BACKGROUND
Methylene blue (MB) is a conventional lymphatic tracer. We evaluated the application of indocyanine green (ICG) lymphography combined with MB staining in lower limb lymphaticovenular anastomosis (LVA).


METHODS
A total of 49 patients with lower limb lymphedema were selected as the study subjects and divided into the research (n = 27) and control groups (n = 22). The patients were treated with LVA using ICG lymphography combined with MB staining and simple ICG lymphography as the positioning method, respectively. The number of lymphatic vessels anastomosed and the operating time were compared between the groups. Lower Extremity Lymphedema Index (LEL index) and Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL) were used as prognostic indices; 6 months after LVA, both groups were evaluated for the symptomatic relief of lymphedema.


RESULTS
The number of anastomotic lymphatic vessels in the study group was higher than that in the control group (p < .05), and their procedural time was shorter than that in the control group. The two groups had no significant difference in lymphatic anastomosis time (p > .05). The LEL index and Lymph-ICF-LL of the research and control groups at 6-month follow-up after LVA were lower than those before the operation (p < .05).


CONCLUSION
The circumference of the affected limb is reduced after LVA in patients with lower extremity lymphedema with a favorable prognosis. ICG lymphography combined with MB staining has the advantages of real-time visualization and accurate localization.

Application of indocyanine green lymphography combined with methylene blue staining in lymphaticovenular anastomosis of lower limb vessels: A prospective study.

Tissue dielectric constant (TDC) values assess certain skin properties that are dependent on multiple factors but mainly on the relative amount of water content within a locally measured tissue volume. Because of the non-invasive nature of these measurements and their ease of use, the method has been widely used in various medically related applications. The goal of this paper was to review and describe the uses and findings of such TDC measurements, considering and including the wide array of medical applications. The review is in part based on information derived from an analysis of published material obtained via literature searches of four major electronic databases and, in part, based on the author’s experience with the TDC measurement methods and their various applications and his professional experiences. The databases searched were PubMed, Web of Science, EMBASE, and CINAHL Complete. Based on the initial search criteria, a total of 1257 titles were identified. After removing duplicates and filtering according to relevancy, 160 remained for detailed further review. In some cases, the bibliography of these retrieved articles provided additional sources. The findings demonstrate multiple research and medical uses and applications of TDC measurements, focusing on detecting and quantifying localized edema and lymphedema in multiple target sites. These include the upper and lower extremities, breasts, and trunk as regions involved in medical conditions causing lymphedema. In addition, the findings suggest that TDC evaluations are a convenient, non-invasive method to study and evaluate other conditions impacting skin, including diabetes mellitus and skin wounds or ulcers. Its ability to detect aspects of tissue changes simply and rapidly at almost any anatomical location makes it a useful tool for investigating multiple dermatological conditions and their treatment as future applications of this method.

Medical Applications of Skin Tissue Dielectric Constant Measurements

Objective To investigate the impact of diaphragmatic breathing combined with limb training on lower limb lymphedema following surgery for gynecological cancer. Methods From January 2022 to May 2022, 60 patients with lower limb lymphedema post-gynecologic cancer surgery were chosen. They were split into a control group ( n = 30) and a treatment group ( n = 30). The control group underwent complex decongestive therapy (CDT) for managing lower limb lymphedema after gynecologic cancer surgery, while the treatment group received diaphragmatic breathing combined with limb coordination training alongside CDT. Both groups completed a 4-week treatment regimen. The lower limb lymphedema symptoms were evaluated using the genital, lower limb, buttock, and abdomen (GCLQ) scores; bilateral lower limb circumference measurements; and anxiety and depression scores. Results Compared to sole CDT administration, individuals undergoing diaphragmatic breathing coupled with limb coordination training experienced notable reductions in scores for the self-perceived symptom assessment questionnaire (GCLQ), bilateral lower limb circumference, as well as anxiety and depression scores. Conclusion The incorporation of diaphragmatic breathing combined withalongside limb coordination training can accelerate and augment the efficacy of treating lower limb lymphedema post-gynecologic cancer surgery. 

pdf/the-rehabilitation-efficacy-of-diaphragmatic-breathing-3y9mp3k0yu.pdf

The rehabilitation efficacy of diaphragmatic breathing combined with limb coordination training for lower limb lymphedema following gynecologic cancer surgery

