• Title/Summary/Keyword: Lymphatic System

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Physical Therapy Approach and Management for Lymphedema : Expert Opinion (림프부종의 물리치료적 접근과 관리 : 전문가 견해)

  • Lee, Hwa-Gyeong;Kim, Seong-Yeol;Choi, Kyoung-Wook
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.3
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    • pp.73-84
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    • 2022
  • Background : Lymphedema is a progressive disorder characterized by the impairment of lymph flow from tissues to the blood circulation system. This occurs as a result of damage to the lymphatic system. Complex decongestive therapy (CDT) is a multimodal, conservative therapeutic approach that is used for the management of lymphedema. CDT consists of a combination of compression therapy, manual lymphatic drainage, exercise, and skin care. Purpose : This study aimed to provide a review of available physical therapy interventions as well as general care guidelines for patients with lymphedema. Methods : The recommendations and guidelines for physical therapy management, medical management, and general information were reviewed from the following sources: 1) The American Physical Therapy Association, 2) The Norton School of Lymphatic Therapy, and 3) The International Society of Lymphology. This review contains general information, including the medical management and the importance of physical therapy in lymphedema. Physical therapy management should be based on an assessment of the patients' presenting impairments, including based on inclusion or exclusion of physical therapy interventions. This review also outlines a step-by-step approach that starts with disease diagnosis and progression all the way through to rehabilitation as an outpatient. Conclusion : Depending on the patients' journey to recovery and the requirement for rehabilitation, physical therapy interventions should focus on the patients' needs including pain, appearance, physical function and general rehabilitation. We hope that this review will provide information on evidence-based physical therapy and general care to patients with lymphedema.

A Case of Huge Cystic Hygroma with the Use of OK-432 (거대 경부 낭성수종 환자에서의 OK-432 치료 1 예)

  • Lee, In-Hyo;Kim, Jung-Eun;Kim, Young-Jae;Kim, Dong-Wook
    • Korean Journal of Bronchoesophagology
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    • v.16 no.1
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    • pp.59-63
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    • 2010
  • Cystic hygroma is a rarc congenital malformation of the lymphatic system and seen rarely in adults. It represents an error in communication between the large draining lymphatic channels and the venous system, Conventional surgical excision remains the most popular method of treatment in many developing countries despite the dangers associated with treatment modality. We present a case of huge cervical cystic hygroma in a 26-year old female who was treated with OK-432 sclerotherapy.

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TREATMENT OF LYMPHANGIOMA BY SURGICAL EXCISION AND SCLEROTHERAPY WITH OK-432 : A CASE REPORT (외과적 절제술과 OK-432 경화요법을 병용한 임파관종의 치료: 증례보고)

  • Cho, Ju-Yeon;Cha, Du-Won;Baek, Sang-Heum;Lee, Ju-Duck
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.3
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    • pp.267-271
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    • 2006
  • Lymphangiomas are benign tumors of the lymphatic system characterized by congenital lymphatic malformation such as anastomosis or obstruction of the lymphatic channels. They are most frequently diagnosed in children younger than 2 years, and the lymphangiomas in head and neck represent about 50-75% of all lymphangiomas. Spontaneous regression is rare, and rapid enlargement occurs secondary to infection or trauma. Enlargement may cause serious sequence such as airway obstruction, feeding difficulties, and cosmetic problems. Treatments previously used for lymphangiomas include surgical excision and intralesional injection of sclerosing agents. Problems associated with surgical excision include the risk of scarring, damage to surrounding vital structure and the high risk of incomplete excision. The sclerosing agents previously used have numerous local and systemic side effects as their problems. We present a case of lymphangioma occured in tongue that was treated by surgical excision and sclerotherapy with OK-432.

