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Oliveira Silvino V, Raffaela Barbosa Barros K, Machado Brito F, Matheus Dias Magalhães F, Augusto Ferreira Carioca A, César Carneiro Loureiro A, Salvador Veras-Silva A, Daniel Motta Drummond M, Antonio Pereira Dos Santos M. Phase angle as an indicator of body composition and physical performance in handball players. BMC Sports Sci Med Rehabil 2024; 16:114. [PMID: 38773478 PMCID: PMC11107023 DOI: 10.1186/s13102-024-00899-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/07/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND Phase angle (PhA), obtained from the bioimpedance analysis, is widely used in clinical situations and in sports. This study evaluated the association between PhA with body composition and physical performance of handball athletes. METHODS 43 national-level players (22.19 ± 3.86 years) of both sexes were evaluated regarding anthropometry, body composition, squat (SJ) and countermovement (CMJ) jumps, handgrip strength, and cardiorespiratory fitness. RESULTS We verified a correlation between PhA of the whole body and fat-free mass (r = 0.511), body mass index (r = 0.307), and body fat % (r = -0.303). There was a positive correlation between PhA of the whole body and SJ (r = 0.376), CMJ (r = 0.419), and handgrip for the dominant hand (r = 0.448). Moreover, PhA of the upper limbs was more strongly correlated with handgrip for the dominant (r = 0.630) and non-dominant hand (r = 0.575) compared to PhA of the whole body considering both sexes. Similarly, segmental PhA had a stronger significant correlation with SJ (r = 0.402) and handgrip for the dominant hand (r = 0.482) in males, as well as CMJ (r = 0.602) in females, compared to PhA of the whole body. CONCLUSION PhA of the whole body was positively related to fat-free mass, body mass index, body fat %, and lower- and upper-limbs strength in handball athletes. Segmental PhA might be used as a tool for estimating lower and upper limbs performance considering the sex, in preference to the PhA of the whole body.
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Affiliation(s)
- Valmir Oliveira Silvino
- Department of Biophysics and Physiology, Federal University of Piaui, 3700 Pedro Freitas Avenue, Teresina, 64018000, Piauí, Brazil.
- Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, Piauí, Brazil.
- Rede Nordeste de Biotecnologia (RENORBIO), Federal University of Piauí, Teresina, Piauí, Brazil.
| | - Kelly Raffaela Barbosa Barros
- Department of Biophysics and Physiology, Federal University of Piaui, 3700 Pedro Freitas Avenue, Teresina, 64018000, Piauí, Brazil
- Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, Piauí, Brazil
| | - Felipe Machado Brito
- Department of Biophysics and Physiology, Federal University of Piaui, 3700 Pedro Freitas Avenue, Teresina, 64018000, Piauí, Brazil
- Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, Piauí, Brazil
| | - Francisco Matheus Dias Magalhães
- Department of Biophysics and Physiology, Federal University of Piaui, 3700 Pedro Freitas Avenue, Teresina, 64018000, Piauí, Brazil
- Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, Piauí, Brazil
| | | | | | - Acácio Salvador Veras-Silva
- Department of Biophysics and Physiology, Federal University of Piaui, 3700 Pedro Freitas Avenue, Teresina, 64018000, Piauí, Brazil
| | - Marcos Daniel Motta Drummond
- Department of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marcos Antonio Pereira Dos Santos
- Department of Biophysics and Physiology, Federal University of Piaui, 3700 Pedro Freitas Avenue, Teresina, 64018000, Piauí, Brazil
- Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, Piauí, Brazil
- Rede Nordeste de Biotecnologia (RENORBIO), Federal University of Piauí, Teresina, Piauí, Brazil
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Mo YW, Lee SJ, Lee DW, Lee WJ, Im SH, Suh YC. Contrast-enhanced ultrasonography as an adjunctive method to ICG lymphography for functional lymphaticovenous anastomosis. J Surg Oncol 2024; 129:965-974. [PMID: 38221666 DOI: 10.1002/jso.27576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 12/20/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND AND OBJECTIVES Indocyanine green (ICG) lymphography is the reference standard for evaluating lymphedema stage and identifying lymphatic vessels. However, the penetration depth was limited to 1-2 cm from the skin surface. This prospective study compares clinical