Human lymphatic pumping measured in healthy and lymphoedematous arms by lymphatic congestion lymphoscintigraphy
Identifieur interne : 007249 ( Main/Exploration ); précédent : 007248; suivant : 007250Human lymphatic pumping measured in healthy and lymphoedematous arms by lymphatic congestion lymphoscintigraphy
Auteurs : S. Modi [Royaume-Uni] ; A W B. Stanton [Royaume-Uni] ; W E Svensson [Royaume-Uni] ; A M Peters [Royaume-Uni] ; Peter Mortimer (dermatologue) [Royaume-Uni] ; J R Levick [Royaume-Uni]Source :
- The Journal of Physiology [ 0022-3751 ] ; 2007.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Bras (), Bras (physiopathologie), Composés organiques du technétium, Femelle, Humains, Immunoglobuline G, Lymphe (physiologie), Lymphoedème (imagerie diagnostique), Lymphoedème (physiopathologie), Lymphoscintigraphie, Mâle, Pression sanguine (physiologie), Radiothérapie (effets indésirables), Relation dose-effet des radiations, Scintigraphie (), Sphygmomanomètres, Système lymphatique (physiologie), Tumeurs du sein (), Tumeurs du sein (radiothérapie).
- MESH :
- effets indésirables : Radiothérapie.
- imagerie diagnostique : Lymphoedème.
- physiologie : Lymphe, Pression sanguine, Système lymphatique.
- physiopathologie : Bras, Lymphoedème.
- radiothérapie : Tumeurs du sein.
- Adulte, Adulte d'âge moyen, Bras, Composés organiques du technétium, Femelle, Humains, Immunoglobuline G, Lymphoscintigraphie, Mâle, Relation dose-effet des radiations, Scintigraphie, Sphygmomanomètres, Tumeurs du sein.
English descriptors
- KwdEn :
- Adult, Arm (blood supply), Arm (physiopathology), Blood Pressure (physiology), Breast Neoplasms (radiotherapy), Breast Neoplasms (surgery), Dose-Response Relationship, Radiation, Female, Humans, Immunoglobulin G, Lymph (physiology), Lymphatic System (physiology), Lymphedema (diagnostic imaging), Lymphedema (physiopathology), Lymphoscintigraphy, Male, Middle Aged, Organotechnetium Compounds, Radionuclide Imaging (methods), Radiotherapy (adverse effects), Sphygmomanometers.
- MESH :
- chemical : Immunoglobulin G, Organotechnetium Compounds.
- adverse effects : Radiotherapy.
- blood supply : Arm.
- diagnostic imaging : Lymphedema.
- methods : Radionuclide Imaging.
- physiology : Blood Pressure, Lymph, Lymphatic System.
- physiopathology : Arm, Lymphedema.
- radiotherapy : Breast Neoplasms.
- surgery : Breast Neoplasms.
- Adult, Dose-Response Relationship, Radiation, Female, Humans, Lymphoscintigraphy, Male, Middle Aged, Sphygmomanometers.
