The Experts below are selected from a list of 1944 Experts worldwide ranked by ideXlab platform
Hasuk Bae - One of the best experts on this subject based on the ideXlab platform.
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Computed Tomography as an Objective Measurement Tool for Secondary Lymphedema Treated With Extracorporeal Shock Wave Therapy
Annals of rehabilitation medicine, 2015Co-Authors: So Yeon Kim, Hasuk BaeAbstract:Two patients with stage three Secondary Lymphedema of the upper extremities underwent treatment for breast cancer, including surgery, chemotherapy, and radiotherapy. They were examined with computed tomography (CT) before and after extracorporeal shock wave therapy (ESWT). We used a manual tracing method using PiViewSTAR software to calculate the volume of the upper extremities. There was a decrease in the volume of the subcutaneous compartment measured by CT before and after ESWT. CT may be helpful in determining the treatment target area of ESWT and to monitor the effect of treatment by measuring the changes in volume before and after ESWT in patients with Lymphedema. Therefore, CT may have good clinical potential for treatment and follow-up in the management of Lymphedema.
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Clinical Outcomes of Extracorporeal Shock Wave Therapy in Patients With Secondary Lymphedema: A Pilot Study
Annals of rehabilitation medicine, 2013Co-Authors: Hasuk Bae, Ho Jeong KimAbstract:Objective To investigate the clinical effect of extracorporeal shock wave therapy (ESWT) in patients with Secondary Lymphedema after breast cancer treatment. Methods In a prospective clinical trial, ESWT was performed consecutively 4 times over two weeks in 7 patients who were diagnosed with stage 3 Secondary Lymphedema after breast cancer treatment. Each patient was treated with four sessions of ESWT (0.056—0.068 mJ/mm 2 , 2,000 impulses). The parameters were the circumference of the arm, thickness of the skin and volume of the arm. We measured these parameters with baseline values before ESWT and repeated the evaluation after each ESWT treatment. Subjective data on skin thickness, edema and sensory impairment were obtained using a visual analogue scale (VAS). Results The mean volume of the affected arm after four consecutive ESWT was significantly reduced from 2,332 to 2,144 mL (p
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clinical outcomes of extracorporeal shock wave therapy in patients with Secondary Lymphedema a pilot study
Annals of Rehabilitation Medicine, 2013Co-Authors: Hasuk Bae, Ho Jeong KimAbstract:Objective To investigate the clinical effect of extracorporeal shock wave therapy (ESWT) in patients with Secondary Lymphedema after breast cancer treatment. Methods In a prospective clinical trial, ESWT was performed consecutively 4 times over two weeks in 7 patients who were diagnosed with stage 3 Secondary Lymphedema after breast cancer treatment. Each patient was treated with four sessions of ESWT (0.056—0.068 mJ/mm 2 , 2,000 impulses). The parameters were the circumference of the arm, thickness of the skin and volume of the arm. We measured these parameters with baseline values before ESWT and repeated the evaluation after each ESWT treatment. Subjective data on skin thickness, edema and sensory impairment were obtained using a visual analogue scale (VAS). Results The mean volume of the affected arm after four consecutive ESWT was significantly reduced from 2,332 to 2,144 mL (p<0.05). The circumference and thickness of the skin fold of the affected arm were significantly decreased after the fourth ESWT (p<0.05). The three VAS scores were significantly improved after the fourth ESWT. Almost all patients were satisfied with this treatment and felt softer texture in their affected arm after treatment. Conclusion ESWT is an effective modality in the treatment of stage 3 Lymphedema after breast cancer treatment. ESWT reduced the circumference and the thickness of arms with Lymphedema and satisfied almost all patients with Lymphedema. Therefore, this treatment provides clinically favorable outcome to patients with breast cancerrelated Lymphedema.
Ho Jeong Kim - One of the best experts on this subject based on the ideXlab platform.