outcomes following lymphaticovenous anastomoses (LVA) in patients with upper and lower limb lymphedema using contrast-enhanced ultrasonography (CEUS) with ICG as a preoperative imaging modality. METHODS Under general anesthesia, Sonazoid® was injected subcutaneously to visualize functional lymphatic channels via CEUS. We analyzed the changes in limb circumference and inter-limb ratio (ILR) using bioimpedance to measure electrical resistance between the CEUS plus ICG group and the ICG-only group to see the effect of CEUS-assisted LVA. RESULTS No significant demographic differences existed between the two groups (CEUS plus ICG group vs. ICG-only group). The ILR decrease of the Z1 value measured using bioimpedance was statistically significant (p = 0.042 for the upper limb, p = 0.002 for the lower limb)- CONCLUSIONS: CEUS allowed us to identify deep-lying, functional, and large lymphatic channels. In conclusion, the combination of CEUS and ICG for identifying lymphatic channels has the potential to lead to a more functional lymphovenous anastomosis.
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Affiliation(s)
- Young Woong Mo
- Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
- Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung Jun Lee
- Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
- Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, South Korea
| | - Dong Won Lee
- Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
- Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, South Korea
| | - Won Jai Lee
- Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
- Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, South Korea
| | - Sang Hee Im
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | - Young Chul Suh
- Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
- Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, South Korea
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da Silva Tozzo FCB, Sarri AJ, Pirola WE, da Silva UBC, de Oliveira MA, de Pádua Souza C, da Costa Vieira RA. Evaluation of upper limb lymphoedema and diagnostic accuracy of bioimpedance spectroscopy. A comprehensive validation in a Brazilian population. Ecancermedicalscience 2023; 17:1649. [PMID: 38419858 PMCID: PMC10901233 DOI: 10.3332/ecancer.2023.1649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Indexed: 03/02/2024] Open
Abstract
Lymphoedema is a complication of breast cancer treatment. Its early diagnosis is related to a good prognosis for lymphoedema treatment. The bioimpedance spectroscopy (BIS) evaluates changes in extracellular fluid. The objective of our study was to evaluate the validity, agreement and accuracy of BIS in the diagnosis of breast cancer-related lymphoedema in a Brazilian population. Methods This is a prospective, cross-sectional study of a convenience sample of 462 women who underwent surgical treatment for breast cancer (mastectomy or breast-conserving treatment). The validity, agreement and accuracy were performed comparing BIS (lymphoedema index (L-DEX) ≥ 6.5 or 10) with volumetry by water displacement, which is the gold standard for evaluating lymphoedema. Receiver operating characteristic curve was performed. Additionally, other methods like perimetry and indirect volumetry of the upper limbs were compared with water displacement volumetry (direct volumetry), and the BIS were compared with subjective evaluation. Results Considering L-DEX ≥ 10 the sensitivity of the BIS was 44.1%, specificity 95.4%, positive predictive value (PPV) was 70.7%, negative predictive value (NPV) was 87% and kappa was 0.459. The BIS with L-DEX ≥ 6.5, the sensitivity, specificity, PPV, NPV and kappa were 57%, 88.5%, 55.8%, 89% and 0.452, respectively. Area under curve was 0.724 and a possible cut-off point of L-DEX ≥ 7.35 with sensitivity of 57%, specificity of 90.7% and kappa value = 0.489. Conclusion Although BIS was significantly associated with the subjective evaluation of lymphoedema, it showed low sensitivity and agreement and moderate correlation when used as a method for diagnosing the condition. Thus, it is not the most valid method for evaluating lymphoedema. In addition, it was not the most accurate method when compared with other objective evaluation tools. Public health resources are scarce and must be used consciously. The knowledge that BIS is not a more accurate method than other, lower-cost instruments allows for better targeting of these resources.
