Application of Photoacoustic Imaging for Lymphedema Treatment

Background Lymphatic vessels are difficult to identify using existing modalities as because of their small diameter and the transparency of the lymph fluid flowing through them. Methods Here, we introduce photoacoustic lymphangiography (PAL), a new modality widely used for lymphedema treatment, to observe limb lymphatic vessels. The photoacoustic imaging system used in this study can simultaneously visualize lymphatic vessels and veins with a high resolution (0.2 mm) and can also observe their three-dimensional relationship with each other. Results High-resolution images of the lymphatic vessels, detailed structure of the dermal back flow, and the three-dimensional positional relationship between the lymphatic vessels and veins were observed by PAL. Conclusion The clear image provided by PAL could have a major application in pre- and postoperative use during lymphaticovenular anastomosis for lymphedema treatment.

The Effects of Kinect-Enhanced Lymphatic Exercise Intervention on Lymphatic Pain, Swelling, and Lymph Fluid Level

Background: The-Optimal-Lymph-Flow (TOLF) intervention aims to promote lymph flow through therapeutic lymphatic exercises to relieve lymphatic pain, swelling, lymphedema symptoms, and to decrease lymph fluid levels among breast cancer survivors. To enhance the efficacy of the TOLF intervention, an innovative, intelligent, Kinect-enhanced lymphatic exercise intervention (Kinect-TOLF) was developed to teach patients to perform the lymphatic exercises correctly. Objectives: This feasibility trial aimed to determine the feasibility, usability, and effects of the Kinect-TOLF on lymphatic pain, swelling, lymphedema symptoms, and lymph fluid levels. Methods: A single-arm feasibility trial with a pre- and post-test design was employed to recruit 30 breast cancer survivors with persistent lymphatic pain or swelling. Patients received a single training session to learn how to perform the lymphatic exercises using the Kinect-TOLF program. Descriptive statistics, Wilcoxon signed-rank tests, t-test, Spearman’s rank correlation coefficients, linear regressions, and Cohen’s d were performed for data analysis. Qualitative data were assessed for common themes. Results: The Kinect-TOLF was effective in training patients to perform the lymphatic exercises correctly with high user satisfaction. Significant reductions were found in scores of lymphatic pain ( MedΔ = −1.00, CI = [−1.5, −0.1], P = .004), arm/hand swelling ( MedΔ = −1.00, CI = [−1.5, −0.5], P = .004), total swelling ( MedΔ = −1.5, CI = [−2.0, −1.0], P = .003), number of lymphedema symptoms ( MΔ = −3.8, CI = [−5.5, −2.1], P < .001), and lymphedema symptom severity ( MΔ = −5.3, CI = [−9.5, −1.1], P = .016). A significant reduction in lymph fluid levels was found in mean L-Dex scores ( MΔ = −2.68, CI = [−4.67, −0.69], P = .010). Greater decrease in mean L-Dex scores were found in patients with abnormal lymph fluid levels (L-Dex ≥ 7.1) ( MΔ = −5.19, CI = [−1.75, −8.63], P = .008). Patients’ qualitative feedback supported the results of the study. Conclusions: The Kinect-TOLF is safe, feasible, and effective in reducing lymphatic pain, swelling, lymphedema symptoms, and in decreasing lymph fluid levels. Future research should focus on a randomized clinical trial to confirm the unique or synergistic efficacy of the Kinect-TOLF in comparison with current lymphedema treatment and other forms of exercises or movement therapy. This study was registered in ClinicalTrials.gov with US ClinicalTrials.gov Identifier: NCT03999177.

Molecular mechanisms of olfactory detection in insects: beyond receptors

Insects thrive in diverse ecological niches in large part because of their highly sophisticated olfactory systems. Over the last two decades, a major focus in the study of insect olfaction has been on the role of olfactory receptors in mediating neuronal responses to environmental chemicals. In vivo , these receptors operate in specialized structures, called sensilla, which comprise neurons and non-neuronal support cells, extracellular lymph fluid and a precisely shaped cuticle. While sensilla are inherent to odour sensing in insects, we are only just beginning to understand their construction and function. Here, we review recent work that illuminates how odour-evoked neuronal activity is impacted by sensillar morphology, lymph fluid biochemistry, accessory signalling molecules in neurons and the physiological crosstalk between sensillar cells. These advances reveal multi-layered molecular and cellular mechanisms that determine the selectivity, sensitivity and dynamic modulation of odour-evoked responses in insects.

