The accuracy of lymphatic ultrasound in measuring the lymphatic vessel size in lower limb lymphedema patients

2021 ◽  
Author(s):  
Hisako Hara ◽  
Makoto Mihara
Keyword(s):  
Lower Limb ◽  
Lymphatic Vessel ◽  
Vessel Size

238. Endometrial vessel morphology is altered following progestin treatment in a mouse xenograft model

2008 ◽  
Vol 20 (9) ◽  
pp. 38
Author(s):  
J. F. Donoghue ◽  
J. E. Girling ◽  
P. A. W. Rogers
Keyword(s):  
Blood Vessel ◽  
Lymphatic Vessel ◽  
Xenograft Model ◽  
Treated Group ◽  
Vessel Density ◽  
Control Group ◽  
Vessel Size ◽  
Mouse Xenograft ◽  
Mouse Xenograft Model ◽  
Progestin Treatment

Human endometrium undergoes cyclic changes under the influence of oestrogen and progesterone. When progestins are used for contraception, the endometrium regresses and breakthrough bleeding often occurs. The aim of this study was to investigate the short-term effects of progestin on human endometrium in a mouse xenograft model. Uterine tissue was placed subcutaneously into NOD/SCID mice (n = 12). Mice were given estradial valerate every fourth day for two weeks. Mice then received an implant containing medroxyprogesterone acetate (MPA) or an empty implant. After two weeks, mice were dissected and the xenografts formalin fixed and serially sectioned (5µm) for immunohistochemical analysis. Sections were double immunostained for α-smooth muscle actin and either FVIII (blood vessels) or D2–40 (lymphatic vessels). The endometrium from the progestin treated group contained decidual-like stroma cells and glandular epithelium with morphology ranging from squamous to columnar. The endometrium from the control group also contained fibroblast-like stromal cells and glandular epithelium with tall columnar epithelium. The endometrial blood vessel density was significantly reduced in the progestin-treated group (156.3 ± 13.4 vessel profiles/mm2) compared with the control group (273.5 ± 41.5 vessel profiles/mm2) (P = 0.02); there was no significant difference in lymphatic vessel density (progestin: 43.5 ± 5.9 v. control: 35.6 ± 9.6 vessel profiles/mm2). Blood vessel area was significantly increased in the progestin-treated group (3.7x10−4 ± 1.7x10−5 mm2) compared with controls (1.8x10−4 ± 1.2x10−5 mm2) (P = 0.0001) and the lymphatic v essel area was also significantly increased in the progestin-treated group (8.8x10−4 ± 7.8x10−5 mm2) compared with controls (2.9x10−4 ± 5.7x10−5 mm2) (P = 0.0001). This work has provided a model for the study of human endometrial vasculature, illustrating a significant increase in blood and lymphatic vessel size during progestin treatment. The increase in blood vessel size was associated with a significant reduction in blood vessel density in progestin treated samples.

scholarly journals Computed tomography lymphangiography findings in 27 cases of lymphangioleiomyomatosis

2017 ◽  
Vol 58 (11) ◽  
pp. 1342-1348 ◽  
Author(s):  
Chunyan Zhang ◽  
Xiaobai Chen ◽  
Tingguo Wen ◽  
Qijin Zhang ◽  
Meng Huo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Contrast Agent ◽  
Lower Limb ◽  
Lymphatic Vessel ◽  
Abdominal Cavity ◽  
Lymphatic Vessels ◽  
Outlet Obstruction ◽  
Pelvic Cavity ◽  
Lung Cysts ◽  
Abnormal Distribution

Background Lymphangioleiomyomatosis (LAM) is a rare disease involving the bronchi, lymphatic vessels, and veins. However, there are few reports about lymphatic vessel abnormalities associated with LAM. Purpose To evaluate computed tomography (CT) lymphangiography findings in cases of LAM, especially lymphatic vessel abnormalities. Material and Methods Twenty-seven patients with LAM underwent direct lymphangiography (DLG), followed by a post-procedural thoracoabdominal CT examination. Results All 27 patients were diagnosed with LAM, including 25 (93%) with chylothorax, eight (30%) with chyloperitoneum, seven (26%) with chylous fluid in the chest and abdomen, and one (4%) with lower-limb lymphedema. The CT lymphangiography showed that 27/27 (100%) patients presented iliac or retroperitoneal lymphatic vessel dilation; 20/27 (74%) presented thoracic duct outlet obstruction; 9/27 (33%) presented pleural lymph leakage; and 13/27 (48%) presented an abnormal distribution of contrast agent in the contralateral lumbar trunk, 3/27 (11%) in the pulmonary field, 1/27 (4%) in the abdominal cavity, and 4/27 (15%) in the pelvic cavity. Five of the 27 patients (19%) had retroperitoneal lymphangioleiomyomas, with contrast agent accumulation in three cases during CT lymphangiography. Two of the 27 (7%) patients had enlarged lymph nodes in the retroperitoneum. All 27 patients (100%) diagnosed with LAM displayed various lung cysts on thoracic high-resolution CT scans. Conclusion CT lymphangiography findings can be used to diagnose most LAM cases accurately. Moreover, these findings also display the various lymphatic vessel abnormalities associated with LAM.

