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T*
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T*
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T*
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T*
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ET
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59.754 77.499 490.11 .22675 re
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214.639 392.882 130.62 .22678 re
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377.178 374.967 172.687 .28348 re
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214.639 374.967 130.62 .28348 re
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59.754 347.301 490.11 .28345 re
f
BT
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18.9802 -1.8197 TD
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(2)Tj
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T*
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T*
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T*
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T*
[(gy)15.1(ne)19.7(co)19.7(lo)20.7(gi)20.7(st)20.9(-l)15(ed)-406.5(ou)20.8(tp)20.7(at)19.5(ie)19.5(nt)-411.3(cl)19.5(in)20.7(ic)-406.7(\()]TJ
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[(20)20.8(\),)-413.4(th)20.7(e)-428.5(a)0(c)18.5(u)0(t)20.7(e)-422.7(ca)18.5(re)]TJ
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T*
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ET
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393.902 682.696 158.853 .28351 re
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BT
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16.0318 -1.8197 TD
(Inpatients)Tj
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-1.8139 -1.8139 TD
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(20\))Tj
3.7603 1.0135 TD
[(Acute)-336.9(care)-334.4(hospital)]TJ
2.4589 -1.0135 TD
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(n)Tj
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(10\))Tj
5.6203 1.0135 TD
[(Long-term)-339(care)]TJ
.0749 -1.0135 TD
[(facility)-333.6(\()]TJ
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(n)Tj
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(30\))Tj
/F5 1 Tf
-48.4409 -1.8946 TD
[(Classication)-340(of)-330.2(edema)]TJ
1.002 -1.0135 TD
[(Primary)-331.7(lymphedema)-11671.2(2)-329.2(\(3.9\))-3969.2(0)-335(\(0.0\))-5190(0)-335(\(0.0\))-6232.3(0)-335(\(0.0\))]TJ
T*
[(Secondary)-334.7(lymphedema)-10168.2(49)-330.2(\(96.1\))-2968.2(18)-336(\(90.0\))-4690(4)-335(\(40.0\))-5732.3(0)-335(\(0.0\))]TJ
0 -1.0077 TD
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-1.002 -1.3187 TD
[(Secondary)-334.7(swelling)-338.5(due)-332.4(to)-336.2(cancer)]TJ
1.002 -1.0135 TD
[(Breast)-337.5(cancer)-14395.5(13)-330.2(\(25.5\))-2968.2(10)-336(\(50.0\))-4690(3)-335(\(30.0\))-6855.2()]TJ
0 -1.0077 TD
[(Endometrial/cervical)-341.2(cancer)-8521.8(24)-330.2(\(47.1\))-3469.2(8)-335(\(40.0\))-4690(0)-335(\(0.0\))-7355.2()]TJ
0 -1.0135 TD
[(Gastric/liver/colorectal)-339.4(cancer)-8193.5(2)-329.2(\(3.9\))-3969.2(0)-335(\(0.0\))-5190(1)-335(\(10.0\))-6855.2()]TJ
T*
[(Others)-17249(12)-330.2(\(23.5\))-3469.2(2)-335(\(10.0\))-4690(6)-335(\(60.0\))-6855.2()]TJ
-1.002 -1.3129 TD
