Sample records for adult soft tissue

  1. Treatment Option Overview (Adult Soft Tissue Sarcoma)

    ... Vascular Tumors Treatment Research Adult Soft Tissue Sarcoma Treatment (PDQ®)–Patient Version General Information About Adult Soft ... dye reacts to the light. Certain factors affect treatment options and prognosis (chance of recovery). The treatment ...

  2. Treatment Options for Adult Soft Tissue Sarcoma

    ... Vascular Tumors Treatment Research Adult Soft Tissue Sarcoma Treatment (PDQ®)–Patient Version General Information About Adult Soft ... dye reacts to the light. Certain factors affect treatment options and prognosis (chance of recovery). The treatment ...

  3. Flexible adult flatfoot: soft tissue procedures.

    Walters, Jeremy L; Mendicino, Samuel S


    Classically, adult posterior tibial tendon dysfunction (PTTD) was considered primarily a tendon rupture and was treated as such with soft tissue repair alone. The understanding that PTTD involves more than simply an inflammatory condition or tendon rupture but also a muscle imbalance, leading to a flatfoot, osteoarthritis, and peritalar subluxation, led to surgeons advocating osseous procedures as well. The advancements in knowledge of the pathomechanics of the deformity have modified the role that soft tissue repair plays in surgical treatment, but the importance of soft tissue restoration in flatfoot repair should not be overlooked.

  4. Magnetic resonance imaging of benign soft tissue neoplasms in adults.

    Walker, Eric A; Fenton, Michael E; Salesky, Joel S; Murphey, Mark D


    This article reviews a spectrum of benign soft tissue tumors found in adults. Rather than presenting a complete review, the focus of this article is on benign tumors for which the diagnosis may be confidently made or strongly suggested on the basis of imaging. Diagnoses presented include nodular fasciitis, superficial and deep fibromatosis, elastofibroma, lipomatous lesions, giant cell tumor of the tendon sheath, pigmented villonodular synovitis, peripheral nerve sheath tumors, Morton neuroma, hemangioma, and myxoma.

  5. Soft tissue sarcomas in adolescents and young adults: a comparison with their paediatric and adult counterparts.

    van der Graaf, Winette T A; Orbach, Daniel; Judson, Ian R; Ferrari, Andrea


    Survival outcomes for adolescent and young adult patients with soft tissue sarcomas lag behind those of children diagnosed with histologically similar tumours. To help understand these differences in outcomes, we discuss the following issues with regard to the management of these patients with soft tissue sarcomas: delays in diagnosis, trial availability and participation, aspects of the organisation of care (with an emphasis on age-specific needs), national centralisation of sarcoma care, international consortia, and factors related to tumour biology. Improved understanding of the causes of the survival gap between adolescents and young adults with sarcomas will help drive new initiatives to improve final health outcomes in these populations. In this Review, we specifically focus on embryonal and alveolar rhabdomyosarcoma, synovial sarcoma, and adult soft tissue sarcomas diagnosed in adolescents and young adults, and discuss the age-specific needs of these patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Facial soft tissue thickness in North Indian adult population

    Tanushri Saxena


    Full Text Available Objectives: Forensic facial reconstruction is an attempt to reproduce a likeness of facial features of an individual, based on characteristics of the skull, for the purpose of individual identification - The aim of this study was to determine the soft tissue thickness values of individuals of Bareilly population, Uttar Pradesh, India and to evaluate whether these values can help in forensic identification. Study design: A total of 40 individuals (19 males, 21 females were evaluated using spiral computed tomographic (CT scan with 2 mm slice thickness in axial sections and soft tissue thicknesses were measured at seven midfacial anthropological facial landmarks. Results: It was found that facial soft tissue thickness values decreased with age. Soft tissue thickness values were less in females than in males, except at ramus region. Comparing the left and right values in individuals it was found to be not significant. Conclusion: Soft tissue thickness values are an important factor in facial reconstruction and also help in forensic identification of an individual. CT scan gives a good representation of these values and hence is considered an important tool in facial reconstruction- This study has been conducted in North Indian population and further studies with larger sample size can surely add to the data regarding soft tissue thicknesses.

  7. General Information about Childhood Soft Tissue Sarcoma

    ... forms in soft tissues of the body, including muscle, tendons, fat, blood vessels, lymph vessels, nerves, and tissue around joints. Soft tissue sarcoma occurs in children and adults. Soft ... disorders can increase the risk of childhood soft tissue sarcoma. Anything ...

  8. Stages of Childhood Soft Tissue Sarcoma

    ... forms in soft tissues of the body, including muscle, tendons, fat, blood vessels, lymph vessels, nerves, and tissue around joints. Soft tissue sarcoma occurs in children and adults. Soft ... disorders can increase the risk of childhood soft tissue sarcoma. Anything ...

  9. Treatment Options for Childhood Soft Tissue Sarcoma

    ... forms in soft tissues of the body, including muscle, tendons, fat, blood vessels, lymph vessels, nerves, and tissue around joints. Soft tissue sarcoma occurs in children and adults. Soft ... disorders can increase the risk of childhood soft tissue sarcoma. Anything ...

  10. Treatment Option Overview (Childhood Soft Tissue Sarcoma)

    ... forms in soft tissues of the body, including muscle, tendons, fat, blood vessels, lymph vessels, nerves, and tissue around joints. Soft tissue sarcoma occurs in children and adults. Soft ... disorders can increase the risk of childhood soft tissue sarcoma. Anything ...

  11. Prognostic factors and assessment of staging systems for head and neck soft tissue sarcomas in adults

    Van Damme, J.P.; Schmitz, S.; Machiels, J.P.; Galant, C.; Grégoire, V.; Lengelé, B.; Hamoir, M.


    Abstract Objectives The primary objectives of this study were to analyse the outcome of patients diagnosed with head and neck soft tissue sarcomas (HNSTS) and to identify relevant prognostic factors. As well as this, we compared the prognostic value of two staging systems proposed by the American Joint Committee on Cancer (AJCC) and the Memorial Sloan-Kettering Cancer Center (MSKCC). Methods From 07/1988 to 01/2008, the charts of 42 adult patients w...

  12. [Primitive neuroectodermal tumour of soft tissue of the index finger in an adult. A case report].

    Berrada, N; Bellarbi, S; El Mannouar, M; Errihani, H


    The primitive neuroectodermal tumours (PNET) of soft tissues belong to the Ewing's tumors family and affects particularly the child. The localization of the disease at the extremities is very rare within the adult population and raises the problem of differential diagnosis with others tumors of the soft tissues. We report the case of a 48-year-old patient with a localized tumor, at the level of the second right finger, of six months evolution. The biopsy showed the infiltrating nature of the tumour; and the diagnosis of (PNET) was confirmed after the histological and immunohistochemical study. The extension assessment was negative and the patient had an amputation of the second and third rays of the right hand. Four years afterwards, the patient showed no recurrence or metastases.

  13. Comparison of Soft Tissue Cephalometric Norms between Turkish and European-American Adults

    Ahmet Arif Celebi


    Full Text Available One of the most important components of orthodontic diagnosis and treatment planning is the evaluation of the patient’s soft tissue profile. The main purpose of this study was to develop soft-tissue cephalometric standards for Turkish men and women and compare them with the cephalometric standards of normal European-American white people. The sample included 96 Turkish adults (48 women, 48 men, aged 20 to 27 years. Turkish subjects have increased facial convexity associated with retruded mandible, more obtuse lower face-throat angle, increased nasolabial angle and upper lip protrusion, deeper mentolabial sulcus, and smaller interlabial gap compared with European-American white people. It is appropriate to consider these differences during routine diagnosis and treatment planning of a Turkish patient or an American patient of European ancestry. Turkish males reveal more obtuse mandibular prognathism and upper lip protrusion, and smaller nasolabial angle than females.

  14. Variations of midline facial soft tissue thicknesses among three skeletal classes in Central Anatolian adults.

    Gungor, Kahraman; Bulut, Ozgur; Hizliol, Ismail; Hekimoglu, Baki; Gurcan, Safa


    Facial reconstruction is a technique employed in a forensic investigation as a last resort to recreate an individual's facial appearance from his/her skull. Forensic anthropologists or artists use facial soft tissue thickness (FSTT) measurements as a guide in facial reconstructions. The aim of this study was to develop FSTT values for Central Anatolian adults, taking into consideration sex and skeletal classes; first, to achieve better results obtaining the likenesses of deceased individuals in two or three-dimensional forensic facial reconstructions and, second, to compare these values to existing databases. Lateral cephalograms were used to determine FSTT values at 10 midline facial landmarks of 167 adults. Descriptive statistics were calculated for these facial soft tissue thickness values, and these values were compared to those reported in two other comparable databases. The majority of the landmarks showed sex-based differences. Males were found to have significantly larger landmark values than female subjects. These results point not only to the necessity to present data in accordance with sexual dimorphism, but also the need to consider that individuals from different geographical areas have unique facial features and that, as a result, geographical population-specific FSTT values are required.

  15. Collecting and Storing Tissue, Blood, and Bone Marrow Samples From Patients With Rhabdomyosarcoma or Other Soft Tissue Sarcoma


    Adult Rhabdomyosarcoma; Childhood Desmoplastic Small Round Cell Tumor; Chordoma; Desmoid Tumor; Metastatic Childhood Soft Tissue Sarcoma; Nonmetastatic Childhood Soft Tissue Sarcoma; Previously Treated Childhood Rhabdomyosarcoma; Previously Untreated Childhood Rhabdomyosarcoma; Recurrent Adult Soft Tissue Sarcoma; Recurrent Childhood Rhabdomyosarcoma; Recurrent Childhood Soft Tissue Sarcoma; Stage I Adult Soft Tissue Sarcoma; Stage II Adult Soft Tissue Sarcoma; Stage III Adult Soft Tissue Sarcoma; Stage IV Adult Soft Tissue Sarcoma

  16. Chemotherapy for Soft Tissue Sarcomas

    ... Stage Soft Tissue Sarcoma Treating Soft Tissue Sarcomas Chemotherapy for Soft Tissue Sarcomas Chemotherapy (chemo) is the use of drugs given into ... Depending on the type and stage of sarcoma, chemotherapy may be given as the main treatment or ...

  17. Trabectedin in Soft Tissue Sarcomas

    Bradley J. Petek


    Full Text Available Soft tissue sarcomas are a group of rare tumors derived from mesenchymal tissue, accounting for about 1% of adult cancers. There are over 60 different histological subtypes, each with their own unique biological behavior and response to systemic therapy. The outcome for patients with metastatic soft tissue sarcoma is poor with few available systemic treatment options. For decades, the mainstay of management has consisted of doxorubicin with or without ifosfamide. Trabectedin is a synthetic agent derived from the Caribbean tunicate, Ecteinascidia turbinata. This drug has a number of potential mechanisms of action, including binding the DNA minor groove, interfering with DNA repair pathways and the cell cycle, as well as interacting with transcription factors. Several phase II trials have shown that trabectedin has activity in anthracycline and alkylating agent-resistant soft tissue sarcoma and suggest use in the second- and third-line setting. More recently, trabectedin has shown similar progression-free survival to doxorubicin in the first-line setting and significant activity in liposarcoma and leiomyosarcoma subtypes. Trabectedin has shown a favorable toxicity profile and has been approved in over 70 countries for the treatment of metastatic soft tissue sarcoma. This manuscript will review the development of trabectedin in soft tissue sarcomas.

  18. Serial variation in histological character of articular soft tissue in young human adult temporomandibular joint condyles.

    Bibb, C A; Pullinger, A G; Baldioceda, F


    Histological variation was studied in serial sections, in contrast to previous studies which have generalized from representative sections. The sample consisted of consecutive serial sagittal sections from the central third of nine condyles, plus an accompanying stone cast showing the intact articular surface before sectioning. The thickness of the articular soft tissue and its fibrous connective tissue and cartilage components was measured, and the presence of undifferentiated mesenchymal (UM) cells was assessed by low-power light microscopy. Components of variance analysis showed that section-to-section variation in thickness was of the same order as differences between joints, each explaining approx. 50% of the variance in both connective tissue and cartilage thickness. The fibrous connective tissue contributed as much to the overall variation in soft tissue thickness as did the cartilage component (SD 0.0946 versus 0.0909 mm for the superior sector). Serial UM cell variability was common, and the UM cells were often distributed in islands rather than uniformly across the articular tissue. Condyles with the greatest surface irregularity were characterized by greater serial variability in fibrous connective tissue thickness, more frequent absence of cartilage, and more areas of UM cell depletion. These results suggest that serial variation in histological character may be more important than mean values in the description of surface contours and articular tissue relations in the temporomandibular joint. This should influence the design of future investigations.

  19. Facial soft tissue depths in French adults: variability, specificity and estimation.

    Guyomarc'h, Pierre; Santos, Frédéric; Dutailly, Bruno; Coqueugniot, Hélène


    Facial soft tissue depths (FSTD) are used in facial approximation to render the shape of the face, and are traditionally published specifically to population, corpulence, and sex amongst other factors. This paper investigates the variability of FSTD collected at 37 landmarks on 500 CT (computed tomography) scans of French living individuals. The specificity of the sample is evaluated by comparing values with six published datasets of various populations and recording techniques. Apart from a significant influence of the corpulence, FSTD show negligible variations with age and sex. The differences between the French sample and other datasets contradict the hypothesis of major influence of population, and underline sample specificity linked with technique and methodology of data measurement. Regression equations were computed to estimate FSTD using age, sex, facial build, and craniometrics, leading to more accurate results if such factors are known. Nevertheless, application of the pooled T-table (Tallied-Facial-Soft-Tissue-Depth-Data) has been validated according to the French sample.

  20. Soft Tissue Extramedullary Plasmacytoma

    Fernando Ruiz Santiago


    Full Text Available We present the uncommon case of a subcutaneous fascia-based extramedullary plasmacytoma in the leg, which was confirmed by the pathology report and followed up until its remission. We report the differential diagnosis with other more common soft tissue masses. Imaging findings are nonspecific but are important to determine the tumour extension and to plan the biopsy.

  1. Genetic Profiling Differentiates Second Primary Tumors from Metastases in Adult Metachronous Soft Tissue Sarcoma

    Josefin Fernebro


    Full Text Available Purpose. Patients with soft tissue sarcomas (STS are at increased risk of second primary malignancies, including a second STS, but distinction between metastases and a second primary STS is difficult. Patients and Methods. Array-based comparative genomic hybridization (aCGH was applied to 30 multiple STS of the extremities and the trunk wall from 13 patients. Different histotypes were present with malignant fibrous histiocytomas/undifferentiated pleomorphic sarcomas being the predominant subtype. Results. aCGH profiling revealed genetic complexity with multiple gains and losses in all tumors. In an unsupervised hierarchical cluster analysis, similar genomic profiles and close clustering between the first and subsequent STS were identified in 5 cases, suggesting metastatic disease, whereas the tumors from the remaining 8 patients did not cluster and showed only weak pairwise correlation, suggesting development of second primary STS. Discussion. The similarities and dissimilarities identified in the first and second STS suggest that genetic profiles can be used to distinguish soft tissue metastases from second primary STS. The demonstration of genetically different soft tissue sarcomas in the same patient suggests independent tumor origin and serves as a reminder to consider development of second primary STS, which has prognostic and therapeutic implications.

  2. Hypoelastic Soft Tissues

    Freed, Alan D.; Einstein, Daniel R.; Sacks, Michael S.


    In Part I, a novel hypoelastic framework for soft-tissues was presented. One of the hallmarks of this new theory is that the well-known exponential behavior of soft-tissues arises consistently and spontaneously from the integration of a rate based formulation. In Part II, we examine the application of this framework to the problem of biaxial kinematics, which are common in experimental soft-tissue characterization. We confine our attention to an isotropic formulation in order to highlight the distinction between non-linearity and anisotropy. In order to provide a sound foundation for the membrane extension of our earlier hypoelastic framework, the kinematics and kinetics of in-plane biaxial extension are revisited, and some enhancements are provided. Specifically, the conventional stress-to-traction mapping for this boundary value problem is shown to violate the conservation of angular momentum. In response, we provide a corrected mapping. In addition, a novel means for applying loads to in-plane biaxial experiments is proposed. An isotropic, isochoric, hypoelastic, constitutive model is applied to an in-plane biaxial experiment done on glutaraldehyde treated bovine pericardium. The experiment is comprised of eight protocols that radially probe the biaxial plane. Considering its simplicity (two adjustable parameters) the model does a reasonably good job of describing the non-linear normal responses observed in these experimental data, which are more prevalent than are the anisotropic responses exhibited by this tissue. PMID:21394222

  3. Genital soft tissue tumors.

    Schoolmeester, John K; Fritchie, Karen J


    Mesenchymal neoplasms of the vulvovaginal and inguinoscrotal regions are among the most diagnostically challenging specimens in the pathology laboratory owing largely to their unique intersection between general soft tissue tumors and relatively genital-specific mesenchymal tumors. Genital stromal tumors are a unique subset of soft tissue tumors encountered at this location, and this group includes fibroepithelial stromal polyp, superficial (cervicovaginal) myofibroblastoma, cellular angiofibroma, mammary-type myofibroblastoma, angiomyofibroblastoma and aggressive angiomyxoma. Aside from the striking morphologic and immunophenotypic similarity that is seen with these entities, there is evidence that a subset of genital stromal tumors may be linked genetically. This review will focus on simplifying this group of tumors and provide the pathologist or dermatopathologist with practical management information. Smooth muscle tumors of the external genitalia will also be discussed.

  4. Genetic profiling differentiates second primary tumors from metastases in adult metachronous soft tissue sarcoma

    Fernebro, Josefin; Carneiro, Ana; Rydholm, Anders


    Purpose. Patients with soft tissue sarcomas (STS) are at increased risk of second primary malignancies, including a second STS, but distinction between metastases and a second primary STS is difficult. Patients and Methods. Array-based comparative genomic hybridization (aCGH) was applied to 30...... multiple STS of the extremities and the trunk wall from 13 patients. Different histotypes were present with malignant fibrous histiocytomas/undifferentiated pleomorphic sarcomas being the predominant subtype. Results. aCGH profiling revealed genetic complexity with multiple gains and losses in all tumors....... In an unsupervised hierarchical cluster analysis, similar genomic profiles and close clustering between the first and subsequent STS were identified in 5 cases, suggesting metastatic disease, whereas the tumors from the remaining 8 patients did not cluster and showed only weak pairwise correlation, suggesting...

  5. Exatecan in pretreated adult patients with advanced soft tissue sarcoma: results of a phase II--study of the EORTC Soft Tissue and Bone Sarcoma Group

    Reichardt, P; Nielsen, Ole Steen; Bauer, S;


    No standard treatment is established for patients with advanced soft tissue sarcoma after previous chemotherapy with anthracyclines and ifosfamide, given either in combination or sequentially. Exatecan (DX-8951f) is a totally synthetic analogue of the topoisomerase I-inhibitor camptothecin, which...... modification. The main toxicity was haematotoxicity with grade 3/4 neutropenia in 49%, grade 3/4 thrombocytopenia in 23%, and grade 3/4 anaemia in 15% of patients, respectively. Non-haematological toxicity consisted mainly of grade 2/3 dyspnoea in 36% of patients and grade 2/3 fatigue in 28%. One treatment...

  6. Myoepithelioma of soft tissue

    Pai Mukhta


    Full Text Available Myoepitheliomas and mixed tumors involving deep subcutaneous and subfascial soft tissues of limb or limb girdle are rare lesions as against salivary lesions that are well established conditions. Here, we report a 22-year-old female who presented with painful hard swelling in the left gluteal region of 1½ year duration. MRI showed a large ill-defined heterogeneous mass lesion measuring about 7-8 cm. in the left sacral region eroding the left sacroiliac region and left sacroiliac joint. With a clinical diagnosis of chondrosarcoma, the tumor with the surrounding tissue was resected in segments at surgery. Histomorphology revealed nests, sheets and cords of round to spindled cells with extensive squamous metaplasia in a myxoid to fibrous stroma. These cells extensively infiltrated muscle and bone. The tumor cells expressed immunoreactivity for cytokeratin (AE1/AE3 and S-100.

  7. Assessment of the relationships among posture, maxillomandibular denture complex, and soft-tissue profile of aesthetic adult Korean women.

    Choi, B; Baek, S H; Yang, W S; Kim, S


    The objective of this study was to assess the relationships among the posture, the maxillomandibular denture complex, and the soft-tissue profile of aesthetic adult Korean women. From an initial group of 346 women, the authors examined 28 beautiful adult Korean women who had normal vertical and sagittal skeletal relationships and normal occlusion. There were no differences in the inclinations of the incisors to the occlusal planes in the maxilla and the mandible in the data for Korean women vs. Arnett's data for white women. However, the overbite and overjet in Korean women were slightly smaller than in white women. AB to maxillary occlusal plane angle (MxOP) represented the anteroposterior denture base discrepancy to the occlusal plane. Angulation of the maxillary occlusal plane to the Frankfurt (FH) plane and the true vertical line at submasale (TVL) (Sn) was a little steeper in Korean women than in white women. The FH plane was almost parallel to the true horizontal line in Korean women who had normal vertical and sagittal skeletal relationships and normal occlusion. With regard to soft-tissue variables, the upper lip length (Sn-Stms), interlabial gap, upper incisor exposure, nasolabial angle, lip and nose tip projection value, and TVL (Sn)-to-upper lip line (UL) angle showed interracial differences. The results of this study can assist in the diagnosis and treatment planning of orthognathic surgery.

  8. Sorafenib in Treating Patients With Soft Tissue Sarcomas (Extremity Sarcoma Closed to Entry as of 5/30/07)


    Metastatic Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor; Metastatic Osteosarcoma; Recurrent Adult Soft Tissue Sarcoma; Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor; Recurrent Osteosarcoma; Stage I Adult Soft Tissue Sarcoma; Stage II Adult Soft Tissue Sarcoma; Stage III Adult Soft Tissue Sarcoma; Stage IV Adult Soft Tissue Sarcoma

  9. Nonspecificity of Chronic Soft Tissue Pain Syndromes

    Eldon Tunks


    Full Text Available Persistent (or chronic pain occurs with a prevalence of about 10% in the adult population, and chronic soft tissue pain is especially problematic. Criteria for diagnosis of these soft tissue pain disorders appear to suffer from specificity problems, even though they appear to be sensitive in distinguishing normal from soft tissue pain sufferers. A few decades ago the term 'neuraesthenia' was used as a diagnosis in individuals who now would probably be diagnosed as suffering from fibromyalgia, chronic fatigue and anxiety disorders with fatigue. Soft tissue pain provokes skepticism, especially among third-party payers, and controversy among clinicians. Recent epidemiological studies have demonstrated sex differences in the prevalence of widespread pain and multiple tender points, which are distributed variably throughout the adult population and tend to be correlated with subjective symptoms. Although there is a tendency for these syndromes to persist, follow-up studies show that they tend to vary in extent and sometimes show remissions over longer follow-up, casting doubt about the distinctions between chronic diffuse pains and localized chronic soft tissue pains. Because both accidents and soft tissue pains are relatively prevalent problems, the possibility of chance coincidence of accident and chronic soft tissue pain in an individual creates the need to be cautious in attributing these syndromes to specific accidents in medicolegal situations. At the same time, the available evidence does not support a generally dismissive attitude towards these patients.

  10. Neoadjuvant Chemotherapy with Ifosfamide, Cisplatin, Adriamycin and Mitomycin (IMAP for High risk Adult Soft Tissue Sarcomas

    Mohagheghi Mohammad Ali


    Full Text Available To define efficacy of pre-operative chemotherapy in down staging of advanced non-round cell soft tissue sarcomas. From Sep 2002 to Dec 2005, 70 patients were treated by Ifosfamid, MESNA, cisplatin, adriamycin, mitomycin and subsequent surgery. Postoperatively, patients received radiotherapy in cases of microscopically incomplete resection or local recurrence. The median age of the patients was 34 years and the median tumor size was 14 cm. According to AJCC classification 46 patients had stage 3 and 24 had stage 4 diseases. The most common subtypes were MFH and leiomyosarcoma. The most common sites of tumors were lower extremity and trunk. Toxicity grades three or higher consisted of nausea, Leucopenia and infection. About 50% of the patients received G-CSF. Response to chemotherapy was assessable in 63 patients; 9 patients achieved complete response and 16 showed partial response. Disease progressed in 8 and did not change in 37. The best response was seen with MFH, fibrosarcoma and synovial sarcoma. After chemotherapy seventy percent of patients underwent complete surgery. Disease relapsed in 41 patients and twenty two patients died of metastasis. Median survival of patients was 30 months. IMAP plus G-CSF is safe and effective as preoperative chemotherapy in some subtypes of sarcomas, although the metastasis problem has not been eliminated

  11. Soft tissue lipoleiomyoma.

    Scurry, J P; Carey, M P; Targett, C S; Dowling, J P


    A primary tumor composed of mature adipose tissue and smooth muscle occurring in the anterior abdominal wall of a 46 yr old Filipino woman is described. The tumor was not attached to the uterus, but had an appearance similar to a uterine lipoleiomyoma. It appeared as a soft, rubbery, encapsulated 11 cm ovoid mass with a uniform, white cut surface. Histologically, there were long intersecting bundles of bland smooth muscle mixed with nests of mature fat cells. The presence of differentiated smooth muscle was confirmed by fuchsinophilia, desmin positivity and electron microscopy. The patient also had 6 intramural leiomyomas, an area of adenomyosis, a subcutaneous lipoma of the subscapular region and chronic schistosomiasis of the appendix and left adnexa.

  12. ECCO Essential Requirements for Quality Cancer Care: Soft Tissue Sarcoma in Adults and Bone Sarcoma. A critical review.

    Andritsch, Elisabeth; Beishon, Marc; Bielack, Stefan; Bonvalot, Sylvie; Casali, Paolo; Crul, Mirjam; Bolton, Roberto Delgado-; Donati, Davide Maria; Douis, Hassan; Haas, Rick; Hogendoorn, Pancras; Kozhaeva, Olga; Lavender, Verna; Lovey, Jozsef; Negrouk, Anastassia; Pereira, Philippe; Roca, Pierre; de Lempdes, Godelieve Rochette; Saarto, Tiina; van Berck, Bert; Vassal, Gilles; Wartenberg, Markus; Yared, Wendy; Costa, Alberto; Naredi, Peter


    ECCO essential requirements for quality cancer care (ERQCC) are checklists and explanations of organisation and actions that are necessary to give high-quality care to patients who have a specific tumour type. They are written by European experts representing all disciplines involved in cancer care. ERQCC papers give oncology teams, patients, policymakers and managers an overview of the elements needed in any healthcare system to provide high quality of care throughout the patient journey. References are made to clinical guidelines and other resources where appropriate, and the focus is on care in Europe. Sarcoma: essential requirements for quality care • Sarcomas - which can be classified into soft tissue and bone sarcomas - are rare, but all rare cancers make up more than 20% of cancers in Europe, and there are substantial inequalities in access to high-quality care. Sarcomas, of which there are many subtypes, comprise a particularly complex and demanding challenge for healthcare systems and providers. This paper presents essential requirements for quality cancer care of soft tissue sarcomas in adults and bone sarcomas. • High-quality care must only be carried out in specialised sarcoma centres (including paediatric cancer centres) which have both a core multidisciplinary team and an extended team of allied professionals, and which are subject to quality and audit procedures. Access to such units is far from universal in all European countries. • It is essential that, to meet European aspirations for high-quality comprehensive cancer control, healthcare organisations implement the requirements in this paper, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis and follow-up, to treatment, to improve survival and quality of life for patients. Taken together, the information presented in this paper provides a comprehensive description of the essential requirements for establishing a high-quality service for soft

  13. Soft tissue angiosarcomas

    Morales, P.H.; Lindberg, R.D.; Barkley, H.T.


    From 1949 to 1979, 12 patients with soft tissue angiosarcoma received radiotherapy (alone or in combination with other modalities of treatment) with curative intent at The University of Texas M.D. Anderson Hospital and Tumor Institute. The primary site was the head and neck in six patients (scalp, four; maxillary antrum, one; and oral tongue, one), the breast in four patients, and the thigh in two patients. All four patients with angiosarcoma of the scalp had advanced multifocal tumors, and two of them had clinically positive neck nodes. None of these tumors were controlled locally, and local recurrences occurred within and/or at a distance from the generous fields of irradiation. The remaining two patients with head and neck lesions had their disease controlled by surgery and postoperative irradiation. Three of the four angiosarcomas of the breast were primary cases which were treated by a combination of surgery (excisional biopsy, simple mastectomy, radical mastectomy) and postoperative irradiation. One patient also received adjuvant chemotherapy. The fourth patient was treated for scar recurrence after radical mastectomy. All four patients had their disease locally controlled, and two of them have survived over 5 years. The two patients with angiosarcoma of the thigh were treated by conservative surgical excision and postoperative irradiation. One patient had her disease controlled; the other had a local recurrence requiring hip disarticulation and subsequent hemipelvectomy for salvage.

  14. Radiation Therapy for Soft Tissue Sarcomas

    ... Stage Soft Tissue Sarcoma Treating Soft Tissue Sarcomas Radiation Therapy for Soft Tissue Sarcomas Radiation therapy uses ... spread. This is called palliative treatment . Types of radiation therapy External beam radiation therapy: For this treatment, ...

  15. Soft tissue application of lasers.

    Holt, Timothy L; Mann, Fred A


    Despite increasing numbers of veterinarians incorporating lasers into their clinical practices, little information has been published about laser clinical applications in soft tissue surgery. This article reviews soft tissue interaction, describes laser equipment and accessories commonly marketed to veterinarians, and discusses clinical applications of the carbon dioxide laser in a systems-based approach. A table of recommended laser tips and settings based on the authors' experiences using a carbon dioxide laser (AccuVet Novapulse LX-20SP, Bothell, WA) is provided.

  16. [Soft tissue rheumatism in erderly].

    Szczepański, Leszek


    Disorders of soft, peri-articular tissues are a common cause of musculoskeletal pain in elderly patients. Nevertheless, most physicians underestimate the role of soft tissue rheumatism in the pathomechanism of the pain. The impairments of soft tissue can not be diagnosed by X-rays examinations, whereas degenerative lesions of joints are easy diagnosed using this method even despite of their uncertain role in producing the symptoms. The incidence of pain syndromes originated from soft tissues differ regarding to the age of patients. In young subjects the incidence of all of them is generally low. Syndromes provoked by overloading during work: repetitive strain syndrome, canal tunnel syndrome, tennis elbow, golfers elbow, shoulder tendon coin disorders and myofascial pain syndrome are common in middle-aged patients. The morbidity of fibromialgia syndrome is also lower in old people probably as the result of diminished numbers and degenerative changes in nociceptive fibers. The syndromes prevailing in elderly patients include trochanteric syndrome and the pain syndromes provoked by muscle spasm depended on posture abnormalities. In the soft tissue pain syndrome prevention adapted to old age kinesitherapy and avoiding muscle overloading are recommended. Soft tissue pain syndromes are usually treated with non steroidal anti inflammatory drugs. In local pain syndromes better results can be obtained by local treatment. Local injections of glikocorticosteroids are usually very effective and safe.

  17. Biomechanical properties of soft tissues

    曾衍钧; 许传青; 杨坚; 徐小虎


    Viscoelasticity is the primary mechanical property of bio-soft tissues. It has been widely applied in basic research of biological tissues including cornea, lung, heart and blood vessels. Along with the development of tissue engineering research, the evaluation of soft tissue viscoelasticity is becoming more and more important. In this paper, using the Whittaker function, we give an approximate power series of the exponential integral E1(x) and the parameters c, ?1 and ?2 of the generalized relaxation function G(t) and generalized creep function J(t). With expanded skin as an example, the relationship between stress relaxation, creep and stress-strain finite deformation are studied.

  18. Analyzing the "CareGap": assessing gaps in adherence to clinical guidelines in adult soft tissue sarcoma.

    Waks, Zeev; Goldbraich, Esther; Farkash, Ariel; Torresani, Michele; Bertulli, Rossella; Restifo, Nicola; Locatelli, Paolo; Casali, Paolo; Carmeli, Boaz


    Clinical decision support systems (CDSSs) are gaining popularity as tools that assist physicians in optimizing medical care. These systems typically comply with evidence-based medicine and are designed with input from domain experts. Nonetheless, deviations from CDSS recommendations are abundant across a broad spectrum of disorders, raising the question as to why this phenomenon exists. Here, we analyze this gap in adherence to a clinical guidelines-based CDSS by examining the physician treatment decisions for 1329 adult soft tissue sarcoma patients in northern Italy using patient-specific parameters. Dubbing this analysis "CareGap", we find that deviations correlate strongly with certain disease features such as local versus metastatic clinical presentation. We also notice that deviations from the guideline-based CDSS suggestions occur more frequently for patients with shorter survival time. Such observations can direct physicians' attention to distinct patient cohorts that are prone to higher deviation levels from clinical practice guidelines. This illustrates the value of CareGap analysis in assessing quality of care for subsets of patients within a larger pathology.

  19. Soft tissue tumours: imaging strategy

    Brisse, Herve J. [Institute Curie, Department of Radiology, Paris (France); Orbach, Daniel [Institute Curie, Department of Paediatric Oncology, Paris (France); Klijanienko, Jerzy [Institute Curie, Department of Pathology, Paris (France)


    Vascular tumours and malformations, fibrous and fibrohistiocytic tumours and pseudotumours are the most common benign soft-tissue masses observed in children, and can be treated conservatively. Rhabdomyosarcomas are the most frequent malignant tumours, accounting for about half of soft tissue sarcomas. A child referred for a soft-tissue mass should ideally be managed by a multidisciplinary team and primary excision should be proscribed until a definite diagnosis has been established. Clinical examination, conventional radiography and US with Doppler represent the first-line examinations and are sometimes sufficient to make a diagnosis. In all other situations, MRI is mandatory to establish the aggressiveness and extension of the tumour. This technique provides the relevant data to guide the decision regarding tissue sampling. (orig.)

  20. Head and Neck Soft Tissue Sarcoma

    Aljabab, A. S.; Nason, R. W.; Kazi, R; Pathak, K. A.


    Sarcomas are malignant neoplasms originating from mesodermal tissues and constitute less than 1% of body’s tumors, including those of the head and neck region. 5–15% of adult sarcomas are in the head and neck region (20% from bones and cartilages and 80% in soft tissues). Commonly encountered sarcomas in the head and neck region are - osteosarcoma, rhabdomyosarcoma, malignant fibrous histiocytoma, fibrosarcoma and angiosarcoma. This article reviews the available literature on head and neck sa...

  1. Soft tissue trauma and scar revision.

    Mobley, Steven R; Sjogren, Phayvanh P


    Numerous techniques and treatments have been described for scar revision, with most studies focusing on the adult population. A comprehensive review of the literature reveals a paucity of references related specifically to scar revision in children. This review describes the available modalities in pediatric facial scar revision. The authors have integrated current practices in soft tissue trauma and scar revision, including closure techniques and materials, topical therapy, steroid injection, cutaneous laser therapy, and tissue expanders.

  2. Correction of Class II malocclusion and soft tissue profile in an adult patient

    Aditi Gaur


    Full Text Available Treatment of Class II malocclusion in nongrowing individuals is a challenging situation for the clinician. Class II malocclusion with bialveolar protrusion often dictates premolar extractions with maximum anchorage. The present article describes the case of an adult female with skeletal Class II malocclusion, bimaxillary protrusion, increased overjet, deep bite, lip protrusion, everted lower lip, deep mentolabial sulcus, and lip incompetence. To correct the malocclusion, all four first premolars were extracted. Direct anchorage from miniscrews was used for retraction of the anterior segment. The mandibular buccal segment was protracted into the extraction space using Class II mechanics. Ideal Class I canine and molar relation were achieved in 24 months. There was a significant improvement in facial profile and smile esthetics of the patient.

  3. CNS Metastases from Bone and Soft Tissue Sarcomas in Children, Adolescents, and Young Adults: Are They Really So Rare?

    Monika Bekiesinska-Figatowska


    Full Text Available Purpose. To check whether primary involvement of brain/spinal cord by bone/soft tissue sarcomas’ metastases in children is as rare as described and to present various morphological forms of bone/soft tissue sarcomas’ CNS metastases. Methods. Patients with first diagnosis in 1999–2014 treated at single center were included with whole course of disease evaluation. Brain/spinal canal magnetic resonance imaging (MRI/computed tomography were performed in cases suspicious for CNS metastases. Extension from skull/vertebral column metastases was excluded. Results. 550 patients were included. MRI revealed CNS metastases in 19 patients (incidence 3.45%, 14 boys, aged 5–22 years. There were 12/250 osteosarcoma cases, 2/200 Ewing’s sarcoma, 1/50 chondrosarcoma, 3/49 rhabdomyosarcoma (RMS, and 1/1 malignant mesenchymoma. There were 10 single metastases and 7 cases of multiple ones; in 2 RMS cases only leptomeningeal spread in brain and spinal cord was found. Calcified metastases were found in 3 patients and hemorrhagic in 4. In one RMS patient there were numerous solid, cystic, hemorrhagic lesions and leptomeningeal spread. Conclusions. CNS metastases are rare and late in children with bone/soft tissue sarcomas, although in our material more frequent (3.45% than in other reports (0.7%. Hematogenous spread to brain and hemorrhagic and calcified lesions dominated in osteosarcoma. Ewing sarcoma tended to metastasize to skull bones. Soft tissue sarcomas presented various morphological forms.