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Clinical Outcomes of Extracorporeal Shock Wave Therapy in Patients With Secondary Lymphedema: A Pilot Study
Annals of rehabilitation medicine, 2013Co-Authors: Hasuk Bae, Ho Jeong KimAbstract:Objective To investigate the clinical effect of extracorporeal shock wave therapy (ESWT) in patients with Secondary Lymphedema after breast cancer treatment. Methods In a prospective clinical trial, ESWT was performed consecutively 4 times over two weeks in 7 patients who were diagnosed with stage 3 Secondary Lymphedema after breast cancer treatment. Each patient was treated with four sessions of ESWT (0.056—0.068 mJ/mm 2 , 2,000 impulses). The parameters were the circumference of the arm, thickness of the skin and volume of the arm. We measured these parameters with baseline values before ESWT and repeated the evaluation after each ESWT treatment. Subjective data on skin thickness, edema and sensory impairment were obtained using a visual analogue scale (VAS). Results The mean volume of the affected arm after four consecutive ESWT was significantly reduced from 2,332 to 2,144 mL (p
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clinical outcomes of extracorporeal shock wave therapy in patients with Secondary Lymphedema a pilot study
Annals of Rehabilitation Medicine, 2013Co-Authors: Hasuk Bae, Ho Jeong KimAbstract:Objective To investigate the clinical effect of extracorporeal shock wave therapy (ESWT) in patients with Secondary Lymphedema after breast cancer treatment. Methods In a prospective clinical trial, ESWT was performed consecutively 4 times over two weeks in 7 patients who were diagnosed with stage 3 Secondary Lymphedema after breast cancer treatment. Each patient was treated with four sessions of ESWT (0.056—0.068 mJ/mm 2 , 2,000 impulses). The parameters were the circumference of the arm, thickness of the skin and volume of the arm. We measured these parameters with baseline values before ESWT and repeated the evaluation after each ESWT treatment. Subjective data on skin thickness, edema and sensory impairment were obtained using a visual analogue scale (VAS). Results The mean volume of the affected arm after four consecutive ESWT was significantly reduced from 2,332 to 2,144 mL (p<0.05). The circumference and thickness of the skin fold of the affected arm were significantly decreased after the fourth ESWT (p<0.05). The three VAS scores were significantly improved after the fourth ESWT. Almost all patients were satisfied with this treatment and felt softer texture in their affected arm after treatment. Conclusion ESWT is an effective modality in the treatment of stage 3 Lymphedema after breast cancer treatment. ESWT reduced the circumference and the thickness of arms with Lymphedema and satisfied almost all patients with Lymphedema. Therefore, this treatment provides clinically favorable outcome to patients with breast cancerrelated Lymphedema.
Kazunori Inuzuka - One of the best experts on this subject based on the ideXlab platform.
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potential role of transforming growth factor beta 1 smad signaling in Secondary Lymphedema after cancer surgery
Cancer Science, 2020Co-Authors: Masaki Sano, Satoshi Hirakawa, Minoru Suzuki, Jun-ichi Sakabe, Mikako Ogawa, Seiji Yamamoto, Takanori Hiraide, Takeshi Sasaki, Naoto Yamamoto, Kazunori InuzukaAbstract:Secondary Lymphedema often develops after cancer surgery, and over 250 million patients suffer from this complication. A major symptom of Secondary Lymphedema is swelling with fibrosis, which lowers the patient's quality of life, even if cancer does not recur. Nonetheless, the pathophysiology of Secondary Lymphedema remains unclear, with therapeutic approaches limited to physical or surgical therapy. There is no effective pharmacological therapy for Secondary Lymphedema. Notably, the lack of animal models that accurately mimic human Secondary Lymphedema has hindered pathophysiological investigations of the disease. Here, we developed a novel rat hindlimb model of Secondary Lymphedema and showed that our rat model mimics human Secondary Lymphedema from early to late stages in terms of cell proliferation, lymphatic fluid accumulation, and skin fibrosis. Using our animal model, we investigated the disease progression and found that transforming growth factor-beta 1 (TGFB1) was produced by macrophages in the acute phase and by fibroblasts in the chronic phase of the disease. TGFB1 promoted the transition of fibroblasts into myofibroblasts and accelerated collagen synthesis, resulting in fibrosis, which further indicates that myofibroblasts and TGFB1/Smad signaling play key roles in fibrotic diseases. Furthermore, the presence of myofibroblasts in skin samples from Lymphedema patients after cancer surgery emphasizes the role of these cells in promoting fibrosis. Suppression of myofibroblast-dependent TGFB1 production may therefore represent an effective pharmacological treatment for inhibiting skin fibrosis in human Secondary Lymphedema after cancer surgery.