[(Treatment)-337.6(of)-336(lymphatic)-335.4(obstruction)-6415.9(49)-330.2(\(96.1\))-2968.2(20)-336(\(100.0\))-4190(4)-335(\(40.0\))-5732.3(0)-335(\(0.0\))]TJ
0 -1.0135 TD
[(Duration)-338.5(of)-330.2(edema)]TJ
1.002 -1.0135 TD
[(36)-331.2(Months)-15531.8(1)-329.2(\(2.0\))-3969.2(1)-335(\(5.0\))-5190(7)-335(\(70.0\))-5732.3(4)-335(\(13.3\))]TJ
0 -1.0077 TD
[(6)-329.2(Months)-335(to)-336.2(1)-335(year)-12519.6(1)-329.2(\(2.0\))-3969.2(3)-335(\(15.0\))-4690(2)-335(\(20.0\))-5732.3(8)-335(\(26.7\))]TJ
0 -1.0135 TD
[(12)-331.2(Years)-16252.8(2)-329.2(\(3.9\))-3969.2(2)-335(\(10.0\))-4690(0)-335(\(0.0\))-6232.3(3)-335(\(10.0\))]TJ
T*
[(25)-331.2(Years)-16252.8(9)-329.2(\(17.6\))-3469.2(5)-335(\(25.0\))-4690(0)-335(\(0.0\))-6232.3(4)-335(\(13.3\))]TJ
T*
[(510)-332.2(Years)-15250.8(23)-330.2(\(45.1\))-3469.2(5)-335(\(25.0\))-4690(1)-335(\(10.0\))-5732.3(4)-335(\(13.3\))]TJ
/F7 1 Tf
0 -1.0077 TD
(>)Tj
/F5 1 Tf
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[(10)-330.2(Years)-15700(15)-330.2(\(29.4\))-3469.2(4)-335(\(20.0\))-4690(0)-335(\(0.0\))-6232.3(7)-335(\(23.3\))]TJ
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[(Cellulitis)-17231(25)-330.2(\(49.0\))-3469.2(3)-335(\(15.0\))-4690(3)-335(\(30.0\))-5732.3(4)-335(\(13.3\))]TJ
0 -1.0077 TD
[(Infection)-17794(9)-329.2(\(17.6\))-3469.2(2)-335(\(10.0\))-4690(1)-335(\(10.0\))-5732.3(4)-335(\(13.3\))]TJ
0 -1.0135 TD
[(Hospitalization)-336.8(due)-338.1(to)-330.4(cellulitis)-8587.6(0)-329.2(\(0.0\))-3969.2(1)-335(\(5.0\))-5190(1)-335(\(10.0\))-5732.3(1)-335(\(3.3\))]TJ
T*
[(Infection,)-337.5(number)-336.5(of)-330.2(times)]TJ
1.002 -1.0135 TD
[(0)-19413(4)0(2)-330.2(\(82.4\))-2968.2(18)-336(\(90.0\))-4690(9)-335(\(90.0\))-5231.3(26)-336(\(86.7\))]TJ
0 -1.0077 TD
[(1)-19914(5)-329.2(\(9.8\))-3969.2(2)-335(\(10.0\))-4690(0)-335(\(0.0\))-6232.3(3)-335(\(10.0\))]TJ
0 -1.0135 TD
[(2)-19914(2)-329.2(\(3.9\))-3969.2(0)-335(\(0.0\))-5190(1)-335(\(10.0\))-5732.3(0)-335(\(0.0\))]TJ
T*
[(3)-19914(2)-329.2(\(3.9\))-3969.2(0)-335(\(0.0\))-5190(0)-335(\(0.0\))-6232.3(1)-335(\(3.3\))]TJ
-1.002 -1.313 TD
[(Skin)-332.2(care)-335.7(advice)-14118.1(48)-330.2(\(94.1\))-2968.2(19)-336(\(95.0\))-4690(3)-335(\(30.0\))-5732.3(0)-335(\(0.0\))]TJ
0 -1.0135 TD
[(Wound)-335.3(dressing)-337.2(use)-13133.5(0)-329.2(\(0.0\))-3969.2(0)-335(\(0.0\))-5190(0)-335(\(0.0\))-6232.3(1)-335(\(3.3\))]TJ
T*
[(Antibiotic)-335.2(use)-15177.7(13)-330.2(\(25.5\))-3469.2(0)-335(\(0.0\))-5190(0)-335(\(0.0\))-6232.3(1)-335(\(3.3\))]TJ
0 -1.0077 TD
[(Massage)-17419(51)-330.2(\(100.0\))-2468.2(16)-336(\(80.0\))-4690(1)-335(\(10.0\))-5231.3(11)-336(\(36.7\))]TJ
0 -1.0135 TD
[(Physiotherapy)-15690(0)-329.2(\(0.0\))-3969.2(0)-335(\(0.0\))-5190(0)-335(\(0.0\))-5731.3(13)-336(\(43.3\))]TJ
T*
[(Compression)-336.5(garment)-12011.4(49)-330.2(\(96.1\))-2968.2(20)-336(\(100.0\))-4190(4)-335(\(40.0\))-5732.3(0)-335(\(0.0\))]TJ
T*
[(Multi-layer)-337.2(bandage)-12667.7(34)-330.2(\(66.7\))-2968.2(15)-336(\(75.0\))-4690(1)-335(\(10.0\))-5732.3(0)-335(\(0.0\))]TJ
0 -1.0077 TD
[(Pneumatic)-336.2(compression)-336.7(pumps)-8782(0)-329.2(\(0.0\))-3969.2(0)-335(\(0.0\))-5190(1)-335(\(10.0\))-5732.3(1)-335(\(3.3\))]TJ
0 -1.0135 TD
[(Debulking)-333.7(lymphedema)-338.4(\(lymphatic)-336.4(surgery\))-3314.3(7)-329.2(\(13.7\))-3469.2(1)-335(\(5.0\))-5190(0)-335(\(0.0\))-6232.3(0)-335(\(0.0\))]TJ
T*
