• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.6
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• pp.548-553
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• 2007

Kikuchi-Fujimoto disease is a rare disease first described in 1972 by Kikuchi and Fujimoto et al. The disease is described as a benign and unusual self-limiting histiocytic necrotizing lymphadenitis of unknown origin, which is characterized histologically by necrotic foci surrounded by histiocytic aggregates. is usually manifested with lymphadenopathy and high fever. This disease mostly affects young Asian women between 20 and 30 years of age and has rarely been reported in children. Main symptoms are indolent or light tender, enlarged lymph nodes in the neck area. The correct diagnosis requires the histologic examination of the lymph node. Kikuchi-Fujimoto disease is easily confused histologically and clinically with lymphoma and systemic lupus erythematosis histologically and clinically. Although it is an uncommon cause of fever of unknown origin, early recognition of KFD is very important and will minimize potentially harmful and unnecessary evaluations and treatments. We reported a case, a 23-year old man who had Kikuchi-Fujimoto disease with a literature review.

• Radiation Oncology Journal
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• v.28 no.1
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• pp.16-22
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• 2010

Purpose: We analyzed the incidence and related factors of radiation dermatitis; at first, to recognize whether a decrease in radiation dermatitis is possible or not in breast cancer patients who received radiation therapy. Materials and Methods: Of 338 patients, 284 with invasive breast cancer who received breast conservation surgery with radiotherapy at Chonbuk National University Hospital from January 2007 to June 2009 were evaluated. Patients who also underwent bolus, previous contralateral breast irradiation and irradiation on both breasts were excluded. For patients who appeared to have greater than moderate radiation dermatitis, the incidence and relating factors for radiation dermatitis were analyzed retrospectively. Results: A total of 207 and 77 patients appeared to have RTOG grade 0/1 or above RTOG grade 2 radiation dermatitis, respectively. The factors found to be statistically significant for the 77 patients who appeared to have greater than moderate radiation dermatitis include the presence of lymphocele due to the stasis of lymph and lymph edema which affect the healing disturbance of radiation dermatitis (p=0.003, p=0.001). Moreover, an allergic reaction to plaster due to the immune cells of skin and the activation of cytokine and concomitant hormonal therapy were also statistically significant factors (p=0.001, p=0.025). Conclusion: Most of the breast cancer patients who received radiation therapy appeared to have a greater than mild case of radiation dermatitis. Lymphocele, lymphedema, an allergy to plaster and concomitant hormonal therapy which affect radiation dermatitis were found to be significant factors. Consequently, we should eliminate lymphocele prior to radiation treatment for patients who appear to have an allergic reaction to plaster. We should also instruct patients of methods to maintain skin moisture if they appear to have a greater than moderate case of radiation dermatitis.

• Journal of Hospice and Palliative Care
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• v.4 no.2
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• pp.161-164
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• 2001

Elephantiasis, which is the final stage of lymphedema, has swelling, papillomas and discharges in the skin. Although this disease is recorded in literature since 50 AD, the treatment is not yet. After all this time, complex lymphedema therapy (CLT) involving lymphatic massaging, bandaging, exercise, and skin care is becoming recognized as the best approach to care for people who develop lymphedema. The patient was a 30-year-old male who complained of swelling, papillomas, and discharges on left leg. He was received with CLT for 2 months, and the symptoms of him were improved.

• The Journal of Korean Physical Therapy
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• v.21 no.4
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• pp.103-109
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• 2009

Purpose: Cases of male external genitalia lymphedema are relatively uncommon in the clinical physical therapy field. Of more than two thousand clinical cases treated by the author in the lymphedema treatment center, only 4~5 cases of male external genitalia lymphedema were encountered. The present case report presents the experience and treatment results of male external genitalia lymphedema from urological cancer. Method: This case was a 47-year-old man, who was treated with complex decongestive physical therapy consisting of manual lymph drainage, compression bandage (including the external genitalia), remedial exercise, skin care. Result: The results were relatively good. The clinical experience would suggest that early treatment and education can reduce the external genitalia lymphedema. However, the treatment efficacy remains limited. Therefore, early treatment is vital for more successful outcomes. Conclusion: The relief of symptoms and a decrease in male external genitalia lymphedema may be the best result from long-term conservative management.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.1
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• pp.31-38
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• 2011