Preparation and Mucoadhesive Test of CSA-loaded Liposomes with Different Characteristics for the Intestinal Lymphatic Delivery

  • Kim, Hyong-Ju;Lee, Chang-Moon;Lee, Yong-Bok;Lee, Ki-Young
    • Biotechnology and Bioprocess Engineering:BBE
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    • v.10 no.6
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    • pp.516-521
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    • 2005
  • Drug delivery to the lymphatic system may be important in terms of the treatment with lymphatic involvement, such as tumor metastases and immunization. Especially, drug transport via the intestinal lymphatics after oral administration has been attracted lots of interests. The purpose of this study was to prepare cyclosporin A (CSA)-loaded liposomes, with different characteristics, and evaluate their mucoadhesivity. Three liposome preparations were formulated: cationic stearylamine liposomes (SA-Lip), anionic phosphatidylserine liposomes (PS-Lip), Polymer (chitosan)-coated liposomes (CS-Lip), and characterized. The liposome preparations were found to be spherical in shape, with PS-Lip being the smallest. The liposome preparations exhibited entrapment efficiencies in the order: PS-Lip $(52.5{\pm}2.9%)$ > SA-Lip $(48.8{\pm}3.3%)$ > CS-Lip $(41.7{\pm}4.2%)$. Finally, mucoadhesive tests were carried out using rat intestine, with SA-Lip (67%) showing the best adhesive rate of the three preparations (PS-Lip: 56%, CS-Lip: 61%). These results suggest that a positive charge on the surface of drug carriers may be an important factor for the intestinal drug delivery.

Bleomycin Sclerotherapy of Lymphatic Maformation in Head and Neck (Bleomycin을 이용한 선천성 림프관기형의 경화요법)

  • 성명훈;장선오;정종우;김진영
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.108-108
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    • 1993
  • Cystic hygroma is a congenital anomaly of the lymphatic system for which the exact pathogenetic mechanism remains to be elucidated. It is filled with lymphatic fluid and commonly present in the cervical area in either single isolated or multiple form. It is usually innocuous without any pain but may be life-threatening when it is large enough to compromise the airway or interfere with swallowing. Since spontaneous regressions rarely occur, it requires surgical removal. However, this may be rendered difficult in multiple forms and in those with extensive infiltration into the surrounding tissue. This is a presentation of 10 pediatric patients with cystic hygroma who have been successfully treated by sclerotherapy using bleomycin at the authors' department.

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The Effect of Manual Lymphatic Drainage on the Stress and Pain in Patient with Postoperative Breast Cancer

  • Ko, Mingyun
    • Physical Therapy Rehabilitation Science
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    • v.10 no.2
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    • pp.141-146
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    • 2021
  • Objective: This study was at investigated the effects of manual lymphatic drainage (MLD) on stress and pain in patients with postoperative breast cancer. Design: A randomized controlled trial. Methods: A total of twenty-two patients with postoperative breast cancer voluntarily participated in the study. Subjects were randomly assigned to the MLD groups (n=12) and rest groups (n=12). The intervention was conducted in each group for twenty minutes a day, five times a week, for four weeks. Before and after the intervention, the participants measured sympathetic nerve, parasympathetic nerve, and pain by using a sphygmograph and short-form McGill pain questionnaire.An independent t-test was used to analyze pretest and posttest changes between the groups, a paired t-test was used to analyze pre-posttests within each group. Results: After analyzing, the MLD group has been shown a significant decrease in the sympathetic nervous system (p<0.05), a significant increase in the parasympathetic nervous system (p<0.05), and a significant increase in pain (p<0.05). However, the rest group was no significant difference between pre and post. Conclusions: The results of this study confirmed that MLD techniques are an effective method in reducing stress and pain in patients with postoperativebreast cancer. And it is thought that can be used as basic data and to develop programs on stress and pain management reduction for patients with breast cancer.

Cavernous Lymphangioma Arising in the Chest Wall 19 Years after Excision of a Cystic Hygroma

  • Lee, Woo-Surng;Kim, Yo-Han;Chee, Hyun-Keun;Lee, Song-Am;Kim, Jong-Duk;Kim, Dong-Chan
    • Journal of Chest Surgery
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    • v.44 no.5
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    • pp.380-382
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    • 2011
  • Lymphangioma is a congenital malformation of the lymphatic system and is thought to result from the failure of the lymphatic system to connect with the venous system. Lymphangioma of the chest wall is a very rare disease entity, and only a few cases have ever been documented in the literature. To the best of our knowledge, there have been few cases of recurrent cavernous lymphangioma after surgical excision of a cystic hygroma on the same side of the chest wall. Here, we report a case of a cavernous lymphangioma of the chest wall in a patient who had undergone surgical excision of a cystic hygroma 19 years earlier.