[(Main)-334.4(categories)-337.2(of)-336(treatment)-336.6(within)-335.5(Complex)]TJ
.9905 -1.0135 TD
[(Decongestive)-340(Therapy)]TJ
.0115 -1.0077 TD
[(Exercise)-335.1(advice)-13501.9(40)-330.2(\(80.0\))-2968.2(17)-336(\(85.0\))-4690(1)-335(\(0.0\))-6232.3(0)-335(\(0.0\))]TJ
0 -1.0135 TD
[(Cellulitis)-335.4(advice)-13271.6(49)-330.2(\(98.0\))-2968.2(19)-336(\(95.0\))-4690(1)-335(\(0.0\))-6232.3(0)-335(\(0.0\))]TJ
T*
[(Psychological)-333.3(support)-10959.7(43)-330.2(\(86.0\))-2968.2(10)-336(\(50.0\))-4690(0)-335(\(0.0\))-6232.3(0)-335(\(0.0\))]TJ
-1.002 -1.3129 TD
[(Subjective)-336.2(control)-336.7(of)-330.2(chronic)-337.7(edema:)-339(in)-330.4(your)]TJ
.9905 -1.0135 TD
[(opinion,)-333.1(is)-336(the)-332.6(swelling)-338.5(well)-334.5(controlled?)]TJ
19.9246 1.0135 TD
[(23)-330.2(\(46.0\))-2968.2(10)-336(\(50.0\))-4690(5)-335(\(50.0\))-5231.3(13)-336(\(43.3\))]TJ
/F11 1 Tf
8.7511 0 0 8.7511 70.0157 211.011 Tm
(N)Tj
/F5 1 Tf
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(\(%\).)Tj
/F3 1 Tf
8.9663 0 0 8.9663 62.022 749.6502 Tm
(198)Tj
49.3883 0 TD
[(DAI)-331.6(ET)-338.7(AL.)]TJ
ET
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BT
/F5 1 Tf
9.843 0 0 9.843 69.7323 422.5889 Tm
0 0 0 rg
0 Tc
0 Tw
[(Lymphedema)-502(conditions)-502(in)-497.7(each)-503.2(facility)-501.2(are)-500.9(shown)-495.8(in)]TJ
-1.0137 -1.1807 TD
[(Table)-331.7(2.)-327.1(Except)-332.8(for)-331.5(two)-326.8(cases,)-328.8(they)-334(all)-327.3(had)-327(secondary)-335.7(lym-)]TJ
0 -1.175 TD
[(phedema.)-430.6(Duration)-431.5(of)-422.6(edema)-430.7(was)-425.6(510)-430.6(years)-428.1(in)-422.8(23)-428.4(cases)]TJ
0 -1.1807 TD
[(\(46%\))-311.8(in)-307.6(the)-304.1(gynecologist-led)-315.2(clinic)-308.8(and)-304(5)-306.4(cases)-313.9(\(25.0%\))-304.8(in)]TJ
0 -1.175 TD
[(the)-355.9(nurse-led)-357.7(clinic,)-358.3(and)-355.8(the)-355.9(duration)-355.8(was)-356.5(36)-354.6(months)-353.4(in)-353.7(7)]TJ
0 -1.1807 TD
[(cases)-210.2(\(70.0%\))-206.9(in)-203.9(the)-206.2(acute)-210.7(care)-209.4(hospital,)-203.7(while)-209.4(the)-206.2(duration)-206(of)]TJ
0 -1.175 TD
[(chronic)-217.5(edema)-217.6(ranged)-216.3(from)-212.9(36)-209.5(months)-215.1(to)-215.4(over)-212.9(10)-215.3(years)-215(in)-209.7(the)]TJ
0 -1.1807 TD
[(patients)-374.2(in)-370.9(the)-373.2(long-term)-375.4(care)-370.7(medical)-375.6(facility.)-377.9(Overall,)-371.7(25)]TJ
T*
[(cases)-336.9(\(50%\))-329.1(had)-332.8(a)-330.6(history)-330.3(of)-330.5(cellulitis,)-334.1(with)-333.8(2)-329.4(cases)-331.1(\(3.9%\))]TJ
0 -1.1116 TD
[(having)-198(2)-191.2(episodes)-195.2(and)-194.5(2)-191.2(cases)-192.9(\(3.9%\))-194.3(having)-192.2(3)-191.2(episodes)-195.2(in)-192.4(the)]TJ
T*
[(gynecologist-led)-194.2(clinic.)-185.5(In)-186.5(each)-186.4(outpatient)-186.7(clinic,)-191.3(over)-184.1(80%)-182.9(of)]TJ
T*
[(patients)-305.1(received)-301.5(standard)-299(lymphedema)-305.1(care,)-299.3(including)-299.5(skin)]TJ
0 -1.1174 TD
[(care)-347.7(advice,)-347.7(massage,)-343.8(multilayer)-343.4(garment,)-348.9(and)-338.5(exerc)-9(ise)-338.5(ad-)]TJ
0 -1.1116 TD
[(vice.)-419.2(Positive)-418.9(subjective)-423.6(opinions)-417.8(regarding)-415.5(the)-419.3(quality)-418.2(of)]TJ
T*
[(edema)-286.7(control)-279.8(ranged)-285.4(from)-282(43.3%)-279.6(to)-278.8(50.0%)-279.6(in)-284.5(all)-281.2(facilities.)]TJ
1.0137 -1.1174 TD
