Vascularized lymph node flaps can survive on venous blood without an arterial inflow: an experimental model describing the dynamics of venous flow using indocyanine green angiography (With video).

Background: Several surgeons have described studies of free-tissue transfers using veins instead of arteries. These innovative microsurgical techniques can offer several advantages, such as an easier dissection during flap harvesting, and represent an alternative during an accidental surgical mistake or development of new surgical procedures. The purpose of this study was to describe and explore different constructs of vascularized lymph node transfer (VLNT) only based on venous blood flow in a mouse model, evaluate their blood flow microcirculation through indocyanine green (ICG) angiography and investigate the lymphatic drainage function and the lymph nodes' structures.

Far Infrared Radiation Therapy for Gynecological Cancer-Related Lymphedema Is an Effective and Oncologically Safe Treatment: A Randomized-Controlled Trial.

Gynecological cancer-related lymphedema (GCRL) is a devastating condition that adversely influences function, health, and quality of life. We conducted a randomized-controlled clinical study as well as experiments to investigate the efficacy and safety of far infrared radiation (FIR) to treat lymphedema in patients having previously undergone surgery for gynecological tumors. Seventy-four women with GCRL, cancer free for 5 years or more, were randomly allocated into two treatment groups: standard of care with bandage treatment and treatment with FIR plus bandage.

Far-Infrared Radiation Thermotherapy Improves Tissue Fibrosis in Chronic Extremity Lymphedema.

Background: Fibrosis can enhance the exacerbation of lymphedema, which becomes obvious in late stage II-III lymphedema. However, whether far-infrared radiation thermotherapy (FIRT) can cure lymphedema fibrosis is still lack of research. This research was to investigate the therapeutic effect of FIRT on tissue fibrosis in the treatment of Late stage II-III lymphedema.

Blockade of angiopoietin-2/Tie2 signaling pathway specifically promotes inflammation-induced angiogenesis in mouse cornea.

Aim: To investigate angiopoietin-2 (Ang-2)/Tie2 signaling pathway involving in inflammatory angiogenesis.

Methods: Three interrupted 11-0 nylon sutures were placed into the corneal stroma of BALB/c mice (6wk old) to induce inflammatory neovascularization. Expression of Ang-2 and Tie2 protein on neovascularization were examined by immunofluorescence.

Far infrared ray (FIR) therapy: An effective and oncological safe treatment modality for breast cancer related lymphedema.

Background: The incidence of breast cancer related lymphedema is approximately 5%. Far infrared ray (FIR) treatment can potentially reduce fluid volume and extremity circumference as well as the frequency of dermato-lymphangitis (DLA). However, there is no published data on the oncological safety of FIR and the potential for activation of any residual breast cancer cells.

Far-infrared ray for treating chronic lower extremity lymphedema with dermatolymphangioadenitis: a postoperative complication of gynecological tumor resection.

Purpose: Lower extremity lymphedema is regarded as a relatively common postoperative complication and is often accompanied with dermatolymphangioadenitis (DLA). This study combines clinical assessment and laboratory investigation to explore therapeutic effects of far-infrared radiation (FIR) therapy for chronic lower extremity lymphedema accompanied with DLA, occurring after gynecological tumor resection.

Methods: Patients who met inclusion and exclusion criteria would be enrolled.

Efficacy and safety of far infrared radiation in lymphedema treatment: clinical evaluation and laboratory analysis.

Swelling is the most common symptom of extremities lymphedema. Clinical evaluation and laboratory analysis were conducted after far infrared radiation (FIR) treatment on the main four components of lymphedema: fluid, fat, protein, and hyaluronan. Far infrared radiation is a kind of hyperthermia therapy with several and additional benefits as well as promoting microcirculation flow and improving collateral lymph circumfluence.

Abnormal mural cell recruitment in lymphatic capillaries: a common pathological feature in chronic lymphedematous skin?

