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Lymphoscintigraphy
Published in Michael Ljungberg, Handbook of Nuclear Medicine and Molecular Imaging for Physicists, 2022
Rimma Axelsson, Maria Holstensson, Ulrika Estenberg
The most common pathological condition with obstruction of lymphatic pathways is called lymphedema. When lymph remains in tissues for some time it will cause progressive and chronic swelling, fat deposition, scarring, and immunosuppression [2]. Lymphedema is divided into two categories – primary (as a congenital disorder with absence of or deficiency of lymphatic vessels [3]) and secondary. Secondary lymphedema can be caused by infections, inflammatory diseases, trauma, or cancer treatments. It is a widespread condition, and about 120 million people in developing countries have lymphedema due to a parasitic infection known as lymphatic filariasis [4], and 10 million people in the Western world have it as a complication after previous cancer treatments, such as surgery or radiation therapy. Lymphedema commonly affects one of the arms or legs but can also be bilateral. In rare cases it can be presented by swelling of the genitals or chest. Lymphedema is incurable, but the right treatment can help reduce the swelling and pain. It can be treated conservatively by Complex Decongestive Therapy (CDT) or, in limited cases, by surgery (transplantation of lymph nodes and vessels, by-pass procedure or liposuction). CDT is initially performed by specially trained lymphedema therapists who will train patients to perform the treatment themselves. CDT consists of four components: (1) Manual lymphatic drainage, or a special massage technique that aims to stimulate an increased flow in the remaining lymphatic pathways; (2) compression therapy in the form of multi-layered bandaging; (3) dermatological skin care to prevent skin infection, and (4) physical training, with light exercises aimed at encouraging movement of the lymph fluid out of the limb.
Biomimetic Microsystems for Blood and Lymphatic Vascular Research
Published in Hyun Jung Kim, Biomimetic Microengineering, 2020
Secondary lymphedema, a major form of lymphedema (~90% by etiology), is an acquired formation of lymphedema that can be caused by lymphatic filariasis (a parasitic disease), lymph node dissection, tumor excision, trauma, infection, inflammation, fibrosis, obesity, and vascular anomaly (Rockson 2014). There is still no clinically available drug treatment, and the standard nonoperative care (e.g., limb elevation, compression garment, decongestive therapy) is largely palliative. Other operative managements (e.g., lymphaticovenular anastomosis, vascularized lymph node transfer) are highly invasive and involve complications.
The application of indocyanine green (ICG) and near-infrared (NIR) fluorescence imaging for assessment of the lymphatic system in reconstructive lymphaticovenular anastomosis surgery
Published in Expert Review of Medical Devices, 2021
Albert H. Chao, Steven A. Schulz, Stephen P. Povoski
Lymphedema is a chronic condition of pathological swelling or volume increase within tissues due to dysfunction of the lymphatic system, which results in retention of fluid, and in more advanced stages collagen formation and cellular proliferation of adipocytes and fibroblasts[5]. Primary lymphedema is caused by abnormal development of the lymphatic system. Secondary lymphedema is relatively more common and results from injury to a normally developed lymphatic system, such as due to infection, surgery, or radiation therapy. Symptoms of lymphedema include swelling, enlargement, heaviness, and pain in the affected tissues, as well as an increased propensity for soft tissue infections. These changes are responsible for the reduced quality of life and substantial morbidity experienced by patients with lymphedema.
A fully coupled fluid-structure interaction model of the secondary lymphatic valve
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2018
John T. Wilson, Lowell T. Edgar, Saurabh Prabhakar, Marc Horner, Raoul van Loon, James E. Moore
In conclusion, we have implemented a fully coupled FSI model of the rat mesenteric secondary lymphatic valve. This model allowed us to calculate the valve resistance to favorable pressure, an important parameter regulating lymphatic pumping. We also observed significant hysteresis during valve opening and closing. This calculated valve resistance presents the most accurate estimation to date and can be used to update future models of lymphatic pumping, providing further insight into the complex fluid dynamics of the lymphatic system. A better understanding of lymphatic pumping is important in understanding basic physiological processes such as fluid balance and immune function. Pathologies involving lymphatic dysfunction (including valve malformation) include primary and secondary lymphedema, which is currently an incurable condition.