The effect of myofascial release in patients with breast cancer-related lymphedema: a cross-over randomized controlled trial.

AIM: This study aimed to compare the effects of myofascial release (MFR) on upper extremity volume in patients with breast cancer-related lymphedema (BCRL). DESIGN: A randomized, single-blinded, cross-over, controlled trial. SETTING: An outpatient rehabilitation clinical setting. POPULATION: Thirty patients with BCRL. METHODS: Within a crossover design with randomized treatment sequences, fifteen subjects received MFR for 4 weeks, followed by 4 weeks of washout period, and then received placebo MFR and the other fifteen subjects received interventions in the reverse order. Each session had a 60 min process including either MFR or placebo MFR for 30 min, followed by complete decongestive therapy for 30 min twice a week. Upper limb volume as the primary outcome and subjective pain, shoulder range of motion (ROM), chest mobility, shoulder function, and quality of life as secondary outcomes were assessed before and at the end of each intervention period. RESULTS: There were significant differences in upper limb volume after both MFR and placebo MFR (P<0.05) while no significant difference between MFR and placebo MFR treatments was found (P>0.05). MFR-based treatment also achieved a greater improvement than placebo MFR-based treatment in subjective pain and shoulder ROM (P<0.05), except for internal rotation, and shoulder function. CONCLUSIONS: MFR-based treatment showed clinical improvement in shoulder function, induced by decreased edema volume and pain, and improved ROM and chest mobility. However, a further study with parallel randomized controlled trials to confirm what was achieved in the present study. CLINICAL REHABILITATION IMPACT: MFR-based treatment is considered an important part of BCRL rehabilitation. Moreover, MFR-based treatment may be safe for patients with BCRL.

Elevated serum soluble E-selectin levels in Korean children with measles.

BACKGROUND: Measles is a highly infectious, acute viral illness characterized by high fever and generalized skin rash of which pathogenesis is uncertain. E-selectin, a ligand of the cutaneous lymphocyte-associated antigen (CLA)+ T lymphocytes is highly expressed on vascular endothelium in atopic dermatitis and psoriasis, but in the past there has been a lack of statistical data on its impact on patients with measles. The aim of the present study was to investigate whether the serum soluble E-selectin (sE-selectin) levels are elevated in children with measles. METHODS: Twenty-five children with measles, 33 children with atopic dermatitis, 20 with atopic asthma and 20 healthy controls were enrolled. Serum sE-selectin and tumor necrosis factor (TNF)-alpha levels were measured using sandwich enzyme-linked immunosorbent assay. RESULTS: Serum levels of sE-selectin were found to be significantly higher in children with measles than in children with atopic dermatitis, atopic asthma and healthy controls. But it was not significantly correlated with the duration of rash or with the presence of a complication in children with measles. Serum TNF-alpha levels were higher in children with measles than in children with atopic dermatitis. There was no correlation between sE-selectin and TNF-alpha levels. CONCLUSIONS: sE-selectin levels are elevated in children with measles, which may imply that CLA+ T lymphocytes are associated with the development of measles rash.

A novel pro-angiogenic function for interferon-γ-secreting natural killer cells.

PURPOSE: To explore the function of natural killer (NK) cells in inflammatory angiogenesis in mice. METHODS: To study ocular angiogenic responses we used the cornea BFGF micropellet and the laser-induced choroidal neovascularization (CNV) mouse models (C57BL/6). To deplete NK cells in these models, we injected an anti-NK1.1 antibody or an isotype antibody as a control. Corneas or choroids were immunohistochemically stained for blood vessels (CD31), macrophages (F4/80), or CNV (isolectin-IB4). Vascular endothelial growth factors (VEGF), IFN-γ, or TNF-α levels were measured by real-time quantitative PCR (qPCR) or flow cytometry. A coculture assay of macrophages, NK cells, and human umbilical vein endothelial cells (HUVECs) was analyzed morphometrically to examine the ability of NK cells to induce angiogenesis in vitro. RESULTS: Our data demonstrate that in vivo depletion of NK cells leads to a significant reduction of corneal angiogenesis and CNV. Furthermore, NK cell depletion reduces macrophage infiltration into the cornea and mRNA expression levels of VEGF-A, VEGF-C, and VEGFR3 at day 7 after micropellet insertion. In the laser-induced CNV model, our data show that NK cell depletion leads to decreased areas of CNV and significantly reduced mRNA expression of VEGFs and IFN-γ in the choroid. An in vitro coculture assay shows an IFN-γ-dependent increase in VEGF expression levels, thereby increasing endothelial cell proliferation. CONCLUSIONS: Our findings demonstrate a novel pro-angiogenic function for NK cells, indicating that IFN-γ-secreting NK cells can induce angiogenesis by promoting enhanced VEGF expression by macrophages.