Objectives: This study aimed to explore the structural and functional characteristics of dermal lymphatic capillaries in patients with chronic LE, specifically focused on the mural cells that are associated with skin lymphatics.

Methods: Forty-four patients (30 primary LE and 14 secondary LE) and eight healthy controls were enrolled in this study. Genetic analysis of the FOXC2 was performed in 18 patients with primary LE.

Pathological Changes of Lymphedematous Skin: Increased Mast Cells, Related Proteases, and Activated Transforming Growth Factor-β1.

Background: Skin fibrosis is a clinically serious pathological process of secondary lymphedema (SLE). Previous studies have shown that mast cells (MCs) are involved in lymphedema (LE) and play a key role in the pathological process of skin fibrosis. However, the role of the protease chymase and transforming growth factor-β1 (TGF-β1) secreted by MCs in the fibrotic skins of patients with secondary lower limb LE has not been explored.

Functional lymphatic collectors in breast cancer-related lymphedema arm.

Background: The pathophysiology of breast cancer-related lymphedema (BCRL) is poorly understood. The present study evaluated the lymphatic collectors in the arms of patients with BCRL.

Methods And Results: In total, 123 patients with ipsilateral BCRL who had undergone magnetic resonance lymphangiography using gadobenate dimeglumine as a contrast agent were enrolled in this study.

Magnetic Resonance Lymphangiography for the Study of Lymphatic System in Lymphedema.

Background: Imaging of the lymphatic system is difficult because of its structural and anatomical characteristics, and the conventional diagnostic method, radionuclide-based imaging, has the disadvantage of poor resolution. Magnetic resonance (MR) imaging has been shown the capability of depicting lymphatic channels in lymphedema recently. The purpose of this study was to evaluate the imaging of MR lymphangiography (MRL) in diagnosis of limb lymphedema and its possible role in the microsurgical management of lymphedema.

[Comparison study of radionuclide lymphoscintigraphy and dynamic magnetic resonance lymphangiography for the diagnosis of extremity lymphedema].

Objective: To compare the role of radionuclide lymphoscintigraphy and dynamic magnetic resonance lymphangiography (MRL) for the diagnosis of extremity lymphedema.

Methods: Sixteen patients with primary extremity lymphedema and two with Klippel-Trenaunay syndrome combined with lymphedema were examined by lymphoscintigraphy using the tracer 99Tc-labelled dextran, and also by MRL using gadobenate dimeglumine as contrast agent. The results of morphological abnormalities and functional state of the lymphatic system at affected limbs from the two imaging methods were compared.

Angiopoietin-2 promotes inflammatory lymphangiogenesis and its effect can be blocked by the specific inhibitor L1-10.

Angiopoietin (Ang)-2, a ligand of the receptor tyrosine kinase Tie2, is known to be involved in the regulation of embryonic lymphangiogenesis. However, the role of Ang-2 in postnatal pathological lymphangiogenesis, such as inflammation, is largely unknown. We used a combination of imaging, molecular, and cellular approaches to investigate whether Ang-2 is involved in inflammatory lymphangiogenesis.

[Treatment of chronic extremity lymphedema with manual lymph drainage].

Objective: To evaluate the effect of manual lymph drainage on chronic extremity lymphedema.

Methods: Fifty patients with chronic lymphedema of extremity were treated with manual lymph drainage (MLD) complex decongestion therapy. Among them, 29 had primary lymphedema, 21 had secondary lymphedema.

Lymphatic malformation is a common component of Klippel-Trenaunay syndrome.

Objectives: Few previous studies have focused on the involvement of the lymphatic system in Klippel-Trenaunay syndrome (KTS), although some evidence suggests that lymphatic abnormalities are associated with the disease. The aim of the present study was to investigate the involvement of the lymphatic system in KTS.

Methods: Magnetic resonance lymphangiography (MRL) with the use of gadobenate dimeglumine as the contrast was performed on 32 patients with KTS involving the extremities to evaluate lymphatic vessels, lymph nodes, and veins.

