• Title/Summary/Keyword: Lymphatic diseases

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Lymphatic Intervention, the Frontline of Modern Lymphatic Medicine: Part II. Classification and Treatment of the Lymphatic Disorders

  • Saebeom Hur;Jinoo Kim;Lakshmi Ratnam;Maxim Itkin
    • Korean Journal of Radiology
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    • v.24 no.2
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    • pp.109-132
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    • 2023
  • Lymphatic disorders encompass a broad spectrum of diseases involving the lymphatic system, ranging from traumatic lymphatic leaks to lymphatic malformations. Lymphatic disorders can be categorized into traumatic and non-traumatic disorders according to their etiology. These two categories may be further divided into subgroups depending on the anatomical location of the lymphatic pathology and their association with clinical syndromes. Thoracic duct embolization was a milestone in the field of lymphatic intervention that encouraged the application of percutaneous embolization techniques to treat leaks and reflux disorders in the lymphatic system. Additional access routes for embolization, including retrograde thoracic duct and transhepatic lymphatic access, have also been developed. This article comprehensively reviews a variety of options for the treatment of lymphatic disorders, from conservative management to the most recent embolization techniques.

Nano-sized Drug Carriers and Key Factors for Lymphatic Delivery

  • Choi, Ji-Hoon;Lee, Yong-Bok
    • Journal of Pharmaceutical Investigation
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    • v.40 no.spc
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    • pp.75-82
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    • 2010
  • Specific diseases like cancer and acquired immune deficiency syndrome (AIDS) occur at various organs including lymphatics and spread through lymphatic system. Thus, if therapeutic agents for such diseases are more distributed or targeted to lymphatic system, we can obtain several advantages like reduction of systemic side effect and increase of efficacy. For these reasons, much interest has been focused on the nature of lymphatics and a lot of studies for lymphatic delivery of drugs have been carried out. Because lymphatics consist of single layer endothelium and have high permeability compared with blood capillaries, especially, the studies using nano-sized carriers have been performed. Polymeric nano-particle, liposome, and lipid-based vehicle have been adopted for lymphatic delivery as carriers. According to the administration route and the kind of carrier, the extent of lymphatic delivery efficiency of nano-sized carriers has been changed and influenced by several factors such as size, charge, hydrophobicity and surface feature of carrier. In this review, we summarized the key factors which affect lymphatic uptake and the major features of carriers for achieving the lymphatic delivery. Lymphatic delivery of drug using nano-sized carriers has many fold improved ability of lymphatic delivery compared with that of conventional dosage forms, but it has not shown whole lymph selectivity yet. Even though nano-sized carriers still have the potential and worth to study as lymphatic drug delivery technology as before, full understanding of delivery mechanism and influencing factors, and setting of pharmacokinetic model are required for more ideal lymphatic delivery of drug.

A novel role of Hippo-Yap/TAZ signaling pathway in lymphatic vascular development

  • Cha, Boksik;Moon, Sungjin;Kim, Wantae
    • BMB Reports
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    • v.54 no.6
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    • pp.285-294
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    • 2021
  • The lymphatic vasculature plays important role in regulating fluid homeostasis, intestinal lipid absorption, and immune surveillance in humans. Malfunction of lymphatic vasculature leads to several human diseases. Understanding the fundamental mechanism in lymphatic vascular development not only expand our knowledge, but also provide a new therapeutic insight. Recently, Hippo-YAP/TAZ signaling pathway, a key mechanism of organ size and tissue homeostasis, has emerged as a critical player that regulate lymphatic specification, sprouting, and maturation. In this review, we discuss the mechanistic regulation and pathophysiological significant of Hippo pathway in lymphatic vascular development.