  4. CNS Metastases from Bone and Soft Tissue Sarcomas in Children, Adolescents, and Young Adults: Are They Really So Rare?

    Duczkowska, Agnieszka; Duczkowski, Marek; Bragoszewska, Hanna; Romaniuk-Doroszewska, Anna; Iwanowska, Beata; Szkudlinska-Pawlak, Sylwia; Madzik, Jaroslaw; Bilska, Katarzyna; Raciborska, Anna


    Purpose. To check whether primary involvement of brain/spinal cord by bone/soft tissue sarcomas' metastases in children is as rare as described and to present various morphological forms of bone/soft tissue sarcomas' CNS metastases. Methods. Patients with first diagnosis in 1999–2014 treated at single center were included with whole course of disease evaluation. Brain/spinal canal magnetic resonance imaging (MRI)/computed tomography were performed in cases suspicious for CNS metastases. Extension from skull/vertebral column metastases was excluded. Results. 550 patients were included. MRI revealed CNS metastases in 19 patients (incidence 3.45%), 14 boys, aged 5–22 years. There were 12/250 osteosarcoma cases, 2/200 Ewing's sarcoma, 1/50 chondrosarcoma, 3/49 rhabdomyosarcoma (RMS), and 1/1 malignant mesenchymoma. There were 10 single metastases and 7 cases of multiple ones; in 2 RMS cases only leptomeningeal spread in brain and spinal cord was found. Calcified metastases were found in 3 patients and hemorrhagic in 4. In one RMS patient there were numerous solid, cystic, hemorrhagic lesions and leptomeningeal spread. Conclusions. CNS metastases are rare and late in children with bone/soft tissue sarcomas, although in our material more frequent (3.45%) than in other reports (0.7%). Hematogenous spread to brain and hemorrhagic and calcified lesions dominated in osteosarcoma. Ewing sarcoma tended to metastasize to skull bones. Soft tissue sarcomas presented various morphological forms.

  5. Necrotizing soft tissue infection

    ... bacteria begins to grow and release harmful substances (toxins) that kill tissue and affect blood flow to ... pressure ( hyperbaric oxygen therapy ) for certain types of bacterial infections Outlook (Prognosis) How well you do depends ...

  6. Regional placement of bone mineral mass, fat mass, and lean soft tissue mass in young adult rugby union players.

    Bell, W; Evans, W D; Cobner, D M; Eston, R G

    The purpose of the present study was to ascertain whether differences existed in the regional placement of bone mineral mass (BMM), fat mass (FM) and lean soft tissue mass (LSTM) between playing units in Rugby Union Football and between players and control subjects. Thirty young adult rugby players and 21 controls participated in the study. Players were assigned to groups as either forwards (n = 15) or backs (n = 15). Control subjects were matched (n = 15) to rugby players using the mean BMI of forwards and backs. BMM, FM and LSTM were measured using dual-energy X-ray absorptiometry. The digital image of each subject was partitioned into regional anatomical segments comprising the head, right and left arms, trunk, and right and left legs. Measurements were summed for the arms and legs respectively. One-way ANOVA was used to differentiate between- and within-groups; Tukey's post-hoc test was applied to identify pairwise differences. The alpha level was set throughout at p = 0.01. Principal components analysis was utilized to contrast the regional segments of each tissue in each of the groups. Forwards exhibited larger absolute (kg) amounts of BMM, FM and LSTM than backs or controls. In relative terms (%) there were no significant differences in BMM(%) between forwards, backs and controls in the arms and legs, but differences did occur between backs and controls at the trunk (2.9 vs. 2.5%). Backs had a significantly larger LSTM(%) than forwards at the arms (84.4 vs. 76.5%), legs (80.0 vs. 71.9%) and trunk (89.2 vs. 79.0%), whereas forwards had a greater FM(%) than backs at the arms (18.7 vs. 10.6%), legs (23.1 vs. 14.7%), and trunk (18.4 vs. 8.0%). The distribution of BMM showed a lower body-upper body contrast in forwards, a trunk-extremity contrast in backs and an arm-lower body contrast in controls. FM exhibited a trunk-extremity contrast in all three groups, while LSTM displayed an arm-lower body contrast in all three groups. It is concluded that there are

  7. Staphylococcus aureus soft tissue infection may increase the risk of subsequent staphylococcal soft tissue infections.

    Bouvet, Cindy; Gjoni, Shpresa; Zenelaj, Besa; Lipsky, Benjamin A; Hakko, Elif; Uçkay, Ilker


    Staphylococcus aureus is the most common cause of soft tissue infections. It is unknown, however, if a patient who has had such an infection is at greater risk for future soft tissue infections with S. aureus. We conducted an epidemiological survey of adult patients hospitalized in the only public hospital in Geneva for treatment (usually combined surgical and medical) of a soft tissue infection caused by S. aureus. By reviewing nursing and medical records from the emergency department and hospital wards, we assessed whether or not they developed any other soft tissue infections (excluding a recurrence) after or before the index one. Among 1023 index episodes of soft tissue infections, 670 (65%) were caused by S. aureus, of which 47 were caused by methicillin-resistant strains (30 healthcare-associated and 17 community-acquired). The patients' median age was 51 years and 334 (34%) were immune-compromised. The median time span between the patient's first and last consultation (for any reason) in our hospital was 21.4 years (interquartile range, 10-30 years). In addition to their index infection, 124 patients (12%) developed a new nosocomial or community-acquired soft tissue infection. Among the index cases with an S. aureus infection, 92 (14%) had another soft tissue infection, compared to 32 (9%) who had a non-staphylococcal index infection (Pearson-χ(2)-test; p=0.03). Similarly, patients with an index S. aureus infection, compared to those with a non-S. aureus infection, had a higher rate of another soft tissue infection caused by S. aureus (χ(2)-test; pS. aureus shows a high association to further S. aureus soft tissue infections (logistic regression; odds ratio 2.5, 95% confidence interval 1.4-4.6). Among adult patients hospitalised for a soft tissue infection, those infected with S. aureus (compared with other pathogens) may be at higher risk of a subsequent soft tissue infection, particularly with S. aureus. Copyright © 2017 The Author(s). Published by

  8. Equine model for soft-tissue regeneration.

    Bellas, Evangelia; Rollins, Amanda; Moreau, Jodie E; Lo, Tim; Quinn, Kyle P; Fourligas, Nicholas; Georgakoudi, Irene; Leisk, Gary G; Mazan, Melissa; Thane, Kristen E; Taeymans, Olivier; Hoffman, A M; Kaplan, D L; Kirker-Head, C A


    Soft-tissue regeneration methods currently yield suboptimal clinical outcomes due to loss of tissue volume and a lack of functional tissue regeneration. Grafted tissues and natural biomaterials often degrade or resorb too quickly, while most synthetic materials do not degrade. In previous research we demonstrated that soft-tissue regeneration can be supported using silk porous biomaterials for at least 18 months in vivo in a rodent model. In the present study, we scaled the system to a survival study using a large animal model and demonstrated the feasibility of these biomaterials for soft-tissue regeneration in adult horses. Both slow and rapidly degrading silk matrices were evaluated in subcutaneous pocket and intramuscular defect depots. We showed that we can effectively employ an equine model over 6 months to simultaneously evaluate many different implants, reducing the number of animals needed. Furthermore, we were able to tailor matrix degradation by varying the initial format of the implanted silk. Finally, we demonstrate ultrasound imaging of implants to be an effective means for tracking tissue regeneration and implant degradation.

  9. Imaging of musculoskeletal soft tissue infections

    Turecki, Marcin B.; Taljanovic, Mihra S.; Holden, Dean A.; Hunter, Tim B.; Rogers, Lee F. [University of Arizona HSC, Department of Radiology, Tucson, AZ (United States); Stubbs, Alana Y. [Southern Arizona VA Health Care System, Department of Radiology, Tucson, AZ (United States); Graham, Anna R. [University of Arizona HSC, Department of Pathology, Tucson, AZ (United States)


    Prompt and appropriate imaging work-up of the various musculoskeletal soft tissue infections aids early diagnosis and treatment and decreases the risk of complications resulting from misdiagnosis or delayed diagnosis. The signs and symptoms of musculoskeletal soft tissue infections can be nonspecific, making it clinically difficult to distinguish between disease processes and the extent of disease. Magnetic resonance imaging (MRI) is the imaging modality of choice in the evaluation of soft tissue infections. Computed tomography (CT), ultrasound, radiography and nuclear medicine studies are considered ancillary. This manuscript illustrates representative images of superficial and deep soft tissue infections such as infectious cellulitis, superficial and deep fasciitis, including the necrotizing fasciitis, pyomyositis/soft tissue abscess, septic bursitis and tenosynovitis on different imaging modalities, with emphasis on MRI. Typical histopathologic findings of soft tissue infections are also presented. The imaging approach described in the manuscript is based on relevant literature and authors' personal experience and everyday practice. (orig.)

  10. Soft tissue aneurysmal bone cyst

    Wang, X.L.; Gielen, J.L.; Delrue, F.; De Schepper, A.M.A. [Department of Radiology, Universitair Ziekenhuis Antwerpen (University of Antwerp), Wilrijkstraat 10, 2650, Edegem (Belgium); Salgado, R. [Department of Pathology, Universitair Ziekenhuis Antwerpen (University of Antwerp), Wilrijkstraat 10, 2650, Edegem (Belgium)


    A soft tissue aneurysmal bone cyst located in the right gluteus medius of a 21-year-old man is reported. On conventional radiography, the lesion demonstrated a spherically trabeculated mass with a calcific rim. On CT scan, it showed a well-organized peripheral calcification resembling a myositis ossificans. On MRI, it presented as a multilocular, cystic lesion with fluid-fluid levels. The lesion had no solid components except for intralesional septa. Although findings on imaging and histology were identical to those described in classical aneurysmal bone cyst, diagnosis was delayed because of lack of knowledge of this entity and its resemblance to the more familiar post-traumatic heterotopic ossification (myositis ossificans). (orig.)

  11. Cephalometric soft tissue facial analysis.

    Bergman, R T


    My objective is to present a cephalometric-based facial analysis to correlate with an article that was published previously in the American Journal of Orthodontic and Dentofacial Orthopedics. Eighteen facial or soft tissue traits are discussed in this article. All of them are significant in successful orthodontic outcome, and none of them depend on skeletal landmarks for measurement. Orthodontic analysis most commonly relies on skeletal and dental measurement, placing far less emphasis on facial feature measurement, particularly their relationship to each other. Yet, a thorough examination of the face is critical for understanding the changes in facial appearance that result from orthodontic treatment. A cephalometric approach to facial examination can also benefit the diagnosis and treatment plan. Individual facial traits and their balance with one another should be identified before treatment. Relying solely on skeletal analysis, assuming that the face will balance if the skeletal/dental cephalometric values are normalized, may not yield the desired outcome. Good occlusion does not necessarily mean good facial balance. Orthodontic norms for facial traits can permit their measurement. Further, with a knowledge of standard facial traits and the patient's soft tissue features, an individualized norm can be established for each patient to optimize facial attractiveness. Four questions should be asked regarding each facial trait before treatment: (1) What is the quality and quantity of the trait? (2) How will future growth affect the trait? (3) How will orthodontic tooth movement affect the existing trait (positively or negatively)? (4) How will surgical bone movement to correct the bite affect the trait (positively or negatively)?

  12. Prognostic and predictive factors for outcome to first-line ifosfamide-containing chemotherapy for adult patients with advanced soft tissue sarcomas An exploratory, retrospective analysis on large series from the European Organization for Research and Treatment of Cancer-Soft Tissue and Bone

    Sleiffer, S.; Ouali, M.; van Glabbeke, M.;


    Background: Adult patients with advanced soft tissue sarcomas (STS) are generally treated similarly, regardless of great differences between STS subtypes, disease presentation and patients' characteristics. As ifosfamide is frequently applied in first line systemic therapy, we aimed to establish ...... contribute to further treatment individualisation of advanced STS patients. (C) 2009 Elsevier Ltd. All rights reserved...

  13. Carbon Ion Radiation Therapy Improves the Prognosis of Unresectable Adult Bone and Soft-Tissue Sarcoma of the Head and Neck

    Jingu, Keiichi [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences (NIRS), Chiba (Japan); Department of Radiation Oncology, Tohoku University School of Medicine, Sendai (Japan); Tsujii, Hirohiko, E-mail: [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences (NIRS), Chiba (Japan); Mizoe, Jun-Etsu; Hasegawa, Azusa; Bessho, Hiroki; Takagi, Ryo; Morikawa, Takamichi [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences (NIRS), Chiba (Japan); Tonogi, Morio [Department of Oral Medicine, Tokyo Dental College, Ichihara (Japan); Tsuji, Hiroshi; Kamada, Tadashi [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences (NIRS), Chiba (Japan); Yamada, Shogo [Department of Radiation Oncology, Tohoku University School of Medicine, Sendai (Japan)


    Purpose: To evaluate the safety and efficacy of carbon ion radiotherapy (C-ion RT) with 70.4 GyE for unresectable bone and soft-tissue sarcoma of the adult head and neck. Methods and Materials: Twenty-seven patients (mean age, 46.2 years) were enrolled in this prospective study on C-ion RT with 70.4 GyE/16 fractions (fr) between April 2001 and February 2008. The primary end points were acute and late reactions of normal tissues, local control rate, and overall survival rate. The secondary end point was efficacy of the treatment in comparison to historical results with 57.6 or 64.0 GyE/16 fr. Results: The 3-year local control rate and overall survival rate for all patients were 91.8% (95% confidence interval [CI] = 81.0-100%) and 74.1% (95% CI = 57.5-90.6%), respectively. Acute reaction of Grade 3 or more was observed in only 1 patient. With regard to late reactions, visual loss was observed in 1 patient and a Grade 3 reaction of the maxillary bone was observed in 4 patients. A comparison with historical results revealed that the local control rate with 70.4 GyE was significantly higher than that with 57.6 or 64.0 GyE (3-year, 91.8% vs. 23.6%, p < 0.0001). Furthermore, the overall survival with 70.4 GyE tended to be higher than that with 57.6 or 64.0 GyE (3-year, 74.1% vs. 42.9%, p = 0.09). Conclusion: C-ion RT with 70.4 GyE/16 fr for bone and soft-tissue sarcoma of the adult head and neck appears to be effective with acceptable toxicities in comparison to conventional RT and C-ion RT with lower doses.

  14. Isolating stem cells from soft musculoskeletal tissues.

    Li, Yong; Pan, Haiying; Huard, Johnny


    Adult stem cells have long been discussed in regards to their application in regenerative medicine. Adult stem cells have generated a great deal of excitement for treating injured and diseased tissues due to their impressive capabilities to undergo multi-lineage cell differentiation and their self-renewal ability. Most importantly, these qualities have made them advantageous for use in autologous cell transplantation therapies. The current protocol will introduce the readers to the modified preplate technique where soft tissues of the musculoskeletal system, e.g. tendon and muscle, are 1(st) enzymatically dissociated and then placed in collagen coated flasks with medium. The supernatant, which is composed of medium and the remaining floating cells, is serially transferred daily to new flasks. The stem cells are the slowest to adhere to the flasks which is usually takes 5-7 days (serial transfers or preplates). By using this technique, adult stem cells present in these tissues can be easily harvested through fairly non-invasive procedures.

  15. Olaratumab for soft tissue sarcoma.

    Teyssonneau, Diego; Italiano, Antoine


    Soft tissue sarcomas (STS) are rare malignant tumors. Unfortunately, the first-line doxorubicin-based treatment has not been improved since the 1970s. Platelet-derived growth factor (PDGF) receptor alpha (PDGFR-α) and its ligands are co-expressed in many types of cancer, including sarcomas. They are involved in stimulating growth and regulating stromal-derived fibroblasts and angiogenesis. PDGFR-α and its ligand may play an important role in tumorigenesis and be a potential target in the treatment of sarcomas. Olaratumab is a fully human IgG1-type anti-PDGFR-α monoclonal antibody with a high affinity and a low 50% inhibitory concentration (IC50). Areas covered: The authors review the role of olaratumab in the treatment of STS by focusing on the recent, randomized Phase II JDGD trial that challenged patients with unresectable or metastatic STS with doxorubicin in the presence or absence of olaratumab. This trial showed a great improvement in overall survival (OS), with an increase in survival from 14.7 months to 26.5 months for patients in the experimental arm and showed acceptable toxicity. Expert opinion: Results seem promising. However, it must be qualified, as the study includes several uncertainties. These uncertainties should be addressed by the ongoing Phase 3 JGDJ confirmatory trial, for which the final efficacy analysis is expected by 2019.

  16. Multidisciplinary Management of Soft Tissue Sarcoma

    Lukas M. Nystrom


    Full Text Available Soft tissue sarcoma is a rare malignancy, with approximately 11,000 cases per year encountered in the United States. It is primarily encountered in adults but can affect patients of any age. There are many histologic subtypes and the malignancy can be low or high grade. Appropriate staging work up includes a physical exam, advanced imaging, and a carefully planned biopsy. This information is then used to guide the discussion of definitive treatment of the tumor which typically involves surgical resection with a negative margin in addition to neoadjuvant or adjuvant external beam radiation. Advances in imaging and radiation therapy have made limb salvage surgery the standard of care, with local control rates greater than 90% in most modern series. Currently, the role of chemotherapy is not well defined and this treatment is typically reserved for patients with metastatic or recurrent disease and for certain histologic subtypes. The goal of this paper is to review the current state of the art in multidisciplinary management of soft tissue sarcoma.

  17. Primary intracranial soft tissue sarcomas in children, adolescents, and young adults: single institution experience and review of the literature.

    Maher, Ossama M; Khatua, Soumen; Mukherjee, Devashis; Olar, Adriana; Lazar, Alexander; Luthra, Raja; Liu, Diane; Wu, Jimin; Ketonen, Leena; Zaky, Wafik


    There is a paucity of literature reporting the outcome of intracranial sarcomas (IS) in children, adolescents, and young adults (CAYA). A multimodal therapeutic approach is commonly used, with no well-established treatment consensus. We conducted a retrospective review of CAYA with IS, treated at our institution, to determine their clinical findings, treatments, and outcomes. Immunohistochemistry (PDGFRA and EGFR) and DNA sequencing were performed on 5 tumor samples. A literature review of IS was also conducted. We reviewed 13 patients (median age, 7 years) with a primary diagnosis of IS between 1990 and 2015. Diagnoses included unclassified sarcoma (n = 9), chondrosarcoma (n = 2), and rhabdomyosarcoma (n = 2). Five patients underwent upfront gross total resection (GTR) of the tumor. The 5-drug regimen (vincristine, doxorubicin, cyclophosphamide, etoposide, and ifosfamide) was the most common treatment used. Nine patients died due to progression or recurrence (n = 8) or secondary malignancy (n = 1). The median follow-up period of the 4 surviving patients was 1.69 years (range 1.44-5.17 years). The 5-year progression-free survival and overall survival rates were 21 and 44 %, respectively. BRAF, TP53, KRAS, KIT, ERBB2, MET, RET, ATM, and EGFR mutations were detected in 4 of the 5 tissue samples. All 5 samples were immunopositive for PDGFRA, and only 2 were positive for EGFR. IS remain a therapeutic challenge due to high progression and recurrence rates. Collaborative multi-institutional studies are warranted to delineate a treatment consensus and investigate tumor biology to improve the disease outcome.

  18. Childhood Soft Tissue Sarcoma: Treatment Information

    ... Non-Hodgkin) Lymphoma (Hodgkin) Neuroblastoma Osteosarcoma Retinoblastoma Rhabdomyosarcoma Skin Cancer Soft Tissue Sarcoma Thyroid Cancer Cancer Resources Childhood Cancer Statistics Coping With Cancer CureSearch CancerCare App Late Effects ...

  19. Drugs Approved for Soft Tissue Sarcoma

    ... 2015 2014 2013 2012 Media Resources Media Contacts Multicultural Media ... This page lists cancer drugs approved by the Food and Drug Administration (FDA) for soft tissue sarcoma. The list includes ...

  20. Extramedullary Plasmacytoma of Soft Tissues and Gingiva

    Amrit Kaur Kaler


    Full Text Available Extramedullary plasmacytoma (EMP is a rare plasma cell neoplasm of soft tissue without bone marrow involvement or other systemic characteristics of multiple myeloma. It accounts for 3% of all plasma cell tumors. Multiple extramedullary plasmacytoma is defined when there is more than one extramedullary tumor of clonal plasma cells and such presentation has not been described earlier. We report such rare case of multiple extramedullary plasmacytoma involving multiple soft tissues in chest, abdomen, mandible, maxilla, and gingiva.

  1. Injectable silk foams for soft tissue regeneration.

    Bellas, Evangelia; Lo, Tim J; Fournier, Eric P; Brown, Joseph E; Abbott, Rosalyn D; Gil, Eun S; Marra, Kacey G; Rubin, J Peter; Leisk, Gary G; Kaplan, David L


    Soft tissue fillers are needed for restoration of a defect or augmentation of existing tissues. Autografts and lipotransfer have been under study for soft tissue reconstruction but yield inconsistent results, often with considerable resorption of the grafted tissue. A minimally invasive procedure would reduce scarring and recovery time as well as allow the implant and/or grafted tissue to be placed closer to existing vasculature. Here, the feasibility of an injectable silk foam for soft tissue regeneration is demonstrated. Adipose-derived stem cells survive and migrate through the foam over a 10-d period in vitro. The silk foams are also successfully injected into the subcutaneous space in a rat and over a 3-month period integrating with the surrounding native tissue. The injected foams are palpable and soft to the touch through the skin and returning to their original dimensions after pressure is applied and then released. The foams readily absorb lipoaspirate making the foams useful as a scaffold or template for existing soft tissue filler technologies, useful either as a biomaterial alone or in combination with the lipoaspirate.

  2. Prognostic and predictive factors for outcome to first-line ifosfamide-containing chemotherapy for adult patients with advanced soft tissue sarcomas An exploratory, retrospective analysis on large series from the European Organization for Research and Treatment of Cancer-Soft Tissue and Bone Sarcoma Group (EORTC-STBSG)

    Sleiffer, S.; Ouali, M.; van Glabbeke, M.;


    Background: Adult patients with advanced soft tissue sarcomas (STS) are generally treated similarly, regardless of great differences between STS subtypes, disease presentation and patients' characteristics. As ifosfamide is frequently applied in first line systemic therapy, we aimed to establish...... prognostic and predictive factors for outcome to ifosfamide-based therapy. Methods: A retrospective, exploratory analysis was performed on data from 1337 advanced STS patients who received first-time ifosfamide-containing chemotherapy. For predictive factor analysis, 660 patients treated with doxorubicin...

  3. Nasal Soft-Tissue Triangle Deformities.

    Foda, Hossam M T


    The soft-tissue triangle is one of the least areas attended to in rhinoplasty. Any postoperative retraction, notching, or asymmetries of soft triangles can seriously affect the rhinoplasty outcome. A good understanding of the risk factors predisposing to soft triangle deformities is necessary to prevent such problems. The commonest risk factors in our study were the wide vertical domal angle between the lateral and intermediate crura, and the increased length of intermediate crus. Two types of soft triangle grafts were described to prevent and treat soft triangle deformities. The used soft triangle grafts resulted in an excellent long-term aesthetic and functional improvement. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Soft tissue and esthetic considerations around implants

    Joann Pauline George


    Full Text Available The health of the peri – implant tissues play an important in the long term outcome of dental implants. The absence of keratinized gingiva (KG may be a risk factor for developing recession or peri –implantitis. However there is still ambiguity in the need for keratinized gingiva around dental implants. The preservation and reconstruction of soft tissue around dental implants is an integral component of dental Implantology. There is no long-term evidence whether augmented soft tissues can be maintained over time and are able to influence the peri-implant bone levels. Among the various soft tissue augmentation techniques Apically positioned flap with vestibuloplasty , Free gingival grafts and Connective tissue grafts are documented as the most predictable methods to increase the width of KG. Autogenous grafts increase the soft tissue thickness and improve aesthetics compared to non-grafted sites. The aim of this review is to critically discuss the need for KG around implants and the techniques to preserve and augment KG. It is difficult to arrive at a definitive conclusion due to scarcity of well designed studies in literature. Reliable evidence is lacking to suggest the ideal soft tissue augmentation/preservation techniques. Long term randomized controlled clinical trials are needed to provide a clearer image.

  5. Soft Tissue Mineralization in Captive 2-Toed Sloths.

    Han, S; Garner, M M


    Soft tissue mineralization was diagnosed in 19 captive 2-toed sloths (Choloepus didactylusandCholoepus hoffmanni) ranging from 2 months to 41 years of age. Gross mineralization was evident at necropsy in 6 of 19 sloths and was prominent in the aorta and arteries. Histologically, 11 sloths had arterial mineralization, including mural osseous and chondroid metaplasia and smooth muscle hyperplasia consistent with arteriosclerosis. Visceral mineralization most commonly involved the gastric mucosa (17 sloths), kidneys (17 sloths), and lungs (8 sloths). Eleven sloths ranging in age from 5 to 41 years old had moderate to severe renal disease, which may be an important underlying cause of soft tissue mineralization in adult sloths. However, 5 sloths (juveniles and adults) had severe soft tissue mineralization with histologically normal kidneys or only mild interstitial inflammation or fibrosis, suggesting other causes of calcium and phosphorus imbalance. Degenerative cardiac disease was a common finding in 10 sloths with vascular mineralization and varied from mild to severe with fibrosis and acute noninflammatory myocardial necrosis. Although the prevalence of cardiac disease in adult sloths has not been documented, disease may be exacerbated by hypertension from degenerative arteriosclerosis as noted in this study group. Although renal disease likely contributed substantially to mineralization of tissues in most sloths in this study, nutritional causes of soft tissue mineralization-such as imbalances in dietary vitamin D or calcium and phosphorus-may be an important contributing factor.

  6. Soft tissues store and return mechanical energy in human running.

    Riddick, R C; Kuo, A D


    During human running, softer parts of the body may deform under load and dissipate mechanical energy. Although tissues such as the heel pad have been characterized individually, the aggregate work performed by all soft tissues during running is unknown. We therefore estimated the work performed by soft tissues (N=8 healthy adults) at running speeds ranging 2-5 m s(-1), computed as the difference between joint work performed on rigid segments, and whole-body estimates of work performed on the (non-rigid) body center of mass (COM) and peripheral to the COM. Soft tissues performed aggregate negative work, with magnitude increasing linearly with speed. The amount was about -19 J per stance phase at a nominal 3 m s(-1), accounting for more than 25% of stance phase negative work performed by the entire body. Fluctuations in soft tissue mechanical power over time resembled a damped oscillation starting at ground contact, with peak negative power comparable to that for the knee joint (about -500 W). Even the positive work from soft tissue rebound was significant, about 13 J per stance phase (about 17% of the positive work of the entire body). Assuming that the net dissipative work is offset by an equal amount of active, positive muscle work performed at 25% efficiency, soft tissue dissipation could account for about 29% of the net metabolic expenditure for running at 5 m s(-1). During running, soft tissue deformations dissipate mechanical energy that must be offset by active muscle work at non-negligible metabolic cost.

  7. Quantification and validation of soft tissue deformation

    Mosbech, Thomas Hammershaimb; Ersbøll, Bjarne Kjær; Christensen, Lars Bager


    markers are easy to distinguish from the surrounding soft tissue in 3D computed tomography images. By tracking corresponding markers using methods from point-based registration, we are able to accurately quantify the magnitude and propagation of the induced deformation. The deformation is parameterised......We present a model for soft tissue deformation derived empirically from 10 pig carcases. The carcasses are subjected to deformation from a known single source of pressure located at the skin surface, and the deformation is quantified by means of steel markers injected into the tissue. The steel...

  8. Tissue Friendly Pendulum: Soft Liner to prevent Tissue Irritation

    Siddharth Shashidhar Revankar


    Full Text Available Palatal mucosal irritation is commonly encountered with the Pendulum appliance. The efficiency of soft liners in reducing tissue irritation has been well documented in the field of prosthodontics. The following article describes an innovative technique where soft liner can be used to reduce palatal mucosal irritation caused by pendulum appliance.

  9. Soft tissue growth of the oropharynx.

    Taylor, M; Hans, M G; Strohl, K P; Nelson, S; Broadbent, B H


    The purpose of this study was to describe the pattern of bony and soft tissue growth of the oropharynx in a sample of healthy, orthodontically untreated children. The sample consisted of 16 males and 16 females with lateral cephalograms at 6, 9, 12, 15, and 18 years of age, for a total of 160 lateral cephalometric radiographs. All subjects were enrolled in the Broadbent Bolton Study and their radiographs were used to produce the Bolton Standard Templates. Each radiograph was traced by hand and the tracings were paired and averaged to create a standard template for pharyngeal tissues at each age. In addition, all 160 tracings were digitized and means and standard deviations were calculated for 29 hard and 7 soft tissue measurements. Four linear (Ar-H,S-H,Go-H, Gn-H) and three angular (N-S-H, SN-ArH,GoGn-H) measurements demonstrated that the hyoid bone descends and moves slightly anteriorly up to age 18. The soft palate (PNS-P) increased 1 mm in length and 0.5 mm in thickness every 3 years after age 9. The distance between the anterior border of the atlas (ATA) and PNS did not change after age 12, while two soft tissue measurements (PNS-pharyngeal wall [PhW2] and posterior soft palate to pharyngeal wall [psp-PhW3]) increased. In general, two periods of accelerated change (6-9 years and 12-15 years) and two periods of quiescence (9-12 years and 15-18 years) were identified for the pharyngeal soft tissues. Further studies are needed to determine in soft tissues in the oropharynx continue to change after age 18.

  10. Primary extranodal soft-tissue B-cell lymphoma with abundant immunoglobulin inclusions mimicking adult rhabdomyoma: a case report

    Wang Zhe


    Full Text Available Abstract Introduction Immunoglobulin inclusions are found in B-cell neoplasms as well as in crystal-storing histiocytosis associated with B-cell lymphoproliferative disorders. At times, the deposits may be so profound as to obscure the diagnosis and may even lead to misdiagnosis. We report one case of low-grade extranodal lymphoplasmacytic lymphoma with abundant immunoglobulin inclusions and emphasize the need for immunophenotyping and molecular assay to make the right decision in diagnosis. To the best of our knowledge, this is the first report of extranodal B-cell lymphoma with abundant intracellular immunoglobulin accumulation. Case presentation A 62-year-old Asian man from China presented with a 13-year history of a right shoulder mass with recent ongoing pain. A desmoplastic fibroma located in the posterior muscles of the neck was suggested by magnetic resonance imaging, and extended local excision was performed. A biopsy, however, revealed large, isolated rhabdoid cells in a diffuse pattern with mild atypia and eosinophilic cytoplasm. Clustered lymphoid cells were interspersed among these cells. The diagnosis was initially suggested to be adult rhabdomyoma. The final diagnosis of lymphoma was made after immunohistochemical, ultrastructural and molecular studies. Conclusion We emphasize this histopathologic and immunohistochemical finding because of the potential for confusion with other tumors or disorders, such as adult rhabdomyoma or crystal-storing histiocytosis.

  11. Soft-tissue mineralization in Werner syndrome

    Leone, Antonio; Costantini, Alessandro Maria; Brigida, Raffaela; Antoniol, Onorina Monica; Bonomo, Lorenzo [Universita Cattolica School of Medicine, Department of Radiology, Rome (Italy); Antonelli-Incalzi, Raffaele [Universita Cattolica School of Medicine, Department of Geriatrics, Rome (Italy)


    Werner syndrome is a rare autosomal recessive disorder characterized by clinical signs of premature aging, short stature, scleroderma-like skin changes, endocrine abnormalities, cataracts, and an increased incidence of malignancies. We report on a 48-year-old woman with Werner syndrome associated with intracranial meningiomas who had extensive musculoskeletal manifestations including osteoporosis of the extremities, extensive tendinopathy about the ankles, osteomyelitis of the phalanges of the first left toe, abundant soft-tissue calcification, and two dense ossified soft-tissue masses, with cortical bone and trabeculae arising from the posterosuperior aspect of the calcanei and extending into Kager fat pads. A review of previous descriptions of the radiological abnormalities of Werner syndrome indicates that the presence of soft-tissue calcifications has either not been noted or been mentioned only briefly. Moreover, there is no mention of bony masses associated with Werner syndrome in the world literature, and this would appear to be the first report of this kind. (orig.)

  12. Phase contrast imaging of cochlear soft tissue.

    Smith, S.; Hwang, M.; Rau, C.; Fishman, A.; Lee, W.; Richter, C. (X-Ray Science Division); (Northwestern Univ.); (Diamond Light Source, Ltd.)


    A noninvasive technique to image soft tissue could expedite diagnosis and disease management in the auditory system. We propose inline phase contrast imaging with hard X-rays as a novel method that overcomes the limitations of conventional absorption radiography for imaging soft tissue. In this study, phase contrast imaging of mouse cochleae was performed at the Argonne National Laboratory Advanced Photon Source. The phase contrast tomographic reconstructions show soft tissue structures of the cochlea, including the inner pillar cells, the inner spiral sulcus, the tectorial membrane, the basilar membrane, and the Reissner's membrane. The results suggest that phase contrast X-ray imaging and tomographic techniques hold promise to noninvasively image cochlear structures at an unprecedented cellular level.

  13. The Italian registry of soft tissue tumors.

    Clemente, C; Orazi, A; Rilke, F


    After a review of the incidence data on malignant soft-tissue tumors in Italy (Registro dei Tumori della Regione Lombardia, provincia di Varese), Europe (nine European Cancer Registries considered representative of various geographical areas) and extra-European countries (data of ten World Cancer Registries), the aim and the organization of the Italian Malignant Soft-Tissue Tumor Registry are described. The collection system is based on dedicated forms prepared for the computerization of all data. From 1.1.1985 to 31.3.1987, 207 cases of malignant and potentially malignant soft-tissue tumors entered the Registry, with exclusion of those sarcomas arising in viscera. The distribution, categorized by histologic type, sex and site, and the preliminary results on relapses and metastases are reported.

  14. Soft tissue biotype affects implant success.

    Lee, Angie; Fu, Jia-Hui; Wang, Hom-Lay


    The influence of tissue biotype in natural dentition is already well demonstrated in the literature, with numerous articles showing that thicker tissue is a preferred biotype for optimal surgical and prosthetic outcomes. In this same line of thought, current studies are directed to explore whether mucosal thickness would have similar implications around dental implants. The purpose of this review was to investigate the effects of soft tissue biotype in relation to success of implant therapy. The influence of tissue biotype was divided into 3 main categories: its relationship with periimplant mucosa and the underlying bone, immediate implant placement, and restorative outcomes. Soft tissue biotype is an important parameter to consider in achieving esthetic implant restoration, improving immediate implant success, and preventing future mucosal recession.

  15. Soft tissue sarcoma of the extremity.

    Cooper, T M


    A retrospective review of 33 cases of soft tissue sarcoma of the extremity presenting over a 10 year period was undertaken. The history, patterns of referral, diagnostic investigations, procedures undertaken and outcomes were studied. We found there was a frequent delay in diagnosis and sometimes misinterpretation of biopsy specimens. Patients were seen by a variety of specialists from disciplines such as general surgery, plastic surgery, orthopaedic surgery and rheumatology. Considerable progress has been made in the treatment of soft tissue sarcomas, often allowing local control of the tumour without amputation. We believe there should be early referral of patients having these tumours to a centre where a combined multidisciplinary approach can be undertaken.

  16. A decision tree for soft tissue grafting.

    Leong, Daylene Jack-Min; Wang, Hom-Lay


    Periodontal plastic surgery is commonly performed for esthetic and physiologic reasons, such as alleviating root sensitivity, root caries, and cervical abrasion and facilitating plaque control at the affected site. Currently, there is a lack of information regarding the most appropriate treatment method for the various clinical situations encountered. The aims of this paper are to review and discuss the various clinical situations that require soft tissue grafting and to attempt to provide recommendations for the most predictable technique. Using MEDLINE and The Cochrane Library, a review of all available literature was performed. Papers published in peer-reviewed journals written in English were chosen and reviewed to validate the decision-making process when planning for soft tissue grafting. A decision tree was subsequently developed to guide clinicians to choose the most appropriate soft tissue grafting procedure by taking into consideration the following clinical parameters: etiology, purpose of the procedure, adjacent interproximal bone level, and overlying tissue thickness. The decision tree proposed serves as a guide for clinicians to select the most appropriate and predictable soft tissue grafting procedure to minimize unnecessary mistakes while providing the ultimate desired treatment outcome.

  17. Biomarkers of necrotising soft tissue infections

    Hansen, Marco Bo; Simonsen, Ulf; Garred, Peter


    INTRODUCTION: The mortality and amputation rates are still high in patients with necrotising soft tissue infections (NSTIs). It would be ideal to have a set of biomarkers that enables the clinician to identify high-risk patients with NSTI on admission. The objectives of this study are to evaluate...

  18. Adverse reactions to injectable soft tissue fillers

    Requena, Luis; Requena, Celia; Christensen, Lise


    In recent years, injections with filler agents are often used for wrinkle-treatment and soft tissue augmentation by dermatologists and plastic surgeons. Unfortunately, the ideal filler has not yet been discovered and all of them may induce adverse reactions. Quickly biodegradable or resorbable...

