Dataset Information

Pathological changes in the lymphatic system of patients with secondary upper limb lymphoedema.

ABSTRACT: Secondary upper limb lymphoedema is usually caused by lymphatic system dysfunction. Diagnosis is primarily based on clinical features. However, there are no distinct diagnostic criteria for lymphoedema. Although conventional lymphoscintigraphy is a useful technique to diagnose the severity of lymphoedema, the resultant data are two-dimensional. In this study, we examined the pathology of lymphoedema using single photon emission computed tomography-computed tomography lymphoscintigraphy (SPECT-CT LSG), a new technique that provides 3-dimensional information on lymph flow. We observed lymph flow pathways in the subcutaneous and muscle layers of the upper limbs. A significant positive correlation was found between the dermal back flow (DBF) type and the visualization of lymph nodes around the clavicle (p?=?0.000266), the type of lymph flow pathways and the visualization of lymph nodes around the clavicle (p?=?0.00963), and the DBF type and the lymph flow pathway (p?=?0.00766). As the severity of lymphoedema increased, the DBF appeared more distally in the upper limb and the flow into the lymph nodes around the clavicle decreased, whereas the lymph flow pathways in the muscle layer became dominant. These findings demonstrate the features of lymphoedema pathology and the functional anatomy and physiology of the lymphatic system without the need for cadaver dissection.

SUBMITTER: Mikami T

PROVIDER: S-EPMC6560042 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Pathological changes in the lymphatic system of patients with secondary upper limb lymphoedema.

Mikami Taro T Koyama Asumi A Hashimoto Koukichi K Maegawa Jiro J Yabuki Yuichiro Y Kagimoto Shintaro S Kitayama Shinya S Kaneta Tomohiro T Yasumura Kazunori K Matsubara Shinobu S Iwai Toshinori T

Scientific reports 20190611 1

Secondary upper limb lymphoedema is usually caused by lymphatic system dysfunction. Diagnosis is primarily based on clinical features. However, there are no distinct diagnostic criteria for lymphoedema. Although conventional lymphoscintigraphy is a useful technique to diagnose the severity of lymphoedema, the resultant data are two-dimensional. In this study, we examined the pathology of lymphoedema using single photon emission computed tomography-computed tomography lymphoscintigraphy (SPECT-CT ...[more]

PMID: 31186436

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Project description:BACKGROUND AND AIM:Understanding the maturation of upper limb (UL) movement characteristics in typically developing (TD) children is key to explore UL deficits in those with neurodevelopmental disorders. Three-dimensional motion analysis (3DMA) offers a reliable tool to comprehensively evaluate UL motion. However, studies thus far mainly focused on specific pre-defined parameters extracted from kinematic waveforms. Here, we investigated age-related differences in UL movement characteristics over the entire movement cycle in TD children. PARTICIPANTS AND METHODS:We assessed the non-dominant UL of 60 TD children (mean age 10y3m±3y1m) using 3DMA during eight tasks: reaching (forwards (RF), upwards (RU), sideways (RS)), reach-to-grasp (sphere (RGS), vertical cylinder (RGV)) and activities-of-daily-living mimicking tasks (hand-to-head (HTH), hand-to-mouth (HTM), hand-to-shoulder (HTS)). We investigated differences between four age-groups (5-7y, 8-10y, 11-12y, 13-15y) in: (1) spatiotemporal parameters (movement duration, peak velocity, time-to-peak velocity and trajectory straightness), and (2) 12 UL joint angles, using Statistical Parametric Mapping (SPM). RESULTS:We found that the 5-7y children moved with lower peak velocity and less straight trajectories compared to the 11-12y group (peak velocity: RS, HTS, p<0.01; trajectory: RU, RS, RGV, HTS, p<0.01) and the 13-15y group (peak velocity: RF, RS, RGS, RGV, HTH, HTS, p<0.01; trajectory, all tasks, p<0.01). The 5-7y children showed increased scapular protraction compared to older children (8-10y and 11-12y, HTS), as well as increased scapular medial rotation compared to the 13-15y group (RGS). During RU, the 5-7y children moved more towards the frontal plane (shoulder), unlike the 13-15y group. Lastly, the 5-7y group used less elbow flexion than older children (11-12y and 13-15y) during HTH and HTS. DISCUSSION AND CONCLUSION:In conclusion, our results point toward a maturation in UL movement characteristics up to age 11-12y, when UL motion seemed to reach a plateau. The reference values provided in this study will help to further optimize the interpretation of UL deficits in children with neurodevelopmental disorders.

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Dataset Information

Pathological changes in the lymphatic system of patients with secondary upper limb lymphoedema.

Publications

Pathological changes in the lymphatic system of patients with secondary upper limb lymphoedema.

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