Human lymphatic pumping measured in healthy and lymphoedematous arms by lymphatic congestion lymphoscintigraphy.
Identifieur interne : 003324 ( PubMed/Checkpoint ); précédent : 003323; suivant : 003325Human lymphatic pumping measured in healthy and lymphoedematous arms by lymphatic congestion lymphoscintigraphy.
Auteurs : S. Modi [Royaume-Uni] ; A W B. Stanton ; W E Svensson ; A M Peters ; Peter Mortimer (dermatologue) [Royaume-Uni] ; J R LevickSource :
- 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, ttransit, was 9.6+/-7.2 min (mean+/-s.d.) (velocity 8.9 cm min(-1)) in seven normal subjects. To assess lymphatic contractility, a sphygmomanometer cuff around the upper arm was inflated to 60 mmHg (Pcuff) before 99mTc-HIG injection and maintained for>ttransit. When Pcuff exceeded the maximum pressure generated by the lymphatic pump (Ppump), radiolabelled lymph was held up at the distal cuff border. Pcuff was then lowered in 10 mmHg steps until 99mTc-HIG began to flow under the cuff to the axilla, indicating Ppump>or=Pcuff. In 16 normal subjects Ppump was 39+/-14 mmHg. Ppump was 38% lower in 16 women with BCRL, namely 24+/-19 mmHg (P=0.014, Student's unpaired t 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.
DOI: 10.1113/jphysiol.2007.130401
PubMed: 17569739
Affiliations:
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xml:lang="en">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, ttransit, was 9.6+/-7.2 min (mean+/-s.d.) (velocity 8.9 cm min(-1)) in seven normal subjects. To assess lymphatic contractility, a sphygmomanometer cuff around the upper arm was inflated to 60 mmHg (Pcuff) before 99mTc-HIG injection and maintained for>ttransit. When Pcuff exceeded the maximum pressure generated by the lymphatic pump (Ppump), radiolabelled lymph was held up at the distal cuff border. Pcuff was then lowered in 10 mmHg steps until 99mTc-HIG began to flow under the cuff to the axilla, indicating Ppump>or=Pcuff. In 16 normal subjects Ppump was 39+/-14 mmHg. Ppump was 38% lower in 16 women with BCRL, namely 24+/-19 mmHg (P=0.014, Student's unpaired t 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.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">17569739</PMID><DateCreated><Year>2007</Year><Month>08</Month><Day>16</Day></DateCreated><DateCompleted><Year>2007</Year><Month>10</Month><Day>30</Day></DateCompleted><DateRevised><Year>2017</Year><Month>02</Month><Day>20</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">0022-3751</ISSN><JournalIssue CitedMedium="Print"><Volume>583</Volume><Issue>Pt 1</Issue><PubDate><Year>2007</Year><Month>Aug</Month><Day>15</Day></PubDate></JournalIssue><Title>The Journal of physiology</Title><ISOAbbreviation>J. Physiol. (Lond.)</ISOAbbreviation></Journal><ArticleTitle>Human lymphatic pumping measured in healthy and lymphoedematous arms by lymphatic congestion lymphoscintigraphy.</ArticleTitle><Pagination><MedlinePgn>271-85</MedlinePgn></Pagination><Abstract><AbstractText>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, ttransit, was 9.6+/-7.2 min (mean+/-s.d.) (velocity 8.9 cm min(-1)) in seven normal subjects. To assess lymphatic contractility, a sphygmomanometer cuff around the upper arm was inflated to 60 mmHg (Pcuff) before 99mTc-HIG injection and maintained for>ttransit. When Pcuff exceeded the maximum pressure generated by the lymphatic pump (Ppump), radiolabelled lymph was held up at the distal cuff border. Pcuff was then lowered in 10 mmHg steps until 99mTc-HIG began to flow under the cuff to the axilla, indicating Ppump>or=Pcuff. In 16 normal subjects Ppump was 39+/-14 mmHg. Ppump was 38% lower in 16 women with BCRL, namely 24+/-19 mmHg (P=0.014, Student's unpaired t 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.