  19. MRI evaluation of soft tissue hydatid disease

    Garcia-Diez, A.I.; Ros Mendoza, L.H.; Villacampa, V.M.; Cozar, M.; Fuertes, M.I. [Dept. of Radiology, Hospital Miguel Servet, Zaragoza (Spain)


    Infestation in soft tissue by Echinococcus granulosus is not a common disease, and its diagnosis is based on clinical, laboratory data and radiological findings. The aim of our retrospective study is to give an overview of the different signs and patterns shown by MRI that can be useful in characterizing soft tissue hydatid disease. The MRI images obtained in seven patients with soft tissue and subcutaneous hydatidosis were reviewed. Typical signs of hydatidosis were multivesicular lesions with or without hypointense peripheral ring (''rim sign''). Related to the presence and absence, respectively, of viable scolices in the microscopic exam, daughter cysts were presented either as high signal intensity or low signal intensity on T2-weighted images. Low-intensity detached layers within the cyst and peripheral enhancement with gadolinium-DTPA were also presented. Atypical signs were presented in an infected muscular cyst, a subcutaneous unilocular cyst and several unilocular cysts. Knowledge of the different patterns in MRI of soft tissue hydatid disease can be useful in diagnosing this entity. We observed that the ''rim sign'' is not as common as in other locations, and in addition, MRI seems to be of assistance when evaluating the vitality of the cysts. (orig.)

  20. Biodegradable elastomeric scaffolds for soft tissue engineering

    Pêgo, A.P.; Poot, Andreas A.; Grijpma, Dirk W.; Feijen, Jan


    Elastomeric copolymers of 1,3-trimethylene carbonate (TMC) and ε-caprolactone (CL) and copolymers of TMC and D,L-lactide (DLLA) have been evaluated as candidate materials for the preparation of biodegradable scaffolds for soft tissue engineering. TMC-DLLA copolymers are amorphous and degrade more


    Pencho Kosev


    Full Text Available We present our experience with the soft tissue balancing in total hip arthroplasty. Detailed indications, planning and surgical technique are presented. The described procedures are performed on 278 hips for a period of 6 years (2008-2014. We conclude that the outcome of a THA can be improved by balancing the stability, ROM, muscle strength and limb length equality.

  2. Resistance and perspectives in soft tissue sarcomas

    Komdeur, Rudy


    Soft tissue sarcomas are rare malignancies originating from mesenchymal origin. They may occur at any age, but the incidence increases with age: about 50% of the patients are over 60 years of age. A distinct peak incidence is made up by embryonal rhabdomyosarcomas that mostly afflict children at age

  3. Biodegradable elastomeric scaffolds for soft tissue engineering

    Pego, Ana Paula; Poot, André A.; Grijpma, Dirk W.; Feijen, Jan


    Elastomeric copolymers of 1,3-trimethylene carbonate (TMC) and ε-caprolactone (CL) and copolymers of TMC and D,L-lactide (DLLA) have been evaluated as candidate materials for the preparation of biodegradable scaffolds for soft tissue engineering. TMC-DLLA copolymers are amorphous and degrade more r

  4. Soft tissue sarcoma : why not treated?

    Farshadpour, F; Schaapveld, M; Suurmeijer, AJH; Wymenga, ANM; Otter, R; Hoekstra, HJ


    Background : Soft tissue sarcomas (STS) are uncommon malignancies and elderly STS patients have been reported to receive less definitive treatment compared to young STS patients. The present study was performed to investigate whether withholding treatment was based on disease specific aspects, patie

  5. Biomimetic 3D tissue printing for soft tissue regeneration.

    Pati, Falguni; Ha, Dong-Heon; Jang, Jinah; Han, Hyun Ho; Rhie, Jong-Won; Cho, Dong-Woo


    Engineered adipose tissue constructs that are capable of reconstructing soft tissue with adequate volume would be worthwhile in plastic and reconstructive surgery. Tissue printing offers the possibility of fabricating anatomically relevant tissue constructs by delivering suitable matrix materials and living cells. Here, we devise a biomimetic approach for printing adipose tissue constructs employing decellularized adipose tissue (DAT) matrix bioink encapsulating human adipose tissue-derived mesenchymal stem cells (hASCs). We designed and printed precisely-defined and flexible dome-shaped structures with engineered porosity using DAT bioink that facilitated high cell viability over 2 weeks and induced expression of standard adipogenic genes without any supplemented adipogenic factors. The printed DAT constructs expressed adipogenic genes more intensely than did non-printed DAT gel. To evaluate the efficacy of our printed tissue constructs for adipose tissue regeneration, we implanted them subcutaneously in mice. The constructs did not induce chronic inflammation or cytotoxicity postimplantation, but supported positive tissue infiltration, constructive tissue remodeling, and adipose tissue formation. This study demonstrates that direct printing of spatially on-demand customized tissue analogs is a promising approach to soft tissue regeneration.

  6. Soft tissue twisting injuries of the knee

    Magee, T.; Shapiro, M. [Neuroimaging Inst., Melbourne, FL (United States)


    Twisting injuries occur as a result of differential motion of different tissue types in injuries with some rotational force. These injuries are well described in brain injuries but, to our knowledge, have not been described in the musculoskeletal literature. We correlated the clinical examination and MR findings of 20 patients with twisting injuries of the soft tissues around the knee. Design and patients: We prospectively followed the clinical courses of 20 patients with knee injuries who had clinical histories and MR findings to suggest twisting injuries of the subcutaneous tissues. Patients with associated internal derangement of the knee (i.e., meniscal tears, ligamentous or bone injuries) were excluded from this study. MR findings to suggest twisting injuries included linear areas of abnormal dark signal on T1-weighted sequences and abnormal bright signal on T2-weighted or short tau inversion recovery (STIR) sequences and/or signal to suggest hemorrhage within the subcutaneous tissues. These MR criteria were adapted from those established for indirect musculotendinous junction injuries. Results: All 20 patients presented with considerable pain that suggested internal derangement on physical examination by the referring orthopedic surgeons. All presented with injuries associated with rotational force. The patients were placed on a course of protected weight-bearing of the affected extremity for 4 weeks. All patients had pain relief by clinical examination after this period of protected weight-bearing. Twisting injuries of the soft tissues can result in considerable pain that can be confused with internal derangement of the knee on physical examination. Soft tissue twisting injuries need to be recognized on MR examinations as they may be the cause of the patient's pain despite no MR evidence of internal derangement of the knee. The demonstration of soft tissue twisting injuries in a patient with severe knee pain but no documented internal derangement on MR

  7. Multiscale mechanical modeling of soft biological tissues

    Stylianopoulos, Triantafyllos


    Soft biological tissues include both native and artificial tissues. In the human body, tissues like the articular cartilage, arterial wall, and heart valve leaflets are examples of structures composed of an underlying network of collagen fibers, cells, proteins and molecules. Artificial tissues are less complex than native tissues and mainly consist of a fiber polymer network with the intent of replacing lost or damaged tissue. Understanding of the mechanical function of these materials is essential for many clinical treatments (e.g. arterial clamping, angioplasty), diseases (e.g. arteriosclerosis) and tissue engineering applications (e.g. engineered blood vessels or heart valves). This thesis presents the derivation and application of a multiscale methodology to describe the macroscopic mechanical function of soft biological tissues incorporating directly their structural architecture. The model, which is based on volume averaging theory, accounts for structural parameters such as the network volume fraction and orientation, the realignment of the fibers in response to strain, the interactions among the fibers and the interactions between the fibers and the interstitial fluid in order to predict the overall tissue behavior. Therefore, instead of using a constitutive equation to relate strain to stress, the tissue microstructure is modeled within a representative volume element (RVE) and the macroscopic response at any point in the tissue is determined by solving a micromechanics problem in the RVE. The model was applied successfully to acellular collagen gels, native blood vessels, and electrospun polyurethane scaffolds and provided accurate predictions for permeability calculations in isotropic and oriented fiber networks. The agreement of model predictions with experimentally determined mechanical properties provided insights into the mechanics of tissues and tissue constructs, while discrepancies revealed limitations of the model framework.

  8. Soft tissue infections and the diabetic foot.

    Smith, A J; Daniels, T; Bohnen, J M


    Soft tissue infections are classified as local or spreading. Spreading soft tissue infections are potentially life-threatening conditions, requiring prompt diagnosis and treatment. The information presented is based on a literature review and the authors' clinical experience. Diagnosis of soft tissue infections is aimed at determining the level of infection (skin, fascia, muscle) and whether necrosis is present. The bacteriology of these infections is varied and is of secondary importance. Treatment of skin infections that have no dead tissue is with antibiotics alone. Infections at the fascial or muscle level and those with necrosis at any level require surgical debridement and adjuvant antibiotics. The feet of diabetic patients are prone to plantar forefoot ulcers associated with tissue destruction and infection. The vast majority are caused by mechanical factors. If local immune defenses are adequate, bacterial colonization occurs without infection. Most diabetic foot ulcers will respond to relief of pressure, which may require total contact casting. Antibiotics and debridement are required in infected or deep ulcers, or when the ulcer does not respond to total contact casting.

  9. Hard-Soft Tissue Interface Engineering.

    Armitage, Oliver E; Oyen, Michelle L


    The musculoskeletal system is comprised of three distinct tissue categories: structural mineralized tissues, actuating muscular soft tissues, and connective tissues. Where connective tissues - ligament, tendon and cartilage - meet with bones, a graded interface in mechanical properties occurs that allows the transmission of load without creating stress concentrations that would cause tissue damage. This interface typically occurs over less than 1 mm and contains a three order of magnitude difference in elastic stiffness, in addition to changes in cell type and growth factor concentrations among others. Like all engineered tissues, the replication of these interfaces requires the production of scaffolds that will provide chemical and mechanical cues, resulting in biologically accurate cellular differentiation. For interface tissues however, the scaffold must provide spatially graded chemical and mechanical cues over sub millimetre length scales. Naturally, this complicates the manufacture of the scaffolds and every stage of their subsequent cell seeding and growth, as each region has different optimal conditions. Given the higher degree of difficulty associated with replicating interface tissues compared to surrounding homogeneous tissues, it is likely that the development of complex musculoskeletal tissue systems will continue to be limited by the engineering of connective tissues interfaces with bone.

  10. Palmar Soft Tissue Infection From Shewanella putrefaciens.

    Ryan, James M; Truelove, Elizabeth; Sabatino, Matthew; Peters, Stephen; Kessler, Michael


    Shewanella putrefaciens, a gram-negative bacillus, ubiquitous in marine environments, is an opportunistic agent reported to cause rare human infection, most commonly in patients who are immunocompromised or who have a preexisting soft tissue defect. We present an immunocompetent, 40-year-old woman with a soft tissue infection of the left palm caused by S. putrefaciens. The patient's infection was complicated by the presence of retained foreign bodies, seashell fragments, from a traumatic fall. Following appropriate evaluation and surgical treatment, our patient experienced a successful outcome with no recurrence of infection or deficit in the affected hand. This case report complements the growing literature regarding morbidity attributed to S. putrefaciens infection. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  11. Soft tissue augmentation in dermatology - 2009 update

    Michael H Gold


    Full Text Available The number of products available to dermatologists for soft tissue augmentation has grown significantly over the past several years in the US. This manuscript will review the various hyaluronic acid fillers and other Food and Drug Administration -approved products we are utilizing for our patients in the rejuvenation process. It is hoped that through this article clinicians will feel more comfortable using these products in their everyday practice of dermatology.

  12. Anatomic Tumor Location Influences the Success of Contemporary Limb-Sparing Surgery and Radiation Among Adults With Soft Tissue Sarcomas of the Extremities

    Korah, Mariam P., E-mail: [Department of Radiation Oncology, Emory University, Atlanta, GA (United States); Deyrup, Andrea T. [Department of Pathology, Emory University, Atlanta, GA (United States); Monson, David K.; Oskouei, Shervin V. [Department of Orthopedics, Emory University, Atlanta, GA (United States); Weiss, Sharon W. [Department of Pathology, Emory University, Atlanta, GA (United States); Landry, Jerome; Godette, Karen D. [Department of Radiation Oncology, Emory University, Atlanta, GA (United States)


    Purpose: To examine the influence of anatomic location in the upper extremity (UE) vs. lower extremity (LE) on the presentation and outcomes of adult soft tissue sarcomas (STS). Methods and Materials: From 2001 to 2008, 118 patients underwent limb-sparing surgery (LSS) and external beam radiotherapy (RT) with curative intent for nonrecurrent extremity STS. RT was delivered preoperatively in 96 and postoperatively in 22 patients. Lesions arose in the UE in 28 and in the LE in 90 patients. Patients with UE lesions had smaller tumors (4.5 vs. 9.0 cm, p < 0.01), were more likely to undergo a prior excision (43 vs. 22%, p = 0.03), to have close or positive margins after resection (71 vs. 49%, p = 0.04), and to undergo postoperative RT (32 vs. 14%, p = 0.04). Results: Five-year actuarial local recurrence-free and distant metastasis-free survival rates for the entire group were 85 and 74%, with no difference observed between the UE and LE cohorts. Five-year actuarial probability of wound reoperation rates were 4 vs. 29% (p < 0.01) in the UE and LE respectively. Thigh lesions accounted for 84% of the required wound reoperations. The distribution of tumors within the anterior, medial, and posterior thigh compartments was 51%, 26%, and 23%. Subset analysis by compartment showed no difference in the probability of wound reoperation between the anterior and medial/posterior compartments (29 vs. 30%, p = 0.68). Neurolysis was performed during resection in (15%, 5%, and 67%, p < 0.01) of tumors in the anterior, medial, and posterior compartments. Conclusions: Tumors in the UE and LE differ significantly with respect to size and management details. The anatomy of the UE poses technical impediments to an R0 resection. Thigh tumors are associated with higher wound reoperation rates. Tumor resection in the posterior thigh compartment is more likely to result in nerve injury. A better understanding of the inherent differences between tumors in various extremity sites will assist in

  13. Lung Cancer Presenting as a Soft-Tissue Metastasis

    Candice Baldeo


    Full Text Available Soft-tissue metastasis refers to the growth of cancer cells, originating from internal cancer, in soft tissues. In most cases, soft-tissue metastases develop after initial diagnosis of the primary internal malignancy and late in the course of the disease. In very rare cases, they may occur at the same time or before the primary cancer has been detected. In our cases, the soft-tissue metastases and the primary lung cancer were diagnosed at the same time.

  14. Imaging of the pediatric hand: Soft tissue abnormalities

    Jimenez, R. Mauricio [Department of Radiology, Children' s Hospital of Philadelphia, 34th Street and Civic Center Blvd., Philadelphia, PA 19104 (United States); Jaramillo, Diego [Department of Radiology, Children' s Hospital of Philadelphia, 34th Street and Civic Center Blvd., Philadelphia, PA 19104 (United States)]. E-mail:; Connolly, Susan A. [Children' s Hospital Boston (United States)


    This review attempts to demonstrate the spectrum of soft tissue masses encountered in the child's hand. The diagnosis may be suggested by the combination of physical exam and radiographs. Frequently the etiology of a soft tissue mass cannot be established by conventional radiographs and further imaging is necessary. MRI by virtue of its ability to provide detailed soft tissue characterization is the preferred method of imaging the problematic soft tissue mass.

  15. Modern Soft Tissue Pathology | Center for Cancer Research

    This book comprehensively covers modern soft tissue pathology and includes both tumors and non-neoplastic entities. Soft tissues make up a large bulk of the human body, and they are susceptible to a wide range of diseases. Many soft-tissue tumors are biologically very aggressive, and the chance of them metastasizing to vital organs is quite high. In recent years, the outlook for soft-tissue cancers has brightened dramatically due to the increased accuracy of the pathologist's tools.

  16. Immunotherapy for Bone and Soft Tissue Sarcomas

    Takenori Uehara


    Full Text Available Although multimodal therapies including surgery, chemotherapy, and radiotherapy have improved clinical outcomes of patients with bone and soft tissue sarcomas, the prognosis of patients has plateaued over these 20 years. Immunotherapies have shown the effectiveness for several types of advanced tumors. Immunotherapies, such as cytokine therapies, vaccinations, and adoptive cell transfers, have also been investigated for bone and soft tissue sarcomas. Cytokine therapies with interleukin-2 or interferons have limited efficacy because of their cytotoxicities. Liposomal muramyl tripeptide phosphatidylethanolamine (L-MTP-PE, an activator of the innate immune system, has been approved as adjuvant therapeutics in combination with conventional chemotherapy in Europe, which has improved the 5-year overall survival of patients. Vaccinations and transfer of T cells transduced to express chimeric antigen receptors have shown some efficacy for sarcomas. Ipilimumab and nivolumab are monoclonal antibodies designed to inhibit immune checkpoint mechanisms. These antibodies have recently been shown to be effective for patients with melanoma and also investigated for patients with sarcomas. In this review, we provide an overview of various trials of immunotherapies for bone and soft tissue sarcomas, and discuss their potential as adjuvant therapies in combination with conventional therapies.

  17. Soft tissue management in endodontic surgery.

    Velvart, Peter; Peters, Christine I


    Modern endodontic surgery involves both root-end preparation and proper sealing of all apical portals of exit. Both components are requirements for mechanical and biological success, but the management of soft tissues becomes increasingly important for an esthetically successful treatment. A healthy appearance of soft tissues plays an important role in the esthetic outcome of periradicular surgery. This is true considering maintenance of attachment levels and regarding the amount of possible recession after surgical procedures. Complete, recession-free and predictable healing of gingival tissue is one important goal of endodontic surgical treatment. A critical review of currently used techniques based on clinical and scientific data reveals great potential for improvements. Possible reasons for scar formation and recession specifically in healthy periodontal conditions requiring surgical endodontic intervention are highlighted. Based on anatomical considerations various incision types are evaluated and recommendations made. Clear understanding of wound closure and tissue-healing patterns call for the use of atraumatic procedures, nonirritating suture materials and adequate suturing techniques. This article gives an overview and guidance for integrating current and new successful flap designs and wound closure methods. The methods described have the intention of maintaining the attachment level and avoiding postoperative recession after surgical endodontic therapy.

  18. Immunoglobulin for necrotising soft tissue infections (INSTINCT)

    Madsen, Martin Bruun; Lange, Theis; Hjortrup, Peter Buhl;


    INTRODUCTION: Necrotising soft tissue infections (NSTI) are aggressive infections that can result in severe disability or death. Intravenous polyspecific immunoglobulin G (IVIG) is used as supplementary treatment for patients with NSTIs. The level of evidence is very low, but suggests that IVIG may....... Secondary outcomes are: mortality; time to resolution of shock; bleeding; sequential organ failure assessment scores on days 1-7; use of renal-replacement therapy, mechanical ventilation and vasopressors; days alive and out of hospital; amputation; and severe adverse reactions. CONCLUSION: This study...

  19. Soft Tissue Preservation in Terrestrial Mesozoic Vertebrates

    Schweitzer, Mary Higby


    Exceptionally preserved fossils -- i.e., those that retain, in some manner, labile components of organisms that are normally degraded far too quickly to enter the fossil record -- hold the greatest potential for understanding aspects of the biology of long-extinct animals and are the best targets for the search for endogenous biomolecules. Yet the modes of preservation of these labile components, and exactly what remains of the original composition, are not well understood. Here, I review a selection of cases of soft tissue preservation in Mesozoic vertebrates, examine chemical and environmental factors that may influence such preservation, explore the potential of these fossils for high-resolution analytical studies, and suggest clarification of terminologies and criteria for determining the endogeneity of source and the degree of preservation of these well-preserved tissues.

  20. Longitudinal nonlinear wave propagation through soft tissue.

    Valdez, M; Balachandran, B


    In this paper, wave propagation through soft tissue is investigated. A primary aim of this investigation is to gain a fundamental understanding of the influence of soft tissue nonlinear material properties on the propagation characteristics of stress waves generated by transient loadings. Here, for computational modeling purposes, the soft tissue is modeled as a nonlinear visco-hyperelastic material, the geometry is assumed to be one-dimensional rod geometry, and uniaxial propagation of longitudinal waves is considered. By using the linearized model, a basic understanding of the characteristics of wave propagation is developed through the dispersion relation and in terms of the propagation speed and attenuation. In addition, it is illustrated as to how the linear system can be used to predict brain tissue material parameters through the use of available experimental ultrasonic attenuation curves. Furthermore, frequency thresholds for wave propagation along internal structures, such as axons in the white matter of the brain, are obtained through the linear analysis. With the nonlinear material model, the authors analyze cases in which one of the ends of the rods is fixed and the other end is subjected to a loading. Two variants of the nonlinear model are analyzed and the associated predictions are compared with the predictions of the corresponding linear model. The numerical results illustrate that one of the imprints of the nonlinearity on the wave propagation phenomenon is the steepening of the wave front, leading to jump-like variations in the stress wave profiles. This phenomenon is a consequence of the dependence of the local wave speed on the local deformation of the material. As per the predictions of the nonlinear material model, compressive waves in the structure travel faster than tensile waves. Furthermore, it is found that wave pulses with large amplitudes and small elapsed times are attenuated over shorter spans. This feature is due to the elevated

  1. Microwave soft tissue ablation (Invited Paper)

    Clegg, Peter J.; Cronin, Nigel J.


    Microsulis, in conjunction with the University of Bath have developed a set of novel microwave applicators for the ablation of soft tissues. These interstitial applicators have been designed for use in open surgical, laparoscopic and percutaneous settings and range in diameter from 2.4 to 7 mm. A 20 mm diameter flat faced interface applicator was developed as an adjunct to the open surgical interstitial applicator and has been applied to the treatment of surface breaking lesions in hepatobiliary surgery. Taken as a complete tool set the applicators are capable of treating a wide range of conditions in a safe and efficacious manner. The modality employs a radiated electromagnetic field at the allocated medical frequency of 2.45 GHz and powers between 30 and 150 Watts. Computer simulations, bench testing, safety and efficacy testing, ex-vivo and in-vivo work plus clinical trials have demonstrated that these systems are capable of generating large volumes of ablation in short times with favourable ablation geometries. Clinical studies have shown very low complication rates with minimal local recurrence. It is considered that this modality offers major advantages over currently marketed products. The technique is considered to be particularly safe as it is quick and there is no passage of current obviating the requirement for grounding pads. Since the microwave field operates primarily on water and all soft tissues with the exception of fat are made up of approximately 70% water the heating pattern is highly predictable making repeatability a key factor for this modality.

  2. Soft-tissue rheumatism: diagnosis and treatment.

    Reveille, J D


    Soft tissue rheumatism is one of the most common and most misunderstood categories of disorders facing the primary care physician. Among the more common types are subacromial bursitis, epicondylitis, trochanteric bursitis, anserine bursitis, and fibromyalgia. The keys to the diagnosis of soft-tissue rheumatism are the history and, more importantly, the physical examination. Extensive laboratory testing and radiographs are not as helpful in evaluating patients with these complaints. Treatment consists of nonsteroidal anti-inflammatory drugs (NSAIDs) and nonnarcotic analgesics. Especially in patients with localized disorders, intralesional injections of corticosteroids are particularly effective and safe and should be part of the armamentarium of the primary care practitioner. Fibromyalgia is a particularly challenging form of nonarticular rheumatism. The clinical presentation is rather characteristic, with the patient typically being a woman 30-60 years of age who presents with diffuse somatic pain. Patients often give a history of sleep disturbance, may be depressed, and show characteristic tender areas, or trigger points. Laboratory findings are normal. Management includes reassurance, correction of the underlying sleep disturbance with low doses of a tricyclic antidepressant, treatment with muscle relaxants and nonnarcotic analgesics or NSAIDs, and an exercise program with a strong aerobic component.

  3. Measurement and analysis of the facial soft tissue in adults laterognathism%成人偏突颌畸形颜面软组织形态测量分析

    张兰成; 侯敏; 张锡忠; 宋大立; 杜清香


    目的 对偏突颌畸形患者面部软组织形态进行测量分析,以便为正颌手术及畸形整复提供参考.方法 对实验组42例偏突颌畸形成人患者,对照组48例颜面对称、咬牙合关系正常的成人,进行颜面软组织相关的线距及角度测量,并对测量值进行统计分析.结果 偏突颌畸形的患者,上、下唇部都有移位,最突出表现在口角区、下唇与颏部.结论正颌手术应充分考虑偏突颌畸形患者的口唇及颜面软组织的位置形态.%Objective To study the morphological characters of facial soft tissue in adults with laterogn-athism of the mandible. Methods Forty-two patients with laterognathism of the mandible and 48 adults with symmetrical face and normal dental articulation were collected. The line distance and angles related with facial soft tissue were measured and the results was analyzed statistically. Results Patients with laterognathism of the mandible showed that there was malposition on both the upper and lower lips, especially in cheilion, lower lip and chin. Conclusion The morphological characters of oral lip and the facial soft tissue should be considered in patients with laterognathism of the mandible undergoing orthognathic surgery.

  4. The study on facial soft tissue thickness using Han population in Xinjiang.

    Wang, Jierui; Zhao, Xi; Mi, Congbo; Raza, Iqbal


    Facial profile is an important aspect in physical anthropology, forensic science, and cosmetic research. Thus, facial soft tissue measurement technology plays a significant role in facial restoration. A considerable amount of work has investigated facial soft tissue thickness, which significantly varies according to gender, age, and race. However, only few studies have considered the nutritional status of the investigated individuals. Moreover, no sufficient research among Chinese ethnic groups, particularly Xinjiang population in China, is currently available. Hence, the current study investigated the adaptability of facial soft tissue to the underlying hard tissue among young adults of Han population in Xinjiang, China; the analysis was performed on the basis of gender, skeletal class, and body mass index (BMI). Measurements were obtained from the lateral cephalometric radiographs of 256 adults aged 18-26 years old. Differences in soft tissue thickness were observed between genders and among skeletal classes. With regard to gender, significant differences in soft tissue thickness were found at rhinion, glabella, subnasale, stomion, labrale superius, pogonion, and gnathion among different BMI groups. Thus, nutritional status should be considered when reconstructing an individual's facial profile. Results showed that the thinnest and thickest craniofacial soft tissues existed in rhinion and lip regions, respectively. Overall, this research provides valuable data for forensic facial reconstruction and identification of young adults in Xinjiang, China.

  5. Ion induced deformation of soft tissue.

    Myers, T G; Aldis, G K; Naili, S


    In this paper the effects of changing the ion concentration in and around a sample of soft tissue are investigated. The triphasic theory developed by Lai et al. (1990, Biomechanics of Diarthrodial Joints, Vol. 1, Berlin, Springer-Verlag) is reduced to two coupled partial differential equations involving fluid ion concentration and tissue solid deformation. These equations are given in general form for Cartesian, cylindrical and spherical geometries. After solving the two equations quantities such as fluid velocity, fluid pressure, chemical potentials and chemical expansion stress may be easily calculated. In the Cartesian geometry comparison is made with the experimental and theoretical work of Myers et al. (1984, ASME J. biomech. Engng, 106, 151-158). This dealt with changing the ion concentration of a salt shower on a strip of bovine articular cartilage. Results were obtained in both free swelling and isometric tension states, using an empirical formula to account for ion induced deformation. The present theory predicts lower ion concentrations inside the tissue than this earlier work. A spherical sample of tissue subjected to a change in salt bath ion concentration is also considered. Numerical results are obtained for both hypertonic and hypotonic bathing solutions. Of particular interest is the finding that tissue may contract internally before reaching a final swollen equilibrium state or swell internally before finally contracting. By considering the relative magnitude, and also variation throughout the time course of terms in the governing equations, an even simpler system is deduced. As well as being linear the concentration equation in the new system is uncoupled. Results obtained from the linear system compare well with those from the spherical section. Thus, biological swelling situations may be modelled by a simple system of equations with the possibility of approximate analytic solutions in certain cases.

  6. Histology and imaging of soft tissue sarcomas

    Kind, Michele [Departement d' Imagerie Medicale, Institut Bergonie, 229 cours de l' Argonne, 33076 Bordeaux Cedex (France)], E-mail:; Stock, Nathalie; Coindre, Jean Michel [Departement de Pathologie, Institut Bergonie, 229 cours de l' Argonne, 33076 Bordeaux Cedex (France); Universite Victor Segalen Bordeaux 2, 146 rue Leo Saignat, 33076 Bordeaux Cedex (France)


    Imaging and histology are two complementary morphological techniques which play a fundamental role in the diagnosis and management of soft tissue sarcomas. Imaging allows to identify some pseudosarcomatous benign lesions such as myositis ossificans, intramuscular hemangioma, angiomyolipoma, intramuscular lipoma, giant cell tumour of tendon sheath, desmoid tumour and elastofibroma. There is no formal criterion for diagnosing a sarcoma on magnetic resonance imaging (MRI) but malignancy is strongly suspected with the presence of necrosis and vascular, bone or joint invasion. Imaging may also suggest some histological types of sarcoma such as well-differentiated liposarcoma, dedifferentiated liposarcoma, synovial sarcoma or extraskeletal osteosarcoma. Imaging is also extremely helpful in determining the appropriate kind of sampling to carry out and in guiding the performance of a microbiopsy. The appearance observed on imaging should always be taken into consideration for the interpretation of the microbiopsy by the pathologist.


    Ivonne eRonchetti


    Full Text Available Soft connective tissue calcification is not a passive process, but the consequence of metabolic changes of local mesenchymal cells that, depending on both genetic and environmental factors, alter the balance between pro- and anti-calcifying pathways. While the role of smooth muscle cells and pericytes in ectopic calcifications has been widely investigated, the involvement of fibroblasts is still elusive. Fibroblasts isolated from the dermis of PXE patients and of patients exhibiting PXE-like clinical and histopathological findings offer an attractive model to investigate the mechanisms leading to the precipitation of mineral deposits within elastic fibres and to explore the influence of the genetic background and of the extracellular environment on fibroblast-associated calcifications, thus improving the knowledge on the role of mesenchymal cells on pathologic mineralization.

  8. Contemporary Management of Retroperitoneal Soft Tissue Sarcomas.

    Olimpiadi, Yuliya; Song, Suisui; Hu, James S; Matcuk, George R; Chopra, Shefali; Eisenberg, Burton L; Sener, Stephen F; Tseng, William W


    Management of retroperitoneal soft tissue sarcomas (RP STS) can be very challenging. In contrast to the more common extremity STS, the two predominant histologic subtypes encountered in the retroperitoneum are well-differentiated/dedifferentiated liposarcoma and leiomyosarcoma. Surgery remains the mainstay of treatment for RP STS. Preoperative planning and anticipation of the need for resection of adjacent organs/structures are critical. The extent of surgery, including the role of compartmental resection, is still controversial. Radiation therapy may be an important adjunct to surgery to provide locoregional disease control; this is currently being evaluated in the preoperative setting in the EORTC STRASS trial. Systemic therapy, tailored to the specific histologic subtype, may also be of benefit for the management of RP STS. Further investigation of novel therapies (e.g., targeted therapies, immunotherapy) is needed. Overall, multi-institutional collaboration is important moving forward, to continue to better understand and optimize management of this disease.

  9. Material parameter identification and inverse problems in soft tissue biomechanics

    Evans, Sam


    The articles in this book review hybrid experimental-computational methods applied to soft tissues which have been developed by worldwide specialists in the field. People developing computational models of soft tissues and organs will find solutions for calibrating the material parameters of their models; people performing tests on soft tissues will learn what to extract from the data and how to use these data for their models and people worried about the complexity of the biomechanical behavior of soft tissues will find relevant approaches to address this complexity.

  10. Pediatric rhabdomyosarcomas and nonrhabdomyosarcoma soft tissue sarcoma

    Agarwala Sandeep


    Full Text Available Tumors arising from the soft tissues are uncommon in children, accounting for about 6% of all childhood malignancies. More than half (53% of these originate from the striated muscles and are called rhabdomyosarcomas (RMS the remaining are nonrhabdomyosarcoma soft tissue sarcomas (NRSTS. Almost two-thirds of RMS cases are diagnosed in children < 6 years of age. They can arise at varied locations like the head and neck region, genitourinary tract, extremities, trunk and retroperitoneum. Pathologically RMS is now classified as superior, intermediate and poor outcome histologies. For stratification of treatment and also comparison of results the RMS are now staged both by the clinical grouping and the TNM staging systems. The ultimate outcome depends on the site, extent of disease and histology. Currently, approximately 70% of the patients survive for 5 years or more and are probably cured. This is credited to the use of multi-modal, risk-adapted therapy, refinements in tumor grouping and better supportive care which has emerged out of cooperative studies like Intergroup Rhabdomyosarcoma Study (IRS and the International Society of Pediatric Oncology studies (SIOP. The treatment involves chemotherapy, radiotherapy and organ/function preserving surgery. The gold standard chemotherapy is still vincristine, actinomycin D and cyclophosphamide (VAC regime with high doses of intensity bone marrow rescue with colony stimulating factors. The NRSTS are rare and of heterogenous histologies and so it has been difficult to arrive at a treatment strategy for these. What is definitely understood is that these are usually immature and poorly differentiated tumors that respond poorly to chemotherapy and so surgical resection forms the mainstay of treatment with adjuvant radiotherapy and chemotherapy to prevent local recurrences. In all likelihood, the molecular analysis of RMS will further refine current classification schemes and knowledge of genetic features of

  11. Necrotizing soft tissue infection in pregnancy

    Nestorović Milica


    Full Text Available Introduction. Necrotizing soft tissue infection (NSTI is a life-threatening condition, characterized by widely spread necrosis of skin, subcutaneous fat, fascia and muscles. Treatment involves surgical debridement and broad-spectrum antimicrobial therapy. Mortality is still high due to diagnostic delays. NSTI is rare in general population, there are even less literature data of this condition in pregnancy. Timely diagnosis and therapy is crucial for outcome of these patients. Clinicians should have in mind NSTI in patients with perianal infections, especially in cases where immunosuppressive role of pregnancy is present. Case outline. We present a case of a 21-year-old pregnant woman with NSTI spreading from perianal region. The patient was admitted to hospital in the 31st week of otherwise healthy twin pregnancy one day after incision of perianal abscess. At admission she was examined by a gynecologist; vital signs were stable, laboratory results showed the presence of infection. She was referred for another surgical procedure and broad-spectrum antibiotics were prescribed. The next morning the patient complained of intense abdominal pain. Clinical exam revealed only discrete redness of the skin tender on palpation, crepitating. She was immediately referred to surgery. Intraoperative findings revealed massive soft tissue infection spreading up to the chest wall. Wide skin incisions and debridement were performed. The patient developed septic shock and after initial resuscitation gynecologist confirmed intrauterine death of twins and indicated labor induction. Over the next few days the patient’s general condition improved. On several occasions the wounds were aggressively debrided under general anesthesia, which left the patient with large abdominal wall defect. Twenty-three days after the initial operation, the defect was reconstructed with partial-thickness skin grafts, providing satisfactory results. Conclusion. Diagnosis and outcome of

  12. Soft tissue management of orbitotemporal neurofibromatosis.

    Singhal, Dhruv; Chen, Yi-Chieh; Chen, Yu-Ray; Chen, Philip Kuo-Ting; Tsai, Yueh-Ju


    The aim of this study was to provide an overview of a single-institution, 30-year surgical experience with the soft tissue management of orbitotemporal neurofibromatosis. Lessons learned are highlighted in case presentations. From 1981 to 2011, all patients who presented to the Chang Gung Memorial Hospital Craniofacial Center with craniofacial neurofibromatosis and orbitotemporal involvement were retrospectively reviewed. The medical records of those patients who underwent surgical correction were reviewed for age, extent of involvement, procedures performed, histologic confirmation, and acute complications. All patients were grouped according to the Jackson Classification. The electronic photobank was queried to evaluate results. Thirty-five patients presented to our center with orbitotemporal neurofibromatosis during the study period. Thirty-one patients underwent surgical management of their disease. The average age was 25 years (range 4 to 57 years). Over half of our patients (n = 18) presented with concomitant disease of the cheek. The 2 most common procedures performed were lateral canthopexy (n = 24) and upper eyelid excision (n = 24). The only acute complication recorded was a postoperative hematoma on the fourth postoperative day following simultaneous lateral canthopexy and upper eyelid excision which required operative evacuation. In orbitotemporal neurofibromatosis, tissue hyperextensibility and tumor weight adversely affect outcomes. Treatment of concomitant disease of the cheek should be prioritized in order to provide periorbital support prior to addressing the delicate structures of the eyelids. Preservation of the lateral canthal unit and levator muscle, despite neurofibroma infiltration, is critical to maximize outcomes following debulking procedures of the eyelid and orbit.