[Diagnosis of peripheral lymph circulation disorders with contrast MR lymphangiography].

Objective: To evaluate anatomical and functional images of contrast MR lymphangiography in the diagnosis of limb lymphatic circulation disorders.

Methods: 30 patients with limb lymphedema were enrolled in the study. There were 27 patients of primary lymphedema and 3 of secondary lymphedema.

Anatomic and functional evaluation of the lymphatics and lymph nodes in diagnosis of lymphatic circulation disorders with contrast magnetic resonance lymphangiography.

Objectives: Owing to its structural and anatomic characteristics, imaging of the lymphatic system has been difficult. The conventional diagnostic method of radionuclide-based imaging has the disadvantage of poor resolution. Recent work has shown that magnetic resonance imaging (MRI) can depict lymphatic channels in patients with lymphedema.

[Experimental studies of VEGF-C gene for the treatment of chronic obstructive lymphedema in mouse tail model].

Objective: To study the therapeutic effect of vascular endothelial growth factor C (VEGF-C) gene for chronic obstructive lymphedema in mouse tail model which may provide a new treatment for lymphedema.

Methods: RT-PCR and immunoabsorption were applied to detect VEGF-C gene expression in fibroblasts and secretion of VEGF-C protein in COS7 cells respectively after pCDNA3.1 (+) VEGF-C transfection.

[Experimental study of gene therapy with human vascular endothelial growth factor-c in lymphedema].

Objective: To study the efficacy of gene therapy with human vascular endothelial growth factor-c (VEGF-C) on obstructive lymphedema.

Methods: Two animal models of lymphedema were created: one in the right hind limb of adult New Zealand white rabbits and the other in SD mouse tail. Each model was randomly divided into two groups to receive intradermal injection of either VEGF-C gene (experimental group), or saline(control group).

[Treatment of primary lower limb lymphedema with ultrasonic assisted liposuction].

Objective: To observe treatment effects of primary lower limb lymphedema using ultrasonic assisted liposuction.

Methods: Internal ultrasonic liposculpture system combined postoperative continual elastic stockings or bandages were used for reducing lymphatic burdens of the affected limbs by partly removal of lymphedematous tissues.

Results: Edema regression in the affected limbs were obvious at 2 weeks postoperative and kept to stable without recurrence during 1 year follow-up.

[Metabolism of hyaluronic acid and extremity lymphedema].

Objective: To investigate the possible influence of the impairment of lymph fluid on the metabolism of hyaluronic acid (HA) in the lymphedematous skin tissue.

Methods: Tissue fluid was collected in lymphedematous limbs and the contralateral healthy limbs of 39 patients and HA content was measured with radioimmunoassay. The protein contents were also measured.

[Expression of hyaluronic acid and its receptor in the process of wound healing in different skin tissues and its significance].

Objective: To explore the expression of hyaluronic acid (HA) and its receptor, Cluster of differentiation 44 (CD44) in proliferative scar and in the process of wound healing of normal human adult skin and fetal skin, and the effect of HA and its receptor on the process of human fetal skin scarless healing.

Methods: An incision and then a hypodermic cavity were made on each side of the dorsal median line of 32 female adult BALB/c rats. Skin grafts from 8 human fetuses delivered by natural abortion, full-thickness skin grafts from 8 normal adults undergoing plastic operation, skin wound sample from the donor sites in legs of 8 patients undergoing dermatoplasty with intermediate split thickness skin graft, and proliferative scar from 8 patients of plastic surgery, non-adult and adult, were grafted into the hypodermic cavities.

[The significance and the expression of homeobox genes during human burn wound healing].

Objective: To investigate the expression of several homeobox genes during the wound healing in fetal and adult skin and their roles in fetal scarless wound healing.

Methods: The expressions of PRX-2, HOXB13, HOX2.2 and HOX2.