Baby Kayden in Oklahoma
Good Morning Everyone
I wanted to bring this to everyone’s attention and encourage anyone who can to help this little baby. Kayden has vascular Lymphedema and was just born on August 18, 2009…he’s got a long road ahead of him so let’s do anything we can for him and his family:
He’s a real little doll too!
Thanks Everyone!!!!!!!!!!!!!!!!!!!!
Understanding the Lymph System
I thought it would be helpful for readers to understand the lymph system, the anatomy, what it does, and how it helps with immunity.
Listed below are information pages that should be quite helpful and each page has many additional links for more a more in depth study.
Pathology of the Lymph Nodes and Lymphoma
Department of Clinical Trial Design and Management, Translational Research Center, Kyoto University Hospital,
BACKGROUND: Lymph node dissection has proven prognostic benefits for patients with ovarian or uterine carcinoma; however, one of the complications associated with this procedure is lymphedema. We aimed to identify the factors that are associated with the occurrence of lymphedema after lymph node dissection for the treatment of ovarian or uterine carcinoma.
METHODS: A total of 694 patients with histologically confirmed ovarian (135 patients) or uterine cancer (258 with cervical cancer, 301 with endometrial cancer) who underwent lymph node dissection were studied retrospectively. Logistic regression analyses were used to identify the risk factors associated with occurrence of lymphedema.
RESULTS: Among ovarian and uterine cancer patients who underwent pelvic lymph node dissection, post-operative radiotherapy (odds ratio: 1.79; 95% confidence interval: 1.20-2.67; p = 0.006) was statistically significantly associated with occurrence of lymphedema.
CONCLUSION: There was no relationship between any surgical procedure and occurrence of lymphedema among patients undergoing pelvic lymphadenectomy. Our findings are supported by a sound biological rationale because they suggest that limb lymphedema is caused by pelvic lymph node dissection.
*Editor's note: It is rare that I openly place a note of disagreement on an article, but in this case, I think one is called for. The incident ratio of lower limb lymphedema from gynecological cancer is skyrocketing with survival rates increasing as well. It is well document that the removal of lymph nodes damages the lymph system and that a damaged lymph system can lead to lymphedema. I would suggest that they doctors involved in this study go back to their research. Pat
Department of Nuclear Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium. pierre.bourgeois@bordet.be
PURPOSE: Angiomyomatous hamartoma (AH) of the lymph node is a rare vascular benign disease of unknown etiology with a predisposition for the lymph nodes of the inguinal area. Only 18 cases have been described up to now in the literature and the disorder was reported to be associated with lymphedema or swelling of the ipsilateral limb in 4 patients. However, scintigraphic investigation of the lymphatic system in these patients was reported in only 2 cases.
MATERIAL AND METHODS: Five patients where the biopsy of inguinal nodes for suspected lymphadenitis led to the diagnosis of angiomyomatous hamartoma were investigated using lymphoscintigraphic techniques (1 girl aged 15; 1 boy aged 9 at the time of first biopsy and 11 at the time of the second one; and 3 men aged 30, 50, and 57). The operated limb was lymphedematous in 3 and 1 developed lymphedema after biopsy. The fifth patient developed a contralateral lymphedema after his second nodal biopsy.
RESULTS: In all cases, lymphoscintigraphic investigation of the limbs showed extensive lymph node abnormalities on the operated side and in 4 cases on the opposite side.
CONCLUSIONS: These observations support not only the hypothesis that lymphatic disturbance was involved in the pathogenesis of these tumors but also the proposition that lymphoscintigraphy should be performed in cases of inguinal lymphadenitis of unknown origin to diagnose the underlying situation of latent lymphedema.
Department of Plastic Surgery, E-Da Hospital/I-Shou University, Taiwan.
Entry lesions at the toes interdigital spaces, in the setting of chronic lymphedema, are strongly associated with repetitive infective episodes which cause significant morbidity. A prospective study was designed to evaluate the outcome in 2 groups of patients affected by end stage III lymphedema of the lower extremity, treated with the Charles procedure with or without simultaneous amputation of the toes. At a mean 3 years of follow-up, 20% of the patients receiving elective toes amputation experienced recurrence of the infection and none required more proximal amputations. Among the patients not desiring elective toes amputation; 83% suffered multiples attacks of cellulitis and in 88% the toes were eventually amputated. The difference in the number of infective episodes between the 2 groups was highly significant. No cases of recurrent lymphedema were registered. Elective toes amputation in combination with the Charles procedure reduces recurrent cellulitis and long-term morbidity in stage III lymphedema of the lower leg.
11th Annual Lymphedema Education & Awareness Program
An educational and awareness conference for patients, caregivers and professionals!
Where?
Piedmont Hospital
Piedmont Hospital
Richard H. Rich Auditorium
1968 Peachtree Road, NW, Building 77
Atlanta, Georgia
When?
Saturday, October 18, 20087:30 am - 5:30 pm
Program includes
What to expect of tissue after radiation?
What is the physiology response of radiation?
What does radiation do to the lymph nodes? - Peter Rossi, MD
How does vascular flow affect the lymphatics? - Ken Harper, MD
Expectations of surgery. - Christopher Hart, MD, FACSThe Lymphatic System, Wound Care,
Infections and Treatment - Paula Stewart, MDParent Networking
Aquatic Exercises
The Connection of obesity and increased swelling in people with lymphedema and lipedema.and more.
Additional information and registration form - Home website - Lighthouse Lymphedema Network
See you there - Pat
Humanitarian rescue medical action for patient with advanced lower extremity lymphedema.