  13. Electrospun nanofiber scaffolds: engineering soft tissues

    Kumbar, S G; Nukavarapu, S P; Laurencin, C T [Department of Orthopaedic Surgery, University of Virginia, VA 22908 (United States); James, R [Department of Biomedical Engineering, University of Virginia, VA 22908 (United States)], E-mail:


    Electrospinning has emerged to be a simple, elegant and scalable technique to fabricate polymeric nanofibers. Pure polymers as well as blends and composites of both natural and synthetics have been successfully electrospun into nanofiber matrices. Physiochemical properties of nanofiber matrices can be controlled by manipulating electrospinning parameters to meet the requirements of a specific application. Such efforts include the fabrication of fiber matrices containing nanofibers, microfibers, combination of nano-microfibers and also different fiber orientation/alignments. Polymeric nanofiber matrices have been extensively investigated for diversified uses such as filtration, barrier fabrics, wipes, personal care, biomedical and pharmaceutical applications. Recently electrospun nanofiber matrices have gained a lot of attention, and are being explored as scaffolds in tissue engineering due to their properties that can modulate cellular behavior. Electrospun nanofiber matrices show morphological similarities to the natural extra-cellular matrix (ECM), characterized by ultrafine continuous fibers, high surface-to-volume ratio, high porosity and variable pore-size distribution. Efforts have been made to modify nanofiber surfaces with several bioactive molecules to provide cells with the necessary chemical cues and a more in vivo like environment. The current paper provides an overlook on such efforts in designing nanofiber matrices as scaffolds in the regeneration of various soft tissues including skin, blood vessel, tendon/ligament, cardiac patch, nerve and skeletal muscle.

  14. Soft matter models of developing tissues and tumors.

    Gonzalez-Rodriguez, David; Guevorkian, Karine; Douezan, Stéphane; Brochard-Wyart, Françoise


    Analogies with inert soft condensed matter--such as viscoelastic liquids, pastes, foams, emulsions, colloids, and polymers--can be used to investigate the mechanical response of soft biological tissues to forces. A variety of experimental techniques and biophysical models have exploited these analogies allowing the quantitative characterization of the mechanical properties of model tissues, such as surface tension, elasticity, and viscosity. The framework of soft matter has been successful in explaining a number of dynamical tissue behaviors observed in physiology and development, such as cell sorting, tissue spreading, or the escape of individual cells from a tumor. However, living tissues also exhibit active responses, such as rigidity sensing or cell pulsation, that are absent in inert soft materials. The soft matter models reviewed here have provided valuable insight in understanding morphogenesis and cancer invasion and have set bases for using tissue engineering within medicine.

  15. What Are the Risk Factors for Soft Tissue Sarcoma?

    ... not been proven to cause soft tissue sarcomas. Arsenic has also been linked to a type of ... Tissue Sarcoma Causes, Risk Factors, and Prevention Early Detection, Diagnosis, and Staging Treatment After Treatment Back To ...

  16. Porous decellularized adipose tissue foams for soft tissue regeneration.

    Yu, Claire; Bianco, Juares; Brown, Cody; Fuetterer, Lydia; Watkins, John F; Samani, Abbas; Flynn, Lauren E


    To design tissue-specific bioscaffolds with well-defined properties and 3-D architecture, methods were developed for preparing porous foams from enzyme-solubilized human decellularized adipose tissue (DAT). Additionally, a technique was established for fabricating "bead foams" comprised of interconnected networks of porous DAT beads fused through a controlled freeze-thawing and lyophilization procedure. In characterization studies, the foams were stable without the need for chemical crosslinking, with properties that could be tuned by controlling the protein concentration and freezing rate during synthesis. Adipogenic differentiation studies with human adipose-derived stem cells (ASCs) suggested that stiffness influenced ASC adipogenesis on the foams. In support of our previous work with DAT scaffolds and microcarriers, the DAT foams and bead foams strongly supported adipogenesis and were also adipo-inductive, as demonstrated by glycerol-3-phosphate dehydrogenase (GPDH) enzyme activity, endpoint RT-PCR analysis of adipogenic gene expression, and intracellular lipid accumulation. Adipogenic differentiation was enhanced on the microporous DAT foams, potentially due to increased cell-cell interactions in this group. In vivo assessment in a subcutaneous Wistar rat model demonstrated that the DAT bioscaffolds were well tolerated and integrated into the host tissues, supporting angiogenesis and adipogenesis. The DAT-based foams induced a strong angiogenic response, promoted inflammatory cell migration and gradually resorbed over the course of 12 weeks, demonstrating potential as scaffolds for wound healing and soft tissue regeneration.

  17. Molecular cytogenetics and its applications to soft tissue tumor analysis.

    D'Amato, L


    Cytogenetic analyses have demonstrated the association of specific chromosomal changes with particular types of soft tissue tumors. This work describes the molecular cytogenetic approaches to genetic analysis of these tumors. It illustrates how molecular cytogenetics may provide a rapid and sensitive method of diagnosis and can contribute to identify specific genes implied in the aetiology of soft tissue tumors.

  18. Soft tissue chondromyxoid fibroma of the foot: sonographic findings.

    Kim, Hye Rin; Lee, Sang Min; Ha, Doo Hoe; Kang, Haeyoun; Rho, Ji Young


    Chondromyxoid fibroma is a rare benign bone tumor, which represents less than 1% of primary bone tumors. However, chondromyxoid fibroma developing in the soft tissue is extremely rare. We report the sonographic findings in a case of soft tissue chondromyxoid fibroma in the foot confirmed pathologically.

  19. Validation of new soft tissue software in orthognathic surgery planning.

    Marchetti, C; Bianchi, A; Muyldermans, L; Di Martino, M; Lancellotti, L; Sarti, A


    This study tests computer imaging software (SurgiCase-CMF(®), Materialise) that enables surgeons to perform virtual orthognathic surgical planning using a three dimensional (3D) utility that previews the final shape of hard and soft tissues. It includes a soft tissue simulation module that has created images of soft tissues altered through bimaxillary orthognathic surgery to correct facial deformities. Cephalometric radiographs and CT scans were taken of each patient before and after surgery. The surgical planning system consists of four stages: CT data reconstruction; 3D model generation of facial hard and soft tissue; different virtual surgical planning and simulation modes; and various preoperative previews of the soft tissues. Surgical planning and simulation is based on a 3D CT reconstructed bone model and soft tissue image generation is based on physical algorithms. The software rapidly follows clinical options to generate a series of simulations and soft tissue models; to avoid TMJ functional problems, pre-surgical plans were evaluated by an orthodontist. Comparing simulation results with postoperative CT data, the reliability of the soft tissues preview was >91%. SurgiCase(®) software can provide a realistic, accurate forecast of the patient's facial appearance after surgery.

  20. Rehabilitation Effect of Exercise with Soft Tissue Manipulation in ...


    May 22, 2017 ... manipulation therapy for patients with lumbar muscle strain. Methods: Patients with lumbar ... Nigerian Journal of Clinical Practice ¦ Volume 20 ¦ Issue 5 ¦ May 2017 .... pain, relieve muscle spasms of soft tissue, improve lumbar muscle .... Zhang L. Clinical study of acupuncture and soft tissue manipulation ...

  1. Imaging techniques for the diagnosis of soft tissue tumors

    Afonso PD


    Full Text Available P Diana Afonso,1,2 VV Mascarenhas21Department of Radiology, Hospital Beatriz Angelo, Loures, 2Department of Radiology, Hospital da Luz, Lisbon, PortugalAbstract: The primary aim in soft tissue tumor imaging should be to reach a specific diagnosis or to narrow the differential diagnosis, and to help to decide whether biopsy, surgical intervention, or simple observation is required for further management. In addition to contributing toward diagnosis, imaging has an important role in the staging of soft tissue malignancies and potentially in response assessment. This general review article highlights a rational diagnostic imaging approach to patients presenting with soft tissue tumors, emphasizing the fundamental principles inherent to soft tissue tumor imaging and diagnosis.Keywords: soft tissue tumors, ultrasound, CT, PET, MRI

  2. A systematic review assessing soft tissue augmentation techniques.

    Thoma, Daniel S; Benić, Goran I; Zwahlen, Marcel; Hämmerle, Christoph H F; Jung, Ronald E


    The aim of the present review was to systematically assess the dental literature in terms of soft tissue grafting techniques. The focused question was: is one method superior over others for augmentation and stability of the augmented soft tissue in terms of increasing the width of keratinized tissue (part 1) and gain in soft tissue volume (part 2). A Medline search was performed for human studies focusing on augmentation of keratinized tissue and/or soft tissue volume, and complemented by additional hand searching. Relevant studies were identified and statistical results were reported for meta-analyses including the test minus control weighted mean differences with 95% confidence intervals, the I-squared statistic for tests of heterogeneity, and the number of significant studies. Twenty-five (part 1) and three (part 2) studies met the inclusion criteria; 14 studies (part 1) were eligible for comparison using meta-analyses. An apically positioned flap/vestibuloplasty (APF/V) procedure resulted in a statistically significantly greater gain in keratinized tissue than untreated controls. APF/V plus autogenous tissue revealed statistically significantly more attached gingiva compared with untreated controls and a borderline statistical significance compared with APF/V plus allogenic tissue. Statistically significantly more shrinkage was observed for the APF/V plus allogenic graft compared with the APF/V plus autogenous tissue. Patient-centered outcomes did not reveal any of the treatment methods to be superior regarding postoperative complications. The three studies reporting on soft tissue volume augmentation could not be compared due to lack of homogeneity. The use of subepithelial connective tissue grafts (SCTGs) resulted in statistically significantly more soft tissue volume gain compared with free gingival grafts (FGGs). APF/V is a successful treatment concept to increase the width of keratinized tissue or attached gingiva around teeth. The addition of autogenous

  3. MR Histoanatomical Distribution of 290 Soft-tissue Tumors

    Moon, Tae Yong; Lee, In Sook; Lee, Gee Won; Kim, Jeung Il; Choi, Kyung Un; Kim, Won Taek [Pusan National University Hospital, Busan (Korea, Republic of)


    This study was designed too identify the MR histoanatomical distribution of soft-tissue tumors. A total of 290 soft-tissue tumors of 281 patients were analyzed by the use of MR imaging and were pathologically confirmed after surgical resection or a biopsy. There were 120 malignant soft-tissue tumors including tumors of an intermediate malignancy and 170 benign tumors. The histoanatomical locations were divided into three types: 'type I' with superficial layer tumors that involved the cutaneous and subcutaneous tissue, 'type II' with deep layer tumors that involved the muscle or tendon and 'type III' with soft tissue tumors that involved both the superficial and deep layers. Soft-tissue tumors with more than three cases with a frequency of more than 75% included dermatofibrosarcoma protuberans, glomus tumor, angiolipoma, leiomyosarcoma and lymphoma as 'type I' tumors. 'Type II' tumors with more than three cases with a frequency of more than 75% included liposarcoma, fibromatosis, papillary endothelial hyperplasia and rhabdomyosarcoma. 'Type III' tumors with more than three cases with a frequency of more than 50% included neurofibromatosis. The MR histoanatomical distributions of soft tissue tumors are useful in the differential pathological diagnosis when a soft-tissue tumor has a nonspecific MR appearance.

  4. Significance of prevertebral soft tissue measurement in cervical spine injuries

    Dai Liyang E-mail:


    Objective: The objective of this study was to evaluate the diagnostic value of prevertebral soft tissue swelling in cervical spine injuries. Materials and methods: A group of 107 consecutive patients with suspected injuries of the cervical vertebrae were reviewed retrospectively to identify the presence of prevertebral soft tissue swelling and to investigate the association of prevertebral soft tissue swelling with the types and degrees of cervical spine injuries. Results: Prevertebral soft tissue swelling occurred in 47 (43.9%) patients. Of the 47 patients, 38 were found with bony injury and nine were without. The statistic difference was significant (P<0.05). No correlation was demonstrated between soft tissue swelling and either the injured level of the cervical vertebrae or the degree of the spinal cord injury (P>0.05). Anterior element injuries in the cervical vertebrae had widening of the prevertebral soft tissue more than posterior element injuries (P<0.05). Conclusion: The diagnostic value of prevertebral soft tissue swelling for cervical spine injuries is significant, but the absence of this sign does not mean that further image evaluation can be spared.

  5. The role of vitamin K in soft-tissue calcification.

    Theuwissen, Elke; Smit, Egbert; Vermeer, Cees


    Seventeen vitamin K-dependent proteins have been identified to date of which several are involved in regulating soft-tissue calcification. Osteocalcin, matrix Gla protein (MGP), and possibly Gla-rich protein are all inhibitors of soft-tissue calcification and need vitamin K-dependent carboxylation for activity. A common characteristic is their low molecular weight, and it has been postulated that their small size is essential for calcification inhibition within tissues. MGP is synthesized by vascular smooth muscle cells and is the most important inhibitor of arterial mineralization currently known. Remarkably, the extrahepatic Gla proteins mentioned are only partly carboxylated in the healthy adult population, suggesting vitamin K insufficiency. Because carboxylation of the most essential Gla proteins is localized in the liver and that of the less essential Gla proteins in the extrahepatic tissues, a transport system has evolved ensuring preferential distribution of dietary vitamin K to the liver when vitamin K is limiting. This is why the first signs of vitamin K insufficiency are seen as undercarboxylation of the extrahepatic Gla proteins. New conformation-specific assays for circulating uncarboxylated MGP were developed; an assay for desphospho-uncarboxylated matrix Gla protein and another assay for total uncarboxylated matrix Gla protein. Circulating desphospho-uncarboxylated matrix Gla protein was found to be predictive of cardiovascular risk and mortality, whereas circulating total uncarboxylated matrix Gla protein was associated with the extent of prevalent arterial calcification. Vitamin K intervention studies have shown that MGP carboxylation can be increased dose dependently, but thus far only 1 study with clinical endpoints has been completed. This study showed maintenance of vascular elasticity during a 3-y supplementation period, with a parallel 12% loss of elasticity in the placebo group. More studies, both in healthy subjects and in patients at risk

  6. Soft Tissue Biomechanical Modeling for Computer Assisted Surgery


      This volume focuses on the biomechanical modeling of biological tissues in the context of Computer Assisted Surgery (CAS). More specifically, deformable soft tissues are addressed since they are the subject of the most recent developments in this field. The pioneering works on this CAS topic date from the 1980's, with applications in orthopaedics and biomechanical models of bones. More recently, however, biomechanical models of soft tissues have been proposed since most of the human body is made of soft organs that can be deformed by the surgical gesture. Such models are much more complicated to handle since the tissues can be subject to large deformations (non-linear geometrical framework) as well as complex stress/strain relationships (non-linear mechanical framework). Part 1 of the volume presents biomechanical models that have been developed in a CAS context and used during surgery. This is particularly new since most of the soft tissues models already proposed concern Computer Assisted Planning, with ...

  7. The Adjunctive Soft-Tissue Diode Laser in Orthodontics.

    Borzabadi-Farahani, Ali


    Lasers are a relatively new addition to the orthodontist's armamentarium. This article reviews the fundamental basic science of available soft-tissue lasers, with an emphasis on diode lasers, and discusses various adjunct applications of the diode laser for soft-tissue orthodontic procedures. Diode lasers function by cutting with an initiated hot tip and produce minimal to no interaction with healthy dental hard tissue, making them suitable for soft-tissue procedures. The contact cutting mode provides enhanced bloodless site visibility and facility to perform delicate soft tissue procedures, which is important in areas with difficult access. Such adjunctive uses include laser gingivectomy to improve oral hygiene or bracket positioning, esthetic laser gingival recontouring, and laser exposure of superficially impacted teeth. Selected cases treated with a 940-nm indium-gallium-arsenide-phosphide (InGaAsP) diode laser will be presented.

  8. Soft-tissue lasers in orthodontics: an overview.

    Kravitz, Neal D; Kusnoto, Budi


    Soft-tissue lasers have numerous applications in orthodontics, including gingivectomy, frenectomy, operculectomy, papilla flattening, uncovering temporary anchorage devices, ablation of aphthous ulcerations, exposure of impacted teeth, and even tooth whitening. As an adjunctive procedure, laser surgery has helped many orthodontists to enhance the design of a patient's smile and improve treatment efficacy. Before incorporating soft-tissue lasers into clinical practice, the clinician must fully understand the basic science, safety protocol, and risks associated with them. The purpose of this article is to provide an overview regarding safe and proper use of soft-tissue lasers in orthodontics.

  9. Hounsfield unit dynamics of adipose tissue and non-adipose soft tissue in growing pigs

    Mcevoy, Fintan; Madsen, Mads T.; Strathe, Anders Bjerring;


    Changes in the Hounsfield Unit value of adipose tissue and of no-adipose soft tissue during growth are poorly documented. This study examines the HU of these tissues in growing pigs.......Changes in the Hounsfield Unit value of adipose tissue and of no-adipose soft tissue during growth are poorly documented. This study examines the HU of these tissues in growing pigs....

  10. Interdigitated interdigital transducer for surface elastometry of soft damping tissue.

    Danicki, Eugene; Nowicki, Andrzej; Tasinkevych, Yuriy


    Measurement of the shear elastic constant of soft and highly damping tissue of high Poisson ratio is quite a challenging task. It is proposed to evaluate shear wave velocity and damping of tissue by measuring the shear skimming bulk waves using one interdigitated interdigital transducer on a piezoelectric layer, such as polyvinylidene fluoride, applied to the surface of the small tissue sample.

  11. Coverage of soft tissue defect in palm with prefabricated flap

    ZHANG Gong-lin; CAI Guo-rong; ZHANG Ming; ZHENG Liang-jun; ZHANG Yan


    @@ The coverage of large soft tissue defects in palm remains a challenge in the plastic recon-structive surgery. There are many local tissue transfers described for small-sized defects of hand, whereas large defect require regional flaps such as the radial forearm flap or free tissue transfer.1-5

  12. [Soft tissue infection associated with bacteremia caused by Shewanella putrefaciens].

    Rouzic, N; Héry-Arnaud, G; Jaffuel, S; Garo, B; Payan, C; Garré, M


    Shewanella putrefaciens is rarely involved in human infectious disease. We report here a case of soft tissue infection with bacteremia on a patient with risk factors (liver cirrhosis, diabetes mellitus). Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  13. Injection resorbable polymer shells for soft tissue augmentation

    Naidoo, Kersch


    Full Text Available CSIR researchers have developed an injectable, resorbable soft tissue bulking product that has potential applications in fields ranging from heart and recontructive surgery, to minimally invasive cosmetic surgery. Biomaterials research is very...


    Xu Yunxiang; Chen Guizhen


    Objective: To observe the therapeutic effect of acupuncture of "Xi" (Cleft)-points in treatment of soft tissue injury. Methods: 335 cases of soft tissue injury patients were divided into Cleft-point group (264 cases) and Ashipoint group (control group, 71 cases) randomly. In Cleft-point group, the 16 Cleft-points were used in combination with Ahshi points. In control group, only local Ahshi-points were punctured. The treatment was conducted once every day, with 5 sessions being a therapeutic course. After 2 courses of treatment, the therapeutic effect was analyzed.Results: Results showed that the therapeutic effect of cleft-point group was significantly better than that of control group (P<0.05), particularly in treatment of acute soft tissue. Conclusion: Cleft-point acupuncture has a better therapeutic effect in treatment of soft tissue injury in comparison with Ashi-point.

  15. Operational morbidity analysis of soft tissue injuries during Operation TELIC.

    Ollerton, J; Hodgetts, T; Russell, R


    Soft tissue injury accounted for one in five of all presentations to the Emergency Department (ED) during Operation TELIC (UK forces in Iraq) from March 2003 to November 2006. This ranks soft tissue complaints as the most frequent cause of attendance to a deployed field hospital ED. This paper analyses the injury patterns, together with implications for future clinical practice and operational planning to prevent injury, optimise patient care and maximize force regeneration.


    A. S. Aladin


    Full Text Available Neck cysts are rather commonly encountered in the practice of a surgeon, including an oncologist, who treats diseases of the head and neck. At the same time there are rare involvements of the organs and soft tissues of the neck. In particular, echinococcosis of neck soft tissues is an unusual site for hydatid cyst. Accounts of this involvement are found only as single communications in the literature. The presented case of hydatid cyst illustrates a variety of neck abnormalities.

  17. How to use PRICE treatment for soft tissue injuries.

    Norton, Cormac


    Rationale and key points This article assists nurses to use the acronym PRICE (protection, rest, ice, compression and elevation) to guide the treatment of patients with uncomplicated soft tissue injuries to their upper or lower limbs. » Treatment of soft tissue injuries to limbs is important to reduce complications following injury, alleviate pain and ensure normal limb function is restored promptly. » Nurses should have an understanding of the rationale and evidence base supporting PRICE treatment of soft tissue injuries. » Providing accurate information to patients and carers about the management of soft tissue injuries and anticipated recovery time is an important aspect of treatment. » Further research is required to develop best practice in the treatment of soft tissue injuries. Reflective activity 'How to' articles can help you update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. How this article might change your practice when managing patients with soft tissue injuries to upper or lower limbs. 2. Positive elements of your current practice and those that could be enhanced. Subscribers can upload their reflective accounts at:

  18. [Soft tissue sarcoma in children and adolescents: experiences of the cooperative Soft Tissue Sarcoma Group Studies (CWS-81 - 96)].

    Brecht, I B; Treuner, J


    The very heterogeneous group of paediatric soft tissue sarcomas account for approximately 7 % of all malignant childhood tumours. More than one half of all cases are rhabdomyosarcomas, some of the over 20 entities are very rare. The prognosis and biology of soft tissue sarcomas in children and adolescents vary greatly depending on histological subtype, the age of the patient, the primary site, the tumour size, tumour invasiveness and the extent of disease at diagnosis. Since 1981, 2918 children and adolescents with soft tissue sarcomas were treated prospectively according to the common treatment protocols of the Cooperative Soft Tissue Sarcoma Study Group (CWS-81 - 96). The known prognostic factors were used to develop a more and more detailed risk stratification. The multimodal treatment includes the use of surgery, chemotherapy and radiotherapy and should be planned by a multidisciplinary team. That way, an overall survival of nearly 70 % over all risk groups could be achieved.

  19. NIH researchers use gene therapy to treat a soft tissue tumor

    Results of an intermediate stage clinical trial of several dozen people provides evidence that a method that has worked for treating patients with metastatic melanoma can also work for patients with metastatic synovial cell sarcoma, one of the most common soft tissue tumors in adolescents and young adults.

  20. Estimation of Soft Tissue Mechanical Parameters from Robotic Manipulation Data.

    Boonvisut, Pasu; Cavuşoğlu, M Cenk


    Robotic motion planning algorithms used for task automation in robotic surgical systems rely on availability of accurate models of target soft tissue's deformation. Relying on generic tissue parameters in constructing the tissue deformation models is problematic because, biological tissues are known to have very large (inter- and intra-subject) variability. A priori mechanical characterization (e.g., uniaxial bench test) of the target tissues before a surgical procedure is also not usually practical. In this paper, a method for estimating mechanical parameters of soft tissue from sensory data collected during robotic surgical manipulation is presented. The method uses force data collected from a multiaxial force sensor mounted on the robotic manipulator, and tissue deformation data collected from a stereo camera system. The tissue parameters are then estimated using an inverse finite element method. The effects of measurement and modeling uncertainties on the proposed method are analyzed in simulation. The results of experimental evaluation of the method are also presented.

  1. Soft tissue sealing around dental implants based on histological interpretation.

    Atsuta, Ikiru; Ayukawa, Yasunori; Kondo, Ryosuke; Oshiro, Wakana; Matsuura, Yuri; Furuhashi, Akihiro; Tsukiyama, Yoshihiro; Koyano, Kiyoshi


    The aim of this study was to provide an overview on the biology and soft tissue sealing around dental implants and teeth. This is a narrative review performed through scientific articles published between 1977 and 2014, indexed in MEDLINE and PubMed databases. The study selected articles that focused on epithelial sealing around dental implant or teeth with cell biology and histology of soft tissue. Implant therapy has been widely applied in dental rehabilitation for many years, with predictable long-term results. The longevity and functionality of dental implants is dependent on both osseointegration around the implant body and the establishment of a soft tissue barrier that protects the underlying hard tissue structures and the implant itself. The health and stability of the peri-implant mucosa also affects the esthetics of the implant. The healing and maintenance of the epithelial and connective tissues around implants are increasingly recognized as being fundamental to implant success. However, there has been little research into the function or formation of the soft tissue seal around dental implants, and the roles of this unique mucosal interface remain unclear. This narrative review explores the extent of the current knowledge of soft tissue barriers around implants from both a basic and clinical perspective, and aims to consolidate this knowledge and highlight the most pertinent questions relating to this area of research. Copyright © 2015 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  2. Third trimester ultrasound soft-tissue measurements accurately predicts macrosomia.

    Maruotti, Giuseppe Maria; Saccone, Gabriele; Martinelli, Pasquale


    To evaluate the accuracy of sonographic measurements of fetal soft tissue in the prediction of macrosomia. Electronic databases were searched from their inception until September 2015 with no limit for language. We included only studies assessing the accuracy of sonographic measurements of fetal soft tissue in the abdomen or thigh in the prediction of macrosomia  ≥34 weeks of gestation. The primary outcome was the accuracy of sonographic measurements of fetal soft tissue in the prediction of macrosomia. We generated the forest plot for the pooled sensitivity and specificity with 95% confidence interval (CI). Additionally, summary receiver-operating characteristics (ROC) curves were plotted and the area under the curve (AUC) was also computed to evaluate the overall performance of the diagnostic test accuracy. Three studies, including 287 singleton gestations, were analyzed. The pooled sensitivity of sonographic measurements of abdominal or thigh fetal soft tissue in the prediction of macrosomia was 80% (95% CI: 66-89%) and the pooled specificity was 95% (95% CI: 91-97%). The AUC for diagnostic accuracy of sonographic measurements of fetal soft tissue in the prediction of macrosomia was 0.92 and suggested high diagnostic accuracy. Third-trimester sonographic measurements of fetal soft tissue after 34 weeks may help to detect macrosomia with a high degree of accuracy. The pooled detection rate was 80%. A standardization of measurements criteria, reproducibility, building reference charts of fetal subcutaneous tissue and large studies to assess the optimal cutoff of fetal adipose thickness are necessary before the introduction of fetal soft-tissue markers in the clinical practice.

  3. Estimation of Soft Tissue Mechanical Parameters from Robotic Manipulation Data

    Boonvisut, Pasu; Çavuşoğlu, M. Cenk


    Robotic motion planning algorithms used for task automation in robotic surgical systems rely on availability of accurate models of target soft tissue’s deformation. Relying on generic tissue parameters in constructing the tissue deformation models is problematic because, biological tissues are known to have very large (inter- and intra-subject) variability. A priori mechanical characterization (e.g., uniaxial bench test) of the target tissues before a surgical procedure is also not usually pr...

  4. Estimation of Soft Tissue Mechanical Parameters from Robotic Manipulation Data

    Boonvisut, Pasu; Jackson, Russell; Çavuşoğlu, M. Cenk


    Robotic motion planning algorithms used for task automation in robotic surgical systems rely on availability of accurate models of target soft tissue’s deformation. Relying on generic tissue parameters in constructing the tissue deformation models is problematic; because, biological tissues are known to have very large (inter- and intra-subject) variability. A priori mechanical characterization (e.g., uniaxial bench test) of the target tissues before a surgical procedure is ...

  5. Constraint-based soft tissue simulation for virtual surgical training.

    Tang, Wen; Wan, Tao Ruan


    Most of surgical simulators employ a linear elastic model to simulate soft tissue material properties due to its computational efficiency and the simplicity. However, soft tissues often have elaborate nonlinear material characteristics. Most prominently, soft tissues are soft and compliant to small strains, but after initial deformations they are very resistant to further deformations even under large forces. Such material characteristic is referred as the nonlinear material incompliant which is computationally expensive and numerically difficult to simulate. This paper presents a constraint-based finite-element algorithm to simulate the nonlinear incompliant tissue materials efficiently for interactive simulation applications such as virtual surgery. Firstly, the proposed algorithm models the material stiffness behavior of soft tissues with a set of 3-D strain limit constraints on deformation strain tensors. By enforcing a large number of geometric constraints to achieve the material stiffness, the algorithm reduces the task of solving stiff equations of motion with a general numerical solver to iteratively resolving a set of constraints with a nonlinear Gauss-Seidel iterative process. Secondly, as a Gauss-Seidel method processes constraints individually, in order to speed up the global convergence of the large constrained system, a multiresolution hierarchy structure is also used to accelerate the computation significantly, making interactive simulations possible at a high level of details. Finally, this paper also presents a simple-to-build data acquisition system to validate simulation results with ex vivo tissue measurements. An interactive virtual reality-based simulation system is also demonstrated.

  6. Revisiting peri-implant soft tissue – histopathological study of the peri-implant soft tissue

    Silva, Eduarda; Félix, Sérgio; Rodriguez-Archilla, Alberto; Oliveira, Pedro; Martins dos Santos, José


    Peri-implant soft tissues are essential for osseointegration. The peri-implant mucosa may lack vascular supply, and histological observation, even without plaque, shows the presence of inflammatory cells. The objectives of this study were to assess the histopathological changes of the epithelium and connective tissue around the implant. Twenty patients of both genders were studied. Twelve weeks after implant placement, fragments of peri-implant gingival sulcus were harvested and processed for light microscopy. Group I (10): without clinical inflammatory signs (control); Group II (10): with clinical inflammatory signs. Histopathological parameters were analyzed and classified in 3 grades: mild, moderate or severe (grade 1, 2 or 3). Control group showed only slight changes, grade 1. In group II we found edema with moderate to severe cellular and nuclear changes. There are more women than men with all grades of inflammation. All patients with moderate edema are male and all patients with severe edema are female. A significant association (p=0.007) exists between these two variables. Significant differences were found when comparing the degree of inflammation with nuclear alterations (p=0.001) and the same results when comparing the degree of edema and nuclear changes (pimplant mucosa. In clinics the predisposition of female patients to greater degree of edema and inflammation should be accounted for. PMID:24551281

  7. X-ray microscopy of soft and hard human tissues

    Müller, Bert, E-mail:; Schulz, Georg, E-mail:; Deyhle, Hans, E-mail:; Stalder, Anja K., E-mail:; Ilgenstein, Bernd, E-mail:; Holme, Margaret N., E-mail:; Hieber, Simone E., E-mail: [Biomaterials Science Center (BMC), University of Basel, c/o University Hospital, 4031 Basel (Switzerland); Weitkamp, Timm, E-mail: [Beamline ANATOMIX, Synchrotron Soleil, L’Orme des Merisiers, Saint Aubin - B.P. 48, 91192 Gif sur Yvette (France); Beckmann, Felix, E-mail: [Institute of Materials Research, Helmholtz-Zentrum Geesthacht, Max-Planck-Str. 1, 21502 Geesthacht, c/o HZG at DESY, Notkestr. 85, 22607 Hamburg (Germany)


    The simultaneous post mortem visualization of soft and hard tissues using absorption-based CT remains a challenge. If the photon energy is optimized for the visualization of hard tissue, the surrounding soft tissue components are almost X-ray transparent. Therefore, the combination with other modalities such as phase-contrast CT, magnetic resonance microscopy, and histology is essential to detect the anatomical features. The combination of the 2D and 3D data sets using sophisticated segmentation and registration tools allows for conclusions about otherwise inaccessible anatomical features essential for improved patient treatments.

  8. Current concepts in non-gastrointestinal stromal tumor soft tissue sarcomas: A primer for radiologists

    Baheti, Akahay D. [Dept. of Radiology, Tata Memorial Centre, Mumbai (India); Tirumani, Harika [Dept. of Radiology, University of Arkansas for Medical Sciences, Little Rock (United States); O' Neill, Alibhe; Jagannathan, Jyothi P. [Dept. of Imaging, Dana-Farber Cancer Institute, Boston (United States)


    Non-gastrointestinal stromal tumor (GIST) soft tissue sarcomas (STSs) are a heterogeneous group of neoplasms whose classification and management continues to evolve with better understanding of their biologic behavior. The 2013 World Health Organization (WHO) has revised their classification based on new immunohistochemical and cytogenetic data. In this article, we will provide a brief overview of the revised WHO classification of soft tissue tumors, discuss in detail the radiology and management of the two most common adult non-GIST STS, namely liposarcoma and leiomyosarcoma, and review some of the emerging histology-driven targeted therapies in non-GIST STS, focusing on the role of the radiologist.

  9. Measuring the Reliability of Sagittal Facial Anthropometric Measurements under Soft Tissue Displacement Using a Modified Ruler

    Faramarz Mojtahedzadeh


    Full Text Available Objective: Despite the current use of radiography for quantifying sagittal skeletal measurements, it is an unsuitable way for screening or epidemiologic purposes. Although not fully approved, anthropometric measurements have been suggested as a substitute, and considering displacement of soft tissues, could possibly lead to more consistent results. The purpose of this study was to evaluate the reliability of anthropometric anteroposterior facial measurements under soft tissue compression using a special ruler.Material and Methods: Anthropometric measurements were done with a specifically designed sliding ruler twice on 36 adult patients with a 14 day lag between two measurements. The ruler measured the distance between the external acoustic meatus and the nasion (Na, subnasal (Sn point and the soft tissue pogonion (Pog. The soft tissue was displaced during measurements only to the extent that the underlying hard tissue resistance was felt subjectively by each assessor. The intraclass correlation coefficient (ICC was calculated for both inter- and intra- rater measurements using SPSS software.Results: All measurements had inter- and intrarater agreements above 0.9, with only a few parameters having lower bound confidence intervals below 0.9, but more than 0.8.Conclusion: Sagittal facial anthropometric measurements under soft tissue displacement using the specific ruler are valid and reliable and could possibly aid orthodontists in chairside craniofacial assessments.

  10. A Temporal View of Soft Tissue Quantitative Ultrasound

    O'Brien, William D.

    The objective of soft tissue quantitative ultrasound (QUS) is to improve diagnostic ultrasound imaging capabilities via quantitative outcomes. Over the past three or so decades, there have been an increasing number of QUS successes. A temporal view moves us back in history almost six decades when techniques and theoretical developments were in their earliest stages that impacted modern QUS successes. The earliest theoretical developments and techniques some six decades ago can be attributed to Lev Chernov, Philip Morse, Herman Feshbach, Uno Ingard, John Wild and Jack Reid. Later, Floyd Dunn developed important views as to how connective tissue affected the interaction between ultrasound and soft tissue. Then, as the theory of wave propagation in soft tissues with random inhomogeneities was extended and applied by Fred Lizzi, Jim Zagzebski and Mike Insana (and their colleagues), contemporary QUS successes started to emerge.

  11. Management of facial soft tissue injuries in children.

    Vasconez, Henry C; Buseman, Jason L; Cunningham, Larry L


    Pediatric facial trauma can present a challenge to even the more experienced plastic surgeon. Injuries to the head and neck may involve bone and soft tissues with an assortment of specialized organs and tissue elements involved. Because of the active nature of children, facial soft tissue injuries can be diverse and extensive as well as some of the more common injuries a plastic surgeon is asked to treat. In 2007, approximately 800,000 patients younger than 15 years presented to emergency departments around the country with significant open wounds of the head that required treatment.In this review, we present the different types and regions of pediatric soft tissue facial trauma, as well as treatment options and goals of plastic surgery wound management. Special aspects, such as bite wounds, burns, pediatric analgesia, and antibiotic therapy, are also discussed.

  12. Increased neck soft tissue mass and worsening of obstructive sleep apnea after growth hormone treatment in men with abdominal obesity

    Karimi, Mahssa; Koranyi, Josef; Franco, Celina


    Risk factors for obstructive sleep apnea (OSA) are male gender, obesity and abnormalities in neck soft tissue mass. OSA is associated with both growth hormone (GH) excess and severe GH deficiency in adults. Adults with abdominal obesity have markedly suppressed GH secretion.......Risk factors for obstructive sleep apnea (OSA) are male gender, obesity and abnormalities in neck soft tissue mass. OSA is associated with both growth hormone (GH) excess and severe GH deficiency in adults. Adults with abdominal obesity have markedly suppressed GH secretion....

  13. Increased neck soft tissue mass and worsening of obstructive sleep apnea after growth hormone treatment in men with abdominal obesity

    Karimi, Mahssa; Koranyi, Josef; Franco, Celina


    Risk factors for obstructive sleep apnea (OSA) are male gender, obesity and abnormalities in neck soft tissue mass. OSA is associated with both growth hormone (GH) excess and severe GH deficiency in adults. Adults with abdominal obesity have markedly suppressed GH secretion.......Risk factors for obstructive sleep apnea (OSA) are male gender, obesity and abnormalities in neck soft tissue mass. OSA is associated with both growth hormone (GH) excess and severe GH deficiency in adults. Adults with abdominal obesity have markedly suppressed GH secretion....

  14. Review of soft tissue augmentation in the face

    James Newman


    Full Text Available James NewmanFacial Plastic Surgery, Stanford University Medical Center, Palo Alto, CAFacial Plastic Surgery, Stanford University Medical Center, Palo Alto, CA, USAAbstract: A primary pillar of facial rejuvenation is the replacement of soft tissue atrophy via a variety of augmentation techniques. The techniques can be classified into three categories, skeletal onlay grafts, subcutaneous volumizers, and dermal fillers. While onlay grafts and subcutaneous volumizers have the most persistent results, the emergence of improved dermal fillers in the past 5 years has become increasingly popular. An accurate diagnosis of the level(s of soft tissue atrophy in the face needs to be made prior to selection of the category or combination of techniques. In the younger patient, the selection of a dermal filler or combination of fillers can be adequate for treatment. A comparison of the composition and characteristics of the available dermal fillers are discussed in detail to assist the clinician in understanding the actual mechanism of soft tissue augmentation. In the more advanced aging face, a combination of the three categories may be necessary to produce optimal results. Just as dermal fillers have become more differentiated to increase their longevity, the non-injectible long-lasting implants are becoming more developed to mimic accurate viscoelastic properties of the facial soft tissues. All three classes of augmentation techniques can provide patients with very satisfactory results as part of overall facial rejuvenation.Keywords: soft tissue, dermal fillers, facial implants, facial augmentation

  15. Roentgenographic study on maxillofacial soft tissue in the mixed dentition

    Lee, Jai Hei; Ahn, Hyung Kyu [Department of Dental Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)


    The purpose of this study was to obtain the cephalometric maxillofacial soft tissue measurements and to define the differences that exist between male and female on the soft tissue profile who had normal occlusion in mixed dentitions. For the object of this study, cephalometric radiographs were obtained from the centric occlusion with the relaxed lip position. Copper filter was designed to obtain both hard and soft tissue structure on the same film. The subjects consist of 100 male and 100 female from 8 to 12.4 years with the normal occlusion and acceptable profiles. The author measured facial depth, vertical height from the cephalometric soft tissue profiles in the mixed dentitions. The significant test was performed to compare male with females. The following results were obtained from the study 1. In facial convexity, much more larger female than that of male. 2. Inclination of the lip posture was more larger in maxilla (male) and in female more larger in the mandible. 3. The thickness of soft tissue was thicker in male, the height of nose was more prominent in female. 4. There were no significant differences in both sexes.