A Tale of Two Models: Mouse and Zebrafish as Complementary Models for Lymphatic Studies

  • Kim, Jun-Dae;Jin, Suk-Won
    • Molecules and Cells
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    • v.37 no.7
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    • pp.503-510
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    • 2014
  • Lymphatic vessels provide essential roles in maintaining fluid homeostasis and lipid absorption. Dysfunctions of the lymphatic vessels lead to debilitating pathological conditions, collectively known as lymphedema. In addition, lymphatic vessels are a critical moderator for the onset and progression of diverse human diseases including metastatic cancer and obesity. Despite their clinical importance, there is no currently effective pharmacological therapy to regulate functions of lymphatic vessels. Recent efforts to manipulate the Vascular Endothelial Growth Factor-C (VEGFC) pathway, which is arguably the most important signaling pathway regulating lymphatic endothelial cells, to alleviate lymphedema yielded largely mixed results, necessitating identification of new targetable signaling pathways for therapeutic intervention for lymphedema. Zebrafish, a relatively new model system to investigate lymphatic biology, appears to be an ideal model to identify novel therapeutic targets for lymphatic biology. In this review, we will provide an overview of our current understanding of the lymphatic vessels in vertebrates, and discuss zebrafish as a promising in vivo model to study lymphatic vessels.

Successful Control of Lymphatic Filariasis in the Republic of Korea

  • Cheun, Hyeng-Il;Kong, Yoon;Cho, Shin-Hyeong;Lee, Jong-Soo;Chai, Jong-Yil;Lee, Joo-Shil;Lee, Jong-Koo;Kim, Tong-Soo
    • Parasites, Hosts and Diseases
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    • v.47 no.4
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    • pp.323-335
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    • 2009
  • A successful experience of lymphatic filariasis control in the Republic of Korea is briefly reviewed. Filariasis in the Republic of Korea was exclusively caused by infection with Brugia malayi. Over the past several decades from the 1950s to 2006, many investigators exerted their efforts to detection, treatment, and follow-up of filariasis patients in endemic areas, and to control filariasis. Mass, combined with selective, treatments with diethylcarbamazine to microfilaria positive persons had been made them free from microfilaremia and contributed to significant decrease of the microfilarial density in previously endemic areas. Significant decrease of microfilaria positive cases in an area influenced eventually to the endemicity of filariasis in the relevant locality. Together with remarkable economic growth followed by improvement of environmental and personal hygiene and living standards, the factors stated above have contributed to blocking the transmission cycle of B. malayi and led to disappearance of this mosquito-borne ancient disease in the Republic of Korea.

Pulmonary Lymphangiomatosis (폐림프관종증 1예)

  • Cho, Yong-Seon;Yoo, Jee-Hong;Son, Sang-Yong;Cho, Hwoang-Lae;Kim, Soo-Joong;Han, Min-Soo;Kang, Hong-Mo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.4
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    • pp.533-537
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    • 1999
  • Pulmonary lymphangiomatosis is a very rare pulmonary lesion with an aggressive potential that occurs mainly in newborns, infants and young children of both sexes. It is characterized by pulmonary abnormalities of lymphatic system, showing an increased number of complex anastomosing lymphatic channels in the pleura, in the subpleural interlobular septa, and along the bronchovascular lymphatic route and uniformly fatal. We report a case of lymphangiomatosis behaving like lymphangioleiomyomatosis in a 26-year-old woman.

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Effect of anti-skin disorders of ginsenosides- A Systematic Review

  • Lele Cong;Jinli Ma;Yundong Zhang;Yifa Zhou;Xianling Cong;Miao Hao
    • Journal of Ginseng Research
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    • v.47 no.5
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    • pp.605-614
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    • 2023
  • Ginsenosides are bioactive components of Panax ginseng with many functions such as anti-aging, anti-oxidation, anti-inflammatory, anti-fatigue, and anti-tumor. Ginsenosides are categorized into dammarane, oleanene, and ocotillol type tricyclic triterpenoids based on the aglycon structure. Based on the sugar moiety linked to C-3, C-20, and C-6, C-20, dammarane type was divided into protopanaxadiol (PPD) and protopanaxatriol (PPT). The effects of ginsenosides on skin disorders are noteworthy. They play antiaging roles by enhancing immune function, resisting melanin formation, inhibiting oxidation, and elevating the concentration of collagen and hyaluronic acid. Thus, ginsenosides have previously been widely used to resist skin diseases and aging. This review details the role of ginsenosides in the anti-skin aging process from mechanisms and experimental research.