[(The)-403.1(relevant)-404.2(anatomical)-403.2(locations)-404.1(of)-399.6(chronic)-401.8(edema)-401.9(for)]TJ
-1.0137 -1.1116 TD
[(both)-275.2(sides)-271.4(of)-272.9(the)-275.3(whole)-272.6(body)-269.4(are)-276.3(summarized)-276.1(in)-273(Table)-274.1(3.)-269.5(Of)]TJ
25.5097 18.3331 TD
[(all)-321.5(the)-321.4(body)-315.4(parts,)-321(chronic)-326.9(edema)-321.3(was)-321.9(most)-322.4(common)-321.3(in)-319.1(the)]TJ
0 -1.1116 TD
[(lower)-382(limb,)-377.9(foot,)-382.3(lower)-382(leg,)-382.4(and)-378.8(upper)-381(leg.)-382.4(Table)-383.5(4)-381.2(shows)]TJ
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[(Upper)-629.6(lymphedema)-633.4(patients)-627.6(at)-631.3(International)-634.6(Society)-632.2(of)]TJ
T*
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[(clinics.)-318.9(Lower)-319.7(lymphedema)-316.6(patients)-322.4(at)-314.5(ISL)-315.3(late)-318(stage)-318.8(II)-318.9(ac-)]TJ
T*
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f
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f
190.488 682.696 135.042 .28351 re
f
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f
BT
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[(Acute)-336.9(care)-334.4(hospital)]TJ
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6.0234 1.0135 TD
[(Acute)-336.9(care)-334.4(hospital)]TJ
2.4589 -1.0135 TD
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(20\))Tj
8.0389 1.0135 TD
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1.002 -1.0135 TD
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T*
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T*
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[(Lower)-336.3(limbs)]TJ
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T*
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(Trunk)Tj
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T*
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T*
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13.6708 1.0135 TD
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(N)Tj
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ET
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f
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f
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f
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f
BT
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[(Upper)-335(lymphedema)]TJ
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[(Lower)-335(lymphedema)]TJ
2.4474 -1.0077 TD
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T*
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(N)Tj
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[(ISL,)-330.6(International)-336.8(Society)-334.8(of)-333.1(Lymphology.)]TJ
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[(LIMPRINT)-339.7(IN)-335.1(JAPAN)]TJ
53.0113 0 TD
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ET
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T*
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T*
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T*
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T*
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T*
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[(10)-6.6(,11)]TJ
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T*
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T*