    Sep 9, 2012 ... Fellow AO CMF, Lecturer, W. A. Odhiambo, BDS, MDS, Senior Lecturer, M. L. Chindia, BDS , MSc, FFDRCS, Associate ... years with changes in lifestyle, industrialisation, .... adults (26-35 years) were at the highest risk of MF.

  17. Trajectory generation for robotic needle insertion in soft tissue.

    Abolhassani, Niki; Patel, Rajni; Moallem, Mehrdad


    Accurate needle insertion in soft, inhomogeneous tissue has been a major concern in several recent studies involving robot-assisted percutaneous therapies. In procedures that involve multiple needle insertions such as transrectal ultrasound guided prostate brachytherapy, it is important to reduce tissue deformation before puncture and during insertion. In order to reduce this deformation, we have studied the effect of different trajectories for a 2-DOF robot performing needle insertion in soft tissue. We have compared tissue deformation and infinitesimal force per tissue displacement for different trajectories. According to the results of our experiments, infinitesimal force per displacement is a useful parameter for online trajectory update. Our proposed position/force controller is shown to provide considerable improvement in performance with regard to tissue deformation before puncture.

  18. Epidemiologic study of soft tissue rheumatism in Shantou and Taiyuan, China

    ZENG Qing-yu; ZANG Chang-hai; LIN Ling; CHEN Su-biao; LI Xiao-feng; XIAO Zheng-yu; DONG Hai-yuan; ZHANG Ai-lian; CHEN Ren


    Background Soft tissue rheumatism is a group of common rheumatic disorders reported in many countries.For investigating the prevalence rate of soft tissue rheumatism in different population in China, we carried out a population study in Shantou rural and Taiyuan urban area.Methods Samples of 3915 adults in an urban area of Taiyuan, Shanxi Province, and 2350 in a rural area of Shantou,Guangdong Province were surveyed.Modified International League of Association for Rheumatology (ILAR)-Asia Pacific League of Association for Rheumatology (APLAR) Community Oriented Program for Control of Rheumatic Diseases (COPCORD) core questionnaire was implemented as screening tool.The positive responders were then all examined by rheumatologists.Results Prevalence rate of soft tissue rheumatism was 2.0% in Taiyuan, and 5.3% in Shantou.Rotator cuff (shoulder)tendinitis, adhesive capsulitis (frozen shoulder), lateral epicondylitis (tennis elbow), and digital flexor tenosynovitis (trigger finger) were the commonly seen soft tissue rheumatism in both areas.Tatarsalgia, plantar fasciitis, and De Quervain's tenosynovitis were more commonly seen in Shantou than that in Taiyuan.Only 1 case of fibromyalgia was found in Taiyuan and 2 cases in Shantou.The prevalence of soft tissue rheumatism varied with age, sex and occupation.Conclusions Soft tissue rheumatism is common in Taiyuan and Shantou, China.The prevalence of soft tissue rheumatism was quite different with different geographic, environmental, and socioeconomic conditions; and varying with age, sex, and occupation.The prevalence of fibromyalgia is low in the present survey.

  19. Bioimpedance of soft tissue under compression.

    Dodde, R E; Bull, J L; Shih, A J


    In this paper compression-dependent bioimpedance measurements of porcine spleen tissue are presented. Using a Cole-Cole model, nonlinear compositional changes in extracellular and intracellular makeup; related to a loss of fluid from the tissue, are identified during compression. Bioimpedance measurements were made using a custom tetrapolar probe and bioimpedance circuitry. As the tissue is increasingly compressed up to 50%, both intracellular and extracellular resistances increase while bulk membrane capacitance decreases. Increasing compression to 80% results in an increase in intracellular resistance and bulk membrane capacitance while extracellular resistance decreases. Tissues compressed incrementally to 80% show a decreased extracellular resistance of 32%, an increased intracellular resistance of 107%, and an increased bulk membrane capacitance of 64% compared to their uncompressed values. Intracellular resistance exhibits double asymptotic curves when plotted against the peak tissue pressure during compression, possibly indicating two distinct phases of mechanical change in the tissue during compression. Based on these findings, differing theories as to what is happening at a cellular level during high tissue compression are discussed, including the possibility of cell rupture and mass exudation of cellular material.

  20. How Are Soft Tissue Sarcomas Diagnosed?

    ... type of cancer or a benign disease. Several types of biopsies are used to diagnose sarcomas. Doctors experienced with ... But if FNA results suggest a sarcoma, another type of biopsy will usually be done to remove enough tissue ...

  1. Tannerella forsythia infection-induced calvarial bone and soft tissue transcriptional profiles.

    Bakthavatchalu, V; Meka, A; Sathishkumar, S; Lopez, M C; Bhattacharyya, I; Boyce, B F; Mans, J J; Lamont, R J; Baker, H V; Ebersole, J L; Kesavalu, L


    Tannerella forsythia is associated with subgingival biofilms in adult periodontitis, although the molecular mechanisms contributing to chronic inflammation and loss of periodontal bone remain unclear. We examined changes in the host transcriptional profiles during a T. forsythia infection using a murine calvarial model of inflammation and bone resorption. Tannerella forsythia was injected into the subcutaneous soft tissue over calvariae of BALB/c mice for 3 days, after which the soft tissues and calvarial bones were excised. RNA was isolated and Murine GeneChip (Affymetrix, Santa Clara, CA) array analysis of transcript profiles showed that 3226 genes were differentially expressed in the infected soft tissues (P < 0.05) and 2586 genes were differentially transcribed in calvarial bones after infection. Quantitative real-time reverse transcription-polymerase chain reaction analysis of transcription levels of selected genes corresponded well with the microarray results. Biological pathways significantly impacted by T. forsythia infection in calvarial bone and soft tissue included leukocyte transendothelial migration, cell adhesion molecules (immune system), extracellular matrix-receptor interaction, adherens junction, and antigen processing and presentation. Histologic examination revealed intense inflammation and increased osteoclasts in calvariae compared with controls. In conclusion, localized T. forsythia infection differentially induces transcription of a broad array of host genes, and the profiles differ between inflamed soft tissues and calvarial bone.

  2. Multimodal imaging in the differential diagnosis of soft tissue calcinosis

    G. Garlaschi


    Full Text Available Soft tissue calcinosis is a common radiographic finding, which may be related to different types of pathological processes. Multimodality imaging, combined with analysis of clinical and laboratory data, plays an important role for the differential diagnosis of these conditions. Conventional radiography is considered the first line approach to soft tissue calcinosis; CT and MRI may provide further information to better characterize calcified deposits. Imaging may help to distinguish metabolic calcification, such as primary tumoral calcinosis and the secondary one (associated with acquired disorders of calcium or phosphate regulation, from dystrophic calcification, which is associated to normal blood values of phosphate. The sedimentation sign typical of tumoral calcinosis has been demonstrated by plain film radiography, CT, MRI, and, more recently, by ultrasonography. Other types of soft tissue calcinosis may have a degenerative, metaplastic or neoplastic origin, and their characterization strongly relies on multimodality imaging.

  3. Soft Tissue Injuries in Hungarian and Austrian Clinical Diagnostic Reports

    Fogarasi-Nuber Katalin


    Full Text Available Introduction: In addition to providing first aid, primary treating doctors are required to describe and register injuries acquired in accidents and assaults. They should do this with the highest possible accuracy, as this official document is often the only documentary evidence of soft tissue injuries in case a lawsuit is filed later. Characteristics of injuries may disappear faster with the healing process of the soft tissue, making it impossible for forensic experts to deduce the weapon involved. Consequently, terminological accuracy is a prerequisite for the appropriate reconstruction of the type and severity of injuries. This study aims at analysing reports on soft tissue injuries in Hungary and Austria from the terminological point of view. It is meant to reveal inaccuracies in the use of noun phrases impairing objective and accurate forensic assessment.

  4. High Grade Myofibroblastic Sarcoma of Paratesticular Soft Tissues

    Ioannis Anastasiou


    Full Text Available Tumors of the paratesticular region most often arise from the soft tissue surrounding the spermatic cord and the epididymis or from the soft tissue (dartos muscle of the scrotal wall. Paratesticular tumors, despite their rarity, present a high incidence of malignancy (30%, and the therapeutic approach of choice is surgical resection with negative margin. The grade, the histology type, the presence of metastases during the diagnosis, the size of the tumor, the age of the patients, and the surgical margins are all important prognostic factors. We present a case report of a 86-year-old patient with a high grade paratesticular and scrotum sarcoma of soft tissues which was presented as a hard painful mass of the scrotum. The patient was subjected to high ligation of the spermatic cord and received no further treatment and 6 months after the operation no local or systematic recurrence was observed.

  5. Gunshot wounds: epidemiology, wound ballistics, and soft-tissue treatment.

    Dougherty, Paul J; Najibi, Soheil; Silverton, Craig; Vaidya, Rahul


    The extremities are the most common anatomic location for gunshot wounds. Because of the prevalence of gunshot injuries, it is important that orthopaedic surgeons are knowledgeable about caring for them. The most common injuries seen with gunshot wounds are those of the soft tissues. Nonsurgical management of patients who have gunshot wounds with minimal soft-tissue disruption has been successfully accomplished in emergency departments for several years; this includes extremity wounds without nerve, intra-articular, or vascular injury. Stable, nonarticular fractures of an extremity have also been successfully treated with either minimal surgical or nonsurgical methods in the emergency department. Indications for surgical treatment include unstable fractures, intra-articular injuries, a significant soft-tissue injury (especially with skin loss), vascular injury, and/or a large or expanding hematoma.

  6. Cytohistopathological and immunohistochemical correlation of soft tissue tumors

    J. Chandralekha


    Full Text Available Background: Fine needle aspiration cytology has become an established tool in the diagnostic armamentarium of many clinical practices. The initial diagnosis of many mass lesions, both superficial and deep-seated, can often be readily and safely assessed by fine needle aspiration cytology. In our study, we assessed 361 cases of soft tissue tumors by fine needle aspiration cytology during a period of three years. We tried to follow up as many cases as possible to obtain corresponding excision biopsies for histopathological examination. Immunohistochemical studies were also performed on biopsy sections in some cases for confirmation of diagnoses. Aims and objectives: 1 To study the age, sex and site-wise distribution of soft tissue tumors. 2 To assess the utility of fine needle aspiration cytology in diagnosing various types of soft tissue tumors. 3 To assess the sensitivity, specificity, positive and negative predictive values, and overall histological correlation percentage of fine needle aspiration cytology in diagnosing soft tissue tumors. Methods: Aspirations were carried out using a 22 gauge disposable needle and a 10c.c disposable syringe for suction. Wet-fixed smears were stained with hematoxylin and eosin and pap stain. Dry-fixed smears were stained with May-Grunwald Giemsa stain. Periodic Acid Schiff stain was used in some cases of extraskeletal Ewing's sarcoma. Corresponding biopsy sections were stained with hematoxylin and eosin. Immunohistochemical stains were also used in some of the cases for confirmation of diagnosis. Results: Of the 361 cases recorded in our study, 320 patients could be successfully followed up and excision biopsies were obtained. The remaining 41 patients were excluded from the study due to inability to obtain biopsy. Of the 320 cases, 200 were diagnosed as benign soft tissue tumors, while 120 were diagnosed as malignant on cytological examination. The median age of occurrence of benign soft tissue tumors was 34

  7. Is Three-Dimensional Soft Tissue Prediction by Software Accurate?

    Nam, Ki-Uk; Hong, Jongrak


    The authors assessed whether virtual surgery, performed with a soft tissue prediction program, could correctly simulate the actual surgical outcome, focusing on soft tissue movement. Preoperative and postoperative computed tomography (CT) data for 29 patients, who had undergone orthognathic surgery, were obtained and analyzed using the Simplant Pro software. The program made a predicted soft tissue image (A) based on presurgical CT data. After the operation, we obtained actual postoperative CT data and an actual soft tissue image (B) was generated. Finally, the 2 images (A and B) were superimposed and analyzed differences between the A and B. Results were grouped in 2 classes: absolute values and vector values. In the absolute values, the left mouth corner was the most significant error point (2.36 mm). The right mouth corner (2.28 mm), labrale inferius (2.08 mm), and the pogonion (2.03 mm) also had significant errors. In vector values, prediction of the right-left side had a left-sided tendency, the superior-inferior had a superior tendency, and the anterior-posterior showed an anterior tendency. As a result, with this program, the position of points tended to be located more left, anterior, and superior than the "real" situation. There is a need to improve the prediction accuracy for soft tissue images. Such software is particularly valuable in predicting craniofacial soft tissues landmarks, such as the pronasale. With this software, landmark positions were most inaccurate in terms of anterior-posterior predictions.

  8. Soft tissue augmentation - Use of hyaluronic acid as dermal filler

    Vedamurthy Maya


    Full Text Available Soft tissue augmentation has revolutionized the treatment of the aging face. It is a technique in which a substance is injected under the skin. The concept of utilizing materials for soft tissue augmentation actually began around 1950 with the use of fluid silicone. Today we have a large armamentarium of implant materials to delay the tell tale signs of aging. Filling has replaced conventional surgery in facial rejuvenation. In this article, the emphasis will be on hyaluronic acid as this substance is easily available in India and ranks among the most widely used dermal fillers.

  9. Investigation of some radiation shielding parameters in soft tissue

    Danial Salehi


    Full Text Available The photon interactions with the soft tissue have been discussed mainly in terms of mass attenuation coefficient, mass energy absorption coefficient, kerma relative to air, effective atomic number and energy absorption buildup factor in the energy range 0.01–10 MeV and penetration depth up to 40 mfp (by using GP fitting method. Over past 2 decades, interest has been growing for theoretical and computational works on photon buildup factor in soft tissue. Actually, besides dosimetry, in radiation therapy and imaging the buildup of X- and gamma photons introduces remarkable error.

  10. Necrotizing Soft Tissue Infection Occurring after Exposure to Mycobacterium marinum

    Shivani S. Patel


    Full Text Available Cutaneous infections caused by Mycobacterium marinum have been attributed to aquarium or fish exposure after a break in the skin barrier. In most instances, the upper limbs and fingers account for a majority of the infection sites. While previous cases of necrotizing soft tissue infections related to M. marinum have been documented, the importance of our presenting case is to illustrate the aggressive nature of M. marinum resulting in a persistent necrotizing soft tissue infection of a finger that required multiple aggressive wound debridements, followed by an amputation of the affected extremity, in order to hasten recovery.

  11. Age Changes of Jaws and Soft Tissue Profile

    Padmaja Sharma


    Full Text Available Age-related changes of jaws and soft tissue profile are important both for orthodontists and general dentists. Mouth profile is the area which is manipulated during dental treatment. These changes should be planned in accordance with other components of facial profile to achieve ultimate aim of structural balance, functional efficacy, and esthetic harmony. Through this paper, the authors wish to discuss age changes of the hard and soft tissues of human face which would help not only the orthodontists but also oral surgeons, prosthodontists, pedodontists, and general dentists.

  12. [Fast neutrons in the treatment of soft tissue sarcomas].

    Chernichenko, V A; Tolstopiatov, B A; Monich, A Iu; Konovalenko, V F; Galakhin, K A; Palivets, A Iu; Vorona, A M


    Results of treatment of 101 cases of soft tissue sarcoma are presented in the paper. Preoperative irradiation technique and radical program of treatment are described. Combined radiation and surgical treatment was given to 45 patients whereas conservative--to 56. Sixty-three cases received adjuvant combination chemotherapy. Response and three-year survival rates were compared to those in control group treated by photons. The results observed in patients of combined and conservative treatment groups who had been irradiated with fast neutrons proved significantly better than in controls. These data suggest vistas in application of fast neutron irradiation for the treatment of soft tissue sarcomas.

  13. Diode laser soft-tissue surgery: advancements aimed at consistent cutting, improved clinical outcomes.

    Romanos, Georgios E


    Laser dentistry and soft-tissue surgery, in particular, have become widely adopted in recent years. Significant cost reductions for dental lasers and the increasing popularity of CADCAM, among other factors, have contributed to a substantial increase in the installed base of dental lasers, especially soft-tissue lasers. New development in soft-tissue surgery, based on the modern understanding of laser-tissue interactions and contact soft-tissue surgery mechanisms, will bring a higher quality and consistency level to laser soft-tissue surgery. Recently introduced diode-laser technology enables enhanced control of side effects that result from tissue overheating and may improve soft-tissue surgical outcomes.

  14. Head and neck soft tissue sarcomas treated with radiation therapy

    Lucas K. Vitzthum


    Full Text Available Head and neck soft tissue sarcomas (HNSTSs are rare and heterogeneous cancers in which radiation therapy (RT has an important role in local tumor control (LC. The purpose of this study was to evaluate outcomes and patterns of treatment failure in patients with HNSTS treated with RT. A retrospective review was performed of adult patients with HNSTS treated with RT from January 1, 1998, to December 31, 2012. LC, locoregional control (LRC, disease-free survival (DFS, overall survival (OS, and predictors thereof were assessed. Forty-eight patients with HNSTS were evaluated. Five-year Kaplan-Meier estimates of LC, LRC, DFS, and OS were 87, 73, 63, and 83%, respectively. Angiosarcomas were found to be associated with worse LC, LRC, DFS, and OS. Patients over the age of 60 had lower rates of DFS. HNSTSs comprise a diverse group of tumors that can be managed with various treatment regimens involving RT. Angiosarcomas have higher recurrence and mortality rates.

  15. Epidemiological study of soft-tissue sarcomas in Ireland.

    Bhatt, Nikita


    Soft-tissue sarcomas (STS) account for 1% of adult and 7% of pediatric malignancies. Histopathology and classification of these rare tumors requires further refinements. The aim of this paper is to describe the current incidence and survival of STS from 1994 to 2012 in Ireland and compare these with comparably coded international published reports. This is a retrospective, population study based on the data from the National Cancer Registry of Ireland (NCRI). Incidence and relative survival rates for STS in Ireland were generated. Incidence of STS based on gender, age and anatomical location was examined. Annual mean incidence rate (European Age Standardized) in Ireland between 1994 and 2012 was 4.48 ± 0.15 per 100,000 person-years. The overall relative 5-year survival rate of STS for the period 1994-2011 in Ireland was 56%, which was similar to that reported in the U.K. but lower than in most of Europe and U.S.A. Survival rate fluctuated over the period examined, declining slightly in females but showing an increase in males. STS incidence trends in Ireland were comparable to international reports. Survival trends of STS were significantly different between Ireland and other European countries, requiring further study to understand causation.

  16. The obesity paradox in patients with severe soft tissue infections.

    Rios-Diaz, Arturo J; Lin, Elissa; Williams, Katherine; Jiang, Wei; Patel, Vihas; Shimizu, Naomi; Metcalfe, David; Olufajo, Olubode A; Cooper, Zara; Havens, Joaquim; Salim, Ali; Askari, Reza


    The "obesity paradox" has been demonstrated in chronic diseases but not in acute surgery. We sought to determine whether obesity is associated with improved outcomes in patients with severe soft tissue infections (SSTIs). The 2006 to 2010 Nationwide Inpatient Sample was used to identify adult patients with SSTIs. Patients were categorized into nonobese and obese (nonmorbid [body mass index 30 to 39.9] and morbid [body mass index ≥ 40]). Logistic regression provided risk-adjusted association between obesity categories and inhospital mortality. There were 2,868 records with SSTI weighted to represent 14,080 patients. Obese patients were less likely to die in hospital than nonobese patients (odds ratio [OR] = .42; 95% confidence interval [CI], .25 to .70; P = .001). Subanalysis revealed a similar trend, with lower odds of mortality in nonmorbid obesity (OR = .46; 95% CI, .23 to .91; P = .025) and morbid obesity (OR = .39; 95% CI, .19 to .80; P = .011) groups. Obesity is independently associated with reduced inhospital mortality in patients with SSTI regardless of the obesity classification. This suggests that the obesity paradox exists in this acute surgical population. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Soft-tissue and hard-tissue profile changes following orthodontic treatment of bimaxillary protrusion in adults with teeth extraction%成人双颌前突错(牙合)畸形患者拔牙正畸治疗后颅面软硬组织的变化

    林铭; 王大为


    Objective To investigate the changes of soft and hard-tissue profile following orthodontic treatment of bimaxillary protrusion in adults with teeth extraction. Methods 16 adult bimaxillary protrusion cases were selected to be treated with straight wire technique consisting of teeth extraction. Cephalometrics were taken before and after treatment. The changes of soft and hard-tissue profile were studied with computer-aided X-ray cephalometric analysis. Results (1)The relationship between the maxillary and the mandible did not change significantly [SNA, SNB, ANB had no significant difference in cephalometric measurement (P > 0.05)]. (2)L1-MP, U1-L1, U1-NA, L1-NB, U1-L1 angle changes in hard tissue had significant difference in cephalometric measurement (P < 0.01). The upper and lower anterior teeth were more retrusive, and the tripping of incisor decreased significantly. (3)Analysis of related projects cephalometric showed that lateral appearance improved significantly, Soft tissue Cephalometric related Cm-Sn-Ls、UL-UI、LL-LI、Pos-Po、A′UL-B′LL measurements increased significantly; Ns-Sn-Pog and other indicators in soft tissue also improved. Conclusion Soft and hard-tissue profile improve significantly after orthodontic treatment with teeth extraction in bimaxillary protrusive adults, however, the relationship between the maxillary and the mandible do not change significantly.%目的 探讨双颌前突错(牙合)畸形成人患者拔牙矫治后软硬组织的变化.方法 选取16例双颌前突错畸形成人患者,均于拔牙后应用直丝弓或方丝弓技术进行矫治,并做治疗前后X线头颅侧位定位片测量,以分析治疗前后软硬组织的变化.结果 (1)上下颌骨间关系无明显变化[SNA、SNB、ANB变化无统计学意义(P > 0.05)];(2)L1-MP、U1-L1、U1-NA、L1-NB前后差异均有统计学意义﹙P < 0.01﹚,上下前牙突度和倾斜度明显减小;(3)颏厚(Pos-Po)、鼻唇角(Cm-Sn-Ls)、面凸角(N′-Sn-Pg′)

  18. New Challenges in Biorobotics: Incorporating Soft Tissue into Control Systems

    Barry A. Trimmer


    Full Text Available The development of truly biomimetic robots requires that soft materials be incorporated into the mechanical design and also used as an integral part of the motor control system. One approach to this challenge is to identify how soft animals control their movements and then apply the found principles in robotic applications. Here I show an example of how a combination of animal kinematics, neural patterning and constitutive modelling of tissues can be used to explore motor control in the caterpillar, Manduca sexta. Although still in the early stages, these findings are being used to design and fabricate a new type of robot that does not have a rigid skeleton and is structured entirely from soft or compliant materials. It is hoped that this new robotic platform will promote the development of actuators, sensors and electronics that are compatible with soft materials.

  19. Fat-containing soft-tissue masses in children

    Sheybani, Elizabeth F. [University of Toronto, Department of Medical Imaging, Toronto, ON (Canada); The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada); Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Eutsler, Eric P. [Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Navarro, Oscar M. [University of Toronto, Department of Medical Imaging, Toronto, ON (Canada); The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada)


    The diagnosis of soft-tissue masses in children can be difficult because of the frequently nonspecific clinical and imaging characteristics of these lesions. However key findings on imaging can aid in diagnosis. The identification of macroscopic fat within a soft-tissue mass narrows the differential diagnosis considerably and suggests a high likelihood of a benign etiology in children. Fat can be difficult to detect with sonography because of the variable appearance of fat using this modality. Fat is easier to recognize using MRI, particularly with the aid of fat-suppression techniques. Although a large portion of fat-containing masses in children are adipocytic tumors, a variety of other tumors and mass-like conditions that contain fat should be considered by the radiologist confronted with a fat-containing mass in a child. In this article we review the sonographic and MRI findings in the most relevant fat-containing soft-tissue masses in the pediatric age group, including adipocytic tumors (lipoma, angiolipoma, lipomatosis, lipoblastoma, lipomatosis of nerve, and liposarcoma); fibroblastic/myofibroblastic tumors (fibrous hamartoma of infancy and lipofibromatosis); vascular anomalies (involuting hemangioma, intramuscular capillary hemangioma, phosphate and tensin homologue (PTEN) hamartoma of soft tissue, fibro-adipose vascular anomaly), and other miscellaneous entities, such as fat necrosis and epigastric hernia. (orig.)

  20. Metastasis in soft tissue sarcomas : Prognostic criteria and treatment perspectives

    Komdeur, R; Hoekstra, HJ; van den Berg, E; Molenaar, WM; Pras, E; de Vries, EGE; van der Graaf, WTA


    Soft tissue sarcomas (STSs) are rare tumors, notorious for early hematogenous metastasizing. Metastatic disease is seldom amenable to curative treatment; therefore new treatment modalities are required. Treatment-related and tumor-related prognostic factors can be assessed to estimate the risk for s

  1. High resolution ultrasonography in isolated soft tissue and intramuscular cysticercosis

    Gaurav Sharma


    Conclusions: With the advent of high resolution ultrasonography and increased clinical awareness of the isolated soft tissue-intramuscular cysticercosis especially in endemic zone, a more conservative non-invasive approach can be applied both in diagnosis and treatment of these isolated cases of cysticercosis. [Int J Res Med Sci 2016; 4(1.000: 42-46

  2. Fat-containing soft-tissue masses in children.

    Sheybani, Elizabeth F; Eutsler, Eric P; Navarro, Oscar M


    The diagnosis of soft-tissue masses in children can be difficult because of the frequently nonspecific clinical and imaging characteristics of these lesions. However key findings on imaging can aid in diagnosis. The identification of macroscopic fat within a soft-tissue mass narrows the differential diagnosis considerably and suggests a high likelihood of a benign etiology in children. Fat can be difficult to detect with sonography because of the variable appearance of fat using this modality. Fat is easier to recognize using MRI, particularly with the aid of fat-suppression techniques. Although a large portion of fat-containing masses in children are adipocytic tumors, a variety of other tumors and mass-like conditions that contain fat should be considered by the radiologist confronted with a fat-containing mass in a child. In this article we review the sonographic and MRI findings in the most relevant fat-containing soft-tissue masses in the pediatric age group, including adipocytic tumors (lipoma, angiolipoma, lipomatosis, lipoblastoma, lipomatosis of nerve, and liposarcoma); fibroblastic/myofibroblastic tumors (fibrous hamartoma of infancy and lipofibromatosis); vascular anomalies (involuting hemangioma, intramuscular capillary hemangioma, phosphate and tensin homologue (PTEN) hamartoma of soft tissue, fibro-adipose vascular anomaly), and other miscellaneous entities, such as fat necrosis and epigastric hernia.

  3. Soft tissue artifact in canine kinematic gait analysis

    Schwencke, M.; Smolders, L.A.; Bergknut, N.; Gustas, P.; Meij, B.P.; Hazewinkel, H.A.W.


    Vet Surg. 2012 Oct;41(7):829-37. doi: 10.1111/j.1532-950X.2012.01021.x. Soft tissue artifact in canine kinematic gait analysis. Schwencke M, Smolders LA, Bergknut N, Gustås P, Meij BP, Hazewinkel HA. Source Department of Clinical Sciences of Companion Animals,, Faculty of Veterinary Medicine, Utrech

  4. The effect of bone displacement operations on facial soft tissues.

    Habib, Ali; Hisham, Ahmed


    A novel biomechanical model for face soft tissue (skin, mucosa, and muscles) is introduced to investigate the effect of mandible and chin bone displacement on the overall appearance of the patient's face. Nonlinear FE analysis is applied to the model and the results obtained are used to help surgeons to decide the amount of displacement required.

  5. Mechanics of Flexible Needles Robotically Steered through Soft Tissue

    Misra, S.; Reed, K.B.; Schafer, B.W.; Ramesh, K.T.; Okamura, A.M.


    The tip asymmetry of a bevel-tip needle results in the needle naturally bending when it is inserted into soft tissue. This enables robotic needle steering, which can be used in medical procedures to reach subsurface targets inaccessible by straight-line trajectories. However, accurate path planning

  6. Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application

    Kim, Jooyoung; Sung, Dong Jun; Lee, Joohyung


    This article reviews the mechanism and effects of instrument-assisted soft tissue mobilization (IASTM), along with guidelines for its practical application. IASTM refers to a technique that uses instruments to remove scar tissues from injured soft tissues and facilitate healing process through formation of new extracellular matrix proteins such as collagen. Recently, frequent use of this instrument has increased in the fields of sports rehabilitation and athlete training. Some experimental studies and case reports have reported that IASTM can significantly improve soft tissue function and range of motion following sports injury, while also reducing pain. Based on the previous studies, it is thought that IASTM can help shorten the rehabilitation period and time to return to sports among athletes and ordinary people who have suffered sports injuries. However, few experimental studies of the mechanisms and effects of IASTM have examined, while case reports have accounted for the majority of articles. In the future, the scientific basis of IASTM and its reliability should be provided through well-designed experimental studies on humans. Moreover, IASTM studies that have mostly focused on tendons need to broaden their scope toward other soft tissues such as muscles and ligaments.

  7. Stages of Adult Soft Tissue Sarcoma

    ... changes in the chromosomes . FISH (fluorescence in situ hybridization) : A laboratory test used to look at genes ... a picture of areas inside the body. Blood chemistry studies : A procedure in which a blood sample ...

  8. General Information about Adult Soft Tissue Sarcoma

    ... changes in the chromosomes . FISH (fluorescence in situ hybridization) : A laboratory test used to look at genes ... a picture of areas inside the body. Blood chemistry studies : A procedure in which a blood sample ...

  9. Soft tissue discrimination ex vivo by dual energy computed tomography

    Zachrisson, H., E-mail: helene.zachrisson@lio.s [Center for Medical Image Science and Visualization, Linkoeping University, Linkoeping University Hospital, SE-581 85 Linkoeping (Sweden); Clinical Physiology, Department of Medical and Health Sciences (IMH), Linkoeping University, Linkoeping University Hospital, SE-581 85 Linkoeping (Sweden); Engstroem, E. [Clinical Physiology, Department of Medical and Health Sciences (IMH), Linkoeping University, Linkoeping University Hospital, SE-581 85 Linkoeping (Sweden); Engvall, J.; Wigstroem, L. [Center for Medical Image Science and Visualization, Linkoeping University, Linkoeping University Hospital, SE-581 85 Linkoeping (Sweden); Clinical Physiology, Department of Medical and Health Sciences (IMH), Linkoeping University, Linkoeping University Hospital, SE-581 85 Linkoeping (Sweden); Smedby, O.; Persson, A. [Center for Medical Image Science and Visualization, Linkoeping University, Linkoeping University Hospital, SE-581 85 Linkoeping (Sweden); Radiology, Department of Medical and Health Sciences (IMH), Linkoeping University, Linkoeping University Hospital, SE-581 85 Linkoeping (Sweden)


    Purpose: Dual Energy Computed Tomography (DECT) may provide additional information about the chemical composition of tissues compared to examination with a single X-ray energy. The aim of this in vitro study was to test whether combining two energies may significantly improve the detection of soft tissue components commonly present in arterial plaques. Methods: Tissue samples of myocardial and psoas muscle, venous and arterial thrombus as well as fat from different locations were scanned using a SOMATOM Definition Dual Source CT system (Siemens AG, Medical Solutions, Forchheim, Germany) with simultaneous tube voltages of 140 and 80 kV. The attenuation (Hounsfield units, HU) at 80 and 140 kV was measured in representative regions of interest, and the association between measured HU values and tissue types was tested with logistic regression. Results: The combination of two energy levels (80 and 140 kV) significantly improved (p < 0.001) the ability to correctly classify venous thrombus vs arterial thrombus, myocardium or psoas; arterial thrombus vs myocardium or psoas; myocardium vs psoas; as well as the differentiation between fat tissue from various locations. Single energy alone was sufficient for distinguishing fat from other tissues. Conclusion: DECT offers significantly improved in vitro differentiation between soft tissues occurring in plaques. If this corresponds to better tissue discrimination in vivo needs to be clarified in future studies.

  10. Medical ultrasound: imaging of soft tissue strain and elasticity.

    Wells, Peter N T; Liang, Hai-Dong


    After X-radiography, ultrasound is now the most common of all the medical imaging technologies. For millennia, manual palpation has been used to assist in diagnosis, but it is subjective and restricted to larger and more superficial structures. Following an introduction to the subject of elasticity, the elasticity of biological soft tissues is discussed and published data are presented. The basic physical principles of pulse-echo and Doppler ultrasonic techniques are explained. The history of ultrasonic imaging of soft tissue strain and elasticity is summarized, together with a brief critique of previously published reviews. The relevant techniques-low-frequency vibration, step, freehand and physiological displacement, and radiation force (displacement, impulse, shear wave and acoustic emission)-are described. Tissue-mimicking materials are indispensible for the assessment of these techniques and their characteristics are reported. Emerging clinical applications in breast disease, cardiology, dermatology, gastroenterology, gynaecology, minimally invasive surgery, musculoskeletal studies, radiotherapy, tissue engineering, urology and vascular disease are critically discussed. It is concluded that ultrasonic imaging of soft tissue strain and elasticity is now sufficiently well developed to have clinical utility. The potential for further research is examined and it is anticipated that the technology will become a powerful mainstream investigative tool.

  11. [Progress on cervical muscle strength and soft tissue stiffness testing].

    Ma, Ming; Zhang, Shi-min


    Biomechanical evaluation of neck muscles has important significance in the diagnosis and treatment for cervical spondylosis, the neck muscle strength and soft tissue stiffness test is two aspects of biomechanical testing. Isometric muscle testing operation is relatively simple, the cost is lower, which can evaluate the muscle force below grade 3. However, isokinetic muscle strength testing can assess the muscle strength of joint motion in any position. It is hard to distinguish stiffness difference in different soft tissues when the load-displacement curve is used to evaluate the local soft tissue stiffness. Elasticity imaging technique can not only show the elastic differences of different tissues by images, but also quantify the elastic modulus of subcutaneous tissues and muscles respectively. Nevertheless, it is difficult to observe the flexibility of the cervical spine by means of the analysis of the whole neck stiffness. In a word, a variety of test method will conduce not only the biomechanical evaluation of neck muscles, but also making an effective biomechanics mathematical model of neck muscles. Besides, isokinetic muscle testing and the elasticity imaging technology still need further validation and optimization before they are better applied to neck muscles biomechanical testing.

  12. Soft tissue sarcoma with metastasis to the stomach: A case report

    Lemuel; Leon; Dent; Cesar; Yamil; Cardona; Michael; Clause; Buchholz; Roosevelt; Peebles; Julie; Denise; Scott; Derrick; Jerome; Beech; Billy; Ray; Ballard


    Soft tissue sarcomas are unusual malignancies comprising 1% of cancer diagnoses in the United States. Undifferentiated pleomorphic sarcoma accounts for approximately 5% of sarcomas occurring in adults. The most common site of metastasis is the lung, with other sites being bone, the brain, and the liver. Metastasis to the gastrointestinal tract has rarely been documented. We present an unusual case of high-grade pleomorphic sarcoma with metastasis to the stomach, complicated by upper gastrointestinal bleedin...

  13. Temperature dependence of postmortem MR quantification for soft tissue discrimination

    Zech, Wolf-Dieter; Schwendener, Nicole; Jackowski, Christian [University of Bern, From the Institute of Forensic Medicine, Bern (Switzerland); Persson, Anders; Warntjes, Marcel J. [University of Linkoeping, The Center for Medical Image Science and Visualization (CMIV), Linkoeping (Sweden)


    To investigate and correct the temperature dependence of postmortem MR quantification used for soft tissue characterization and differentiation in thoraco-abdominal organs. Thirty-five postmortem short axis cardiac 3-T MR examinations were quantified using a quantification sequence. Liver, spleen, left ventricular myocardium, pectoralis muscle and subcutaneous fat were analysed in cardiac short axis images to obtain mean T1, T2 and PD tissue values. The core body temperature was measured using a rectally inserted thermometer. The tissue-specific quantitative values were related to the body core temperature. Equations to correct for temperature differences were generated. In a 3D plot comprising the combined data of T1, T2 and PD, different organs/tissues could be well differentiated from each other. The quantitative values were influenced by the temperature. T1 in particular exhibited strong temperature dependence. The correction of quantitative values to a temperature of 37 C resulted in better tissue discrimination. Postmortem MR quantification is feasible for soft tissue discrimination and characterization of thoraco-abdominal organs. This provides a base for computer-aided diagnosis and detection of tissue lesions. The temperature dependence of the T1 values challenges postmortem MR quantification. Equations to correct for the temperature dependence are provided. (orig.)