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Affiliation(s)
| | - Almir José Sarri
- Department of Physical Therapy, Barretos Cancer Hospital, São Paulo 14784-390, Brazil
- https://orcid.org/0000-0001-9184-584X
| | - Willian Eduardo Pirola
- Post-Graduate Program, Barretos Cancer Hospital, São Paulo 14784-400, Brazil
- https://orcid.org/0000-0003-3372-2504
| | | | - Marco Antonio de Oliveira
- Center of Epidemiology and Biostatistics, Barretos Cancer Hospital, São Paulo 14784-400, Brazil
- https://orcid.org/0000-0001-6879-2778
| | - Cristiano de Pádua Souza
- Post-Graduate Program, Barretos Cancer Hospital, São Paulo 14784-400, Brazil
- https://orcid.org/0000-0002-6412-8041
| | - René Aloisio da Costa Vieira
- Post-Graduate Program, Barretos Cancer Hospital, São Paulo 14784-400, Brazil
- Department of Breast Cancer, Barretos Cancer Hospital, São Paulo 14784-400, Brazil
- https://orcid.org/0000-0003-2014-9016
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Severo JS, da Silva Barros VJ, Moraes Mendes PH, Dos Santos BLB, da Silva ACA, de Oliveira KBV, de Moura MSB, de Almeida Fonseca Viola PC, do Nascimento Nogueira N, Luz Parente JM, Lima MM, Dos Santos AA, Silva MTB. Phase angle values and ultra-processed food consumption are associated with changes in oxidative stress in inflammatory bowel disease patients. Clin Nutr ESPEN 2023; 57:10-20. [PMID: 37739643 DOI: 10.1016/j.clnesp.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/19/2023] [Accepted: 06/07/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND & AIMS Changes in dietary habits including increased intake of refined sugars and fats and decreased intake of fiber have been suggested as potential risk factors for the development of inflammatory bowel diseases (IBD). Bioelectrical impedance analysis-derived phase angle (PhA) has been gaining attention in the clinical evaluation of nutritional status. In this study, we for the first time investigated the relationship of PhA and ultra-processed food intake with oxidative stress, body composition and biochemical parameters in adult patients with IBD. METHODS Body composition and PhA were evaluated through electrical bioimpedance. Nitrite (Nox), myeloperoxidase (MPO), glutathione (GSH), malondialdehyde (MDA) and superoxide dismutase (SOD) levels were determined in both groups. Food consumption was obtained by a food frequency questionnaire (FFQ). RESULTS In comparison with the control group, the IBD group had increased (p < 0.05) concentrations of Nox (19.95 ± 1.4 vs. 35.43 ± 7.7 μM), MDA (0.70 ± 0.31 vs. 4.56 ± 0.62 nmol/L), and GSH (9.35 ± 0.38 vs. 10.74 ± 0.51 mg NPSH/μL plasma). PhA was positively correlated with GSH (R2:0.22; p:0.02) and SOD (R2:0.25; p:0.01). IBD patients ingested higher amounts of ultra-processed foods (IBD:17.04 ± 2.76 vs. Control:24.88 ± 2.30%). However, IBD patients had better consumption of unprocessed or minimally processed foods (IBD:79.06 ± 3.07 vs. Control:67.83 ± 2.32%). We found a positive correlation between ultra-processed food consumption and MDA (R2 0.43; p:0.01). CONCLUSIONS PhA may be a practical and effective measure in clinical follow-up of IBD patients, being associated with bilirubin levels and antioxidant enzymes. Also, we recommend evaluating consumption of ultra-processed foods, since this was related with increasing oxidative stress markers in clinical follow-up of IBD patients.
