• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.25 no.1
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• pp.53-61
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• 2019

Background: This study aimed to investigate the effects of manual lymph drainage (MLD) on women with breast cancer and lymph edema. Methods: This study was carried out with a total of 23 women with breast cancer and lymph edema. By drawing lots, women were assigned to either the manual drainage group (MLD, n=12), a control group (n=11). Outcomes such as the arm size, visual analogue scale, shoulder pain and disability index, and functional assessment cancer therapy-breast (FACT-B) were measured to 0 week, 2 weeks, 4 weeks, and 8 weeks intervention for both groups. Results: A significant difference was found in the arm size, pain, functional disability level, and quality of life between the two groups and time(p<.01). Significant difference in functional disability level between 2 and 8 weeks at 4 weeks and 8 weeks for pain(p<.01), and the quality for life was significantly different at all time points (p<.01). Conclusions: Applying MLD treatment to women with breast cancer proved to have a positive effect.

• The Journal of Korean Physical Therapy
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• v.21 no.4
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• pp.89-96
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• 2009

Purpose: This study examined the effects of manual lymph drainage (MLD) on edema and the quality of life (QOL) of lymphedema patients in the maintenance phase. Method: Forty five lymphedema patients, who had completed intensive decongestive therapy, were enrolled in this study. All subjects were assigned randomly to two groups: Experimental (MLD) group (n=23) and control (self-MLD) group (n=22). MLD by a specialist was applied with a comfortable pressure for 40~60 minutes in the experimental group and self-MLD was carried out by the control group 5 times a week for 2 weeks. The % edema and a SF-36 questionnaire were used to measure the decrease in edema and the QOL. A paired t-test was used to compare the period, and an independent T-test was used to compare experiment and control groups. Result: The % edema was significantly lower in the experimental group after MLD (p<0.05). The physical, vitality, and mental health scores of the experimental group was significantly higher than those of the control group (p<0.05). Conclusion: TMLD by a specialist in the maintenance phase is effective in reducing the % edema and enhancing the QOL of lymphedema patients. Further studies will be needed to determine if there are differences in the effects of many types of treatment methods in the lymphedema treatment.

• Archives of Craniofacial Surgery
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• v.24 no.3
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• pp.124-128
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• 2023

Morbihan disease (MD) is a very rare condition characterized by rosaceous or erythematous lymphedema on the upper two-thirds of the face. A definitive management strategy for MD is lacking, and treatment is challenging. Herein, we present a case of persistent bilateral eyelid edema treated by lymphaticovenular anastomosis (LVA) and lymph node-vein bypass surgery. The patient experienced persistent bilateral eyelid edema. Indocyanine green lymphography was performed, and the diagnosis of bilateral facial lymphedema was confirmed. On the right side, a preauricular lymphatic vessel was anastomosed to a vein. On the left side, lymphostomy on the preauricular lymph node was done, with anastomosis to the transected proximal end of the concomitant vein of the transverse facial artery. Furthermore, a preauricular lymphatic vessel was anastomosed to a vein. Eyelid edema decreased and progressively improved on both sides. The outcome of this case suggests that LVA and lymph node-vein bypass surgery are appropriate for treating persistent eyelid edema related to MD.

• Journal of Veterinary Clinics
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• v.19 no.4
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• pp.450-454
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• 2002

A five-year-old, female Great Dane dog with edema, localized trauma, mild pain, and lameness of the right hind limb was referred to the Veterinary Medical Teaching Hospital of Chungbuk National University. This dog had a history of mammary tumor excisions 6 months ago. Abnormal changes were not seen in the values of complete blood count and serum biochemical tests. But pedal direct lymphangiography using aqueous-based radiographic agent showed the obstructed lymph flow in right popliteal lymph node. Based on these observations, the dog was suspected as lymphedema resulted from lymph drainage flilure without any other possibilities of inflammation or other causes. Although recommended chemotherapy and physiotherapy had been applied for resolvinr presented problems for one month, there was no improvement on edema of damaged region and any other clinical signs. Therefore, the necropsy was performed after euthanasia under agreement of the owner of patient. In histopatholofical examination, the most characteristic lesions in the mass of femoral region were diffuse edema fibrosis and neoplastic cells in the lymphatics. Also, the neoplastic cells were very similar to those found in the tumor mass of mammary gland, which had diagnosed as fibrosing carcinoma. These facts suggested that the cause of obstructed lymph flow was the neoplasia in lymphatics of the right hind limb. With these results, a diagnosis of malignant lymphedema was made in this dog.

• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.152-155
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• 2005

Purpose: The lower extremity edema (LEE) is a common distressful symptom in advanced cancer patients and is hard to manage. We analyze the characteristics of LEE in patients with advanced cancer to provide the basic information of causes and adequate management. Methods: Physical examination, assessment of the location and severity of edema, blood chemistry (albumin, creatinine), Doppler Sono for patients with suspecting deep vein thrombosis (DVT), and abdomen CT scan for patient with suspecting lymph edema were performed. Severity of edema was classified according to NCI lymph edema scaling and improvement was defined as lowering at least 1 grade of edema after management. Results: Among 154 patient who had been admitted to Hospice Ward from Mar 2003 to Jan 2004, 33 had LEE, and 6 had both upper extremity edema and LEE except generalized edema. Their underlying cancers were stomach (7), lung (6), biliary tract (5), liver (5), colorectal (5), pancreas (2), and others (9). There were 12 patient with grade I, 20 patients with grade II, and 7 patients with grade III edema. The causes were hypoalbuminemia (11), lymph edema (10), DVT (7), obstruction of inferior vena cava (IVC) or portal vein (6), and dependent edema (5). The common managements were including leg elevation and diuretics. Elastic stocking was applied for patients with DVT and leg massage and pneumatic compression was used for lymph edema. The 2/3 patients were improved after management. Conclusion: The incidence of LEE in terminal cancer pts was high (25.3%) and their causes were variable including lymph edema, DVT, hypoalbuminemia and dependent edema. Active noninvasive management according to causes could result in good palliation.

• PNF and Movement
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• v.10 no.2
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• pp.1-8
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• 2012

Purpose : The purpose of study was aimed to identify whether the painless dynamic PNF techniques makes any differences in reducing lymphedema by applying this technique to lymphedema patients, and to provide the basic reference data for the purpose of applying to lymphedema patients. Methods : A total of 40 women participated in this study, and they did PNF techniques before applying lymph compression bandages. Group 1 of 20 subjects performed PNF techniques three times a week with 30 minutes each time. Group 2 of 20 subjects only practiced edema reducing massaging for 30 minutes. Results : In addition, the interaction between treatment method and treatment time was significant (p<.0001), which indicates that the changes in edema rates by measurement times appear differently according to treatment methods. In this study, it means that the 'PNF techniques' group has a steeper slope of decline than the 'message' group. Conclusion : In conclusion, both massaging and PNF techniques helped to lower edema rates. Four weeks after the beginning of treatment, PNF techniques was exhibited as generating a large degree of decline in edema rates than massaging.

• Physical Therapy Korea
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• v.14 no.3
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• pp.1-8
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• 2007

The purpose of this study was to determine whether aromatherapy massages with manual lymph drainage (MLD) are significantly more effective than sham massages with MLD in reducing edematous limb volume in lymphedema. This study was performed on 46 patients who had developed unilateral upper or lower lymphedema. Twenty-three patients served as the experimental group and were treated with complex decongestive physiotherapy (CDP) applications including aroma massages with MLD, multi layered compression bandages, remedial exercises and skin care. Twenty-three patients in the control group were treated with CDP applications including sham massages with MLD, bandages, exercises and skin care. Patients undergo a therapy program once a day; 5 days a week for 2 weeks. Percentage excess volume (PEV) and body mass index (BMI) were recorded before and after treatment. PEV and BMI were significantly decreased before and after treatment in the experimental as well as in the control groups (p<.05). However, the percentage excess volume and BMI were not significantly improved after treatment between the two groups (p>.05). This study there suggests that aroma massages is not effective in the edema of patients with lymphedema.

