISH) on four and five of these mLM tissue samples, respectively...
March 22, 2019: Lymphatic Research and Biology
Jiwon Hong, Cherie Blenkiron, Peter Tsai, Rakesh Premkumar, Shorena Nachkebia, Soe M Tun, Amorita Petzer, John A Windsor, Anthony J Hickey, Anthony R Phillips
BACKGROUND: Mesenteric lymph (ML) has been implicated in the development of multiple organ dysfunction syndrome in critical illness. Extracellular RNAs play a role in cell-to-cell communication during physiological and disease processes but they are rarely studied in ML. We aimed at examining the RNA profiles of peripheral plasma, ML, and ML's extracellular vesicle (ML-EV) and triglyceride-rich lipoprotein (ML-TRL) fractions, obtained from rodent models of critical illness. METHODS AND RESULTS: We collected ML for 5 hours from rodent models of critical illness [Acute Pancreatitis, Cecal Ligation and Incision (CLI), Gut Ischemia-Reperfusion (IR)] and matching Sham control rats...
March 13, 2019: Lymphatic Research and Biology
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March 13, 2019: Lymphatic Research and Biology
Alice Zhi Ting Xie, Mi-Joung Lee, Elizabeth Dylke
BACKGROUND: The use of bioimpedance spectroscopy (BIS) for the detection of unilateral upper limb lymphedema is growing. Currently, normatively determined diagnostic thresholds using bioimpedance are available for females only. It is unclear if they are suitable for males at risk of unilateral upper limb lymphedema. The aim of the present study was to determine normatively based bioimpedance thresholds for male unilateral upper limb lymphedema. METHODS AND RESULTS: Impedance values (R0 ) for the upper limbs of 60 healthy adult male participants were assessed using BIS...
March 5, 2019: Lymphatic Research and Biology
Waldemar L Olszewski, Marzanna T Zaleska, Rajesh Hydrabadi, Mohal Banker, Pallavi Kurulkar
BACKGROUND: Lymphedema of limbs is caused by partial or total obstruction of lymphatic collectors. In advanced cases all main lymphatics are obstructed and tissue fluid accumulates in the interstitial spaces. The microsurgical lympho-venous shunts cannot be performed. We propose in such cases drainage of fluid accumulations by creating artificial flow pathways to the nonobstructed regions by implantation of silicone tubes. AIM: To present the 3 to over 6 year follow-up results of therapy by subcutaneous implantation of silicone tubes...
February 27, 2019: Lymphatic Research and Biology
Janet Douglass, Louise Kelly-Hope
BACKGROUND: Lymphedema is a disease of the skin and subcutaneous tissue resulting from a disturbance in lymph flow. Anyone can be affected, and causes include cancer therapy when lymph nodes are removed or irradiated, the parasitic disease lymphatic filariasis, and damage caused by exposure to irritant soils known as podoconiosis. Manifest lymphedema is progressive and a major contributor to disability, stigma, and social isolation for affected people. Although the pathogenesis of connective tissue changes in lymphedema will follow a similar course regardless of the disease of causation, several systems are used to stage progression...
February 21, 2019: Lymphatic Research and Biology
Tessa De Vrieze, Lore Vos, Nick Gebruers, An De Groef, Lore Dams, Elien Van der Gucht, Ines Nevelsteen, Nele Devoogdt
BACKGROUND: Lymphedema is associated with significant physical and psychosocial problems. The Lymphedema Functioning, Disability and Health questionnaire for upper limb lymphedema is a valid and reliable tool quantifying the amount of problems in functioning in patients with breast cancer-related lymphedema. Patients suggested a revision of the scoring system to facilitate completion of the questionnaire. Therefore, adjustment of the questionnaire was carried out by implementing a numeric rating scale instead of the existing visual analog scale...
February 13, 2019: Lymphatic Research and Biology
Onur Engin, Elif Akalın, Efe Sarıbay, Ceren Aslan, Ebru Şahin, Serap Alper
Aim and Hypothesis: The standard volumeter is heavy and fragile, and using the same volumeter for different patients can result in hygiene problems. These disadvantages point to the need for the development of a new model of volumeter. The new volumeter put forward in this study is lighter, smaller, sturdier, and easier to clean, while also having its own scale. In this study, the validity of this newly designed volumeter is investigated. MATERIALS AND METHODS: In the first step, the volume of standard cylinders was measured thrice using a standard volumeter and an easy-measurement volumeter, after which a total of 30 arm volumes of 15 volunteers were measured...
February 8, 2019: Lymphatic Research and Biology
Harvey N Mayrovitz
BACKGROUND: Lower extremity swelling accompanies many conditions, including gynecological surgery and chronic venous dysfunction. Some clinical and quantitative assessment methods exist, but other ways to rapidly assess early lymphedema and track changes are needed. Our goal was to use lower to upper extremity intraside tissue dielectric constant (TDC) ratios with the specific aim of providing normal reference values potentially useful as a comparison measure against which persons at risk for lower extremity lymphedema might be evaluated...
January 30, 2019: Lymphatic Research and Biology
Iris M Lu, J Brandon Dixon
BACKGROUND: There are various methods of detecting and monitoring arm lymphedema after breast cancer (BC) treatment. Using volumetric measurements is the most common method performed clinically in the United States, and several techniques exist. Recently, the use of infrared cameras has been explored by several groups. This study shows the use of this technology and its ability to assess arm volume measurements comparable to the Perometer while being more inexpensive, having a smaller footprint in clinics, and being easy to use...