<title>Abstract</title> Chronic edema in the lower extremities leads to significant negative effects on quality of life(QOL), body image perception, satisfaction, self-confidence, and self-esteem of affected individuals. This study aims to evaluate body image, QOL, and related factors in the lower extremity edema.This cross-sectional study includes 14 lymphedema, 12 lipedema patients receiving manual lymphatic drainage(MLD) treatment between December 1–30, 2023. Body image, dysfunctional thoughts about appearance, and QOL were evaluated using the Body Cathexis Scale (BCS), Beliefs About Appearance Scale (BAAS), and Lymphedema Quality of Life (LYMQOL). Circumference measurements of the lower extremities were taken before and after 20 sessions MLD. The mean age was 57.27 ± 11.5. No significant differences were found between the lymphedema and lipedema groups in terms of age, BMI, or pre-treatment BCS, BAAS, and LYMQOL scores (p &gt; 0.05). Improvements in BCS and LYMQOL scores were significantly correlated with reductions in limb circumferences (p &lt; 0.05). Post-treatment, both groups experienced significant improvements in body image and QOL scores, with no significant differences between the groups. It highlights that patients with lower extremity lymphedema and lipedema experience significant body image disturbances and reduced QOL. Early diagnosis and intervention are crucial not only for physical healt but also for enhancing social and mental well-being. 

Body Image and Related Factors in Patients with Lower Extremity Lymphoedema and Lipedema

SUMMARY OBJECTIVE: Chronic edema in the lower extremities leads to significant negative effects on the quality of life, body image perception, satisfaction, self-confidence, and self-esteem of affected individuals. The aim of this study was to evaluate body image, quality of life, and related factors in patients with chronic lower extremity edema due to lymphedema and lipedema. METHODS: This cross-sectional study included 14 lymphedema and 12 lipedema patients receiving treatment at the lymphedema unit. Individuals aged 18–65 years with a confirmed diagnosis were enrolled; those with active infections, malignancies, or systemic diseases were excluded. Body image, dysfunctional thoughts about appearance, and quality of life were evaluated using the Body Cathexis Scale, Beliefs About Appearance Scale, and Lymphedema Quality of Life scale. Circumference measurements of the lower extremities were taken before and after 20 sessions of manual lymphatic drainage therapy. Quantitative data were analyzed to compare the two groups and assess correlations between clinical and psychosocial parameters. RESULTS: No significant differences were observed between the lymphedema and lipedema groups in terms of age, body mass index, or pre-treatment Body Cathexis Scale, Beliefs About Appearance Scale, and Lymphedema Quality of Life scale scores (p&gt;0.05). After 20 sessions of manual lymphatic drainage therapy, both groups showed reductions in limb circumference measurements (p&lt;0.05). Reductions in limb size were moderately associated with improvements in Body Cathexis Scale and Lymphedema Quality of Life scale scores (p&lt;0.05). Post-treatment improvements in body image and quality of life scores were observed in both groups. CONCLUSIONS: This study highlights that patients with lower extremity lymphedema and lipedema experience significant body image disturbances and reduced quality of life. Manual lymphatic drainage therapy improves limb circumference, body image, and quality of life. 

Body image and related factors in patients with lower extremity lymphedema and lipedema: a cross-sectional study

Secondary lower extremity lymphedema is a common complication of treatment for gynecological cancers. Conservative therapy plays an important role in the treatment of patients with secondary lower extremity lymphedema; in particular, complex decongestive therapy (CDT) has been recognized as an effective nonoperative technique for these patients. But CDT therapy for secondary lower extremity lymphedema remains a problem in China because this technique and its effectiveness have not achieved widespread use and popularity. Our goal was to assess effects of CDT in patients with secondary lower limb lymphedema after treatment for gynecological cancers. The retrospective study consisted of 60 patients who were treated with 20 sessions of CDT. Assessments included objective changes in limb circumference, degree of LE, imaging features, and incidence of erysipelas before and after CDT treatment. We found that CDT can effectively improve lymph stasis and promote backflow, and decrease circumference, interstitial fluid content, and incidence of erysipelas of lymphedematous lower limb. Our results demonstrate that CDT is an effective treatment method for patients with secondary lower limb lymphedema following treatment for gynecologic cancers. This technique should be more widely utilized and popularized in China to improve the quality of life of millions of patients with secondary lower limb lymphedema.

Treatment of secondary lower limb lymphedema after gynecologic cancer with complex decongestive therapy.

Activity and safety of preclinical and a phase 1 study of purinostat mesylate, a uniquely potent and selective hdac i/iib inhibitor in relapsed or refractory lymphoma

Preclinical and a phase 1 study of purinostat mesylate, a novel hdac i/iib selective inhibitor, for the treatment of relapsed or refractory multiple myeloma

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Treatment of secondary lower limb lymphedema after gynecologic cancer with complex decongestive therapy.

Activity and safety of preclinical and a phase 1 study of purinostat mesylate, a uniquely potent and selective hdac i/iib inhibitor in relapsed or refractory lymphoma

Preclinical and a phase 1 study of purinostat mesylate, a novel hdac i/iib selective inhibitor, for the treatment of relapsed or refractory multiple myeloma