Purpose : The purpose of this study was to examine the effect of upper extremity exercise and Bandage on the edema and range of motion. Complex decongestive physiotherapy was one of the latest methods to deal with the limitation of range of motion and the edema that were the prime problems of patients with lymphedema. Methods : Twenty patients undergone mastectomy were participated in this study voluntarily. They had lymphedema on upper extremity and partial limitation of range of motion. The subjects had been treated with upper extremity home exercise and complex decongestive physiotherapy with Bandage for 4 weeks. The measure of these patients with upper extremity edema was included: the volume, arm circumfenence and range of motion. These were measured two times: before the treatment, after 4 weeks of the treatment. Results : The upper extremity edema of patients treated home exercise group and complex decongestive physiotherapy group with Bandage was definitely decreased (p<0.05). Moreover, the upper volume of those who were the same condition also significantly shrank and patients' arm circumferences of upper arm breathtakingly diminished as well (p<0.05). But home exercise group patients' arm circumferences of forearm was not remarkable(p>0.05). However, patients' range of motion who were treated with upper extremity exercise were evidently increased when compared to that of the before treatment (p<0.05). Conclusion : Complex decongestive physiotherapy and bandage performed by physical therapist increased the ROM of upper arm and reduced the edema in patients with lymphedema.

• Radiation Oncology Journal
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• v.6 no.1
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• pp.81-84
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• 1988

Since the entity of postmastectomy lymphangiosarcoma was first reported by Stewart and Treves in 1948, postmastectomy lymphangiosarcoma has become a well recognized, uncommon malignant tumor which occurs in the upper extremity following mastectomy for mammary carcinoma. The postmastectomy lymphangiosarcoma occurred at an average age of 63.9 years and at an average of 10 years and 3 months following mastectomy. The lymphangiosarcoma raised from blood and lymphatic vessel. The histologic appearance has been observed edematous dermiss and dilated lymphatics lining with malignant cells. Most authors recommend radical amputation for treatment, either shoulder disarticulation or forequarter amputation. Other modalities of treatment including radiotherapy were considered as ineffetive. The present report provides a case of the regression of postmastectomy lymphangiosarcoma with chronic lymphedema by external irradiation. Radiation therapy was used as primary therapy. Total tumor dose of 6500 cGy in 9 wks was delivered using 6 MV x-ray and 8 MeV electron.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.22 no.2
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• pp.35-39
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• 2016

Background: The superficial lymphatic system is divided into areas called lymphatic territories which are separated by watersheds. When the lymphatic system fails to remove its load either due to surgery, radiotherapy or some congenital malformation of it then the fluid and the proteins and wastes contained within it accumulates in that territory. Anastomotic connections exist across the watersheds and while they can work unaided manual lymph drainage (MLD) can significantly help drainage across them into unaffected lymphatic territories. The purpose of the study is to examine the effectiveness of a manual technique in moving fluids and softening hardened tissues using a tape measure and Patient-Specific Functional Scale. Methods: We examined the movement of fluids from the affected limbs of lymphedema patients who underwent a standardized 30-min treatment using the Dr. Vodder method of MLD. We chose a typical cross section of patients with secondary leg or secondary arm lymphedema. The lymphedema patient was also measured after the conclusion of treatment and underwent a follow-up control measurement, within 8 weeks. Both evaluation tools indicated a movement of fluid to different and unblocked lymphatic territories as well as a softening of tissues in some of the affected limbs. Results: MLD is an effective means of fluid clearance when it accumulates as a consequence of a failure of the lymphatic system. It seems likely that MLD has a systemic effect on the lymphatic system and that it can improve flow from otherwise normal tissues. Conclusions: It is hypothesized that a series of treatments would result in even more significant improvements.