• Journal of Chest Surgery
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• v.27 no.11
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• pp.922-929
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• 1994

This research represents an attempt to study the postoperative results among 32 patients who underwent complete resections of primary lung and involved mediastinal lymph nodes between January 1988 and June 1993. Ages ranged from 34 to 73 years with a mean age of 51.31 $\pm$ 8.17 years. There were 29 male patients[90.6%]. Left lung cancers were more frequent than right lung cancers. There were 19 cases of left lung cancers accounting for 59.4% of the total lung cancers. The difference, however, was insignificant. There was no T1 lesion. T2 and T3 lesions were 21[65.6%] and 11 cases[34.4%], respectively. As for cell type, squamous cell carcinomas were reported in 25 cases making up 78.1% of the cell types. Pneumonectomy was conducted on 20[62.5%] cases. Lobectomy and sleeve lobectomy were conducted on 12[37.5%] cases respectively. Mediastinal lymph node involvemednts were most frequent in subcarinal lymph node[9/13] among right lung cancers, while subaortic lymph noce[12/19] was most frequent among left lung cancers. Postoperative complications were reported in 18.9% of the total cases, including 2 cases each of paralysis of the recurrent laryngeal nerve and 1 case each of chylothorax and pyothorax. They were more frequent among patients who underwent pneumonectomy. The operative mortality stood at 3.1% with 1 patient who underwent pneumonectomy dying of pulmonary edema. The 1-year and 5-year survival rates were 50.8% and 30.1%, respectively. Patients treated with squamous cell carcinoma, involvement of single level mediastinal lymph node and lobectomy showed a higher level of survival. These fidings suggest that a long-term survival can be expected of a considerable number of N2 non-small cell lung cancer patients with a selective complete surgical resection of primary lung cancers involved mediastinal lymph nodes.

• Korean Journal of Veterinary Research
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• v.32 no.1
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• pp.99-109
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• 1992

Pathological studies by light and electron microscope were carried out on the twenty piglets naturally affected by encephalomyocarditis virus infection. Gross findings included pale or yellow, small necrotic foci on myocardium, together with pulmonary edema and liver congestion in some cases. On light microscopy, nonsuppurative interstitial endocarcitis, epicarditis and myocarditis, myocardial infarction, and dystrophic calcification or fibtosis were observed in heart. Perivascular cuffings, gliosis and nonsuppurative meningitis were appeared in brain. Focal or diffuse necrosis with mononuclear cell infiltration in lacrimal gland and multifocal necrosis in liver were observed in some cases. Congestion and edema of lung, hyperemia, hemorrhage and deletion of lymphocytes of lymph nodes and spleen were recognized. On electron microscopy, severe swelling and vacuolization of mitochondria and sarcoplasmic reticulum, large intracellular vacuolation and edema, separation and fragmentation of myofibrils were observed. Virus particles were seen in the sarcoplasm of degenerated cardiac muscle cell.

• PNF and Movement
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• v.18 no.1
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• pp.1-10
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• 2020

Purpose: This study was conducted to examine the effects of a PNF intervention using elastic bands on edema, range of motion (ROM), and pain in post-mastectomy patients with upper limb lymphedema, according to their hand grip type. Methods: The subjects were 14 female patients who were at Stage II lymphedema after undergoing mastectomy for Stage II breast cancer. They were randomly divided into an experimental group (n =7) and a control group (n = 7). Both groups participated in a treatment program four times (one time under the therapist's instructions and three times as self-exercise) a week for 4 weeks. Both groups repeated an upper limb PNF pattern exercise for 30 min using elastic bands after receiving a manual lymph drainage treatment for 1 hour. Here, subjects in the experimental group performed the PNF exercise with an open-hand grip by putting their hands into the loops of elastic bands and keeping their fingers spread out. Subjects in the control group performed the PNF exercise with a closed-hand grip by holding the loops of elastic bands with their fingers. In both groups, the subjects' edema, ROM, and pain levels were measured before the intervention and 2, 3 and 4 weeks after the intervention. Results: As a result of the experiment, both groups demonstrated edema reductions, ROM increases, and pain reductions in four areas of the upper limbs. Notably, the experimental group exhibited larger ROM increases in flexion, extension, and abduction as well as greater edema and pain reductions than the control group. In particular, the most significant effects were found in the elbow of the four upper limb areas for edema reductions and in extension for ROM increases. Conclusion: The present study indicates that exercise therapy-based approaches using elastic bands in post-mastectomy patients with upper limb lymphedema can have different effects depending on the type of hand grip (open or closed), which is the body's most distal part. Therefore, these approaches should be based on the conditions of the distal parts of the patient's body for their effective applications in clinical practice.