Lymphology. 2008 Jun
Chen HC, Salgado CJ, Mardini S, Feng GM, Li TS.
E-Da Hospital/I-Shou University, Department of Plastic Surgery, Yan-Chau Shiang, Kaohsiung County, Taiwan. salgado_plastics@hotmail.com
No clear data exists regarding the initiating process of medial care delivery in cases of humanitarian rescue for advanced and debilitating patient conditions. We report on the delivery of care from a hospital located in a rural area in Southern Taiwan to a desperate patient from a country across the world in Lima, Peru. The patient is a 45-year old woman with unilateral severe, progressive primary lymphedema of 26 years who was scheduled to undergo a high femoral amputation for infections, lymphatic leak, inability to ambulate, and symptomatic cardiomegaly. All arrangements for care, including dental restoration, were made by our hospital in collaboration with the government of Peru. Upon multi-departmental consultation, an 8-hour Charles procedure was performed removing 47 kg of lymphedematous thigh and leg tissue. Eleven months postoperatively the patient is healed and ambulating without assistance. Her weight dropped from 120 to 73 kg. This case of humanitarian action demonstrates intense collaboration and coordination between two governments with dialogue, diplomatic success, a lymphedema surgical feat, and ultimately a successful outcome for the patient.
Anatomy of the subcutaneous lymph vascular network of the human leg in relation to the great saphenous vein.
Anat Rec (Hoboken). 2009
Schacht V, Luedemann W, Abels C, Berens von Rautenfeld D.
Department of Dermatology, University Medical Center Freiburg, Freiburg, Germany. vivien.schacht@uniklinik-freiburg.de
The anatomical relationship between lymphatic collectors and veins is of clinical importance for preventing lymphedema secondary to lymphatic collector injury during surgical procedures. To identify areas at risk during surgical interventions, we performed an anatomical study of human legs. The lymphatic collectors of 42 legs of human cadavers were injected with Berlin Blue solution or contrast medium. After fixation, the collectors were dissected and their distances from the great saphenous vein were determined. We found that the lymphatic collectors on the dorsum of the foot ran in close parallel with the corium, whereas in the groin a greater number of lymphatic collectors clustered around the great saphenous vein. The ventromedial bundle that drains into the superficial inguinal nodes included 5-20 lymphatic collectors. The average width of the ventromedial bundle varied between 116 mm at the middle of the lower leg and 32 mm at the groin. Our study cannot confirm the previous observation of a bottleneck of the ventromedial bundle occurring at the knee, but does support the finding of an elongated bottleneck at the thigh and groin draining into the superficial inguinal lymph nodes. In addition, the idea of one sentinel lymph node for a specific region of the leg is not supported by these data. These observations will help surgeons to plan incisions and dissections with respect to lymphatic collectors, thereby minimizing damage to them and reducing complications resulting from unnecessary lymphatic excisions. Anat Rec, 2009.
PubMedBergersen TK, Mørk C.
kristin.bergersen@rikshospitalet.no
A patient presented with non-pitting lymphoedema of the legs and finger clubbing. A skin biopsy showed epidermal hyperkeratosis and abundant mucinous material (Alcian blue positive) in reticular dermis. Treatment (radioactive iodine) for Grave's disease (with exophthalmus) 20 years ago, raised suspicion of thyroid dermopathy. Together, these three extrathyroidal manifestations of Graves' disease are typical of the EMO syndrome. In addition, the patient had elevated serum concentrations of thyroid-stimulating hormone receptor autoantibodies. Autoimmune mechanisms are involved in the stimulation of fibroblasts and the production of large amounts of mucin. Pretibial myxoedema relates to scars, mechanical factors, and dependent position. Lack of steroid treatment during radioactive iodine therapy and smoking, may have exacerbated the thyroid dermopathy in this case. Awareness of pretibial myxoedema as a late autoimmune manifestation of Graves' disease, may contribute to earlier diagnosis and correct treatment.
Lu Q, Xu J, Liu N.
Department of Radiology, Shanghai Renji Hospital, Shanghai Jiao Tong University School of Medicine, 1630 Dong Fang Rd, Shanghai 200127, China.
PURPOSE: To assess the role of heavily T2-weighted image and interstitial MR lymphangiography (MRL) for the visualization of lymphatic vessels in patients with disorders of the lymphatic circulation.
METHODS: Forty lower extremities in 31 patients (9 bilateral and 22 unilateral) with primary lymphedema were examined by heavily T2-weighted image and indirect MRL. Maximum-intensity projection (MIP) was used to reconstruct the images of the lymphatic system. Two experienced radiologists analyzed the images with regard to the differences in image quality, number of lymphatic vessels, its maximum diameter and two other findings: accumulated lymph fluid in the tissue and honeycombing pattern.
RESULTS: The beaded appearance of the affected vessels in 73 leg segments of 40 lower extremities were present on both modalities 3D MIP. Larger amount of the dilated lymphatic vessels were visualized on heavily T2-weighted image than that on MRL (p=0.003) and the maximum diameter of it was 4.28+/-1.53mm on heavily T2-weighted image, whereas 3.41+/-1.05mm on MRL (p<0.01).>
CONCLUSION: The heavily T2-weighted imaging has greater sensitivity and the MRL image has higher legibility for detecting the pathologically modified lymphatic vessels and accompanying complications non-invasively. Combining these two MR techniques can accurately access the pathological changes in the lower extremity with lymphedema.
Elsevier