A Case of Pulmonary Lymphangiomatosis (폐림프관종증 1예)

  • Jang, Eun-Kyung;Kim, Chang-Rae;Choi, Chang-Min;Oh, Yeon-Mok;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Song, Jin-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.5
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    • pp.428-432
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    • 2011
  • Pulmonary lymphangiomatosis is a rare disorder involving the entire intrathoracic lymphatic system from the mediastinum to the pleura. Pulmonary lymphangiomatosis mostly occurs in children and young adults without gender predilection. Although it is pathologically benign, it shows a progressive and fatal course with variable initial presentation. We now report a case of pulmonary lymphangiomatosis in a 35-year-old man. He presented with hemoptysis 6 months previously. Chest x-ray and a chest computed tomography scan showed diffuse interstitial thickening with left pleural effusion. Chylothorax was confirmed by thoracentesis. Lymphangiography showed dilated and tortuous lymphatic channels. Surgical lung biopsy revealed proliferation of complex anastomosing lymphatic channels. He was diagnosed with pulmonary lymophangiomatosis. Closed thoracostomy and chemical pleurodesis were done and the dyspnea was reduced.

Proximal ligation after the side-to-end anastomosis recovery technique for lymphaticovenous anastomosis

  • Suzuki, Yushi;Sakuma, Hisashi;Ihara, Jun;Shimizu, Yusuke
    • Archives of Plastic Surgery
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    • v.46 no.4
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    • pp.344-349
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    • 2019
  • Background Lymphaticovenous anastomosis is an important surgical treatment for lymphedema, with lymphaticovenous side-to-end anastomosis (LVSEA) and lymphaticovenous end-to-end anastomosis being the most frequently performed procedures. However, LVSEA can cause lymphatic flow obstruction because of regurgitation and tension in the anastomosis. In this study, we introduce a novel and simple procedure to overcome this problem. Methods Thirty-five female patients with lower extremity lymphedema who underwent lymphaticovenous anastomosis at our hospital were included in this study. Eighty-five LVSEA procedures were performed, of which 12 resulted in insufficient venous blood flow. For these 12 anastomoses, the proximal lymphatic vessel underwent clipping after the anastomotic procedure and the venous inflow was monitored. Subsequently, the proximal ligation after side-to-end anastomosis recovery (PLASTER) technique, which involves ligating the proximal side of the lymphatic vessel, was applied. A postoperative evaluation was performed using indocyanine green 6 months after surgery. Results Despite the clipping procedure, three of the 12 anastomoses still showed poor venous inflow. Therefore, it was not possible to apply the PLASTER technique in those cases. Among the nine remaining anastomoses in which the PLASTER technique was applied, three (33%) were patent. Conclusions Our findings show that achieving patent anastomosis is challenging when postoperative venous inflow is poor. We achieved good results by performing proximal ligation after LVSEA. Thus, the PLASTER technique is a particularly useful recovery technique when LVSEA does not result in good run-off.

Nomenclature and Lymphatic Drainage Patterns of Abdominal Lymph Nodes (복부 림프절의 명명법 및 림프 배액 패턴)

  • Hyun Seok Cho;Jhii-Hyun Ahn
    • Journal of the Korean Society of Radiology
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    • v.83 no.6
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    • pp.1240-1258
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    • 2022
  • The lymphatic system provides a route for the spread of inflammation and malignancies. The identification of nodal stations and lymphatic pathways of tumor spread is important for tumor staging, choice of therapy, and the prediction of the prognosis of patients with malignant diseases. Because lymph node metastasis is common in primary intra-abdominal malignant tumors, its detection is essential for radiologists to understand the pattern of disease spread. Using schematic pictures and color-coded CT images, this pictorial essay describes the locations and nomenclature of the abdominal lymph nodes. Furthermore, the lymphatic drainage pathways of the upper and lower gastrointestinal tracts, liver, gallbladder, bile duct, and pancreas have been highlighted. In addition, lymph nodes belonging to the regional lymph nodes in malignant tumors arising from each organ are described, and certain cases are presented with images from patients.