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T*
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[(pr)6.4(ac)5.2(tic)5.2(es)6.5(.)]TJ
7.3823 0 0 6.5614 100.6299 148.8755 Tm
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(13)Tj
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T*
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[(cl)5.1(in)5.2(ic)-191.7(was)-196.1(t)5.1(he)-191.7(larg)5.2(er)-190.6(numbers)-190.4(of)]TJ
13.0861 0 TD
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[(lo)6.4(we)5.3(r)-195.1(l)6.3(ym)5.2(ph)6.4(ed)6.4(em)5.2(a)-196.3(p)6.4(at)6.3(ien)6.4(t).6(s)]TJ
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(\()Tj
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(n)Tj
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[(3)5.4(8)-.3(\))-368.9(a)-1.5(n)5.4(d)-368.9(late)-370.1(II)-368.9(p)5.4(a)-1.5(ti)5.3(en)5.4(ts)-368.7(\(6)5.4(3.2%\))-368.9(t)-.4(h)5.4(a)-1.5(n)-368.9(i)-.4(n)-368.9(t)5.3(he)-370.1(nu)5.4(rs)5.6(e-l)5.3(e)-1.5(d)]TJ
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T*
.0117 Tc
[(related)-254.3(t)-1(o)-254.3(c)-2.1(ell)4.7(u)-.9(li)4.7(ti)4.7(s.)]TJ
7.3823 0 0 6.5614 140.3716 94.1102 Tm
.0145 Tc
(14)Tj
9.843 0 0 9.843 150.5196 89.7448 Tm
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[(Fu)5.6(rth)5.6(e)-1.3(r)-253.5(i)-.2(nv)5.6(es)5.8(tig)5.6(at)5.5(io)5.6(n)-259.3(\()-.1(e.g.,)-255.9(f)-.1(r)5.7(e)-1.3(qu)5.6(en)5.6(cy)]TJ
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[(an)5.4(d)-282.5(m)4.2(et)5.3(hod)5.4(ol)5.3(ogy)-276.8(of)-282.5(man)5.4(a)-1.5(g)5.4(e)-1.5(men)5.4(t)-.4(,)-279.1(a)-1.5(n)5.4(d)-282.5(pati)5.3(en)5.4(t)-282.7(c)-1.5(o)5.4(m)-1.5(p)5.4(liance\))]TJ
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[(is)-295(n)4.3(e)-2.6(eded)-295.2(to)-295.2(clarif)4.4(y)-295.2(t)-1.5(h)4.3(e)-296.3(details)-295(t)4.2(h)-1.4(at)-295.3(po)4.3(tenti)4.2(a)-2.6(l)4.2(l)-1.5(y)-295.2(p)4.3(reven)4.3(t)-295.3(cel-)]TJ
T*
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[(lu)5.7(li)5.6(tis)-276.3(epis)5.9(od)5.7(es)-276.3(in)-276.5(th)5.7(es)5.9(e)-283.4(p)5.7(at)5.6(ients)5.9(.)]TJ
26.5177 41.1934 TD
0 Tc
[(This)-385.7(study)-385.6(also)-385.6(showed)-388.6(that)-386(edema)-384.6(can)-385.8(be)-383.5(found)-385.6(in)-388.2(the)]TJ
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[(trunk)-685.2(region.)-685.2(In)-687.6(the)-684.2(gynecologist-led)-689.5(outpatient)-687.8(clinic,)]TJ
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[(chest-)-8.8(breast)-417.8(areas.)-426.9(Previous)-418.7(studies)-423.4(have)-421.4(not)-418.1(provided)-424.8(the)]TJ
T*
[(details)-223.3(of)-221(the)-223.5(regions)-221.9(affected)-220.9(by)-221.1(chronic)-223.2(edema)-223.3(in)-221.2(outpatient)]TJ
T*
[(clinics.)-359.2(Further)-354.4(investigation)-362.7(of)-353.5(the)-355.9(details)-355.8(of)-353.5(the)-355.9(care)-359.2(pro-)]TJ
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1.0137 -1.1116 TD
[(Generic)-542.1(QOL)-541.9(scores)-538.4(in)-538(lymphedema)-541.2(outpatients)-544.7(were)]TJ
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[(88.8%10)-6.5(0.0%,)-362.6(a)-359.4(relatively)-372.1(good)-361.5(status)-364.7(compared)-364.8(to)-365.2(inpa-)]TJ