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Affiliation(s)
- Juliana Soares Severo
- Graduate Program in Food and Nutrition, Federal University of Piauí, Teresina, PI, Brazil; Laboratory of Exercise and Gastrointestinal Tract, Department of Physical Education, Federal University of Piauí, Teresina, PI, Brazil
| | | | - Pedro Henrique Moraes Mendes
- Laboratory of Exercise and Gastrointestinal Tract, Department of Physical Education, Federal University of Piauí, Teresina, PI, Brazil
| | - Brenda Lois Barros Dos Santos
- Laboratory of Exercise and Gastrointestinal Tract, Department of Physical Education, Federal University of Piauí, Teresina, PI, Brazil
| | - Alda Cássia Alves da Silva
- Graduate Program in Pharmacology, Federal University of Piauí, Teresina, PI, Brazil; Laboratory of Exercise and Gastrointestinal Tract, Department of Physical Education, Federal University of Piauí, Teresina, PI, Brazil
| | - Kelly Beatriz Vieira de Oliveira
- Graduate Program in Pharmacology, Federal University of Piauí, Teresina, PI, Brazil; Laboratory of Exercise and Gastrointestinal Tract, Department of Physical Education, Federal University of Piauí, Teresina, PI, Brazil
| | | | | | | | | | - Murilo Moura Lima
- University Hospital, Federal University of Piauí, Teresina, PI, Brazil
| | - Armênio Aguiar Dos Santos
- Department of Physiology and Pharmacology, School of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Moisés Tolentino Bento Silva
- Graduate Program in Food and Nutrition, Federal University of Piauí, Teresina, PI, Brazil; Graduate Program in Pharmacology, Federal University of Piauí, Teresina, PI, Brazil; Laboratory of Exercise and Gastrointestinal Tract, Department of Physical Education, Federal University of Piauí, Teresina, PI, Brazil; Laboratory of Physiology, Department of Immuno-Physiology and Pharmacology, School of Medicine and Biomedical Sciences, Institute of Biomedical Sciences Abel Salazar - ICBAS, Center for Drug Discovery and Innovative Medicines (MedInUP), University of Porto, Porto, Portugal.
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Yasunaga Y, Kinjo Y, Kondoh S, Yanagisawa D, Yuzuriha S, Kondoh S. Screening for Breast Cancer-Related Lymphedema Development Using Extracellular Water Ratio. Lymphat Res Biol 2023; 21:447-455. [PMID: 36951667 DOI: 10.1089/lrb.2022.0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
Background: This case-control retrospective study examined whether the extracellular water ratio (%ECW) of the upper extremity, as measured through bioelectrical impedance analysis (BIA), could be an indicator of the development and severity of breast cancer-related lymphedema (BCRL). Methods and Results: BIA was used to evaluate the changes in %ECW due to BCRL development, with the %ECW measured in female patients with unilateral BCRL and healthy controls. Receiver operating characteristic (ROC) analysis was performed to assess the diagnostic ability of %ECW to distinguish BCRL patients from controls. Twenty female patients, who were eligible for inclusion, and 20 healthy control volunteers were included. The %ECW of the affected arm correlated with the water volume difference between the affected and unaffected arms (R2 = 0.7183). ROC analysis showed that %ECW had a high diagnostic ability as a screening tool for BCRL development (area under the ROC curve = 0.982). A cutoff %ECW value of 38.5% could predict the presence of BCRL with a sensitivity of 91.7% and specificity of 97.9%. Conclusions: This study confirmed that %ECW could assess the presence and severity of BCRL in a single measurement noninvasively in a shorter amount of time. The %ECW value strongly correlated with excess arm body water volume, an indicator of the severity of unilateral arm lymphedema. The cutoff %ECW value could predict the presence of BCRL with high accuracy.