A Case of Infected Huge Lymphangioma in Pelvic Cavity (골반강에 발생한 감염된 거대 림프관종 1예)

  • Choi, Woo-Seok;Lee, Seong-Ho;Chung, Seok-Young;Song, Phil-Hyun;Baek, Un-Gi;Cho, Chul-Kyu;Park, Tong-Choon;Choi, Joon-Hyuk
    • Journal of Yeungnam Medical Science
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    • v.19 no.1
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    • pp.63-67
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    • 2002
  • Lymphangioma is a benign tumor resulted from abnormal communication between large dermal lymphatic channels and central lymphatic system. The tumor is encountered more often in the neck and axilla and less often in mediastinum, omentum, retroperitoneum, and scrotum. It rarely developes at urogenital system, and there has been no previous description of lymphangioma involving the bladder wall in Korea. We report a case of 35-year-old female with infected huge lymphagioma ansing from pelvic cavity and involving bladder wall.

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Evaluation of Error Factors in Quantitative Analysis of Lymphoscintigraphy (Lymphoscintigraphy의 정량분석 시 오류 요인에 관한 평가)

  • Yeon, Joon-Ho;Kim, Soo-Yung;Choi, Sung-Ook;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.76-82
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    • 2011
  • Purpose: Lymphoscintigraphy is absolutely being used standard examination in lymphatic diagnosis, evaluation after treatment, and it is useful for lymphedema to plan therapy. In case of lymphoscintigraphy of lower-extremity lymphedema, it had an effect on results if patients had not pose same position on the examination of 1 min, 1 hour and 2 hours after injection. So we'll study the methods to improve confidence with minimized quantitative analysis errors by influence factors. Materials and Methods: Being used the Infinia of GE Co. we injected $^{99m}Tc$-phytate 37 MBq (1.0 mCi) 4 sylinges into 40 people's feet hypodermically from June to August 2010 in Samsung Medical Center. After we acquired images of fixed and unfixed condition, we confirmed the count values change by attenuation of soft tissue and bone according to different feet position. And we estimated 5 times increasing 2 cm of distance between $^{99m}Tc$ point source and detector each time to check counts difference according to distance change by different feet position. Finally, we compared 1 and 6 min lymphoscintigraphy images with same position to check the effect of quantitative analysis results owing to difference of amounts of movement of the $^{99m}Tc$-phytate in the lymphatic duct. Results: Percentage difference regarding error values showed minimum 2.7% and maximum 25.8% when comparing fixed and unfixed feet position of lymphoscintigraphy examination at 1 min after injection. And count values according to distance were 173,661 (2 cm), 172,095 (4 cm), 170,996 (6 cm), 167,677 (8 cm), 169,208 counts (10 cm) which distance was increased interval of 2 cm and basal value was mean 176,587 counts, and percentage difference values were not over 2.5% such as 1.27, 1.79, 2.04, 2.42, 2.35%. Also, Assessment results about amounts of movement in lymphatic duct within 6 min until scanning after injection showed minimum 0.15%, and maximum 2.3% which were amounts of movement. We can recognize that error values represent over 20% due to only attenuation of soft tissue and bone except for distance difference (2.42%) and amounts of movement in lymphatic duct (2.3%). Conclusion: It was show that if same patients posed different feet position on the examination of 1 min, 1 hour and 2 hours after injection in the lymphoscintigraphy which is evaluating lymphatic flow of patients with lymphedema and analyzing amount of intake by lymphatic system, maximum error value represented 25.8% due to attenuation of soft tissue and bone, and PASW (Predictive Analytics Software) showed that fixed and unfixed feet position was different each other. And difference of distance between detector and feet and change of count values by difference of examination beginning time after injection influence on quantitative analysis results partially. Therefore, we'll make an effort to fix feet position and make the most of fixing board in lymphoscintigraphy with quantitative analysis.

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