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Potential role of transforming growth factor‐beta 1/Smad signaling in Secondary Lymphedema after cancer surgery
Cancer science, 2020Co-Authors: Masaki Sano, Satoshi Hirakawa, Minoru Suzuki, Jun-ichi Sakabe, Mikako Ogawa, Seiji Yamamoto, Takanori Hiraide, Takeshi Sasaki, Naoto Yamamoto, Kazunori InuzukaAbstract:Secondary Lymphedema often develops after cancer surgery, and over 250 million patients suffer from this complication. A major symptom of Secondary Lymphedema is swelling with fibrosis, which lowers the patient's quality of life, even if cancer does not recur. Nonetheless, the pathophysiology of Secondary Lymphedema remains unclear, with therapeutic approaches limited to physical or surgical therapy. There is no effective pharmacological therapy for Secondary Lymphedema. Notably, the lack of animal models that accurately mimic human Secondary Lymphedema has hindered pathophysiological investigations of the disease. Here, we developed a novel rat hindlimb model of Secondary Lymphedema and showed that our rat model mimics human Secondary Lymphedema from early to late stages in terms of cell proliferation, lymphatic fluid accumulation, and skin fibrosis. Using our animal model, we investigated the disease progression and found that transforming growth factor-beta 1 (TGFB1) was produced by macrophages in the acute phase and by fibroblasts in the chronic phase of the disease. TGFB1 promoted the transition of fibroblasts into myofibroblasts and accelerated collagen synthesis, resulting in fibrosis, which further indicates that myofibroblasts and TGFB1/Smad signaling play key roles in fibrotic diseases. Furthermore, the presence of myofibroblasts in skin samples from Lymphedema patients after cancer surgery emphasizes the role of these cells in promoting fibrosis. Suppression of myofibroblast-dependent TGFB1 production may therefore represent an effective pharmacological treatment for inhibiting skin fibrosis in human Secondary Lymphedema after cancer surgery.
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Preliminary experience with a novel fluorescence lymphography using indocyanine green in patients with Secondary Lymphedema.
Journal of vascular surgery, 2007Co-Authors: Naoki Unno, Minoru Suzuki, Naoto Yamamoto, Kazunori Inuzuka, Daisuke Sagara, Motohiro Nishiyama, Hiroyuki KonnoAbstract:Background Lymphoscintigraphy has largely been performed to diagnose Lymphedema. It is, however a time-consuming and expensive technique, which has not been covered by Japanese medical insurance since the year 2002. In this report we introduce a new imaging technique of fluorescent lymphography to diagnose Lymphedema. Methods Fluorescence images of subcutaneous lymphatic drainage after subcutaneous injection of indocyanine green (ICG) at the foot were obtained using a newly developed near-infrared camera system. ICG fluorescent lymphography was performed in 12 patients with Secondary Lymphedema and 10 healthy volunteers. The 12 patients were diagnosed with Secondary Lymphedema according to the medical history and lymphoscintigram, of which 11 had a history of hysterectomy with extended lymph node dissection and local radiation therapy for uterine cancer. Lymphedema developed in one patient after femorotibial artery bypass for peripheral artery occlusive disease. Results Four abnormal fluorescent patterns of the lymph drainage were observed in Lymphedema: dermal backflow (an abnormal filling of the lymph capillaries), extended fluorescent signal at the dorsum and plantar region of the foot, dilated lymph channels with proximal obliteration, and diffuse glittering of fluorescent signals with scattered twinkling of the dye. Continuous lymph channels from the injection site of the foot to the groin were observed along the medial aspect of thigh in healthy subjects. Conclusion ICG fluorescence lymphography is safe, simple, and minimally invasive. The device is portable and easy to use. The technique may be useful in clinical practice to identify presence of lymphatic disorder.
Kimikazu Hamano - One of the best experts on this subject based on the ideXlab platform.
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Extracorporeal shock wave therapy ameliorates Secondary Lymphedema by promoting lymphangiogenesis
Journal of vascular surgery, 2010Co-Authors: Masayuki Kubo, Takahiro Kamota, Mako Ohshima, Bungo Shirasawa, Kimikazu HamanoAbstract:Objective Although Secondary Lymphedema is a common complication after surgical and radiation therapy for cancer, the treatment options for Lymphedema remain limited and largely ineffective. We thus studied the effect of extracorporeal shock wave therapy on promoting lymphangiogenesis and improving Secondary Lymphedema. Methods A rabbit ear model of Lymphedema was created by disruption of lymphatic vessels. Two weeks after surgery, the Lymphedematous ear was treated with or without low-energy shock waves (0.09 mJ/mm 2 , 200 shots), three times per week for 4 weeks. Results Western blot analysis showed that the expression of vascular endothelial growth factor (VEGF)-C (1.23-fold, P P P P Conclusion Extracorporeal shock wave therapy promotes lymphangiogenesis and ameliorates Secondary Lymphedema, suggesting that extracorporeal shock wave therapy may be a novel, feasible, effective, and noninvasive treatment for Lymphedema.