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[(tients)-249.9(at)-239.6(an)-245.3(acute)-245.3(care)-244(hospital)-246.3(\(71.7%\).)-244.9(It)-244.2(is)-244(quite)-243.1(interesting)]TJ
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T*
[(was)-379.5(extremely)-383.5(high)-378.9(\(0.7961.000\).)-373.7(Professional-led)-383.7(clinics)]TJ
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[(can)-437.6(preserve)-438.3(patients)-438.6(functional)-434.2(status,)-437.3(leading)-436.5(to)-434.3(a)-434.2(high)]TJ
T*
[(utilit)-7.3(y)-208.4(score.)-218.4(However,)-216.8(subjective)-222(satisfaction)-218.4(with)-212.9(control)-216.4(of)]TJ
T*
[(chronic)-269.3(edema)-263.7(was)-264.3(only)-258(46.6%)-262.3(or)-261.3(50.0%)-262.3(in)-261.5(both)-263.7(outpatients)]TJ
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T*
[(subjective)-216.3(satisfaction)-218.4(with)-207.1(edema)-211.8(control.)-214.1(Further)-210.4(study)-212.8(will)]TJ
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[(This)-212.9(study)-207(has)-211.6(two)-211.7(limitations.)-214.4(First,)-210.4(this)-206.1(investigation)-218.7(was)]TJ
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[(LIMPRINT.)-230.3(Second,)-231.1(the)-229.2(questionnaires)-226.2(related)-230.3(to)-227(QOL)-230.9(were)]TJ
T*
[(not)-320.2(suitable)-322.4(for)-320(elderly)-321.3(inpatients)-324.7(due)-321.2(to)-319.1(cognitive)-317.9(dysfunc-)]TJ
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/F3 1 Tf
8.9663 0 0 8.9663 313.0582 149.726 Tm
(Conclusion)Tj
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9.843 0 0 9.843 323.0361 133.285 Tm
[(This)-506.6(LIMPRINT)-503.4(Japan)-508.7(branch)-504.2(survey)-502.9(investigated)-512.4(the)]TJ
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[(prevalence)-299.2(of)-290.2(chronic)-292.4(edema)-292.5(in)-284.5(various)-291(care)-295.8(settings)-292.2(and)-286.7(its)]TJ
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[(chronic)-292.4(edema)-286.7(varied)-285.5(according)-290(to)-284.5(the)-286.8(facility)-288.1(type,)-285.6(ranging)]TJ
T*
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T*
[(large)-284.4(health)-285.7(care)-284.3(issue)-277.1(needs)-284.1(more)-283.2(attention.)]TJ
ET
62.022 719.49 490.167 .22668 re
f
62.022 508.705 490.167 .22678 re
f
210.047 700.611 214.923 .22681 re
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62.022 682.923 490.167 .22675 re
f
BT
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(Table)Tj
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11.4768 -1.8427 TD
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18.3525 -1.8197 TD
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[(51\))-5133.8(Nurse)-335(led)-332.6(\()]TJ
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(20\))Tj
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(EQ-5D)Tj
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T*
[(Symptom)-11468.8(2.3)-333.6(\(1.72.7\))-8000.8(1.9)-333.6(\(1.52.3\))-10171.7(3.0)]TJ
T*
[(Mood)-12978.8(1.0)-333.6(\(1.02.0\))-8000.8(1.9)-333.6(\(1.02.5\))-10171.7(2.8)]TJ
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[(Appearance)-10577.7(2.3)-333.6(\(1.22.8\))-8000.8(2.2)-333.6(\(1.32.8\))-7672.5(2.2)-333.6(\(2.02.3\))]TJ
T*
[(Symptom)-11468.8(2.0)-333.6(\(1.32.7\))-8000.8(1.9)-333.6(\(1.72.2\))-10298.4()]TJ
T*
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