Podoconiosis (nonfilarial elephantiasis)

Podoconiosis is the lesser-known of the two major forms of tropical lymphoedema. The disease affects genetically susceptible individuals who go barefoot and whose feet and legs are exposed long term to red clay soils. It is found focally across tropical Africa, Central America, and north India where such soils coexist with high altitude, high rainfall, and low-income populations. Prodromal symptoms include itching and a burning sensation in the foot; early changes include spreading or ‘splaying’ of the forefoot and leakage of colourless ‘lymph’ fluid. Later stages are manifested by lymphoedema, which is usually bilateral and limited to below the knee. Studies examining host immunological and inflammatory responses are currently underway to improve possible future treatment options for the disease.

Post-therapeutic lymphedema in breast cancer

Introductions. Lymphedema is an interstitial accumulation of protein-rich lymph fluid, due to the post-therapeutic alteration of lymphatic circulation in the upper limb. The appearance of lymphedema is favoured by a number of risk factors. All of these factors ultimately lead to a process of tissue fibrosis. Materials and methods. This study was carried out in an outpatient regimen, for a period of 12 months, in the kinetotherapy room, using massage elements for lymphatic drainage and kinetotherapy technique. The study group included 15 patients aged 27-65 years.Results and discutions. Patients evaluated the quality of life after surgery based on the physical and mental symptoms, which is why anxiety, pain reduction through massage and kinetotherapy give patients self-confidence as well as confidence in the recovery process. Conclusions. This complex programme that includes lymphatic drainage massage methods and kinetotherapy techniques should be applied individually, progressively, under the control of the kinetotherapist. Key words: lymphedema, kinetotherapy technique, lymphatic drainage massage,

Peculiarities of Lymph Fluid and Its Rheology as a Metastasisin

Introduction.Despite the large number of scientific studies on metastasis problems, the state of liquid media (lymph and blood) in oncological diseases remained without sufficient attention.Materials and methods.A study of the lymph fluid properties, including viscosity, of 100 female patients with malignant breast tumours was carried out. The age of the patients ranged from 50 to 80 years. All patients were in menopause. The material for determination of viscosity was taken 5–7 days following mastectomy with extended dissection of axillary lymph nodes. On the first and second days, the contents of the wound were represented by blood clots and serous fluid. Between three- and five-days following surgery, the discharge from the wound consisted of serous discharge, prelims and lymph. On the fifth day and the following days, the wound discharge consisted primarily of lymph fluid caused by the completed haemostasis and continuation of discharge from the small lymphatic vessels.Results.The metastatic process is more active during the initial stages of cancer, since the metastatic medium is represented by less viscous lymph fluid while the vessels for the most part retain their permeability. With advanced stages of cancer, when the viscosity of the lymph rises, metastasis slows down.Conclusions:(1) In breast cancer, the viscosity depends on the stage of the cancer, while the lymph in the tumour pool behaves like a non-Newtonian fluid. (2) In stages I-II of cancer, metastasis occurs more actively than in cancer at more advanced stages. This phenomenon is determined by the rheological properties of the lymph and the functional viability of the regional vascular system.

Progress in the treatment of sudden deafness

<p>In recent years, the incidence of sudden deafness has a tendency to rise. Most scholars believe that the cause of the disease are virus infection, lymph fluid and cochlear circulation dysfunction and so on. The above several etiology may play a role in the process of sudden deafness, it is hard to isolate one of the causes, so there is no definite treatment of sudden deafness, the treatments of sudden deafness are based on the conjectural cause, lacking pertinence. This paper summarize the treatments of sudden deafness, in order to explore better ways to treat sudden deafness and to promote the development of clinical research.</p>