Abstract
Axillary surgery for breast cancer partially obstructs lymph outflow from the arm, chronically raising the lymphatic smooth muscle afterload. This may lead to pump failure, as in hypertensive cardiac failure, and could explain features of breast cancer treatment-related lymphoedema (BCRL) such as its delayed onset. A new method was developed to measure human lymphatic contractility non-invasively and test the hypothesis of contractile impairment. 99mTc-human IgG (Tc-HIG), injected into the hand dermis, drained into the arm lymphatic system which was imaged using a gamma-camera. Lymph transit time from hand to axilla,
Url:
DOI: 10.1113/jphysiol.2007.130401
PubMed: 17569739
PubMed Central: 2277237
Affiliations:
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Modi</name><affiliation wicri:level="1"><nlm:aff id="au1"><institution>Cardiac and Vascular Sciences (Dermatology), University of London</institution><addr-line>London SW17 0RE, UK</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London SW17 0RE</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="au3"><institution>Nuclear Medicine, Hammersmith Hospital</institution><addr-line>London W12 0HS, UK</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London W12 0HS</wicri:regionArea></affiliation></author><author><name sortKey="Stanton, A W B" sort="Stanton, A W B" uniqKey="Stanton A" first="A W B" last="Stanton">A W B. Stanton</name><affiliation wicri:level="1"><nlm:aff id="au1"><institution>Cardiac and Vascular Sciences (Dermatology), University of London</institution><addr-line>London SW17 0RE, UK</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London SW17 0RE</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="au3"><institution>Nuclear Medicine, Hammersmith Hospital</institution><addr-line>London W12 0HS, UK</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London W12 0HS</wicri:regionArea></affiliation></author><author><name sortKey="Svensson, W E" sort="Svensson, W E" uniqKey="Svensson W" first="W E" last="Svensson">W E Svensson</name><affiliation wicri:level="1"><nlm:aff id="au3"><institution>Nuclear Medicine, Hammersmith Hospital</institution><addr-line>London W12 0HS, UK</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London W12 0HS</wicri:regionArea></affiliation></author><author><name sortKey="Peters, A M" sort="Peters, A M" uniqKey="Peters A" first="A M" last="Peters">A M Peters</name><affiliation wicri:level="1"><nlm:aff id="au4"><institution>Nuclear Medicine, Royal Sussex County Hospital</institution><addr-line>Brighton BN2 5BE, UK</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Brighton BN2 5BE</wicri:regionArea></affiliation></author><author><name sortKey="Mortimer, P S" sort="Mortimer, P S" uniqKey="Mortimer P" first="P S" last="Mortimer">Peter Mortimer (dermatologue)</name><affiliation wicri:level="1"><nlm:aff id="au1"><institution>Cardiac and Vascular Sciences (Dermatology), University of London</institution><addr-line>London SW17 0RE, UK</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London SW17 0RE</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName type="university">Université de Londres</orgName></affiliation></author><author><name sortKey="Levick, J R" sort="Levick, J R" uniqKey="Levick J" first="J R" last="Levick">J R Levick</name><affiliation wicri:level="1"><nlm:aff id="au2"><institution>Basic Medical Sciences (Physiology), St George's Hospital Medical School, University of London</institution><addr-line>London SW17 0RE, UK</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London SW17 0RE</wicri:regionArea></affiliation></author></analytic><series><title level="j">The Journal of Physiology</title><idno type="ISSN">0022-3751</idno><idno type="eISSN">1469-7793</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Arm (blood supply)</term><term>Arm (physiopathology)</term><term>Blood Pressure (physiology)</term><term>Breast Neoplasms (radiotherapy)</term><term>Breast Neoplasms (surgery)</term><term>Dose-Response Relationship, Radiation</term><term>Female</term><term>Humans</term><term>Immunoglobulin G</term><term>Lymph (physiology)</term><term>Lymphatic System (physiology)</term><term>Lymphedema (diagnostic imaging)</term><term>Lymphedema (physiopathology)</term><term>Lymphoscintigraphy</term><term>Male</term><term>Middle Aged</term><term>Organotechnetium Compounds</term><term>Radionuclide Imaging (methods)</term><term>Radiotherapy (adverse effects)</term><term>Sphygmomanometers</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Bras ()</term><term>Bras (physiopathologie)</term><term>Composés organiques du technétium</term><term>Femelle</term><term>Humains</term><term>Immunoglobuline G</term><term>Lymphe (physiologie)</term><term>Lymphoedème (imagerie diagnostique)</term><term>Lymphoedème (physiopathologie)</term><term>Lymphoscintigraphie</term><term>Mâle</term><term>Pression sanguine (physiologie)</term><term>Radiothérapie (effets indésirables)</term><term>Relation dose-effet des radiations</term><term>Scintigraphie ()</term><term>Sphygmomanomètres</term><term>Système lymphatique (physiologie)</term><term>Tumeurs du sein ()</term><term>Tumeurs du sein (radiothérapie)</term></keywords><keywords scheme="MESH" type="chemical" xml:lang="en"><term>Immunoglobulin G</term><term>Organotechnetium Compounds</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Radiotherapy</term></keywords><keywords scheme="MESH" qualifier="blood supply" xml:lang="en"><term>Arm</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Radiothérapie</term></keywords><keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Radionuclide Imaging</term></keywords><keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>Lymphe</term><term>Pression sanguine</term><term>Système lymphatique</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Blood Pressure</term><term>Lymph</term><term>Lymphatic System</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Bras</term><term>Lymphoedème</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Arm</term><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="radiotherapy" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="radiothérapie" xml:lang="fr"><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Dose-Response Relationship, Radiation</term><term>Female</term><term>Humans</term><term>Lymphoscintigraphy</term><term>Male</term><term>Middle Aged</term><term>Sphygmomanometers</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Bras</term><term>Composés organiques du technétium</term><term>Femelle</term><term>Humains</term><term>Immunoglobuline G</term><term>Lymphoscintigraphie</term><term>Mâle</term><term>Relation dose-effet des radiations</term><term>Scintigraphie</term><term>Sphygmomanomètres</term><term>Tumeurs du sein</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Axillary surgery for breast cancer partially obstructs lymph outflow from the arm, chronically raising the lymphatic smooth muscle afterload. This may lead to pump failure, as in hypertensive cardiac failure, and could explain features of breast cancer treatment-related lymphoedema (BCRL) such as its delayed onset. A new method was developed to measure human lymphatic contractility non-invasively and test the hypothesis of contractile impairment. <sup>99m</sup>Tc-human IgG (Tc-HIG), injected into the hand dermis, drained into the arm lymphatic system which was imaged using a gamma-camera. Lymph transit time from hand to axilla, <italic>t</italic><sub>transit</sub>, was 9.6 ± 7.2 min (mean ±<sc>s.d.</sc>) (velocity 8.9 cm min<sup>−1</sup>) in seven normal subjects. To assess lymphatic contractility, a sphygmomanometer cuff around the upper arm was inflated to 60 mmHg (<italic>P</italic><sub>cuff</sub>) before <sup>99m</sup>Tc-HIG injection and maintained for >> <italic>t</italic><sub>transit</sub>. When <italic>P</italic><sub>cuff</sub> exceeded the maximum pressure generated by the lymphatic pump (<italic>P</italic><sub>pump</sub>), radiolabelled lymph was held up at the distal cuff border. <italic>P</italic><sub>cuff</sub> was then lowered in 10 mmHg steps until <sup>99m</sup>Tc-HIG began to flow under the cuff to the axilla, indicating <italic>P</italic><sub>pump</sub>≥<italic>P</italic><sub>cuff</sub>. In 16 normal subjects <italic>P</italic><sub>pump</sub> was 39 ± 14 mmHg. <italic>P</italic><sub>pump</sub> was 38% lower in 16 women with BCRL, namely 24 ± 19 mmHg (<italic>P</italic> = 0.014, Student's unpaired <italic>t</italic> test), and correlated negatively with the degree of swelling (12–56%). Blood radiolabel accumulation proved an unreliable measure of lymphatic pump function. Lymphatic congestion lymphoscintigraphy thus provided a quantitative measure of human lymphatic contractility without surgical cut-down, and the results supported the hypothesis of lymphatic pump failure in BCRL.</p></div></front></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement><orgName><li>Université de Londres</li></orgName></list><tree><country name="Royaume-Uni"><noRegion><name sortKey="Modi, S" sort="Modi, S" uniqKey="Modi S" first="S" last="Modi">S. Modi</name></noRegion><name sortKey="Levick, J R" sort="Levick, J R" uniqKey="Levick J" first="J R" last="Levick">J R Levick</name><name sortKey="Modi, S" sort="Modi, S" uniqKey="Modi S" first="S" last="Modi">S. Modi</name><name sortKey="Mortimer, P S" sort="Mortimer, P S" uniqKey="Mortimer P" first="P S" last="Mortimer">Peter Mortimer (dermatologue)</name><name sortKey="Peters, A M" sort="Peters, A M" uniqKey="Peters A" first="A M" last="Peters">A M Peters</name><name sortKey="Stanton, A W B" sort="Stanton, A W B" uniqKey="Stanton A" first="A W B" last="Stanton">A W B. Stanton</name><name sortKey="Stanton, A W B" sort="Stanton, A W B" uniqKey="Stanton A" first="A W B" last="Stanton">A W B. Stanton</name><name sortKey="Svensson, W E" sort="Svensson, W E" uniqKey="Svensson W" first="W E" last="Svensson">W E Svensson</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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