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Affiliation(s)
- Yoshichika Yasunaga
- Division of Plastic and Aesthetic Surgery, Ina Central Hospital, Ina, Japan
- Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Matsumoto, Japan
- Division of Plastic and Reconstructive Surgery, Shizuoka Cancer Center, Nagaizumi, Japan
| | - Yuto Kinjo
- Division of Plastic and Aesthetic Surgery, Ina Central Hospital, Ina, Japan
| | - Saeko Kondoh
- Nursing Division, Ina Central Hospital, Ina, Japan
| | - Daisuke Yanagisawa
- Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shunsuke Yuzuriha
- Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shoji Kondoh
- Division of Plastic and Aesthetic Surgery, Ina Central Hospital, Ina, Japan
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Wright T, Scarfino CD, O’Malley EM. Effect of pneumatic compression device and stocking use on symptoms and quality of life in women with lipedema: A proof-in-principle randomized trial. Phlebology 2023; 38:51-61. [PMID: 36519532 PMCID: PMC9902958 DOI: 10.1177/02683555221145779] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Does short-term use of pneumatic compression devices (PCD) and off-the-shelf compression alleviate symptoms and improve quality of life in women with lipedema and secondary lipolymphedema? METHODS Prospective, randomized controlled, industry-sponsored, proof-in-principle study comparing PCD plus conservative care (PCD+CC) to CC alone (control). Adult females with bilateral lipedema and secondary lymphedema were randomized to PCD+CC or CC. Outcome measures were lower limb and truncal circumferential measurements, bioimpedance, and quality-of-life, symptom, and pain intensity questionnaires. RESULTS Both groups experienced improvements in leg circumference and bioimpedance with more improvement in the PCD+CC group than the CC group. Pain scores of the SF-36 survey and numerical rating scales were improved in the PCD+CC group. Wong-Baker Faces scores showed trends toward improvement in both groups. CONCLUSIONS This proof-in-principle study supports conservative management with graduated compression and with or without PCD for improvement in leg circumference, bioimpedance measurements, and pain in patients with lipedema.
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Affiliation(s)
- Thomas Wright
- Laser Lipo and Vein Center, O’Fallon, MO, USA,Thomas Wright, Laser Lipo and Vein Center, 1630 Market Center Boulevard, Suite 201, O’Fallon, MO 63368, USA.
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Long-Term Effects of Extracorporeal Shock Wave Therapy on Breast Cancer-Related Lymphedema. J Clin Med 2022; 11:jcm11226747. [PMID: 36431224 PMCID: PMC9699053 DOI: 10.3390/jcm11226747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/12/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022] Open
Abstract
Extracorporeal shock wave therapy (ESWT) can reduce breast cancer-related lymphedema (BCRL). However, evidence of the long-term effectiveness of ESWT on BCRL is sparse. The aim of the study was to investigate whether ESWT has long-term effects on BCRL. We enrolled patients with stage 2 lymphedema. The 28 female patients were randomly divided into the ESWT group (n = 14) and the control group (n = 14). ESWT was applied thrice a week for a total of 3 weeks with an intensity of 0.056 to 0.068 mJ/mm2 and a frequency of 4 Hz. Complex decongestive therapy (CDT) was applied in both groups. The arm circumference, fluid volume, ratio of water content, and skin thickness were measured. Patients were evaluated at before treatment, 3 weeks after ESWT completion, and 3 months post-ESWT completion. The ESWT group, the circumference of the whole arm, volume, ratio of water content, QuickDASH score, and skin thickness showed statistically significant improvement at 3 weeks and 3 months post-treatment. When comparing the changes in measurement between the two groups at 3 weeks and 3 months post-treatment, ESWT group showed statistically significant improvement in circumference (cm) below the elbow, ratio of water content and skin thickness at 3 weeks and 3 months post treatment. Overall, ESWT improved lymphedema in patients with stage 2 BCRL, and the effects persisted for at least 3 months. Therefore, ESWT may be an additional treatment method for patients with lymphedema.