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The outcomes of program based on complex decongestive physiotherapy for a patient with Secondary Lymphedema caused by infection on the leg
Fukuoka igaku zasshi = Hukuoka acta medica, 2009Co-Authors: Fujiko Nakao, Kimikazu Hamano, Akira Furutani, Koichi Yoshimura, Yumiko Kinoshita, Rieko Kawamoto, Hisako Nakao, Shizue SuzukiAbstract:Lymphedema is a chronic problem causing distress and loss of functions throughout the lifespan. Complex decongestive physiotherapy (CDP) is in common use in developed countries but has only recently been used in Japan for people in outpatient settings. CDP is a representative conservative treatment for Lymphedema, conducted by combining four kinds of physical therapies: skin care, manual lymph drainage (MLD), bandage and exercise. This research project lead by a nurse is underway using CDP in an outpatient department. We report a case of Secondary Lymphedema caused by infection successfully treated by CDP. A 22-year-old man suffered from cellulitis of unknown origin when he was a high school student. After this event, he had been repeatedly admitted to hospital with infections as a result of the Lymphedema. He underwent MLD once or twice monthly and received health education for skin care, self-massage and exercise, and was advised to wear compression stockings. Within 7 months the leg swelling had significantly reduced and his feelings of malaise and pain disappeared. Fourteen months later the circumferences of his knee and ankle had kept the sizes, and he has not re-entered hospital for infections. For this man, CDP had a positive outcome, as it has for many others around the world. Our experience has found it very important to establish adequate support systems for such people in outpatient and community settings. However, more research and knowledge sharing are required to understand the usefulness and effectiveness about this program as a primary treatment combined with health education in community settings in Japan.
Zhiyu Liu - One of the best experts on this subject based on the ideXlab platform.
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effect of vascular endothelial growth factor c vegf c gene transfer in rat model of Secondary Lymphedema
Vascular Pharmacology, 2008Co-Authors: Yanli Liu, Yunhai Fang, Ping Dong, Jie Gao, Rong Liu, Zhaoxi Ding, Hua Tian, M Hhahbaz, Zhiyu LiuAbstract:Secondary Lymphedema has been clinically well described, but a cure is still lacking. Although there have been previous investigations using plasmid DNA for gene therapy, few have focused on the use for the treatment of Lymphedema. Therefore, we investigated the effects of VEGF-C gene transfer for the treatment of Lymphedema using our plasmid pcDNA3.1-VEGF-C. We produced a surgical model of Secondary Lymphedema in the rat hindlimb and treated with local intradermal VEGF-C transfection to investigate the efficacy of gene transfer. Magnetic resonance imaging (MRI) (P<0.05), B ultrasound (P<0.05), and water displacement volumetry (P<0.05) demonstrated a reduction of Lymphedema in therapy group as compared to controls. Histological and immunofluorescent studies demonstrated numerous newly formed lymphatic vessels in therapy group. Our results indicate that VEGF-C gene therapy has produced new lymphatic vessels which may have improved functional lymphatic drainage to reduce Lymphedema volume in our model.
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Effect of vascular endothelial growth factor C (VEGF-C) gene transfer in rat model of Secondary Lymphedema.
Vascular pharmacology, 2008Co-Authors: Yanli Liu, Yunhai Fang, Ping Dong, Jie Gao, Rong Liu, Hhahbaz M, Zhaoxi Ding, Hua Tian, Zhiyu LiuAbstract:Secondary Lymphedema has been clinically well described, but a cure is still lacking. Although there have been previous investigations using plasmid DNA for gene therapy, few have focused on the use for the treatment of Lymphedema. Therefore, we investigated the effects of VEGF-C gene transfer for the treatment of Lymphedema using our plasmid pcDNA3.1-VEGF-C. We produced a surgical model of Secondary Lymphedema in the rat hindlimb and treated with local intradermal VEGF-C transfection to investigate the efficacy of gene transfer. Magnetic resonance imaging (MRI) (P