  14. Soft Tissue Engineering with Micronized-Gingival Connective Tissues.

    Noda, Sawako; Sumita, Yoshinori; Ohba, Seigo; Yamamoto, Hideyuki; Asahina, Izumi


    The free gingival graft (FGG) and connective tissue graft (CTG) are currently considered to be the gold standards for keratinized gingival tissue reconstruction and augmentation. However, these procedures have some disadvantages in harvesting large grafts, such as donor-site morbidity as well as insufficient gingival width and thickness at the recipient site post-treatment. To solve these problems, we focused on an alternative strategy using micronized tissue transplantation (micro-graft). In this study, we first investigated whether transplantation of micronized gingival connective tissues (MGCTs) promotes skin wound healing. MGCTs (≤100 µm) were obtained by mincing a small piece (8 mm(3) ) of porcine keratinized gingiva using the RIGENERA system. The MGCTs were then transplanted to a full skin defect (5 mm in diameter) on the dorsal surface of immunodeficient mice after seeding to an atelocollagen matrix. Transplantations of atelocollagen matrixes with and without micronized dermis were employed as experimental controls. The results indicated that MGCTs markedly promote the vascularization and epithelialization of the defect area 14 days after transplantation compared to the experimental controls. After 21 days, complete wound closure with low contraction was obtained only in the MGCT grafts. Tracking analysis of transplanted MGCTs revealed that some mesenchymal cells derived from MGCTs can survive during healing and may function to assist in wound healing. We propose here that micro-grafting with MGCTs represents an alternative strategy for keratinized tissue reconstruction that is characterized by low morbidity and ready availability. This article is protected by copyright. All rights reserved.

  15. [Microbiological diagnosis of infections of the skin and soft tissues].

    Burillo, Almudena; Moreno, Antonio; Salas, Carlos


    Skin and soft tissue infections are often seen in clinical practice, yet their microbiological diagnosis is among the most complex of laboratory tasks. The diagnosis of a skin and a soft tissue infection is generally based on clinical criteria and not microbiological results. A microbiological diagnosis is reserved for cases in which the etiology of infection is required, e.g., when the infection is particularly severe, when less common microorganisms are suspected as the causative agent (e.g. in immunocompromised patients), when response to antimicrobial treatment is poor, or when a longstanding wound does not heal within a reasonable period of time. We report the indications, sampling and processing techniques, and interpretation criteria for various culture types, including quantitative cultures from biopsy or tissue specimens and semiquantitative and qualitative cultures performed on all types of samples. For non-invasive samples taken from open wounds, application of the Q index to Gram stains is a cost-effective way to standardize sample quality assessment and interpretation of the pathogenic involvement of the different microorganisms isolated from cultures. All these issues are covered in the SEIMC microbiological procedure number 22: Diagnóstico microbiológico de las infecciones de piel y tejidos blandos (Microbiological diagnosis of infections of the skin and soft tissues) (2nd ed., 2006,

  16. Hypoelastic Soft Tissues: Part II: In-Plane Biaxial Experiments.

    Freed, Alan D; Einstein, Daniel R; Sacks, Michael S


    In Part I, a novel hypoelastic framework for soft-tissues was presented. One of the hallmarks of this new theory is that the well-known exponential behavior of soft-tissues arises consistently and spontaneously from the integration of a rate based formulation. In Part II, we examine the application of this framework to the problem of biaxial kinematics, which are common in experimental soft-tissue characterization. We confine our attention to an isotropic formulation in order to highlight the distinction between non-linearity and anisotropy. In order to provide a sound foundation for the membrane extension of our earlier hypoelastic framework, the kinematics and kinetics of in-plane biaxial extension are revisited, and some enhancements are provided. Specifically, the conventional stress-to-traction mapping for this boundary value problem is shown to violate the conservation of angular momentum. In response, we provide a corrected mapping. In addition, a novel means for applying loads to in-plane biaxial experiments is proposed. An isotropic, isochoric, hypoelastic, constitutive model is applied to an in-plane biaxial experiment done on glutaraldehyde treated bovine pericardium. The experiment is comprised of eight protocols that radially probe the biaxial plane. Considering its simplicity (two adjustable parameters) the model does a reasonably good job of describing the non-linear normal responses observed in these experimental data, which are more prevalent than are the anisotropic responses exhibited by this tissue.

  17. ALK-positive anaplastic large cell lymphoma with soft tissue involvement in a young woman

    Gao KH


    Full Text Available Kehai Gao, Hongtao Li, Caihong Huang, Huazhuang Li, Jun Fang, Chen Tian Department of Orthopaedics, Yidu Central Hospital, Shandong, People’s Republic of China Introduction: Anaplastic large cell lymphoma (ALCL is a type of non-Hodgkin lymphoma that has strong expression of CD30. ALCL can sometimes involve the bone marrow, and in advanced stages, it can produce destructive extranodal lesions. But anaplastic large cell lymphoma kinase (ALK+ ALCL with soft tissue involvement is very rare.Case report: A 35-year-old woman presented with waist pain for over 1 month. The biopsy of soft tissue lesions showed that these cells were positive for ALK-1, CD30, TIA-1, GranzymeB, CD4, CD8, and Ki67 (90%+ and negative for CD3, CD5, CD20, CD10, cytokeratin (CK, TdT, HMB-45, epithelial membrane antigen (EMA, and pan-CK, which identified ALCL. After six cycles of Hyper-CVAD/MA regimen, she achieved partial remission. Three months later, she died due to disease progression.Conclusion: This case illustrates the unusual presentation of ALCL in soft tissue with a bad response to chemotherapy. Because of the tendency for rapid progression, ALCL in young adults with extranodal lesions are often treated with high-grade chemotherapy, such as Hyper-CVAD/MA. Keywords: anaplastic large cell lymphoma, ALK+, soft tissue involvement, Hyper-CVAD/MA

  18. [Research progress in peri-implant soft tissue engineering augmentation method].

    Pei, Tingting; Yu, Hongqiang; Wen, Chaoju; Guo, Tianqi; Zhou, Yanmin; Peng, Huimin


    The sufficiency of hard and soft tissue at the implant site is the guarantee of long-term function, health and the appearance of implant denture. Problem of soft tissue recession at the implant site has always been bothering dentists. Traditional methods for augmentation of soft tissue such as gingival transplantation have disadvantages of instability of the increased soft-tissue and more trauma. Lately the methods that base on tissue engineering to increase the soft tissue of peri-implant sites have drawn great attention. This review focuses on the current methods of peri-implant restoration through tissue engineering, seed cells, biological scaffolds and cytokines.

  19. Articular soft tissue anatomy of the archosaur hip joint: Structural homology and functional implications.

    Tsai, Henry P; Holliday, Casey M


    Archosaurs evolved a wide diversity of locomotor postures, body sizes, and hip joint morphologies. The two extant archosaurs clades (birds and crocodylians) possess highly divergent hip joint morphologies, and the homologies and functions of their articular soft tissues, such as ligaments, cartilage, and tendons, are poorly understood. Reconstructing joint anatomy and function of extinct vertebrates is critical to understanding their posture, locomotor behavior, ecology, and evolution. However, the lack of soft tissues in fossil taxa makes accurate inferences of joint function difficult. Here, we describe the soft tissue anatomies and their osteological correlates in the hip joint of archosaurs and their sauropsid outgroups, and infer structural homology across the extant taxa. A comparative sample of 35 species of birds, crocodylians, lepidosaurs, and turtles ranging from hatchling to skeletally mature adult were studied using dissection, imaging, and histology. Birds and crocodylians possess topologically and histologically consistent articular soft tissues in their hip joints. Epiphyseal cartilages, fibrocartilages, and ligaments leave consistent osteological correlates. The archosaur acetabulum possesses distinct labrum and antitrochanter structures on the supraacetabulum. The ligamentum capitis femoris consists of distinct pubic- and ischial attachments, and is homologous with the ventral capsular ligament of lepidosaurs. The proximal femur has a hyaline cartilage core attached to the metaphysis via a fibrocartilaginous sleeve. This study provides new insight into soft tissue structures and their osteological correlates (e.g., the antitrochanter, the fovea capitis, and the metaphyseal collar) in the archosaur hip joint. The topological arrangement of fibro- and hyaline cartilage may provide mechanical support for the chondroepiphysis. The osteological correlates identified here will inform systematic and functional analyses of archosaur hindlimb evolution and

  20. Regeneration of soft tissues is promoted by MMP1 treatment after digit amputation in mice.

    Xiaodong Mu

    Full Text Available The ratio of matrix metalloproteinases (MMPs to the tissue inhibitors of metalloproteinases (TIMPs in wounded tissues strictly control the protease activity of MMPs, and therefore regulate the progress of wound closure, tissue regeneration and scar formation. Some amphibians (i.e. axolotl/newt demonstrate complete regeneration of missing or wounded digits and even limbs; MMPs play a critical role during amphibian regeneration. Conversely, mammalian wound healing re-establishes tissue integrity, but at the expense of scar tissue formation. The differences between amphibian regeneration and mammalian wound healing can be attributed to the greater ratio of MMPs to TIMPs in amphibian tissue. Previous studies have demonstrated the ability of MMP1 to effectively promote skeletal muscle regeneration by favoring extracellular matrix (ECM remodeling to enhance cell proliferation and migration. In this study, MMP1 was administered to the digits amputated at the mid-second phalanx of adult mice to observe its effect on digit regeneration. Results indicated that the regeneration of soft tissue and the rate of wound closure were significantly improved by MMP1 administration, but the elongation of the skeletal tissue was insignificantly affected. During digit regeneration, more mutipotent progenitor cells, capillary vasculature and neuromuscular-related tissues were observed in MMP1 treated tissues; moreover, there was less fibrotic tissue formed in treated digits. In summary, MMP1 was found to be effective in promoting wound healing in amputated digits of adult mice.

  1. Regeneration of soft tissues is promoted by MMP1 treatment after digit amputation in mice.

    Mu, Xiaodong; Bellayr, Ian; Pan, Haiying; Choi, Yohan; Li, Yong


    The ratio of matrix metalloproteinases (MMPs) to the tissue inhibitors of metalloproteinases (TIMPs) in wounded tissues strictly control the protease activity of MMPs, and therefore regulate the progress of wound closure, tissue regeneration and scar formation. Some amphibians (i.e. axolotl/newt) demonstrate complete regeneration of missing or wounded digits and even limbs; MMPs play a critical role during amphibian regeneration. Conversely, mammalian wound healing re-establishes tissue integrity, but at the expense of scar tissue formation. The differences between amphibian regeneration and mammalian wound healing can be attributed to the greater ratio of MMPs to TIMPs in amphibian tissue. Previous studies have demonstrated the ability of MMP1 to effectively promote skeletal muscle regeneration by favoring extracellular matrix (ECM) remodeling to enhance cell proliferation and migration. In this study, MMP1 was administered to the digits amputated at the mid-second phalanx of adult mice to observe its effect on digit regeneration. Results indicated that the regeneration of soft tissue and the rate of wound closure were significantly improved by MMP1 administration, but the elongation of the skeletal tissue was insignificantly affected. During digit regeneration, more mutipotent progenitor cells, capillary vasculature and neuromuscular-related tissues were observed in MMP1 treated tissues; moreover, there was less fibrotic tissue formed in treated digits. In summary, MMP1 was found to be effective in promoting wound healing in amputated digits of adult mice.

  2. Delayed phlegmon with gallstone fragments masquerading as soft tissue sarcoma

    Goodman, Laura F.; Bateni, Cyrus P.; Bishop, John W.; Canter, Robert J.


    Complications from lost gallstones after cholecystectomy are rare but varied from simple perihepatic abscess to empyema and expectoration of gallstones. Gallstone complications have been reported in nearly every organ system, although reports of malignant masquerade of retained gallstones are few. We present the case of an 87-year-old woman with a flank soft tissue tumor 4 years after laparoscopic cholecystectomy. The initial clinical, radiographic and biopsy findings were consistent with soft tissue sarcoma (STS), but careful review of her case in multidisciplinary conference raised the suspicion for retained gallstones rather than STS. The patient was treated with incisional biopsy/drainage of the mass, and gallstones were retrieved. The patient recovered completely without an extensive resectional procedure, emphasizing the importance of multidisciplinary sarcoma care to optimize outcomes for potential sarcoma patients. PMID:27333918

  3. On the elasticity of transverse isotropic soft tissues (L).

    Royer, Daniel; Gennisson, Jean-Luc; Deffieux, Thomas; Tanter, Mickaël


    Quantitative elastography techniques have recently been developed to estimate the shear modulus μ of soft tissues in vivo. In the case of isotropic and quasi-incompressible media, the Young's modulus E is close to 3 μ, which is not true in transverse anisotropic tissues such as muscles. In this letter, the transverse isotropic model established for hexagonal crystals is revisited in the case of soft solids. Relationships between elastic constants and Young's moduli are derived and validated on experimental data found in the literature. It is shown that 3 μ(⊥) ≤ E(⊥) ≤ 4 μ(⊥) and that E(//) cannot only be determined from the measurements of μ(//) and μ(⊥).

  4. Photoacoustic imaging in both soft and hard biological tissue

    Li, T; Dewhurst, R J, E-mail: [Photon Science Institute, University of Manchester, Alan Turing Building, Oxford road, Manchester, M13 9PL (United Kingdom)


    To date, most Photoacoustic (PA) imaging results have been from soft biotissues. In this study, a PA imaging system with a near-infrared pulsed laser source has been applied to obtain 2-D and 3-D images from both soft tissue and post-mortem dental samples. Imaging results showed that the PA technique has the potential to image human oral disease, such as early-stage teeth decay. For non-invasive photoacoustic imaging, the induced temperature and pressure rises within biotissues should not cause physical damage to the tissue. Several simulations based on the thermoelastic effect have been applied to predict initial temperature and pressure fields within a tooth sample. Predicted initial temperature and pressure rises are below corresponding safety limits.

  5. Micromechanics and constitutive modeling of connective soft tissues.

    Fallah, A; Ahmadian, M T; Firozbakhsh, K; Aghdam, M M


    In this paper, a micromechanical model for connective soft tissues based on the available histological evidences is developed. The proposed model constituents i.e. collagen fibers and ground matrix are considered as hyperelastic materials. The matrix material is assumed to be isotropic Neo-Hookean while the collagen fibers are considered to be transversely isotropic hyperelastic. In order to take into account the effects of tissue structure in lower scales on the macroscopic behavior of tissue, a strain energy density function (SEDF) is developed for collagen fibers based on tissue hierarchical structure. Macroscopic response and properties of tissue are obtained using the numerical homogenization method with the help of ABAQUS software. The periodic boundary conditions and the proposed constitutive models are implemented into ABAQUS using the DISP and the UMAT subroutines, respectively. The existence of the solution and stable material behavior of proposed constitutive model for collagen fibers are investigated based on the poly-convexity condition. Results of the presented micromechanics model for connective tissues are compared and validated with available experimental data. Effects of geometrical and material parameters variation at microscale on macroscopic mechanical behavior of tissues are investigated. The results show that decrease in collagen content of the connective tissues like the tendon due to diseases leads 20% more stretch than healthy tissue under the same load which can results in connective tissue malfunction and hypermobility in joints.

  6. Wilms tumor arising in extracoelomic paravertebral soft tissues.

    Mulligan, Linda


    Extrarenal Wilms tumor (ERWT) is a well-established entity which most commonly arises within the genitourinary tract, including intracoelomic paranephric soft tissue. Rarely, ERWT arises within teratoma, and it tends to occur predominantly in distinct settings, such as females with spinal defects and males with testicular teratomas. We report a unique ERWT arising within an extracoelomic teratoma of the paraspinal musculature, thereby expanding the range of reported locations for this unusual tumor.

  7. Oncogenic osteomalacia associated with soft tissue chondromyxoid fibroma

    Park, Jeong Mi E-mail:; Woo, Young Kyun; Kang, Moo Il; Kang, Chang Suk; Hahn, Seong Tae


    Oncogenic osteomalacia is a rarely described clinical entity characterized by hypophosphatemia, phosphaturia, and a low concentration of 1,25-dihydroxyvitamin D{sub 3}. It is most often associated with benign mesenchymal tumor and can be cured with surgical removal of the tumor. In this paper, we present a case of oncogenic osteomalacia caused by chondromyxoid fibroma in the soft tissue of the sole of the foot in a 56-year-old woman.

  8. Soft tissue infection caused by Kingella kingae in a child.

    Rolle, U; Schille, R; Hörmann, D; Friedrich, T; Handrick, W


    During the last years an increasing number of reports concerning Kingella kingae infections in children has been published. Most cases were osteoarticular infections. The authors report the clinical and laboratory findings from a 3-year-old child with a presternal soft tissue infection due to K kingae. After surgical excochleation and antibiotic treatment there was an uneventful recovery. J Pediatr Surg 36:946-947.

  9. Realistic soft tissue deformation strategies for real time surgery simulation.

    Shen, Yunhe; Zhou, Xiangmin; Zhang, Nan; Tamma, Kumar; Sweet, Robert


    A volume-preserving deformation method (VPDM) is developed in complement with the mass-spring method (MSM) to improve the deformation quality of the MSM to model soft tissue in surgical simulation. This method can also be implemented as a stand-alone model. The proposed VPDM satisfies the Newton's laws of motion by obtaining the resultant vectors form an equilibrium condition. The proposed method has been tested in virtual surgery systems with haptic rendering demands.


    Işıl ARAS


    Full Text Available Purpose: The aim of this study was to compare the mandibular hard and soft tissue measurements of unilateral and bilateral cleft lip and palate patients with non-cleft individuals. Materials and Methods: The study sample comprised of lateral cephalograms of 45 subjects. Sample included 15 non-cleft (NC, 15 unilateral cleft lip and palate (UCLP and 15 bilateral cleft lip and palate (BCLP cases whose age were between 15 to 17. 1 angular 13 linear measurements were carried out using Arnett and Gunson soft tissue cephalometric analysis and 4 angular measurements were calculated with Steiner Analysis. Results: Mandibular incisor inclinations relative to the occlusal plane (Md1-Md OP were significantly greater and mandibular incisor projections (Md1-TVL were significantly retrusive in cleft subjects (p<0.05. Projection values pertaining to lower lip anterior (LLA-TVL, soft tissue B point (B’-TVL, and soft tissue pogonion (Pog’-TVL were significantly deficient as well in cleft patients (p<0.05. Sagittal position of the maxilla (SNA (p<0.001 and intermaxillary relation of the jaws (ANB were significantly deficient in UCLP subjects (p<0.05 and BCLP individuals (p<0.01. LLA-TVL and B’-TVL correlated with SNB in cleft patients (p<0.05. Conclusion: Decreased lower lip and chin projection values suggest that mandibular region of cleft patients should be taken into account in forming the treatment plan to improve the esthetic outcome of orthodontic and plastic surgery interventions.

  11. Oral Soft Tissue Pathologies among Diabetic Patients in Rasht- 2005

    H Hassannia; Kalantari, S; Z Mohtasham Amiri; M Rabiei


    Introduction: Diabetes can affect organs including the oral mucosa. There is a disagreement about the prevalence of oral mucosal disease in diabetic patients. We therefore decided to investigate more about that. The aim of this study was to determine the prevalence of soft tissue pathologies by assessing burning mouth and xerostomia in diabetic patients on the basis of type of diabetes and control status of diabetes. Methods: This descriptive, analytic study was done by visiting 486 known dia...

  12. Non-neoplastic conditions presenting as soft-tissue tumours

    Crundwell, N. [Royal National Orthopaedic Hospital, Stanmore, Middlesex (United Kingdom); O' Donnell, P. [Royal National Orthopaedic Hospital, Stanmore, Middlesex (United Kingdom); Saifuddin, A. [Royal National Orthopaedic Hospital, Stanmore, Middlesex (United Kingdom)]. E-mail:


    Review of referrals to our unit over the last 7 years showed that of approximately 750 cases referred as soft-tissue tumours, 132 were subsequently diagnosed as non-neoplastic lesions. The imaging characteristics of these lesions are presented to differentiate them from neoplasms. The most common diagnoses were myositis ossificans, ganglion cyst, abscess/infection, bursitis and synovitis. The imaging features of other rarer conditions will also be discussed.

  13. Soft tissue chondroma of hard palate associated with cleft palate

    Rajendra Nehete; Anita Nehete; Sandeep Singla; Sudhir Sankalecha


    Soft tissue chondroma of palate is very rare. It has never been reported in a cleft palate patient. We report a case of 22-year-old male who came with asymptomatic swelling on the palate since birth, along with complete cleft of secondary palate. He had symptoms related to cleft palate only, i.e., nasal regurgitation and speech abnormalities. Swelling was excised and the cleft palate was repaired. Histopathological examination revealed chondroma of the palate. The patient had no recurrence af...

  14. Surface and interfacial creases in a bilayer tubular soft tissue

    Razavi, Mir Jalil; Pidaparti, Ramana; Wang, Xianqiao


    Surface and interfacial creases induced by biological growth are common types of instability in soft biological tissues. This study focuses on the criteria for the onset of surface and interfacial creases as well as their morphological evolution in a growing bilayer soft tube within a confined environment. Critical growth ratios for triggering surface and interfacial creases are investigated both analytically and numerically. Analytical interpretations provide preliminary insights into critical stretches and growth ratios for the onset of instability and formation of both surface and interfacial creases. However, the analytical approach cannot predict the evolution pattern of the model after instability; therefore nonlinear finite element simulations are carried out to replicate the poststability morphological patterns of the structure. Analytical and computational simulation results demonstrate that the initial geometry, growth ratio, and shear modulus ratio of the layers are the most influential factors to control surface and interfacial crease formation in this soft tubular bilayer. The competition between the stretch ratios in the free and interfacial surfaces is one of the key driving factors to determine the location of the first crease initiation. These findings may provide some fundamental understanding in the growth modeling of tubular biological tissues such as esophagi and airways as well as offering useful clues into normal and pathological functions of these tissues.

  15. Characterisation of significant Gram positive bacilli from soft tissue infections.

    Sim, James Heng Chiak; Ng, Lily Siew Yong; Eng, Li Ching; Chan, Kian Sing; Tan, Thean Yen


    Gram positive bacilli (GPB) isolated from soft tissue infections are often neglected or ignored due to their fastidious nature and the lack of reliable phenotypic identification methods. This study was done to characterise clinically significant aero-tolerant GPB isolated from surgically obtained samples in patients with soft tissue infections. Forty-six GPB isolates collected during a 2 year study period were identified using partial 16s rRNA sequencing and API Coryne. Antibiotic susceptibility testing to penicillin, amoxycillin/clavulanate, moxifloxacin and erythromycin was performed on these isolates using Etest. Clinical data were gathered from patients' medical records. The most common isolates identified by 16s rRNA sequencing were Actinomyces species (n = 30, 65%) and Corynebacterium species (n = 9, 20%). The majority of the Actinomyces species infections were located below the waist, in particular the perianal region. There was poor agreement between API Coryne and genotypic identification, with only one-third of the isolates being correctly identified to species level. Actinomyces species were uniformly susceptible to penicillin and amoxicillin/clavulanate. Antibiotic susceptibilities were more varied for the other genera isolated. Actinomyces species comprised two-thirds of aerobically growing GPB isolates and may represent an under-reported cause of bacterial soft tissue infections. Penicillin and amoxycillin/clavulanate may be the empiric antibiotics of choice for Actinomyces species as all isolates were susceptible.

  16. Soft Tissue Masses of Hand: A Radio-Pathological Correlation

    Aditi Agarwal


    Full Text Available Aim. To evaluate soft tissue masses of the hand with magnetic resonance imaging (MRI and ultrasonography (USG and to correlate imaging findings with pathological findings. Material and Methods. Thirty-five patients with soft tissue masses of the hand were evaluated with high resolution USG and contrast enhanced MRI of the hand, prospectively over a period of 2.5 years. The radiological diagnosis was then compared with cytology/histopathology. Results. There were a total of 19 (55% females. The mean age was 27.45 ± 14.7 years. Majority (45% of cases were heteroechoic. Four cases were predominantly hyperechoic. These were later diagnosed as lipomas. Four cases were anechoic (diagnosed as ganglions. Only four lesions showed hyperintense signal on T1-weighted images. Out of these, 3 were lipomas and one was cavernous haemangioma. Three lesions were hypointense on T2-weighted images. All these lesions were diagnosed as giant cell tumor of the tendon sheath. A correct diagnosis was possible on MRI in 80% of cases n=28. Conclusion. MRI provides specific findings for diagnosis of certain soft tissue lesions of the hand. Ultrasonography allows accurate diagnosis of hemangioma/vascular malformations. However, in most conditions, imaging findings are nonspecific and diagnosis rests on pathologic evaluation.

  17. Medical image of the week: necrotizing soft tissue infection

    Taylor A


    Full Text Available No abstract available. Article truncated at 150 words. A 70-year-old man with a history of coronary artery disease, chronic back pain, and general debilitation presented to the emergency department with complaints of fever, weakness and right buttock discomfort. Physical exam was remarkable for a temperature of 101.7º F, and for moderate erythema of the skin of the right inguinal area and right buttock, with associated tenderness. Laboratory exam was significant for a WBC of 22.7 K/ɥL, erythrocyte sedimentation rate of 82 mm, and serum creatinine phosphokinase of 2856 U/L. CAT of the abdomen and pelvis demonstrated extensive gluteal and perineal soft tissue inflammation with gas formation, consistent with a necrotizing soft tissue infection (Figures 1 and 2. Three basic subsets of necrotizing soft tissue infections (NSTIs have been described. Type I infections are the most common form and are characterized by a polymicrobial process typically involving gram positive cocci, gram negative rods, and anaerobes. Type I infections occur ...

  18. Soft Tissue Surgical Procedures for Optimizing Anterior Implant Esthetics

    Andreas L. Ioannou


    Full Text Available Implant dentistry has been established as a predictable treatment with excellent clinical success to replace missing or nonrestorable teeth. A successful esthetic implant reconstruction is predicated on two fundamental components: the reproduction of the natural tooth characteristics on the implant crown and the establishment of soft tissue housing that will simulate a healthy periodontium. In order for an implant to optimally rehabilitate esthetics, the peri-implant soft tissues must be preserved and/or augmented by means of periodontal surgical procedures. Clinicians who practice implant dentistry should strive to achieve an esthetically successful outcome beyond just osseointegration. Knowledge of a variety of available techniques and proper treatment planning enables the clinician to meet the ever-increasing esthetic demands as requested by patients. The purpose of this paper is to enhance the implant surgeon’s rationale and techniques beyond that of simply placing a functional restoration in an edentulous site to a level whereby an implant-supported restoration is placed in reconstructed soft tissue, so the site is indiscernible from a natural tooth.

  19. Ultrasonographic findings of the soft tissue lesions of the extremities

    Lee, Jung Hee; Lee, Kun Won; Park, Cheol Min; Kim, Jung Hyuk; Chung, Kyoo Byung; Suh, Won Hyuck; Son, Won Young [Korea University College of Medicine, Seoul (Korea, Republic of)


    The ultrasonography is safe, rapid, and very effective method for evaluation of soft tissue lesions, especially by using high frequency transducer. The authors analyzed ultrasonographic findings of 49 cases of the soft tissue lesions of extremities which were proven clinically and surgically and/or pathologically in Korea University Hospital for recent 5 years. The result were as follows: 1. Of the 49 cases, 27 cases were male and 22 cases female. 2. Infectious conditions were 22 case, benign tumor 6 cases, malignant tumor 6 cases, and miscellaneous 15 cases. 3. The accurate diagnosis of nature of the lesions was possible in all cases except tuberculous tendinitis of Achilles tendon in infectious conditions (21/22), except neurilemmoma in benign tumors (5/6), except soft tissue synovial sarcoma and liposarcoma in malignant tumors (4/6), and all cases of miscellaneous conditions (15/15) with clinical symptom and plain X-ray film. 4. By using high frequency transducer for extremity lesions, we obtained precise location, size , shape, and internal structure of the lesions and guide for aspiration and/or biopsy.

  20. Thallium-201 scintigraphy for bone and soft tissue tumors

    Tokuumi, Yuji; Tsuchiya, Hiroyuki; Sunayama, Chiaki; Matsuda, Eizo; Asada, Naohiro; Taki, Junichi; Sumiya, Hisashi; Miyauchi, Tsutomu; Tomita, Katsuro [Kanazawa Univ. (Japan). School of Medicine


    This study was undertaken to assess the usefulness of thallium-201 scintigraphy in bone and soft tissue tumors. Pre-therapy scintigraphy was undertaken in a total of 136 patients with histologically confirmed diagnosis, consisting of 74 with malignant bone and soft tissue tumors, 39 with benign ones, 12 with diseases analogous to tumors, and 11 others. Thallium activity was graded on a scale of 0-4: 0=background activity, 1=equivocal activity, 2=definitive activity, but less than myocardium, 3=definite activity equal to myocardium, and 4=activity greater than myocardium. In the group of malignant tumors, thallium-201 uptake was found in 80%, although it was low for chondrosarcoma (2/8) and malignant Schwannoma (one/3). The group of benign tumors, however, showed it in only 41%, being restricted to those with giant cell tumors, chondroblastoma, fibromatosis, and osteoid osteoma. Thallium-201 uptake was also found in all 8 patients with metastatic tumors. In 23 patients undergoing thallium imaging before and after chemotherapy, scintigraphic findings revealed a high correlation with histopathological findings. Thus, thallium-201 scintigraphy may be potentially used to distinguish malignant from benign bone and soft tissue tumors, except for a few histopathological cases, as well as to determine loco-regional metastases and response to chemotherapy. (N.K.).

  1. [Systemic therapy and hyperthermia for locally advanced soft tissue sarcoma].

    Lindner, L H; Angele, M; Dürr, H R; Rauch, J; Bruns, C


    Patients with high-risk soft tissue sarcomas (FNCLCC grades 2-3, > 5 cm and deep lying) are at a high risk of local recurrence or distant metastases despite optimal surgical tumor resection. Therefore, multimodal treatment should be considered for this difficult to treat patient group. Besides surgery, radiation therapy and chemotherapy, hyperthermia has become a valid, complementary treatment option within multimodal treatment concepts. Hyperthermia in this context means the selective heating of the tumor region to temperatures of 40-43 °C for 60 min by microwave radiation in addition to simultaneous chemotherapy or radiation therapy. A randomized phase III study demonstrated that the addition of hyperthermia to neoadjuvant chemotherapy improved tumor response and was associated with a minimal risk of early disease progression as compared to chemotherapy alone. The addition of hyperthermia to a multimodal treatment regimen for high-risk soft tissue sarcoma consisting of surgery, radiation therapy and chemotherapy, either in the neoadjuvant or adjuvant setting after incomplete or marginal tumor resection, significantly improved local progression-free and disease-free survival. Based on these results and due to the generally good tolerability of hyperthermia, this treatment method in combination with chemotherapy should be considered as a standard treatment option within multimodal treatment approaches for locally advanced high-risk soft tissue sarcoma.

  2. Enterobacter asburiae and Aeromonas hydrophila: soft tissue infection requiring debridement.

    Koth, Kevin; Boniface, James; Chance, Elisha A; Hanes, Marina C


    Enterobacter asburiae and Aeromonas hydrophila are gram-negative bacilli that have been isolated in soil and water. Enterobacter asburiae can cause an array of diseases, and exposure to A hydrophila can cause soft tissue infections, including necrotizing faciitis.A healthy-appearing 22-year-old man presented with an innocuous soft tissue injury to his leg due to an all-terrain vehicle crash. He received intravenous antibiotics and was discharged with prophylactic oral antibiotics. After the rapid onset of high fevers (102°F-103°F) <24 hours postinjury, he returned to the emergency department. Emergent surgical debridement was performed, and broad-spectrum intravenous antibiotics were started. Fevers persisted, and the patient underwent repeat extensive surgical debridement and antibiotic bead placement <30 hours after the initial surgical debridement and broad-spectrum antibiotics. Intraoperative cultures found E asburiae and A hydrophila in the wound. Following a long course of antibiotics and a skin graft, he fully recovered and had no functional deficits 1 year postoperatively.Extensive research revealed that these organisms are rare in soft tissue infections. E asburiae is opportunistic but has not been reported as a primary wound organism, and A hydrophila infections have been reported following motor vehicle crashes involving wound contamination. At presentation, it is challenging to determine rare organisms in a timely fashion; however, emergent extensive surgical intervention of an accelerated aberrant disease process should be considered to avoid catastrophic outcomes.

  3. Post-treatment complications of soft tissue tumours

    Shapeero, L.G. [Department of Radiology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 (United States); Bone and Soft Tissue Program, United States Military Cancer Institute, 6900 Georgia Ave, NW, Washington, DC 20307 (United States)], E-mail:; De Visschere, P.J.L.; Verstraete, K.L. [Department of Radiology and Magnetic Resonance/MR-1K12 IB, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Poffyn, B. [Department of Orthopaedic Surgery, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Forsyth, R. [Department of Pathology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Sys, G. [Department of Orthopaedic Surgery, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Uyttendaele, D. [Department of Radiology and Magnetic Resonance/MR-1K12 IB, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium)


    Purpose: To identify local and distant complications of patients with soft tissue tumours and evaluate their relationships to types of therapy. Methods and materials: Fifty-one patients (29 males and 22 females, ages 14-80 years) with 34 malignant and 17 benign soft tissue tumours were evaluated for local and distant complications after resection or amputation only (26 patients) or after the addition of radiotherapy (25 patients: 17 patients had external beam therapy, 7 patients had external beam therapy and brachytherapy, and one patient had extracorporeal irradiation and reimplantation). Duration of follow-up averaged 3.75 years for malignant tumours and 2.79 years for benign tumours. Follow-up studies included radiography, T1- and T2-weighted magnetic resonance (MR) imaging, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), computed tomography for thoracic and abdominal metastases, and 3-phase technetium-99m-labeled-methylene-diphosphonate scintigraphy for bone metastases. Results: Recurrent tumours were 2.2 times more frequent in patients who had undergone their initial resection at an outside hospital as compared with those first treated at the university hospital. Nine of 11 recurrences occurred after marginal surgery. Metastases from soft tissue sarcomas, most commonly to lung (nine patients) and to bone and muscle (five patients), showed no specific relationship to type of therapy. DCE-MRI differentiated rapidly enhancing soft tissue recurrences (11 patients) and residual tumours (6 patients) from slowly enhancing muscle inflammation, and non-enhancing fibrosis and seromas that usually did not enhance. Seromas developed in 76% of patients who had postoperative radiation therapy and in 7.7% of patients who had only surgery. Subcutaneous and cutaneous oedema and muscle inflammation was at least four times more frequent after adjunct radiotherapy than after resection alone. Irrespective of the type of treatment, inflammatory changes in muscle and

  4. Biofilm in group A streptococcal necrotizing soft tissue infections

    Siemens, Nikolai; Chakrakodi, Bhavya; Shambat, Srikanth Mairpady


    Necrotizing fasciitis caused by group A streptococcus (GAS) is a life-threatening, rapidly progressing infection. At present, biofilm is not recognized as a potential problem in GAS necrotizing soft tissue infections (NSTI), as it is typically linked to chronic infections or associated with foreign...... devices. Here, we present a case of a previously healthy male presenting with NSTI caused by GAS. The infection persisted over 24 days, and the surgeon documented the presence of a "thick layer biofilm" in the fascia. Subsequent analysis of NSTI patient tissue biopsies prospectively included...

  5. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module VIII. Soft Tissue Injuries.

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This instructor's lesson plan guide on soft tissue injuries is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Six units of study are presented: (1) anatomy and physiology of the skin; (2) patient assessment for soft-tissue injuries; (3) pathophysiology and management of soft tissue injuries;…

  6. Magnetic resonance imaging appearance of soft-tissue metastases: our experience at an orthopedic oncology center

    Sammon, Jennifer; Jain, Abhishek; Bleakney, Robert; Mohankumar, Rakesh [Mount Sinai Hospital and University of Toronto, Division of Musculoskeletal Imaging, Joint Department of Medical Imaging, Toronto, Ontario (Canada)


    To assess the prevalence and magnetic resonance imaging appearance of metastasis presenting as a soft-tissue mass. A retrospective chart review was performed on 51 patients who presented to an orthopedic oncology center with soft-tissue masses, with a histology-proven diagnosis of soft-tissue metastasis, over a 14-year period. Their magnetic resonance imaging, primary origin, and follow-up have been assessed. Soft-tissue metastasis was identified in patients ranging from 18 to 85 years old. Most (80%) of the masses were located deep to the deep fascia. In our cohort of patients, melanoma was the most common primary malignancy contributing to soft-tissue metastasis (21.8%). Among soft-tissue metastasis from solid organs, breast and lung were the most frequent (9.1% each). Five patients had soft-tissue metastases from an unknown primary. Imaging diagnosis of soft-tissue metastases is challenging as it can demonstrate imaging appearances similar to primary soft-tissue sarcoma. The presence of a known malignancy may not be evident in everyone, and even if available, histopathology will be necessary for diagnosis if this is the only site of recurrence/metastasis to differentiate from a primary soft-tissue sarcoma. Moreover, soft-tissue metastasis may be the initial presentation of a malignancy. Primary malignancies with soft-tissue metastasis carry a poor prognosis; hence, prompt diagnosis and management in essential. (orig.)