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Zhuang L, Chen H, Zheng X, Wu S, Yu Y, Lan L, Xu L, Xu J, Fan H. Bioelectrical impedance analysis for early screening of upper limb subclinical lymphedema: A case–control study. PLoS One 2022; 17:e0274570. [PMID: 36121834 PMCID: PMC9484636 DOI: 10.1371/journal.pone.0274570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 08/30/2022] [Indexed: 11/18/2022] Open
Abstract
Breast cancer-related lymphedema is a treatment-related chronic disease that causes great distress and medical burden. Early screening and precautionary measures for lymphedema could improve well-being and decrease medical costs. Herein, we used bioelectrical impedance analysis for early screening of lymphedema. We set up a verifiable standardized subclinical standard to screen subclinical lymphedema in postoperative breast cancer patients using bioelectrical impedance. The first part determined the criteria of subclinical lymphedema. Among the 424 female participants, 127 were healthy women, whereas 297 were postoperative breast cancer survivors. Subclinical standard boundaries were determined by the 95% confidence interval of the healthy women. The screening rate of patients with subclinical lymphedema was inferred by comparing the subclinical standard boundaries and the postoperative patient values. A total of 14.81–20.87% of postoperative breast cancer survivors were identified as patients with subclinical lymphedema. The second part provided the results of the verification test of this subclinical standard. The data of the verification test from 30 healthy women and 30 screened patients met the subclinical standard, and 30 breast cancer survivors with lymphedema verified the utility and feasibility of the subclinical standard. Therefore, this standard could provide a screening tool for early the identification of subclinical breast cancer survivors. Early detection helps implement personal and precise medical precautions for patients with subclinical lymphedema.
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Affiliation(s)
- Linli Zhuang
- Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Huaying Chen
- Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xuemei Zheng
- Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Shaoyong Wu
- Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
- * E-mail:
| | - Youhui Yu
- Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Lu Lan
- Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Liang Xu
- Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jumei Xu
- Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Hongying Fan
- Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
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Kim RS, Yi CC, Lee JW, Yoon JA, Lee S, Kim JH. Outcomes of lipectomy in patients with advanced unilateral upper extremity lymphedema with regard to the difference in time required for indocyanine green to reach the axilla: A retrospective cohort study in a single center. Medicine (Baltimore) 2022; 101:e30742. [PMID: 36123869 PMCID: PMC9478229 DOI: 10.1097/md.0000000000030742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
This study aimed to compare and analyze the prognosis after lipectomy with respect to the difference in time required for indocyanine green (ICG) to reach the axilla in patients with advanced unilateral upper extremity lymphedema. The study population was divided into 2 groups, according to the time required by ICG to reach the axilla after injection, that is, <1 hour (<1 hour; n = 9) and over 1 hour (>1 hour; n = 8). The patient's arm volume was examined before surgery and up to 12 months after surgery. The volume difference between the 2 groups was compared using the excess volume ratio. Statistically significant differences were not observed before surgery (P = .847) and 1 month (P = .336), 3 months (P = .630), and 6 months after surgery (P = .124) between the excess volume ratio values of the < 1 hour and > 1 hour groups. A statistically significant difference was confirmed 12 months after surgery (P = .034). The difference in the time when ICG reached the axilla in patients with lymphedema was associated with prognosis after lipectomy. The difference in time could possibly be used as a variable to classify the progress of lymphedema in the future.