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Modi</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Cardiac and Vascular Sciences, St George's Hospital Medical School, University of London, Cranmer Terrace, London SW17 0RE, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Stanton</LastName><ForeName>A W B</ForeName><Initials>AW</Initials></Author><Author ValidYN="Y"><LastName>Svensson</LastName><ForeName>W E</ForeName><Initials>WE</Initials></Author><Author ValidYN="Y"><LastName>Peters</LastName><ForeName>A M</ForeName><Initials>AM</Initials></Author><Author ValidYN="Y"><LastName>Mortimer</LastName><ForeName>P S</ForeName><Initials>PS</Initials></Author><Author ValidYN="Y"><LastName>Levick</LastName><ForeName>J R</ForeName><Initials>JR</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>063025</GrantID><Agency>Wellcome Trust</Agency><Country>United Kingdom</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016430">Clinical Trial</PublicationType><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2007</Year><Month>06</Month><Day>14</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Physiol</MedlineTA><NlmUniqueID>0266262</NlmUniqueID><ISSNLinking>0022-3751</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007074">Immunoglobulin G</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D015609">Organotechnetium Compounds</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="C079358">technetium TC 99m polyclonal IgG</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Clin Sci (Lond). 2001 Aug;101(2):131-40</RefSource><PMID Version="1">11473486</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>N Engl J Med. 1993 Oct 14;329(16):1158-63</RefSource><PMID Version="1">8377779</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Clin Sci (Lond). 2006 May;110(5):553-61</RefSource><PMID Version="1">16343054</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Invest Dermatol. 1990 Dec;95(6):677-82</RefSource><PMID 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Version="1">2217560</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Br Med J. 1957 Jan 19;1(5011):133-7</RefSource><PMID Version="1">13383211</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001132" MajorTopicYN="N">Arm</DescriptorName><QualifierName UI="Q000098" MajorTopicYN="N">blood supply</QualifierName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001794" MajorTopicYN="N">Blood Pressure</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001943" MajorTopicYN="N">Breast Neoplasms</DescriptorName><QualifierName UI="Q000532" MajorTopicYN="N">radiotherapy</QualifierName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004307" MajorTopicYN="N">Dose-Response Relationship, Radiation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007074" MajorTopicYN="N">Immunoglobulin G</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008196" MajorTopicYN="N">Lymph</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008208" MajorTopicYN="N">Lymphatic System</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="Y">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D061305" MajorTopicYN="N">Lymphoscintigraphy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015609" MajorTopicYN="N">Organotechnetium Compounds</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011877" MajorTopicYN="N">Radionuclide Imaging</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011878" MajorTopicYN="N">Radiotherapy</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D019722" MajorTopicYN="N">Sphygmomanometers</DescriptorName></MeshHeading></MeshHeadingList><OtherID Source="NLM">PMC2277237</OtherID></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2007</Year><Month>6</Month><Day>16</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2007</Year><Month>10</Month><Day>31</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2007</Year><Month>6</Month><Day>16</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">17569739</ArticleId><ArticleId IdType="pii">jphysiol.2007.130401</ArticleId><ArticleId IdType="doi">10.1113/jphysiol.2007.130401</ArticleId><ArticleId IdType="pmc">PMC2277237</ArticleId></ArticleIdList></PubmedData></pubmed><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><noCountry><name sortKey="Levick, J R" sort="Levick, J R" uniqKey="Levick J" first="J R" last="Levick">J R Levick</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="Svensson, W E" sort="Svensson, W E" uniqKey="Svensson W" first="W E" last="Svensson">W E Svensson</name></noCountry><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Modi, S" sort="Modi, S" uniqKey="Modi S" first="S" last="Modi">S. Modi</name></region><name sortKey="Mortimer, P S" sort="Mortimer, P S" uniqKey="Mortimer P" first="P S" last="Mortimer">Peter Mortimer (dermatologue)</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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