  7. Artery Soft-Tissue Modelling for Stent Implant Training System

    Giovanni Aloisio


    Full Text Available Virtual reality technology can be utilised to provide new systematic training methods for surgical procedures. Our aim is to build a simulator that allows medical students to practice the coronary stent implant procedure and avoids exposing patients to risks. The designed simulation system consists of a virtual environment and a haptic interface, in order to provide both the visualization of the coronary arteries and the tactile and force feedback generated during the interactions of the surgical instruments in the virtual environment. Since the arteries are soft tissues, their shape may change during an operation; for this reason physical modelling of the organs is necessary to render their behaviour under the influence of surgeon's instruments. The idea is to define a model that computes the displacement of the tissue versus time; from the displacement it is possible to calculate the response of the tissue to the surgical tool external stimuli. Information about tools displacements and tissue responses are also used to graphically model the artery wall and virtual surgical instrument deformations generated as a consequence of their coming into contact. In order to obtain a realistic simulation, the Finite Element Method has been used to model the soft tissues of the artery, using linear elasticity to reduce computational time and speed up interaction rates.

  8. Photothermal lesions in soft tissue induced by optical fiber microheaters.

    Pimentel-Domínguez, Reinher; Moreno-Álvarez, Paola; Hautefeuille, Mathieu; Chavarría, Anahí; Hernández-Cordero, Juan


    Photothermal therapy has shown to be a promising technique for local treatment of tumors. However, the main challenge for this technique is the availability of localized heat sources to minimize thermal damage in the surrounding healthy tissue. In this work, we demonstrate the use of optical fiber microheaters for inducing thermal lesions in soft tissue. The proposed devices incorporate carbon nanotubes or gold nanolayers on the tips of optical fibers for enhanced photothermal effects and heating of ex vivo biological tissues. We report preliminary results of small size photothermal lesions induced on mice liver tissues. The morphology of the resulting lesions shows that optical fiber microheaters may render useful for delivering highly localized heat for photothermal therapy.

  9. An augmented reality framework for soft tissue surgery.

    Mountney, Peter; Fallert, Johannes; Nicolau, Stephane; Soler, Luc; Mewes, Philip W


    Augmented reality for soft tissue laparoscopic surgery is a growing topic of interest in the medical community and has potential application in intra-operative planning and image guidance. Delivery of such systems to the operating room remains complex with theoretical challenges related to tissue deformation and the practical limitations of imaging equipment. Current research in this area generally only solves part of the registration pipeline or relies on fiducials, manual model alignment or assumes that tissue is static. This paper proposes a novel augmented reality framework for intra-operative planning: the approach co-registers pre-operative CT with stereo laparoscopic images using cone beam CT and fluoroscopy as bridging modalities. It does not require fiducials or manual alignment and compensates for tissue deformation from insufflation and respiration while allowing the laparoscope to be navigated. The paper's theoretical and practical contributions are validated using simulated, phantom, ex vivo, in vivo and non medical data.

  10. Evaluation of long-term soft tissue changes after bimaxillary orthognathic surgery in Class III patients.

    Aydemir, Halise; Efendiyeva, Ruchengiz; Karasu, Hakan; Toygar-Memikoğlu, Ufuk


    To assess soft tissues in the short and long term after bimaxillary surgery in Class III patients by comparing the hard tissue changes and results between time periods. Twenty-six Class III adult patients treated with bimaxillary surgery were included in the study. Cephalometric records were taken before surgery (T1) and 5 months (T2), 1.4 years (T3), 3 years (T4), and 5 years (T5) after surgery. There was no significant relapse in skeletal parameters. Overjet was significantly reduced between T4-T3 time intervals (P bimaxillary surgery patients in the first 3 years after surgery.

  11. Regional Analysis of Soft Tissue Thickness on Korean Buttocks and Application to Fasciocutaneous Flap Design

    Do Yup Kim


    Full Text Available Background Various shapes and designs of the gluteal artery perforator flap have been used for treating sacral pressure sores and reconstructing breasts. To establish the ideal fasciocutaneous flap design for use in the gluteal area, the soft tissue thickness distribution was measured. Methods Twenty-one buttocks of adult Korean cadavers were analyzed through rectangular subfascial dissection. Each buttock was divided horizontally into 10 sections and vertically into 10 sections, and then, the thickness at the corners of the sections was measured. For the sake of comparison and statistical verification with living bodies, computed tomography (CT images of 120 buttocks of patients were randomly selected. Five horizontal sections and 4 vertical sections were made, and the thickness at each corner was recorded. Results According to the dissection and the CT images, the area with the thinnest soft tissues in the buttock was around the posterior superior iliac spine, close to the sacral area. The thickest area was the superolateral area of the buttock, which was 3.24 times and 2.15 times thicker than the thinnest area in the studies on cadaver anatomy and the CT images, respectively. Conclusions The thickness of the soft tissues in the buttocks differed by area. The superolateral area had the thickest soft tissues, and the superomedial area had the thinnest. This study includes information on the distribution of the thickness of the gluteal soft tissues of Koreans. The outcome of this study may contribute to the design of effective local flaps for pressure sore reconstruction and free flaps for breast reconstruction.

  12. Development of stable peri-implant soft tissue and mentolabial sulcus depth with an implant-retained soft tissue conformer after osteocutaneous flap reconstruction.

    Dhima, Matilda; Rieck, Kevin L; Arce, Kevin; Salinas, Thomas J


    Excessive soft tissue bulk, movement, chronic inflammation, and hypertrophy in periimplant areas pose challenges for long-term management of peri-implant soft tissues surrounding osteocutaneous flap reconstructions. A case history report is presented on the predictable establishment of stable peri-implant soft tissue and improved mentolabial sulcus depth in a patient treated for high-grade osteosarcoma of the mandible. Following surgical resection, reconstruction with osteocutaneous fibula free flap, and endosseous implant placement, a combined surgical and prosthetic approach was used through a lip switch vestibuloplasty and an implant-retained soft tissue conformer.

  13. Navigation in endoscopic soft tissue surgery: perspectives and limitations.

    Baumhauer, Matthias; Feuerstein, Marco; Meinzer, Hans-Peter; Rassweiler, J


    Despite rapid developments in the research areas of medical imaging, medical image processing, and robotics, the use of computer assistance in surgical routine is still limited to diagnostics, surgical planning, and interventions on mostly rigid structures. In order to establish a computer-aided workflow from diagnosis to surgical treatment and follow-up, several proposals for computer-assisted soft tissue interventions have been made in recent years. By means of different pre- and intraoperative information sources, such as surgical planning, intraoperative imaging, and tracking devices, surgical navigation systems aim to support surgeons in localizing anatomical targets, observing critical structures, and sparing healthy tissue. Current research in particular addresses the problem of organ shift and tissue deformation, and obstacles in communication between navigation system and surgeon. In this paper, we review computer-assisted navigation systems for soft tissue surgery. We concentrate on approaches that can be applied in endoscopic thoracic and abdominal surgery, because endoscopic surgery has special needs for image guidance due to limitations in perception. Furthermore, this paper informs the reader about new trends and technologies in the area of computer-assisted surgery. Finally, a balancing of the key challenges and possible benefits of endoscopic navigation refines the perspectives of this increasingly important discipline of computer-aided medical procedures.

  14. 成人骨性Ⅲ类不同垂直骨面型软组织侧貌特征比较%Comparison of characteristics among facial soft tissue profile in adult skeleton class Ⅲ vertical facial skeletal types

    李娟; 丁寅; 叶艳艳; 惠雯婷; 黄曼


    目的 研究成人骨性Ⅲ类不同垂直骨面型软组织侧貌特征的差异,为临床诊断和治疗提供参考.方法 选择未治疗的成年骨性Ⅲ类男性患者60例,根据下颌平面角(SN-MP)分为高、中、低角3组,每组各20例,进行X线头颅侧位片的头影测量,进行单因素方差分析,比较各组间的差异性.结果 在成人骨性Ⅲ类不同垂直骨面型间,有10项指标具有统计学差异(P<0.05),且差异主要存在于高角组.与低角和均角组相比,高角组面下1/3的比例明显增大(Gl' - Sn/Sn-Me'、Sn-sto/sto-Me',P<0.01),面型凹陷程度加重(Gl'SnPog'、FH-N'Pog',P<0.05),上唇相对后缩(CotgSnLs、Sn-H line,P<0.01),下唇前突(Li-H line、Li-NsPog',P<0.05),颏唇沟变浅(Sm-H line、LiB'Pog',P<0.01).结论 成人骨性Ⅲ类患者不同垂直骨面型侧貌特征不同,在临床中要注意骨面型垂直向的差异,制定出更加合理的治疗方案.%Objective To study the differences of the facial soft tissue profile characteristics in adult skeleton class Ⅲ vertical facial skeletal types. Methods Sixty males patients with skeleton class Ⅲ malocclusion were selected. They were divided into three groups:low angle,medium angle,and high angle group based on their SN - MP angle with 20 ones in each group. The cephalometry was carried out by X ray skull lateral projection. One - factor analysis of variance was carried out, and the differences were compared among the groups. Results There were significant differences in 10 indexes among the adult skeleton class Ⅲ vertical facial skeletal types ( P<0. 05 ). And the main differences existed in the high angle group. The proportion of anterior lower 1/3 face in the high angle increased significantly compared with that in the low angle and the medium angle group( Gl'- Sn/Sn - Me', Sn - sto/sto - Me', P< 0.01 );its degree of the facial profile introcession increased significantly( Gl'SnPog', FH - NPog', P <0. 05 );the upper lip

  15. Multimodality Treatment in Adult Patients with High-risk Soft-tissue Sarcomas%成人高风险性软组织肉瘤的多形性治疗


    Objective: We enrolled retrospective data to determine the efficacy of combined chemotherapy and surgery for local tumour control and survival in patients with high-risk soft-tissue sarcomas. Methods: We collected data from 25 patients with high-risk soft-tissue sarcomas treated with four cycles of etoposide, ifosfamide and doxorubicin (EIA) followed by definitive surgery with or without postoperative radiotherapy and adjuvant chemotherapy. 21 patients received chemotherapy in a neoadjuvant/adjuvant clinical setting;eighteen of them completed adjuvant chemotherapy. Four patients received chemotherapy in an adjuvant setting only. Results: The objective response rate of neoadjuvant chemotherapy assessable in 21 patients was 43%. Including NED (n=7) and partial remissions (n=3), the radiographic response rate was 47.6% with additional 42.9% stable diseases (n=9). Surgery was performed in two patients before completing four neoadjuvant chemotherapy cycles because of disease progression. Median overall survival for all patients was 21.6+ months. After completion of chemotherapy, in 62% of patients R0-resection could be performed. Conclusion: High proportion of R0-resections supports the idea of tumour down-staging after neoadjuvant treatment. Response to neoadjuvant chemotherapy is predictive for improved local tumour control resulting in long-term survival benefit.

  16. Facial Soft Tissue Measurement in Microgravity-induces Fluid Shifts

    Marshburn, Thomas; Cole, Richard; Pavela, James; Garcia, Kathleen; Sargsyan, Ashot


    Fluid shifts are a well-known phenomenon in microgravity, and one result is facial edema. Objective measurement of tissue thickness in a standardized location could provide a correlate with the severity of the fluid shift. Previous studies of forehead tissue thickness (TTf) suggest that when exposed to environments that cause fluid shifts, including hypergravity, head-down tilt, and high-altitude/lowpressure, TTf changes in a consistent and measurable fashion. However, the technique in past studies is not well described or standardized. The International Space Station (ISS) houses an ultrasound (US) system capable of accurate sub-millimeter measurements of TTf. We undertook to measure TTf during long-duration space flight using a new accurate, repeatable and transferable technique. Methods: In-flight and post-flight B-mode ultrasound images of a single astronaut's facial soft tissues were obtained using a Vivid-q US system with a 12L-RS high-frequency linear array probe (General Electric, USA). Strictly mid-sagittal images were obtained involving the lower frontal bone, the nasofrontal angle, and the osseo-cartilaginous junction below. Single images were chosen for comparison that contained identical views of the bony landmarks and identical acoustical interface between the probe and skin. Using Gingko CADx DICOM viewing software, soft tissue thickness was measured at a right angle to the most prominent point of the inferior frontal bone to the epidermis. Four independent thickness measurements were made. Conclusions: Forehead tissue thickness measurement by ultrasound in microgravity is feasible, and our data suggest a decrease in tissue thickness upon return from microgravity environment, which is likely related to the cessation of fluid shifts. Further study is warranted to standardize the technique with regard to the individual variability of the local anatomy in this area.

  17. Presentation and outcomes of necrotizing soft tissue infections

    Chen KJ


    Full Text Available Kuan-Chin Jean Chen,1 Michelle Klingel,2 Shelley McLeod,3 Sean Mindra,4 Victor K Ng5 1Department of Emergency Medicine, Faculty of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, 2Division of Respiratory Medicine, Department of Pediatrics, Hospital for Sick Children, University of Toronto, 3Department of Family and Community Medicine, University of Toronto, Schwartz/Reisman Emergency Medicine Institute, Mount Sinai Hospital, Toronto, 4Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, 5Division of Emergency Medicine, Faculty of Medicine, London Health Sciences Centre, Western University, London, ON, Canada Background: Necrotizing soft tissue infections (NSTIs are aggressive infections associated with significant morbidity, including amputation and organ failure, and high mortality. The rapid progression and significant risk of morbidity and mortality associated with NSTIs makes quick diagnosis and treatment critical. The objective of this study was to determine the presentation of patients diagnosed with NSTIs and their in-hospital outcomes. Methods: This was a retrospective review of adult (>17 years patients with a discharge diagnosis of necrotizing fasciitis at London Health Sciences Centre (annual census 125,000 over a 5-year period (April 2008–March 2013. Results: Sixty patients with confirmed NSTI were included in this study. Common comorbidities at presentation included immunocompromise (58.3%, diabetes mellitus (41.7%, vascular disease (45.0%, and obesity (24.6%. Initial presentations included swelling (91.7%, erythema (86.7%, bullae (28.3%, petechiae (8.3%, and bruising (45.0%. Fifty (83.3% underwent surgery, with a median (interquartile range time from initial emergency department presentation to surgery of 15.5 hours (7.8, 74.9. In-hospital mortality among those who had surgical intervention was 14.0%, compared to 60.0% for patients who did not have surgery (Δ46.0%; 95% CI: 14.8% to 70




    Full Text Available Necrotizing Soft-Tissue Infections (NSTI are a dreaded form of infections of the layers within the soft tissue compartment (dermis, subcutaneous tissue, superficial fascia, deep fascia, or muscle that are associated with necrotizing changes and systemic toxicity. These spread rapidly and carry high mortality (16%-24%. These infections can present with trivial features like small ulcers or mild cellulitis. Gram staining is important for empirical treatment and specific treatment starts after culture and sensitivity of the toxic fluid according to the organisms isolated. Even after the advancements of antibiotics, adequate surgical debridement remains the mainstay in limiting the spread of the infection. Novel therapeutic management like hyperbaric oxygen, Intravenous immunoglobulin have been developed but with limited success. Various prognostic scoring systems are present to predict the morbidity and mortality associated with these infections which help to identify high-risk patients who may benefit from the new therapeutic strategies. Care for patients with NSTIs requires an approach with expertise from critical care, surgery, reconstructive surgery, and rehabilitation specialists.

  19. Role of trabectedin in the treatment of soft tissue sarcoma

    Alexandre Christinat


    Full Text Available Alexandre Christinat, Serge LeyvrazCentre Pluridisciplinaire d’Oncologie, University Hospital, Lausanne, SwitzerlandAbstract: Interest in marine natural products has allowed the discovery of new drugs and trabectedin (ET-743, Yondelis, derived from the marine tunicate Ecteinascidia turbinata, was approved for clinical use in 2007. It binds to the DNA minor groove leading to interferences with the intracellular transcription pathways and DNA-repair proteins. In vitro antitumor activity was demonstrated against various cancer cell lines and soft tissue sarcoma cell lines. In phase I studies tumor responses were observed also in osteosarcomas and different soft tissue sarcoma subtypes. The most common toxicities were myelosuppression and transient elevation of liver function tests, which could be reduced by dexamethasone premedication. The efficacy of trabectedin was established in three phase II studies where it was administered at 1.5 mg/m2 as a 24 h intravenous infusion repeated every three weeks, in previously treated patients. The objective response rate was 3.7%–8.3% and the tumor control rate (which included complete response, partial response and stable disease was obtained in half of patients for a median overall survival reaching 12 months. In nonpretreated patients the overall response rate was 17%. Twenty-four percent of patients were without progression at six months. The median overall survival was almost 16 months with 72% surviving at one year. Predictive factors of response are being explored to identify patients who are most likely to respond to trabectedin. Combination with other agents are currently studied with promising results. In summary trabectedin is an active new chemotherapeutic agents that has demonstrated its role in the armamentarium of treatments for patients with sarcomas.Keywords: soft tissue sarcoma, trabectedin, chemotherapy, DNA-minor groove binder

  20. The soft-tissue manifestations of neurofibromatosis type 1

    Hillier, J.C. [Department of Clinical Radiology, Chelsea and Westminster Hospital, London (United Kingdom)]. E-mail:; Moskovic, E. [Department of Clinical Radiology, Royal Mardsen Hospital, London (United Kingdom)


    The radiological appearances of neurofibromatosis type 1 (NF-1) are numerous and variable, because of the widespread presence of peripheral nerves. Knowledge of this variability can prevent unnecessary intervention. For example, occasionally lesions can be misinterpreted and biopsies performed unnecessarily. Thus, familiarity with the manifestations of this disease and the spectrum of associated abnormalities is an important part of the radiologist's armamentarium. This paper explores the manifold radiological appearances of extracranial NF-1 as experienced by the Sarcoma and Soft Tissue Tumour Unit at the Royal Marsden Hospital.

  1. Immunoglobulin G for patients with necrotising soft tissue infection (INSTINCT)

    Madsen, Martin B; Hjortrup, Peter B; Hansen, Marco B


    PURPOSE: The aim of the INSTINCT trial was to assess the effect of intravenous polyspecific immunoglobulin G (IVIG) compared with placebo on self-reported physical function in intensive care unit (ICU) patients with necrotising soft tissue infection (NSTI). METHODS: We randomised 100 patients...... with NSTI 1:1 to masked infusion of 25 g of IVIG (Privigen, CSL Behring) or an equal volume of 0.9% saline once daily for the first 3 days of ICU admission. The primary outcome was the physical component summary (PCS) score of the 36-item short form health survey (SF-36) 6 months after randomisation...

  2. Unexpected complication associated with balneotherapy: Skin and soft tissue infection

    Alım, Bülent; Bostancı, Fahrettin; Servi, M. Alperen; Ćetinel, Sinan; Bingöl, M. Ozan


    Balneotherapy cure is an ongoing process, but patients can benefit most when cure is complete. For these reason, patients should be closely monitored and necessary precautions should be taken in terms of the complications that may occur in order to prevent the interruption or discontinuation of balneotherapy. Here, we wanted to represent a case that developed left leg soft tissue infection during the application of balneotherapy and because of this reason we stopped the balneotherapy As a result, when balneotherapy is planned for patients with risk factors such as diabetes and obesity, frequent examination of the skin and the application of skin moisturizers will be beneficial to prevent itching and skin dryness.

  3. Genetic heterogeneity in leiomyomas of deep soft tissue.

    Panagopoulos, Ioannis; Gorunova, Ludmila; Brunetti, Marta; Agostini, Antonio; Andersen, Hege Kilen; Lobmaier, Ingvild; Bjerkehagen, Bodil; Heim, Sverre


    Leiomyoma of deep soft tissue is a rare type of benign smooth muscle tumor that mostly occurs in the retroperitoneum or abdominal cavity of women, and about which very little genetic information exists. In the present study, eight leiomyomas of deep soft tissue were genetically analyzed. G-banding showed that three tumors carried rearrangements of the long arm of chromosome 12, three others had 8q rearrangements, the 7th tumor had deletion of the long arm of chromosome 7, del(7)(q22), and the 8th had aberrations of chromosome bands 3q21~23 and 11q21~22. The target genes of the 12q and 8q aberrations were HMGA2 and PLAG1, respectively. In the leiomyomas with 12q rearrangements, both HMGA2 and PLAG1 were expressed whereas in the tumors with 8q aberrations, only PLAG1 was expressed. In the cases without 12q or 8q aberrations, the expression of HMGA2 was very low and PLAG1 was expressed only in the case with del(7)(q22). All eight leiomyomas of deep soft tissue expressed MED12 but none of them had mutation in exon 2 of that gene. In two tumors with 12q rearrangements, RPSAP52 on 12q14.3 was fused with non-coding RNA (accession number XR_944195) from 14q32.2 or ZFP36L1 from14q24.1. In a tumor with inv(12), exon 3 of HMGA2 was fused to a sequence in intron 1 of the CRADD gene from 12q22. The present data together with those of our two previous studies in which the fusions KAT6B-KANSL1 and EWSR1-PBX3 were described in two retroperitoneal leiomyomas carrying a t(10;17)(q22;q21) and a t(9;22)(q33;q12) translocation, respectively, show that leiomyomas of deep soft tissue are genetically heterogenous but have marked similarities to uterine leiomyomas.

  4. Denoised and texture enhanced MVCT to improve soft tissue conspicuity

    Sheng, Ke, E-mail:; Qi, Sharon X. [Department of Radiation Oncology, University of California, Los Angeles, California 90095 (United States); Gou, Shuiping [Department of Radiation Oncology, University of California, Los Angeles, California 90095 and Xidian University, Xi’An 710071 (China); Wu, Jiaolong [Xidian University, Xi’An 710071 (China)


    Purpose: MVCT images have been used in TomoTherapy treatment to align patients based on bony anatomies but its usefulness for soft tissue registration, delineation, and adaptive radiation therapy is limited due to insignificant photoelectric interaction components and the presence of noise resulting from low detector quantum efficiency of megavoltage x-rays. Algebraic reconstruction with sparsity regularizers as well as local denoising methods has not significantly improved the soft tissue conspicuity. The authors aim to utilize a nonlocal means denoising method and texture enhancement to recover the soft tissue information in MVCT (DeTECT). Methods: A block matching 3D (BM3D) algorithm was adapted to reduce the noise while keeping the texture information of the MVCT images. Following imaging denoising, a saliency map was created to further enhance visual conspicuity of low contrast structures. In this study, BM3D and saliency maps were applied to MVCT images of a CT imaging quality phantom, a head and neck, and four prostate patients. Following these steps, the contrast-to-noise ratios (CNRs) were quantified. Results: By applying BM3D denoising and saliency map, postprocessed MVCT images show remarkable improvements in imaging contrast without compromising resolution. For the head and neck patient, the difficult-to-see lymph nodes and vein in the carotid space in the original MVCT image became conspicuous in DeTECT. For the prostate patients, the ambiguous boundary between the bladder and the prostate in the original MVCT was clarified. The CNRs of phantom low contrast inserts were improved from 1.48 and 3.8 to 13.67 and 16.17, respectively. The CNRs of two regions-of-interest were improved from 1.5 and 3.17 to 3.14 and 15.76, respectively, for the head and neck patient. DeTECT also increased the CNR of prostate from 0.13 to 1.46 for the four prostate patients. The results are substantially better than a local denoising method using anisotropic diffusion

  5. Imaging of Soft Tissue Lesions of the Foot and Ankle

    Seyed Hassan Mostafavi


    Full Text Available Differential diagnosis of soft tissue lesions of the foot may be narrowed with imaging. The cystic nature of ganglia, synovial cysts, and bursitis can be confirmed with MR imaging or sonography. Location and signal characteristics of noncystic lesions may suggest Morton's neuroma, giant cell tumor of the tendon sheath and plantar fibromatosis. Synovial-based lesions of the foot and ankle can be differentiated based on presence or absence of mineralization, lesion density, signal intensity, and the enhancement pattern. Knowledge of the incidence of specific neoplasms of the foot and ankle based on patient age aids in providing a limited differential diagnosis

  6. Wavelength dependence of soft tissue ablation by using pulsed lasers

    Xianzeng Zhang; Shusen Xie; Qing Ye; Zhenlin Zhan


    Pulsed laser ablation of soft biological tissue was studied at 10.6-, 2.94-, and 2.08-μm wavelengths. The ablation effects were assessed by means of optical microscope, the ablation crater depths were measured with reading microscope. It was shown that Er:YAG laser produced the highest quality ablation with clear,sharp cuts following closely the patial contour of the incident beam and the lowest fluence threshold. The pulsed CO2 laser presented the moderate quality ablation with the highest ablation efficiency. The craters drilled with Ho:YAG laser were generally larger than the incident laser beam spot, irregular in shape, and clearly dependent on the local morphology of biotissue. The blation characteristics, including fluence threshold and ablation efficiency, varied substantially with wavelength. It is not evident that water is the only dominant chromophore in tissue.

  7. MRI evaluation of superficial soft tissue lesions in children

    Jabra, A.A. (Russel H. Morgan Dept. of Radiology and Radiological Sciences, Johns Hopkins Medical Institutions, Baltimore, MD (United States)); Taylor, G.A. (Russel H. Morgan Dept. of Radiology and Radiological Sciences, Johns Hopkins Medical Institutions, Baltimore, MD (United States))


    The role of MRI in the evaluation of superficial soft tissue lesions in children has not been well established. We present our experience with MRI in the evaluation of nineteen children with a variety of cutaneous and subcutaneous lesions. We find MRI to have a definite role in the evaluation of these lesions particularly when determining extent or depth of involvement would affect medical or surgical management. MRI has a less well defined role in tissue determination. Spin echo T1 and T2 weighted images were sufficient for evaluation in most cases. Fat suppression images added additional information in fatty tumors. The MRI appearance of juvenile hyaline fibromatosis and lipoblastomatosis has not been previously described and is included in this study. (orig.)

  8. Computational model of soft tissues in the human upper airway.

    Pelteret, J-P V; Reddy, B D


    This paper presents a three-dimensional finite element model of the tongue and surrounding soft tissues with potential application to the study of sleep apnoea and of linguistics and speech therapy. The anatomical data was obtained from the Visible Human Project, and the underlying histological data was also extracted and incorporated into the model. Hyperelastic constitutive models were used to describe the material behaviour, and material incompressibility was accounted for. An active Hill three-element muscle model was used to represent the muscular tissue of the tongue. The neural stimulus for each muscle group was determined through the use of a genetic algorithm-based neural control model. The fundamental behaviour of the tongue under gravitational and breathing-induced loading is investigated. It is demonstrated that, when a time-dependent loading is applied to the tongue, the neural model is able to control the position of the tongue and produce a physiologically realistic response for the genioglossus.

  9. Imaging of the most frequent superficial soft-tissue sarcomas

    Morel, Melanie; Taieb, Sophie; Ceugnart, Luc [Centre Oscar Lambret, Department of Radiology, Lille (France); Penel, Nicolas [Centre Oscar Lambret, Department of Oncology, Lille (France); Mortier, Laurent [Centre Hospitalier Universitaire de Lille, Department of Dermatology, Hopital Claude Huriez, Lille (France); Vanseymortier, Luc [Centre Oscar Lambret, Department of Surgery, Lille (France); Robin, Y.M. [Centre Oscar Lambret, Departement of Pathology, Lille (France); Gosset, Pierre [Groupement Hospitalier de l' Institut Catholique-Faculte Libre de Medecine de Lille, Department of Pathology, Hopital Saint-Philibert, Lomme (France); Cotten, Anne [Centre Hospitalier Universitaire de Lille, Department of Musculoskeletal Radiology, Centre Hopital Roger Salengro, Lille (France)


    Superficial soft-tissue sarcomas are malignant mesenchymal tumors located within the cutaneous and/or subcutaneous layers. Most superficial soft-tissue sarcomas are low-grade tumors; yet, the risk of local recurrence is high, and initial wide surgery is the main prognostic factor. Some of these superficial sarcomas may grow, following an infiltrative pattern, and their real extent may be underestimated clinically. Imaging techniques are useful to determine precisely the real margins of the tumor, especially in cases of clinically doubtful or recurrent or large superficial lesions. Imaging tools enable one to determine the relationship with the superficial fascia separating the subcutaneous layer from the underlying muscle. In our institution ultrasonographic examination is followed by magnetic resonance (MR) imaging when the size of the lesion exceeds 3-5 cm. Imaging assessment is performed prior to biopsy, enabling optimal surgical management. Imaging features of the main superficial sarcomas are detailed in the following article, according to their major locations: those arising in the epidermis and/or dermis, which are most often diagnosed by dermatologists, and the subcutaneous sarcomas. (orig.)

  10. Soft tissue strain measurement using an optical method

    Toh, Siew Lok; Tay, Cho Jui; Goh, Cho Hong James


    Digital image correlation (DIC) is a non-contact optical technique that allows the full-field estimation of strains on a surface under an applied deformation. In this project, the application of an optimized DIC technique is applied, which can achieve efficiency and accuracy in the measurement of two-dimensional deformation fields in soft tissue. This technique relies on matching the random patterns recorded in images to directly obtain surface displacements and to get displacement gradients from which the strain field can be determined. Digital image correlation is a well developed technique that has numerous and varied engineering applications, including the application in soft and hard tissue biomechanics. Chicken drumstick ligaments were harvested and used during the experiments. The surface of the ligament was speckled with black paint to allow for correlation to be done. Results show that the stress-strain curve exhibits a bi-linear behavior i.e. a "toe region" and a "linear elastic region". The Young's modulus obtained for the toe region is about 92 MPa and the modulus for the linear elastic region is about 230 MPa. The results are within the values for mammalian anterior cruciate ligaments of 150-300 MPa.

  11. Soft tissue cephalometric norms in Iranian normal subjects

    Hossein Aghili


    Full Text Available Soft tissue analysis has been proposed by many authors as a reliable guide in treatment planning. Thus establishing population norms is an important issue in orthodontic treatment. The aim of this study was to determine the mean values of some of the soft tissue facial traits in Iranian subjecsts as determined by Bergman. Lateral cephalograms of 120 Iranian subjects (60 males and 60 females in five age groups (n= 24 with well balanced face and normal occlusion were used.statistical analyses were done by means of unpaired student’s t-test and one way AOVA. The associations of variables with age and also with each other were assessed using Pearson’s correlation coefficient. The norms valuesfor Iranian subjects differ from those of Bergman in upper and lower lip thicknesses, facial profile angle and upper lip length (in males.sexual dimorphism was determined in lower facial height, upper lip length, upper lip thickness and lower lip thickness. All of the variables were significantly correlated with age except for facial profile angle. Iranian norms differ from those of other population which are usually used. Therefore, when planning a treatment for this population their own norms should be employed

  12. Cytogenetics and Molecular Genetics of Myxoid Soft-Tissue Sarcomas

    Jun Nishio


    Full Text Available Myxoid soft-tissue sarcomas represent a heterogeneous group of mesenchymal tumors characterized by a predominantly myxoid matrix, including myxoid liposarcoma (MLS, low-grade fibromyxoid sarcoma (LGFMS, extraskeletal myxoid chondrosarcoma (EMC, myxofibrosarcoma, myxoinflammatory fibroblastic sarcoma (MIFS, and myxoid dermatofibrosarcoma protuberans (DFSP. Cytogenetic and molecular genetic analyses have shown that many of these sarcomas are characterized by recurrent chromosomal translocations resulting in highly specific fusion genes (e.g., FUS-DDIT3 in MLS, FUS-CREB3L2 in LGFMS, EWSR1-NR4A3 in EMC, and COL1A1-PDGFB in myxoid DFSP. Moreover, recent molecular analysis has demonstrated a translocation t(1; 10(p22; q24 resulting in transcriptional upregulation of FGF8 and NPM3 in MIFS. Most recently, the presence of TGFBR3 and MGEA5 rearrangements has been identified in a subset of MIFS. These genetic alterations can be utilized as an adjunct in diagnostically challenging cases. In contrast, most myxofibrosarcomas have complex karyotypes lacking specific genetic alterations. This paper focuses on the cytogenetic and molecular genetic findings of myxoid soft-tissue sarcomas as well as their clinicopathological characteristics.

  13. First cosmic-ray images of bone and soft tissue

    Mrdja, Dusan; Bikit, Istvan; Bikit, Kristina; Slivka, Jaroslav; Hansman, Jan; Oláh, László; Varga, Dezső


    More than 120 years after Roentgen's first X-ray image, the first cosmic-ray muon images of bone and soft tissue are created. The pictures, shown in the present paper, represent the first radiographies of structures of organic origin ever recorded by cosmic rays. This result is achieved by a uniquely designed, simple and versatile cosmic-ray muon-imaging system, which consists of four plastic scintillation detectors and a muon tracker. This system does not use scattering or absorption of muons in order to deduct image information, but takes advantage of the production rate of secondaries in the target materials, detected in coincidence with muons. The 2D image slices of cow femur bone are obtained at several depths along the bone axis, together with the corresponding 3D image. Real organic soft tissue, polymethyl methacrylate and water, never seen before by any other muon imaging techniques, are also registered in the images. Thus, similar imaging systems, placed around structures of organic or inorganic origin, can be used for tomographic imaging using only the omnipresent cosmic radiation.

  14. Massive osteoradionecrosis of facial bones and soft tissues.

    Benlier, E; Alicioglu, B; Kocak, Z; Yurdakul-Sikar, E; Top, H


    Osteoradionecrosis (ORN) is one of the most serious and uncommon complications in head and neck irradiation for cancer. It is defined as a combination of necrotic soft tissue and bone not being able to heal spontaneously, it demonstrates a general resistance to antibiotics and requires conservative surgical management. Even with modern radiation therapy, its incidence is highly unpredictable and varies between 4-30%. We report on a patient with a huge open cavitation in the cheek, communicating with the mouth and extending to contralateral periodontal gingival and temporal fossa. He had been treated with radiation therapy for nasopharyngeal cancer 5 years ago and presented with restriction of the opening of the mouth. Osteonecrosis complicated with osteomyelitis was evident in bilateral mandible and maxillary bones and the temporal bone. The ramus of the mandible and zygomatic arc were resected, subtotal maxillectomy was performed and the defect was repaired by a free double island flap from the scapular and parascapular osteocutaneous latissimus dorsi muscle flap supplied by subscapular artery. To our knowledge, this is the most extensive bone and soft tissue destruction due to radiation reported in the literature.

  15. Effects of energy drinks on soft tissue healing.

    Tek, Mustafa; Toptas, Orcun; Akkas, Ismail; Kazancioglu, Hakki Oguz; Firat, Tulin; Ezirganli, Seref; Ozan, Fatih


    The aim of the present study was to investigate the effects of an energy drink (ED) on soft tissue wound healing in the rat model. Thirty-six male Wistar albino rats were randomly divided into 2 groups. A full-thickness paravertebral linear incision wound model was created. The experimental group (EG) received an ED (Red Bull), and the control group (CG) received water. Red Bull (3.57 mL/kg/d) was administered to the rats by the oral gavage method on the day before the skin incision and continued for 14 days. The rats were sacrificed (n = 6 in each group) on the 3rd, 7th, and 14th day of the study. Sections were obtained from excised linear wound healing site and stained with hematoxylin-eosin and Masson trichrome for morphological analysis. To assess angiogenesis on the sections, immunohistochemical studies were carried out using vascular endothelial growth factor antibody and alpha smooth muscle actin Ab-1. The breaking strength of the wound healing site was measured in Newtons using a tensiometer. Morphological analysis showed that collagen deposition in the wound areas was statistically higher in the EG compared with that of the CG at both the third and seventh days (P soft tissue wound healing and that its effect may be due to increased collagen deposition, re-epithelialization, and new blood vessel formation in the wound.

  16. Unusual case of Hodgkin lymphoma presenting as soft tissue mass with intracranial metastasis and review of literature

    Vandana Singh Kushwaha


    Full Text Available Hodgkin lymphoma (HL primarily presents as nodal disease and may involve extranodal sites during the progression of the disease. Extra nodal involvement of lung, gastrointestinal tract, testis and thyroid etc., is well-recognized in non-HL but clinically detectable soft tissue involvement is rare and quite exceptional with HL. We report here an unusual case of a young adult male, who presented with a frontal soft tissue mass associated with cervical lymph node. Histopathology supplemented with immunohistochemistry revealed classical HL. Patient did not respond to treatment adequately, and he developed intracranial metastasis during the course of treatment.

  17. [An observation on the histological structure of Oncomelania hupensis soft tissue by agar-paraffin double-embedding method].

    Tan, Ping; Zhang, Jie; Li, Qing; Yu, Zhi-jun


    In order to study the histological structure of Oncomelania hupensis soft tissue, the fixed soft tissues of O. hupensis were pre-embedded in the agar and made blocks, then dehydrated, transparentized, immersed in paraffin, sectioned, and stained with haematoxylin-eosin (HE). Permanent slides of O. hupensis soft tissue were obtained. The histological structure of soft tissues was clear under the microscope.