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Affiliation(s)
- Ryuck Seong Kim
- Department of Plastic and Reconstructive Surgery, Pusan National University, School of Medicine, Busan, Korea
| | - Changryul Claud Yi
- Department of Plastic and Reconstructive Surgery, Pusan National University, School of Medicine, Busan, Korea
| | - Jae Woo Lee
- Department of Plastic and Reconstructive Surgery, Pusan National University, School of Medicine, Yangsan, Republic of Korea
| | - Jin A Yoon
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- Department of Rehabilitation Medicine, Pusan National University, School of Medicine, Busan, Republic of Korea
| | - Seungbeom Lee
- Department of Artificial Intelligence, Pohang University of Science and Technology, Pohang, Gyeongsangbuk-do, Korea
| | - Joo Hyoung Kim
- Department of Plastic and Reconstructive Surgery, Pusan National University, School of Medicine, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- * Correspondence: Joo Hyoung Kim, MD, PhD, Department of Plastic and Reconstructive Surgery, Pusan National University, School of Medicine, 179, Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea (e-mail: )
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Lee H, Lee B, Kim Y, Min S, Yang E, Lee S. Effects of Sodium Selenite Injection on Serum Metabolic Profiles in Women Diagnosed with Breast Cancer-Related Lymphedema-Secondary Analysis of a Randomized Placebo-Controlled Trial Using Global Metabolomics. Nutrients 2021; 13:nu13093253. [PMID: 34579131 PMCID: PMC8470409 DOI: 10.3390/nu13093253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/15/2021] [Accepted: 09/15/2021] [Indexed: 02/06/2023] Open
Abstract
In our previous study, intravenous (IV) injection of selenium alleviated breast cancer-related lymphedema (BCRL). This secondary analysis aimed to explore the metabolic effects of selenium on patients with BCRL. Serum samples of the selenium-treated (SE, n = 15) or the placebo-controlled (CTRL, n = 14) groups were analyzed by ultra-high-performance liquid chromatography with Q-Exactive Orbitrap tandem mass spectrometry (UHPLC-Q-Exactive Orbitrap/MS). The SE group showed a lower ratio of extracellular water to segmental water (ECW/SW) in the affected arm to ECW/SW in the unaffected arm (arm ECW/SW ratio) than the CTRL group. Metabolomics analysis showed a valid classification at 2-weeks and 107 differential metabolites were identified. Among them, the levels of corticosterone, LTB4-DMA, and PGE3—which are known anti-inflammatory compounds—were elevated in the SE group. Pathway analysis demonstrated that lipid metabolism (glycerophospholipid metabolism, steroid hormone biosynthesis, or arachidonic acid metabolism), nucleotide metabolism (pyrimidine or purine metabolism), and vitamin metabolism (pantothenate and CoA biosynthesis, vitamin B6 metabolism, ascorbate and aldarate metabolism) were altered in the SE group compared to the CTRL group. In addition, xanthurenic acid levels were negatively associated with whole blood selenium level (WBSe) and positively associated with the arm ECW/SW. In conclusion, selenium IV injection improved the arm ECW/SW ratio and altered the serum metabolic profiles in patients with BCRL, and improved the anti-inflammatory process in lipid, nucleotide and vitamin pathways, which might alleviate the symptoms of BCRL.
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Affiliation(s)
- Heeju Lee
- Department of Food and Nutrition, BK21 FOUR Project, College of Human Ecology, Yonsei University, Seoul 03722, Korea; (H.L.); (Y.K.); (S.M.)
| | - Bora Lee
- Graduate Program in Biomedical Engineering, College of Medicine, Yonsei University, Seoul 03722, Korea;
| | - Yeonhee Kim
- Department of Food and Nutrition, BK21 FOUR Project, College of Human Ecology, Yonsei University, Seoul 03722, Korea; (H.L.); (Y.K.); (S.M.)
| | - Sohyun Min
- Department of Food and Nutrition, BK21 FOUR Project, College of Human Ecology, Yonsei University, Seoul 03722, Korea; (H.L.); (Y.K.); (S.M.)
| | - Eunjoo Yang
- Department of Rehabilitation Medicine, College of Medicine, Seoul National University Bundang Hospital, Seoul National University, Seongnam 13620, Korea;
| | - Seungmin Lee
- Department of Food and Nutrition, BK21 FOUR Project, College of Human Ecology, Yonsei University, Seoul 03722, Korea; (H.L.); (Y.K.); (S.M.)
- Correspondence: ; Tel.: +82-2-2123-3118
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