January 29, 2019: Lymphatic Research and Biology
Hin-Lun Liu, Joseph Chun-Kit Chung
INTRODUCTION: Vascularized lymph node transfer (VLNT) has become the established treatment for secondary lymphedema. The proposed mechanisms of VLNT include lymphangiogenesis and absorptive action of transplanted lymphatic tissue. Therefore, in theory, the lymph node content of lymph node flap is crucial to clinical response. The supraclavicular lymph node flap (SCLNF) has been described as one of the flap options for VLNT. However, its lymph node content has not been fully studied. The aim of this study is to find out the lymph node content of SCLNF with histological examination...
January 29, 2019: Lymphatic Research and Biology
Christine J Moffatt, Vaughan Keeley, Andrew Hughes, Kath Clark, Jill Lisle, Margaret Benson, Rebecca Gaskin, Martina Sykorova, Eleanor Dring, Susie Murray, Gregoire Mercier, Isabelle Quere, Peter J Franks
Background and Study Design: This study was undertaken as part of the UK LIMPRINT international study to determine the number of people with chronic edema (CO) and its impact on health services. Overall 7436 with CO were recruited in the main UK study from a range of health settings. Methods and Results: Factors relating to subjective control of arm and leg CO were defined in the UK. A total of 1565 patients were included in the study with exclusions for: no limb swelling or not recorded (1669), having concurrent arm/leg CO (272), control of assessment missing (5) and professional being unsure of control status of CO (325)...
April 2019: Lymphatic Research and Biology
Vaughan Keeley, Peter Franks, Isabelle Quere, Gregoire Mercier, Sandro Michelini, Marina Cestari, Pinar Borman, Andrew Hughes, Kath Clark, Jill Lisle, Margaret Benson, Susan Noerregaard, Tonny Karlsmark, Susie Murray, Christine Moffatt
Background: There is no standardized international model for specialist lymphedema services, which covers the types of lymphedema treated and the treatments provided. The aim of this study was to provide a profile of patients attending specialist lymphedema services in different countries to explore similarities and differences. Methods and Results: The LIMPRINT core tool was used in specialist lymphedema services in the United Kingdom, France, Italy, and Turkey. Services in Turkey saw a slightly younger age group, with a higher proportion of female patients reflecting a particular focus on breast cancer-related lymphedema...
April 2019: Lymphatic Research and Biology
Misako Dai, Gojiro Nakagami, Junko Sugama, Noriko Kobayashi, Emiko Kimura, Yoko Arai, Aya Sato, Gregoire Mercier, Christine Moffatt, Susie Murray, Hiromi Sanada
Background: This was a part of LIMPRINT (Lymphoedema IMpact and PRevalence-INTernational), an international study aimed at capturing the size and impact of lymphedema and chronic edema in different countries and health services across the world. The purpose of this study was to clarify the prevalence and the impact of chronic edema in Japan. Methods and Results: This was a two-phase facility-based study to determine the prevalence and functional impact of chronic edema in the adult population in Japan between 2014 and 2015...
April 2019: Lymphatic Research and Biology
Susan Nørregaard, Susan Bermark, Tonny Karlsmark, Peter J Franks, Susie Murray, Christine J Moffatt
Background: The International Lymphedema Framework developed an international study, Lymphedema Impact and Prevalence International (LIMPRINT), to estimate the prevalence and impact of chronic edema (CO) in heterogeneous populations. Methods and Results: A validation study using the LIMPRINT methodology was undertaken in Denmark. Participants with CO were identified from inpatient services and compared with those identified within a specialist lymphedema service and three primary care settings. Of 452 inpatients available for screening, CO was present in 177 (39%) and absent in 275 (61%)...
April 2019: Lymphatic Research and Biology
Pinar Borman, Christine Moffatt, Susie Murray, Aysegul Yaman, Merve Denizli, Meltem Dalyan, Sibel Unsal-Delialioğlu, Sibel Eyigör, Figen Ayhan, Burcu Duyur Çakıt, Secil Vural, Oya Özdemir, Eda Kurt, Evrim Coşkun Çelik, Lale Cerrahoğlu, Müge Kepekçi, Fusun Terzioğlu, Ayşe Arikan Donmez
Background: Lymphedema and chronic edema is a major health care problem in both developed and nondeveloped countries The Lymphoedema Impact and Prevelance - International (LIMPRINT) study is an international health service-based study to determine the prevalence and functional impact in adult populations of member countries of the International Lymphoedema Framework (ILF). Methods and Results: A total of 1051 patients from eight centers in Turkey were recruited using the LIMPRINT study protocol. Data were collected using the core and module tools that assess the demographic and clinical properties as well as disability and quality of life (QoL)...
April 2019: Lymphatic Research and Biology
Isabelle Quéré, Sylvie Palmier, Susan Noerregaard, Jenica Pastor, Martina Sykorova, Eleanor Dring, Peter J Franks, Susie Murray, Vaughan Keeley, Susan Bermark, Tonny Karlsmark, Norah Kyne, Mary-Paula Colgan, Marie-Michelle Coulombe, Sandrine Mestre, Gregoire Mercier, Christine J Moffatt
Background: To estimate the prevalence of lymphedema/chronic edema (CO) and wounds in acute hospital inpatients in five different countries. Methods and Results: A point-prevalence study was carried out during working day periods in six general hospitals in four countries (Denmark, France, United Kingdom, and Australia) and one hospital oncology inpatient unit in one other country (Ireland). The study used validated clinical tools for the assessment and collection of data. Data were collected by expert clinicians through interviews and physical examination of the patients present in the wards...
April 2019: Lymphatic Research and Biology
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