• Journal of Korean Academy of Nursing
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• v.35 no.7
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• pp.1390-1400
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• 2005

Purpose: The purpose of this study was to determine the effect of EPMLM(educational program of manual lymph massage) on the arm functioning and QOL(quality of life) in breast cancer patients with lymphedema. Method: Subjects in the experimental group(n=20) participated in EPMLM for 6 weeks from June to July, 2005. The EPMLM consisted of training of lymph massage for 2 weeks and encourage and support of self-care using lymph massage for 4 weeks. The arm functioning assessed at pre-treatment, 2weeks, and 6weeks using Arm functioning questionnaire. The QOL assessed at pre-treatment and 6 weeks using SF-36. The outcome data of experimental group was compared with control group(n=20). The collected data was analyzed by using SPSS 10.0 statistical program. Result: The arm functioning of experimental group was increased from 2 weeks after(W=.224, p=.011) and statistically differenced with control group at 2 weeks(Z=-2.241, p=.024) and 6 weeks(Z=-2.453, p=.013). Physical function of QOL domain increased in experimental group(Z=-1.162, p=.050), also statistically differenced with control group(Z=-2.182, p= .030) at 6weeks. Conclusion: The results suggest that the educational program of manual lymph massage can improve arm functioning and physical function of QOL domain in breast cancer patients with lymphedema.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.15 no.2
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• pp.8-14
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• 2009

Purpose: to apply lymph massage to the patients that contracted lymphedema after mastectomy to resolve blood congestion, stimulate circulation, and control swelling long-term. Methods: The subjects include 20 female patients that were diagnosed with breast cancer histologically and contracted lymphedema within one to two years after mastectomy. They received lymph massage from March to August, 2008. Using a measuring tape(capable of measuring mm), the arm circumference was measured in both the sick and normal arm. Only the data from the sick arm were compared before and after the treatment. The measuring points were five; the back of the hand(a certain distance[about 10cm] was set between the end of the middle finger to the center of the palm), the wrist(the smallest section), the lower arm(at a certain distance[about 10cm] from the internal bending part of the elbow), the elbow(the bending part), and the upper arm(at a certain distance[about 10cm] from the internal bending part of the elbow). Collected data were analyzed using the SPSS/WINDOWS Version 12.0 program. Results: There was a reduction of lymphedema observed in all the points including 10cm in the upper arm, the elbow, 10cm in the lower arm, the wrist and the back of the hand after lymph massage, and the reduction had statistically significant differences(p<.05). Conclusion: Those results indicate that lymph massage has effects on the reduction of lymphedema in the early patients that contracted it after mastectomy.

• Radiation Oncology Journal
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• v.19 no.1
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• pp.21-26
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• 2001

Purpose : This study was peformed to evaluate the cosmetic outcome of conservative treatment for early breast cancer and to analyze the factors influencing cosmetic outcome. Materials and Methods : From February 1992 through January 1997, 120 patients with early breast cancer were treated with conservative surgery and postoperative radiotherapy. The types of conservative surgery were quadrantectomy and axillary node dissection for 108 patients $(90\%)$ and lumpectomy or excisional biopsy for 10 patients $(8.3\%)$. Forty six patients $(38\%)$ received adjuvant chemotherapy (CMF or CAF). Cosmetic result evaluation was carried out between 16 and 74 months (median, 33 months) after surgery. The cosmetic results were classified into four categories, i.e., excellent, good, fair, and poor. The appearances of the patients' breasts were also analyzed for symmetry using the differences in distances from the sternal notch to right and left nipples. A logistic regression analysis was performed to identify independent variables influencing the cosmetic outcome. Results : Cosmetic score was excellent or good in $76\%$ (91/120), fair in $19\%$ (23/120) and poor in $5\%$ (6/120) of the patients. Univariate analysis showed that tumor size (T1 versus T2) (p=0.04), axillary node status (N0 versus N1) (p=0.0002), extent of surgery (quadrantectomy versus lumpectomy or excisional biopsy) (p=0.02), axillary node irradiation (p=0.0005) and chemotherapy (p=0.0001) affected cosmetic score. Multivariate analysis revealed that extent of surgery (p=0.04) and chemotherapy (p=0.0002) were significant factors. For breast symmetry, univariate analysis confirmed exactly the same factors as above. Multivariate analysis revealed that tumor size (p=0.003) and lymph node status (p=0.007) affected breast symmetry. Conclusion : Conservative surgery and postoperative radiotherapy resulted in excellent or good cosmetic outcome in a large portion of the patients. Better cosmetic results were achieved generally in the group of patients with smaller tumor size, without axillary node metastasis and treated with less extensive surgery without chemotherapy.