Forearm blood flow measured by venous occlusion plethysmography in healthy subjects and in women with postmastectomy oedema

Abstract

A chronic swelling of the arm may develop following damage to axillary lymph vessels during breast cancer treatment. Certain unusual pathophysiological features of postmastectomy oedema indicate that factors additional to lymphatic damage are important. One factor postulated previously is a haemodynamic abnormality. Forearm blood flow was therefore measured by venous occlusion plethysmography using both a conventional mercury strain gauge and a newer optical volumeter (Perometer). The latter was initially assessed in healthy subjects. When forearm blood flow was measured using the two methods simultaneously, the strain gauge and Perometer did not differ significantly for healthy or oedematous arms. Dominant and non-dominant arm blood flow in healthy subjects was similar but with greater variation between sides with the Perometer. Using the strain gauge, blood flow in the oedematous arm (2.51 +/- 1.33 ml/100 ml per min) was significantly lower than in the opposite unaffected arm (3.77 +/- 2.29 ml/100 ml per min; p = 0.026). The Perometer results showed a similar but nonsignificant trend (p = 0.105). Taking into account the greater limb volume on the affected side, total forearm blood flow was essentially the same in each arm (unaffected: 40.72 +/- 28.70 micromilligrams/min; oedematous: 41.78 +/- 22.11 ml/min). The reduced blood flow per unit volume of arm was therefore likely to be due to a simple 'dilution' effect of the increase in volume. The results indicate that it is unlikely that raised blood flow contributes to oedema formation, contrary to the haemodynamic concept.

A novel method for the in vivo isolation of circulating tumor cells from peripheral blood of cancer patients using a functionalized and structured medical wire

“…The flow rate, velocity, and flow direction can be regulated by a peristaltic pump. A flow rate of 20 ml/min was applied to reflect in vivo flow conditions within cubital veins (21). In this in vitro flow system the FSMW was tested for binding of cultured EpCAM-positive SK-BR-3 breast cancer cells (CLS, Eppelheim, Germany), which were grown in cell culture flasks until cell monolayers reached a confluency of ∼80%.…”

Effects of Qigong Exercise on Upper Limb Lymphedema and Blood Flow in Survivors of Breast Cancer

“…1 Conventional treatments for breast cancer (eg, surgery and radiotherapy) are aggressive and commonly result in many side effects such as chronic lymphedema and altered circulation in the affected upper limb. 2,3 These side effects, in turn, present adverse psychological effects (eg, low self-esteem or body image) and functional inconvenience (eg, ill-fitting clothing) to survivors of breast cancer. 2,4 It has been reported that 48% to 83% of breast cancer patients or survivors turn to complementary therapies (eg, mind-body exercise and herbal therapy), which they believe can assist them in managing the side effects of conventional cancer treatments such as persistent fatigue and hence improve their quality of life.…”

Post-prandial endothelial dysfunction is ameliorated following weight loss in obese premenopausal women

“…Importantly, physical exercise [33,34] and macronutrient composition of the diet have a profound impact on endothelial function [35]. It is also important to note that our subjects showed only very mild impairments in fasting PIFBF at the beginning of the study compared to healthy controls [36], and thus potential for further improvement detected by plethysmography might have been limited. Indeed, in general agreement with other authors [37–42], we observed a decrease in plasma levels of ICAM-1 and VCAM-1 following weight loss, which suggests overall improvement of endothelial function.…”