Site Specific Evaluation of Lymphatic Vessel Sclerosis in Lower Limb Lymphedema Patients

2018 ◽  
Vol 16 (4) ◽  
pp. 360-367 ◽  
Author(s):  
Makoto Mihara ◽  
Hisako Hara ◽  
Yoshihisa Kawakami ◽  
Han Peng Zhou ◽  
Shuichi Tange ◽  
...  
Keyword(s):  
Lower Limb ◽  
Lymphatic Vessel ◽  
Site Specific ◽  
Specific Evaluation

scholarly journals Usefulness of preoperative echography for detection of lymphatic vessels for lymphaticovenous anastomosis

2017 ◽  
Vol 5 ◽  
pp. 2050313X1774520 ◽  
Author(s):  
Hisako Hara ◽  
Makoto Mihara
Keyword(s):  
Indocyanine Green ◽  
Contrast Medium ◽  
Lower Limb ◽  
Lymphatic Vessel ◽  
Lymphatic Vessels ◽  
Superficial Fascia ◽  
Iodinated Contrast Medium ◽  
Iodinated Contrast ◽  
The Right ◽  
Preoperative Examination

Case 1: A 63-year-old woman with secondary lower limb lymphedema. As it was difficult to detect the lymphatic vessels in the right thigh in indocyanine green lymphography because of thick fat, we tried echography and observed circular structures beneath the superficial fascia. Intraoperatively, we found a dilated lymphatic vessel just as observed on echography. Case 2: A 45-year-old woman with primary lower limb lymphedema. As she was allergic to iodinated contrast medium, we could not use indocyanine green lymphography preoperatively. In echography, we found vascular architectures and found the dilated lymphatic vessels intraoperatively just as observed on echography. In conclusion, application of echography in detecting the lymphatic vessels was useful as a preoperative examination of lymphaticovenous anastomosis.

The chronically ischemic lower limb

JAMA ◽  
1966 ◽  
Vol 197 (11) ◽  
pp. 915-916
Author(s):  
I. J. Schatz
Keyword(s):  
Lower Limb

Cardiac troponin I in patients with acute upper and lower limb ischemia

VASA ◽  
2008 ◽  
Vol 37 (4) ◽  
pp. 327-332 ◽  
Author(s):  
Koutouzis ◽  
Sfyroeras ◽  
Moulakakis ◽  
Kontaras ◽  
Nikolaou ◽  
...  
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Cardiac Troponin ◽  
Cardiac Involvement ◽  
Troponin I ◽  
Limb Ischemia ◽  
Elevated Troponin ◽  
Troponin Elevation ◽  
Lower Limb Ischemia ◽  
Ischemia Group

Background: The aim of this study was to investigate the presence, etiology and clinical significance of elevated troponin I in patients with acute upper or lower limb ischemia. The high sensitivity and specificity of cardiac troponin for the diagnosis of myocardial cell damage suggested a significant role for troponin in the patients investigated for this condition. The initial enthusiasm for the diagnostic potential of troponin was limited by the discovery that elevated cardiac troponin levels are also observed in conditions other than acute myocardial infarction, even conditions without obvious cardiac involvement. Patients and Methods: 71 consecutive patients participated in this study. 31 (44%) of them were men and mean age was 75.4 ± 10.3 years (range 44–92 years). 60 (85%) patients had acute lower limb ischemia and the remaining (11; 15%) had acute upper limb ischemia. Serial creatine kinase (CK), isoenzyme MB (CK-MB) and troponin I measurements were performed in all patients. Results: 33 (46%) patients had elevated peak troponin I (> 0.2 ng/ml) levels, all from the lower limb ischemia group (33/60 vs. 0/11 from the acute upper limb ischemia group; p = 0.04). Patients with lower limb ischemia had higher peak troponin I values than patients with upper limb ischemia (0.97 ± 2.3 [range 0.01–12.1] ng/ml vs. 0.04 ± 0.04 [0.01–0.14] ng/ml respectively; p = 0.003), higher peak CK values (2504 ± 7409 [range 42–45 940] U/ml vs. 340 ± 775 [range 34–2403] U/ml, p = 0.002, respectively, in the two groups) and peak CK-MB values (59.4 ± 84.5 [range 12–480] U/ml vs. 21.2 ± 9.1 [range 12–39] U/ml, respectively, in the two groups; p = 0.04). Peak cardiac troponin I levels were correlated with peak CK and CK-MB values. Conclusions: Patients with lower limb ischemia often have elevated troponin I without a primary cardiac source; this was not observed in patients presenting with acute upper limb ischemia. It is very important for these critically ill patients to focus on the main problem of acute limb ischemia and to attempt to treat the patient rather than the troponin elevation per se. Cardiac troponin elevation should not prevent physicians from providing immediate treatment for limb ischaemia to these patients, espescially when signs, symptoms and electrocardiographic findings preclude acute cardiac involvement.

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