  18. Giant cell tumor of soft tissue: a case report with emphasis on MR imaging

    Lee, Moon Young; Jee, Won-Hee [The Catholic University of Korea, Department of Radiology, Seoul St. Mary' s Hospital, School of Medicine, Seocho-gu, Seoul (Korea, Republic of); Jung, Chan Kwon [The Catholic University of Korea, Department of Pathology, Seoul St. Mary' s Hospital, College of Medicine, Seocho-gu, Seoul (Korea, Republic of); Yoo, Ie Ryung [The Catholic University of Korea, Department of Nuclear Medicine, Seoul St. Mary' s Hospital, College of Medicine, Seocho-gu, Seoul (Korea, Republic of); Chung, Yang-Guk [The Catholic University of Korea, Department of Orthopedic Surgery, Seoul St. Mary' s Hospital, College of Medicine, Seocho-gu, Seoul (Korea, Republic of)


    Giant cell tumor of soft tissue is a rare neoplasm, histologically resembling giant cell tumor of bone. In this report, we describe a deep and solid giant cell tumor of soft tissue interpreted as a benign soft tissue tumor based on magnetic resonance (MR) findings with hypointense to intermediate signals on T2-weighted images and impeded diffusivity (water movement) on diffusion-weighted imaging (DWI), which could suggest a giant-cell-containing benign soft tissue tumor, despite the malignancy suggested by {sup 18}F-fluorodeoxyglucose positron emission tomography-computed tomography in a 35-year-old male. To our knowledge, this report introduces the first deep, solid giant cell tumor of soft tissue with MR features of a giant-cell-containing benign soft tissue tumor, despite the malignancy-mimicking findings on {sup 18}F-FDG PET-CT. (orig.)

  19. X-Ray Scatter Correction on Soft Tissue Images for Portable Cone Beam CT

    Sorapong Aootaphao; Saowapak S. Thongvigitmanee; Jartuwat Rajruangrabin; Chalinee Thanasupsombat; Tanapon Srivongsa; Pairash Thajchayapong


    Soft tissue images from portable cone beam computed tomography (CBCT) scanners can be used for diagnosis and detection of tumor, cancer, intracerebral hemorrhage, and so forth. Due to large field of view, X-ray scattering which is the main cause of artifacts degrades image quality, such as cupping artifacts, CT number inaccuracy, and low contrast, especially on soft tissue images. In this work, we propose the X-ray scatter correction method for improving soft tissue images. The X-ray scatter ...

  20. Suction based mechanical characterization of superficial facial soft tissues.

    Weickenmeier, J; Jabareen, M; Mazza, E


    The present study is aimed at a combined experimental and numerical investigation of the mechanical response of superficial facial tissues. Suction based experiments provide the location, time, and history dependent behavior of skin and SMAS (superficial musculoaponeurotic system) by means of Cutometer and Aspiration measurements. The suction method is particularly suitable for in vivo, multi-axial testing of soft biological tissue including a high repeatability in subsequent tests. The campaign comprises three measurement sites in the face, i.e. jaw, parotid, and forehead, using two different loading profiles (instantaneous loading and a linearly increasing and decreasing loading curve), multiple loading magnitudes, and cyclic loading cases to quantify history dependent behavior. In an inverse finite element analysis based on anatomically detailed models an optimized set of material parameters for the implementation of an elastic-viscoplastic material model was determined, yielding an initial shear modulus of 2.32kPa for skin and 0.05kPa for SMAS, respectively. Apex displacements at maximum instantaneous and linear loading showed significant location specificity with variations of up to 18% with respect to the facial average response while observing variations in repeated measurements in the same location of less than 12%. In summary, the proposed parameter sets for skin and SMAS are shown to provide remarkable agreement between the experimentally observed and numerically predicted tissue response under all loading conditions considered in the present study, including cyclic tests.

  1. Fine needle aspiration (FNA) of soft tissue tumours (STT).

    Hirachand, S; Lakhey, M; Singha, A K; Devkota, S; Akhter, J


    The cytological findings of 50 ST Ts were evaluated aiming to determine the role of FNA in diagnosis of STTs Fifty patients with soft tissue tumours underwent FNA in the preoperative investigation during a one year period. The smears were stained with Papanicolaou and May-Graunvald Giemsa stains. Forty-four cases were reported as benign, whereas 2 were malignant. Four cases revealed insufficient material. The malignant STTs were small round cell tumour and malignant spindle cell tumour. Cytological and histological correlation could be achieved in 40 cases. The overall sensitivity and specificity were 25% and 100% respectively with overall accuracy of 80%. A reliable diagnosis of STTs can be made with FNA when supported by other clinical and other diagnostic data.

  2. Advances and controversies in the management of soft tissue sarcomas.

    Demetri, George D; Blay, Jean-Yves; Casali, Paolo G


    Intensive clinical research in the sarcoma field has provided insight into the histopathological diversity of soft tissue sarcomas (STS) and led to the introduction of many new agents that promise to play an important role in the management of patients with STS. While an increasing body of scientific data has advanced our knowledge of this complex family of mesenchymal diseases, several controversies remain to be resolved: Is doxorubicin-based therapy still the definitive standard first-line treatment for all patients with unresectable and/or metastatic STS of all subtypes? Is histology-driven therapy beyond gastrointestinal stromal tumors a reality or are we pursuing an unachievable objective? Are we making practical headway in the establishment of sarcoma reference centers? Is it clearly established which is the best parameter to evaluate the efficacy of a new agent in STS?

  3. Chondromyxoid fibroma of the acromium with soft tissue extension

    Macdonald, D. [Departments of Anatomic and Clinical Pathology, Sunnybrook and Women' s College Health Sciences Centre, Orthopedic and Arthritic Institute, Toronto, Ontario (Canada); University of Toronto, Toronto, Ontario (Canada); Fornasier, V. [Department of Anatomical Pathology and Cytology, St. Michael' s Hospital, Wellesley-Central Site, Toronto, Ontario (Canada); Holtby, R. [Department of Surgery, Sunnybrook and Women' s College Health Sciences Centre, Orthopedic and Arthritic Institute, Toronto, Ontario (Canada)


    Chondromyxoid fibroma is an unusual, benign tumor of cartilaginous origin and represents less than 1% of all primary bone tumors. It usually involves the long bones around the knee joint or the flat bones of the pelvis or ribs. Soft tissue extension is also thought to be rare in these lesions. They are usually eccentrically located in the metaphyses of the long bones and centrally in the flat bones. The radiographic appearances are characteristically those of a single, lytic lesion with lobulated margins, septations, cortical expansion and a sclerotic rim. Histologically, they display a lobulated pattern with spindle-shaped cells lying within a myxoid matrix with areas of hyaline cartilage. The differential diagnosis includes giant cell tumor, chondroblastoma or enchondroma as well as chondrosarcoma. The rarity of these lesions may render the diagnosis difficult to make, especially when the lesion involves an unusual site such as the acromium. (orig.)

  4. Evaluation of immediate soft tissue changes after rapid maxillary expansion

    Ki Beom Kim


    Full Text Available OBJECTIVE: To evaluate immediate soft tissue changes following rapid maxillary expansion (RME in growing patients, using cone beam computed tomography (CBCT. METHODS: Twenty-three consecutive patients (10 male, 13 female treated by RME were selected. Patients were scanned using CBCT prior to placement of the rapid maxillary expander (T0, then immediately following full activation of the appliance (T1. Defined landmarks were then located on the pre- and post-treatment orientated images. Change in landmark position from pre- to post-treatment was then measured. In addition to landmarks, 10 direct measures were made to determine distance change without regard to direction to measure soft tissue change of the lips. RESULTS: Significant transverse expansion was measured on most soft tissue landmark locations. All the measures made showed significant change in the lip position with a lengthening of the vertical dimension of the upper lip, and a generalized decrease of anterior-posterior thickness of both the upper and lower lips. CONCLUSIONS: Significant changes in the soft tissue do occur with RME treatment. There is a transverse widening of the midface, and a thinning of the lips.OBJETIVO: avaliar as mudanças imediatas no tecido mole após a expansão rápida da maxila (ERM em pacientes em fase de crescimento, usando tomografia computadorizada de feixe cônico (TCFC. MÉTODOS: vinte e três pacientes (10 do sexo masculino e 13 do feminino tratados com ERM foram selecionados. Os pacientes foram escaneados por TCFC antes da implantação do expansor maxilar (T0 e imediatamente após a completa ativação do aparelho (T1. Pontos cefalométricos definidos foram localizados nas imagens pré- e pós-tratamento. As mudanças de posição desses pontos do pré- para o pós-tratamento foram, então, analisadas. Adicionalmente aos pontos, 10 medições diretas foram realizadas para determinar a mudança nas distâncias - independentemente da direção - nos

  5. Soft tissue changes after a mandibular osteotomy for symmetric skeletal class III malocclusion.

    Ohba, Seigo; Kohara, Haruka; Koga, Takamitsu; Kawasaki, Takako; Miura, Kei-Ichirou; Yoshida, Noriaki; Asahina, Izumi


    The soft tissue profile is crucial to esthetics after orthognathic surgery. The aim of this study was to assess the soft tissue changes of the subnasal and submental regions more than 1 year after a sagittal split ramus osteotomy (SSRO) in patients with skeletal class III malocclusion. A total of 22 patients with mandibular prognathism were included in this study. Patients had lateral cephalograms before and more than 1 year after they underwent an isolated SSRO. Soft and hard tissue changes were assessed using the lateral cephalograms. The lower lip, labiomenton, and soft tissue menton moved posteriorly by 85, 89, and 88% compared with the corresponding hard tissue, and the movement of the soft tissue B point and the top of the chin nearly reflected the displacement of the hard tissues, at 96 and 99%, respectively. The labiomenton, stomions, and naso-labial angles were changed after the mandibular set-back and the changes in these angles correlated with either the width of the soft tissue or skeletal displacement. The naso-labial angle could be altered even if an isolated mandibular osteotomy is performed. Changes to the stomions and naso-labial angles were affected by hard tissue movement, while changes to the labiomental angle were affected by the width of the soft tissue after the mandibular osteotomy. It is important to create an accurate preoperative prediction of the esthetic outcomes after a mandibular osteotomy by considering the interrelations between the hard and soft tissues.

  6. Modelling soft tissue for kinematic analysis of multi-segment human body models.

    Benham, M P; Wright, D K; Bibb, R


    Traditionally biomechanical models represent the musculoskeletal system by a series of rigid links connected by rigidly defined rotational joints. More recently though the mechanics of joints and the action of soft tissues has come under closer scrutiny: biomechanical models might now include a full range of physiological structures. However, soft tissue representation, within multi-segment human body models, presents significant problems; not least in computational speed. We present a method for representing soft tissue physiology which provides for soft tissue wrapping around multiple bony objects; while showing forces at the insertion points, as well as normal reactions due to contact between the soft and bony tissues. These soft tissue representations may therefore be used to constrain the joint, as ligaments would, or to generate motion, like a muscle, so that joints may be modelled which more accurately simulate musculoskeletal motion in all degrees of freedom--rotational and translational. This method produces soft tissues that do not need to be tied to a certain path or route between the bony structures, but may move with the motion of the model; demonstrating a more realistic analysis of soft tissue activity in the musculoskeletal system. The combination of solid geometry models of the skeletal structure, and these novel soft tissue representations, may also provide a useful approach to synthesised human motion.

  7. A technique to replicate soft tissues around fixed restoration pontics on working casts.

    Chee, W W; Cho, G C; Ikoma, M M; Arcidiacono, A


    When missing maxillary incisors are replaced, the patient's primary concern is usually esthetics. Depending on the patient's smile line and the display of the incisors, the esthetic zone may extend to the entire clinical crown and include the surrounding soft tissue. For these patients, the appearance and form of the soft tissue at the base of the pontics is as critical as the esthetics of the incisal edges of the restoration. A technique is presented to precisely transfer the soft tissue morphology of the pontic area to the working cast. This modified master cast allows the laboratory technician to fabricate restorations that will harmonize precisely with the soft tissues of the patient.

  8. Dentoskeletal and Soft Tissue Profile Changes Associated with Mandibular Setback Osteotomy: A Cephalometric Study

    Manish Goyal


    The conclusions indicated that the facial concavity, in regard to the relationship of the hard and soft tissue chin to the upper face, was decreased by this surgical procedure; facial esthetics was improved. The mandible assumed a more normal relationship to the upper denture base. The least amount of change of the soft tissue profile was exhibited by the upper lip and maxillary sulcus of the upper lip. The greatest amount of change of the soft tissue profile was exhibited by the lower lip, the mandibular sulcus of the lower lip and the soft tissue chin.

  9. Postoperative External Beam Radiotherapy for Retroperitoneal Soft Tissue Sarcoma

    Jang, Na Yong; Kim, Il Han; Choi, Jin Hwa; Park, Charn Il [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    To evaluate the clinical outcomes and prognostic factors in retroperitoneal soft tissue sarcomas treated by postoperative radiotherapy. The records of 23 patients with retroperitoneal soft tissue sarcomas, who underwent postoperative radiotherapy between 1985 and 2003, were analyzed. The median follow-up period was 77 months (range, 8-240 months). A total of 21 patients presented with primary disease, and two patients presented with recurrent disease. Liposarcomas and leiomyosarcomas represented 78% of the diagnosed tumor cases. Moreover, 17 cases were of high grade (grade 2 or 3). The median tumor size was 13 cm (range, 3-50 cm). Complete excision was achieved in 65% of patients. The median radiation dose was 50.4 Gy (range, 45.0 to 59.4 Gy), with conventional fractionation. The 5-year overall, local recurrence-free, and distant metastasis-free survival rates were 68%, 58%, and 71%, respectively. Eleven patients experienced local recurrence, while 9 patients experienced distant metastasis. The most common site for distant metastasis was the liver. A univariate analysis revealed that adjacent organ invasion and age (>60 years) as the significant risk factors contributing to the prediction of poor overall survival. Moreover, multivariate analyses indicated that adjacent organ invasion remained significantly associated with a higher risk of death. In addition, patient age (>60 years) was the other identified risk factor for local recurrence by univariate and multivariate analyses. Except for one case of grade 3 diarrhea, no patient suffered grade 3 or higher complications. Our results were comparable to previous reports in that adjacent organ invasion and patient age (>60 years) were significant predictors of poor survival and tumor recurrence, respectively.

  10. Preliminary assessment of facial soft tissue thickness utilizing three-dimensional computed tomography models of living individuals.

    Parks, Connie L; Richard, Adam H; Monson, Keith L


    Facial approximation is the technique of developing a representation of the face from the skull of an unknown individual. Facial approximation relies heavily on average craniofacial soft tissue depths. For more than a century, researchers have employed a broad array of tissue depth collection methodologies, a practice which has resulted in a lack of standardization in craniofacial soft tissue depth research. To combat such methodological inconsistencies, Stephan and Simpson 2008 [15] examined and synthesized a large number of previously published soft tissue depth studies. Their comprehensive meta-analysis produced a pooled dataset of averaged tissue depths and a simplified methodology, which the researchers suggest be utilized as a minimum standard protocol for future craniofacial soft tissue depth research. The authors of the present paper collected craniofacial soft tissue depths using three-dimensional models generated from computed tomography scans of living males and females of four self-identified ancestry groups from the United States ranging in age from 18 to 62 years. This paper assesses the differences between: (i) the pooled mean tissue depth values from the sample utilized in this paper and those published by Stephan 2012 [21] and (ii) the mean tissue depth values of two demographically similar subsets of the sample utilized in this paper and those published by Rhine and Moore 1984 [16]. Statistical test results indicate that the tissue depths collected from the sample evaluated in this paper are significantly and consistently larger than those published by Stephan 2012 [21]. Although a lack of published variance data by Rhine and Moore 1984 [16] precluded a direct statistical assessment, a substantive difference was also concluded. Further, the dataset presented in this study is representative of modern American adults and is, therefore, appropriate for use in constructing contemporary facial approximations.

  11. Checklist and Scoring System for the Assessment of Soft Tissue Preservation in CT Examinations of Human Mummies.

    Stephanie Panzer

    Full Text Available The purpose of this study was to develop a checklist for standardized assessment of soft tissue preservation in human mummies based on whole-body computed tomography examinations, and to add a scoring system to facilitate quantitative comparison of mummies. Computed tomography examinations of 23 mummies from the Capuchin Catacombs of Palermo, Sicily (17 adults, 6 children; 17 anthropogenically and 6 naturally mummified and 7 mummies from the crypt of the Dominican Church of the Holy Spirit of Vilnius, Lithuania (5 adults, 2 children; all naturally mummified were used to develop the checklist following previously published guidelines. The scoring system was developed by assigning equal scores for checkpoints with equivalent quality. The checklist was evaluated by intra- and inter-observer reliability. The finalized checklist was applied to compare the groups of anthropogenically and naturally mummified bodies. The finalized checklist contains 97 checkpoints and was divided into two main categories, "A. Soft Tissues of Head and Musculoskeletal System" and "B. Organs and Organ Systems", each including various subcategories. The complete checklist had an intra-observer reliability of 98% and an inter-observer reliability of 93%. Statistical comparison revealed significantly higher values in anthropogenically compared to naturally mummified bodies for the total score and for three subcategories. In conclusion, the developed checklist allows for a standardized assessment and documentation of soft tissue preservation in whole-body computed tomography examinations of human mummies. The scoring system facilitates a quantitative comparison of the soft tissue preservation status between single mummies or mummy collections.

  12. The Use of Adobe Photoshop Software for the Development of Individualized Soft Tissue Facial Analysis with Special Emphasis on Soft Tissue Nose for Planning Rhinoplasty Procedures

    Kanhoba Mahabaleshwar Keluskar; N D Zingade; Madhu P Sivan


    .... Here, we have used Adobe Photoshop (CS 3) software for the development of individualized soft tissue facial analysis with special emphasis on parameters related to nose useful in planning for rhinoplasty procedures...

  13. Laser surgery for selected small animal soft-tissue conditions

    Bartels, Kenneth E.


    With the acquisition of a Nd:YAG and a CO2 laser in the College of Veterinary Medicine at Oklahoma State University in 1989, over 100 small animal clinical cases have been managed with these modern modalities for surgical excision and tissue vaporization. Most procedures have been for oncologic problems, but inflammatory, infectious, or congenital conditions including vaporization of acral lick 'granulomas,' excision/vaporization of foreign body induced, infected draining tracts, and resection of elongated soft palates have been successfully accomplished. Laser excision or vaporization of both benign and malignant neoplasms have effectively been performed and include feline nasal squamous cell carcinoma, mast cell tumors, and rectal/anal neoplasms. Results to date have been excellent with animals exhibiting little postoperative pain, swelling, and inflammation. Investigations involving application of laser energy for tissue welding of esophageal lacerations and hepatitic interstitial hyperthermia for metastatic colorectal cancer have also shown potential. A review of cases with an emphasis on survival time and postoperative morbidity suggests that carefully planned laser surgical procedures in clinical veterinary practice done with standardized protocols and techniques offer an acceptable means of treating conditions that were previously considered extremely difficult or virtually impossible to perform.

  14. Incidence of soft tissue sarcomas in an Italian area affected by illegal waste dumping sites.

    Benedetti, Marta; Fazzo, Lucia; Buzzoni, Carlotta; Comba, Pietro; Magnani, Corrado; Fusco, Mario


    The aim of the present study was to investigate the possible association between occurrence of soft tissue sarcomas (STS) and residence in an Italian area affected by illegal practices of dumping and setting fire to both hazardous and solid urban wastes. Standardized incidence ratios (SIRs) were computed separately for STS and some specific STS subtypes. The analysis was performed for the total population and for specific age groups, namely, children, adolescents, and adults. In adults, no significant increase in STS was found other than for gastrointestinal stromal tumors in males. A nonsignificant increase in incidence of STS was observed for male children and female adolescents. The results of the present study do not allow conclusions for a causal association. In the absence of previous epidemiological studies on this issue, further investigations are needed.

  15. A constitutive model of soft tissue: From nanoscale collagen to tissue continuum

    Tang, Huang


    Soft collagenous tissue features many hierarchies of structure, starting from tropocollagen molecules that form fibrils, and proceeding to a bundle of fibrils that form fibers. Here we report the development of an atomistically informed continuum model of collagenous tissue. Results from full atomistic and molecular modeling are linked with a continuum theory of a fiber-reinforced composite, handshaking the fibril scale to the fiber and continuum scale in a hierarchical multi-scale simulation approach. Our model enables us to study the continuum-level response of the tissue as a function of cross-link density, making a link between nanoscale collagen features and material properties at larger tissue scales. The results illustrate a strong dependence of the continuum response as a function of nanoscopic structural features, providing evidence for the notion that the molecular basis for protein materials is important in defining their larger-scale mechanical properties. © 2009 Biomedical Engineering Society.

  16. Soft-tissue masses in the shoulder girdle: an imaging perspective

    Harish, Srinivasan [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); Cambridge University Hospitals NHS Foundation Trust, Department of Radiology, Hills Road, Cambridge (United Kingdom); Saifuddin, Asif [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); Bearcroft, Philip W.P. [Cambridge University Hospitals NHS Foundation Trust, Department of Radiology, Hills Road, Cambridge (United Kingdom)


    We discuss the radiological assessment of soft-tissue masses presenting in the shoulder girdle and emphasise the relative strengths and weaknesses of the different imaging modalities available. The appearances of the common benign and malignant soft-tissue tumours are presented together with conditions that present with specific imaging features around the shoulder region. (orig.)

  17. Microwave tomography for functional imaging of extremity soft tissues: feasibility assessment

    Semenov, Serguei [Keele University, School of Medicine, ISTM, Stoke-on-Trent, ST4 7QB (United Kingdom); Kellam, James [Carolinas Medical Center, Charlotte, NC 28203 (United States); Althausen, Peter [Reno Orthopaedic Clinic, Reno, NV 89503 (United States); Williams, Thomas [Carolinas Medical Center, Charlotte, NC 28203 (United States); Abubakar, Aria [Schlumberger-Doll, Ridgefield, CT 06877 (United States); Bulyshev, Alexander [MA-Inc, Hampton, VA (United States); Sizov, Yuri [TRINITI, Moscow Region (Russian Federation)


    It is important to assess the viability of extremity soft tissues, as this component is often the determinant of the final outcome of fracture treatment. Microwave tomography (MWT) and sensing might be able to provide a fast and mobile assessment of such properties. MWT imaging of extremities possesses a complicated, nonlinear, high dielectric contrast inverse problem of diffraction tomography. There is a high dielectric contrast between bone and soft tissue in the extremities. A contrast between soft tissue abnormalities is less pronounced when compared with the high bone-soft tissue contrast. The goal of this study was to assess the feasibility of MWT for functional imaging of extremity soft tissues, i.e. to detect a relatively small contrast within soft tissues in closer proximity to high contrast boney areas. Both experimental studies and computer simulation were performed. Experiments were conducted using live pigs with compromised blood flow and compartment syndrome within an extremity. A whole 2D tomographic imaging cycle at 1 GHz was computer simulated and images were reconstructed using the Newton, MR-CSI and modified Born methods. Results of experimental studies demonstrate that microwave technology is sensitive to changes in the soft tissue blood content and elevated compartment pressure. It was demonstrated that MWT is feasible for functional imaging of extremity soft tissues, circulatory-related changes, blood flow and elevated compartment pressure.

  18. High resolution ultrasound characterization of soft tissue masses in children. [Comparison with CT findings

    Glasier, C.M.; Seibert, J.J.; Williamson, S.L.; Seibert, R.W.; Lange, T.A.; Corbitt, S.L.; Rodgers, A.B.


    Forty-two soft tissue masses in infants and children were examined with high resolution ultrasonography. Sonography was diagnostically specific in 17/42 (40%), useful but not diagnostic in 24/42 (58%), and misleading in 1/42 (2%) of soft tissue masses. Lesions with diagnostic sonographic features included cystic hygroma, fibromatosis colli, lymphadenopathy with abscess formation, and one case of osteomyelitis.

  19. Cranial Base Superimposition for 3D Evaluation of Soft Tissue Changes

    Cevidanes, Lucia H.C.; Motta, Alexandre; Proffit, William R.; Ackerman, James L.; Styner, Martin


    The recent emphasis on soft tissues as the limiting factor in treatment and on soft tissue relationships in establishing the goals of treatment has made 3D analysis of soft tissues more important in diagnosis and treatment planning. It is equally important to be able to detect changes in the facial soft tissues produced by growth and/or treatment. This requires structures of reference for superimposition, and a way to display the changes with quantitative information. This paper outlines a technique for quantifying facial soft tissue changes as viewed in CBCT data, using fully-automated voxel-wise registration of the cranial base surface. The assessment of change of soft tissues is done via calculation of the Euclidean surface distances between the 3D models. Color maps are used for visual assessment of the location and quantification of changes. This methodology allows a detailed examination of soft tissue changes with growth and/or treatment. Because of the lack of stable references with 3D photogrammetry, 3D photography and laser scanning, soft tissue changes cannot be accurately quantified by these methods. PMID:20381752

  20. Soft tissue augmentation techniques and materials used in the oral cavity : an overview

    Wolff, J.; Farré-Guasch, E.; Sandor, G.K.; Gibbs, S.; Jager, D.J.; Forouzanfar, T.


    Purpose: Oral soft tissue augmentation or grafting procedures are often necessary to achieve proper wound closure after deficits resulting from tumor excision, clefts, trauma, dental implants, and tooth recessions. Materials and Methods: Autologous soft tissue grafts still remain the gold standard t

  1. Accuracy and reliability of facial soft tissue depth measurements using cone beam computer tomography

    Fourie, Zacharias; Damstra, Janalt; Gerrits, Pieter; Ren, Yijin


    It is important to have accurate and reliable measurements of soft tissue thickness for specific landmarks of the face and scalp when producing a facial reconstruction. In the past several methods have been created to measure facial soft tissue thickness (FSTT) in cadavers and in the living. The con

  2. Lasers in Esthetic Dentistry: Soft Tissue Photobiomodulation, Hard Tissue Decontamination, and Ceramics Conditioning

    Ramalho, Karen Müller; de Freitas, Patrícia Moreira; Correa-Aranha, Ana Cecília; Bello-Silva, Marina Stella; Lopes, Roberta Marques da Graça; Eduardo, Carlos de Paula


    The increasing concern and the search for conservative dental treatments have resulted in the development of several new technologies. Low and high power lasers can be cited as one of these new technologies. Low power lasers act at cellular level leading to pain reduction, modulation of inflammation, and improvement of tissue healing. High power lasers act by increasing temperature and have the potential to promote microbial reduction and ablation of hard and soft tissues. The clinical application of both low and high power lasers requires specific knowledge concerning laser interaction with biological tissues, so that the correct irradiation protocol can be established. The present case report describes the clinical steps of two metal-ceramic crowns development in a 60-year-old patient. Three different laser wavelengths were applied throughout the treatment with different purposes: Nd:YAG laser (1,064 nm) for dentin decontamination, diode (660 nm) for soft tissue biomodulation, and Er:YAG laser (2,940 nm) for inner ceramic surface conditioning. Lasers were successfully applied in the present case report as coadjutant in the treatment. This coadjutant technology can be a potential tool to assist treatment to reach the final success. PMID:25147746

  3. Lasers in Esthetic Dentistry: Soft Tissue Photobiomodulation, Hard Tissue Decontamination, and Ceramics Conditioning

    Karen Müller Ramalho


    Full Text Available The increasing concern and the search for conservative dental treatments have resulted in the development of several new technologies. Low and high power lasers can be cited as one of these new technologies. Low power lasers act at cellular level leading to pain reduction, modulation of inflammation, and improvement of tissue healing. High power lasers act by increasing temperature and have the potential to promote microbial reduction and ablation of hard and soft tissues. The clinical application of both low and high power lasers requires specific knowledge concerning laser interaction with biological tissues, so that the correct irradiation protocol can be established. The present case report describes the clinical steps of two metal-ceramic crowns development in a 60-year-old patient. Three different laser wavelengths were applied throughout the treatment with different purposes: Nd:YAG laser (1,064 nm for dentin decontamination, diode (660 nm for soft tissue biomodulation, and Er:YAG laser (2,940 nm for inner ceramic surface conditioning. Lasers were successfully applied in the present case report as coadjutant in the treatment. This coadjutant technology can be a potential tool to assist treatment to reach the final success.

  4. Radiation-induced pseudotumor following therapy for soft tissue sarcoma

    Moore, Lacey F.; Kransdorf, Mark J. [Mayo Clinic, Department of Radiology, Jacksonville, FL (United States); Buskirk, Steven J. [Mayo Clinic, Department of Radiation Oncology, Jacksonville, FL (United States); O' Connor, Mary I. [Mayo Clinic, Department of Orthopedic Surgery, Jacksonville, FL (United States); Menke, David M. [Mayo Clinic, Department of Pathology, Jacksonville, FL (United States)


    The purpose of this study was to describe the prevalence and imaging appearance of radiation induced pseudotumors in patients following radiation therapy for extremity soft tissue sarcomas. We retrospectively reviewed the serial magnetic resonance (MR) images of 24 patients following radiation therapy for extremity soft tissue sarcomas. A total of 208 exams were reviewed (mean, 8.7 exams per patient) and included all available studies following the start of radiation therapy. Exams were analyzed for the identification of focal signal abnormalities within the surgical bed suggesting local tumor recurrence. Histopathologic correlation was available in nine patients suspected of having local tumor recurrence. Additional information recorded included patient demographics, tumor type and location, radiation type, and dose. The study group consisted of 12 men and 12 women, having an average age of 63 years (range, 39-88 years). Primary tumors were malignant fibrous histiocytoma (n = 13), leiomyosarcoma (n = 6), liposarcoma (n = 3), synovial sarcoma (n = 1), and extraskeletal chondrosarcoma (n = 1). All lesions were high-grade sarcomas, except for two myxoid liposarcomas. Average patient radiation dose was 5,658 cGy (range, 4,500-8,040 cGy). Average follow-up time was 63 months (range, 3-204 months). Focal signal abnormalities suggesting local recurrence were seen in nine (38%) patients. Three of the nine patients with these signal abnormalities were surgically proven to have radiation-induced pseudotumor. The pseudotumors developed between 11 and 61 months following the initiation of radiation therapy (mean, 38 months), with an average radiation dose of 5,527 cGy (range, 5,040-6,500 cGy). MR imaging demonstrated a relatively ill-defined ovoid focus of abnormal signal and intense heterogeneous enhancement with little or no associated mass effect. MR imaging of radiation-induced pseudotumor typically demonstrates a relatively ill-defined ovoid mass-like focus of intense

  5. Extracranial soft-tissue swelling: a normal postmortem radiographic finding or a sign of trauma?

    Strouse, P.J. [Section of Pediatric Radiology, University of Michigan Medical Center, Ann Arbor (United States); Caplan, M. [Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan (United States); Owings, C.L. [Department of Pediatrics and Communicable Diseases, C. S. Mott Children`s Hospital, Ann Arbor, Michigan (United States)


    Objective. To determine if extracranial soft-tissue swelling is an expected postmortem finding or a sign of trauma. Materials and methods. Extracranial soft-tissue thickness was measured at 5 standardized locations on postmortem skull films obtained of 18 infants with no evidence of trauma on autopsy. The same measurements were performed on the skull films of 100 living children, all less than 3 years old and without clinical history of trauma. Results. Extracranial soft tissues measured only slightly greater in the postmortem group than on films of living children; however, the difference did achieve statistical significance. Conclusion. Minimal extracranial soft-tissue swelling is a normal finding on a postmortem skeletal survey. The presence of substantial or asymmetric extracranial soft-tissue swelling should be viewed with suspicion for trauma. (orig.) With 2 tabs., 5 refs.

  6. Prognostic impact of lymphocytes in soft tissue sarcomas.

    Sveinung W Sorbye

    Full Text Available PURPOSE: The purpose of this study was to clarify the prognostic significance of lymphocyte infiltration in soft tissue sarcomas (STS. Prognostic markers in potentially curable STS should guide therapy after surgical resection. The immune status at the time of resection may be important, but the prognostic significance of tumor infiltrating lymphocytes is controversial as the immune system has conflicting roles during cancer development. EXPERIMENTAL DESIGN: Tissue microarrays from 249 patients with STS were constructed from duplicate cores of viable and representative neoplastic tumor areas. Immunohistochemistry was used to evaluate the CD3+, CD4+, CD8+, CD20+ and CD45+ lymphocytes in tumors. RESULTS: In univariate analyses, increased numbers of CD4+ (P = 0.008 and CD20+ (P = 0.006 lymphocytes in tumor correlated significantly with an improved disease-specific survival (DSS in patients with wide resection margins (n = 108. In patients with non-wide resection margins (n = 141 increased numbers of CD3+ (P = 0.028 lymphocytes in tumor correlated significantly with shorter DSS. In multivariate analyses, a high number of CD20+ lymphocytes (HR = 5.5, CI 95%  = 1.6-18.6, P = 0.006 in the tumor was an independent positive prognostic factor for DSS in patients with wide resections margins. CONCLUSIONS: High density of CD20+ lymphocytes in STS with wide resection margins is an independent positive prognostic indicator for these patients. Further research is needed to define if CD20+ cells can modify tumors in a way that reduces disease progression and metastatic potential.

  7. Microscopic histological characteristics of soft tissue sarcomas: analysis of tissue features and electrical resistance.

    Tosi, A L; Campana, L G; Dughiero, F; Forzan, M; Rastrelli, M; Sieni, E; Rossi, C R


    Tissue electrical conductivity is correlated with tissue characteristics. In this work, some soft tissue sarcomas (STS) excised from patients have been evaluated in terms of histological characteristics (cell size and density) and electrical resistance. The electrical resistance has been measured using the ex vivo study on soft tissue tumors electrical characteristics (ESTTE) protocol proposed by the authors in order to study electrical resistance of surgical samples excised by patients in a fixed measurement setup. The measurement setup includes a voltage pulse generator (700 V, 100 µs long at 5 kHz, period 200 µs) and an electrode with 7 needles, 20 mm-long, with the same distance arranged in a fixed hexagonal geometry. In the ESTTE protocol, the same voltage pulse sequence is applied to each different tumor mass and the corresponding resistance has been evaluated from voltage and current recorded by the equipment. For each tumor mass, a histological sample of the volume treated by means of voltage pulses has been taken for histological analysis. Each mass has been studied in order to identify the sarcoma type. For each histological sample, an image at 20× or 40× of magnification was acquired. In this work, the electrical resistance measured for each tumor has been correlated with tissue characteristics like the type, size and density of cells. This work presents a preliminary study to explore possible correlations between tissue characteristics and electrical resistance of STS. These results can be helpful to adjust the pulse voltage intensity in order to improve the electrochemotherapy efficacy on some histotype of STS.

  8. Demographics, Microbiology and Outcome in Necrotizing Soft Tissue Infections

    Chance Witt


    Full Text Available Background: Necrotizing soft tissue infections (NSTI are potentially severe infections that have a high morbidity and mortality even with modern medical care. This study examines factors associated with outcomes in patients with NSTI in an academic tertiary care hospital. Design: This is a retrospective cohort study of patients admitted with NSTI between 2003 and 2008. Baseline demographics and comorbid conditions, laboratory and clinical parameters, timing of surgery, and outcomes, including length of stay and mortality, were compared with univariate analysis; significant factors were then analyzed for their effects on mortality using binary logistic regression analysis. Results: Sixty-nine patients with NSTI were analyzed; 61% were men. Diabetes (39% was the most common comorbid condition. Most infections (55% were polymicrobial. The most common organism in monomicrobial infections was Staphylococcus aureus, and 50 % of these isolates were methicillin resistant. Nine patients (13% required amputation. Mortality was 20%, and the most significant predictor of mortality was a higher respiratory rate on admission (p=0.02. Conclusion: Patients in this series frequently had diabetes, usually had polymicrobial infections, and had a 20% mortality rate.

  9. Fabrication of pliable biodegradable polymer foams to engineer soft tissues.

    Wake, M C; Gupta, P K; Mikos, A G


    We have fabricated pliable, porous, biodegradable scaffolds with poly(lactic-co-glycolic acid) (PLGA) and poly(ethylene glycol) (PEG) blends using a solvent-casting and particulate-leaching technique. Our study investigated the effects of four different processing parameters on pliability and pore morphology of the biodegradable scaffolds. The parameters investigated were the PLGA copolymer ratio, the PLGA/PEG blend ratio, the initial salt weight fraction, and the salt particle size. A wide range of shear moduli (0.59 to 9.55 MPa), porosities (0.798 to 0.942), and median pore diameters (71 to 154 microns) was able to be achieved by varying the combination of these parameters. Our study indicates that initial salt weight fraction and PLGA/PEG blend ratio have the most significant effects on the physico-mechanical properties of the scaffolds. Enhanced pliability of the three dimensional foams made with blends of PLGA and PEG is evidenced by the ability to roll them into a tube without macroscopic damage to the scaffold. Pliable polymer substrates hold great promise for regeneration of soft tissues such as skin, or those requiring a tubular conformation such as intestine or vascular grafts.

  10. Torsional Ultrasound Sensor Optimization for Soft Tissue Characterization

    Juan Melchor


    Full Text Available Torsion mechanical waves have the capability to characterize shear stiffness moduli of soft tissue. Under this hypothesis, a computational methodology is proposed to design and optimize a piezoelectrics-based transmitter and receiver to generate and measure the response of torsional ultrasonic waves. The procedure employed is divided into two steps: (i a finite element method (FEM is developed to obtain a transmitted and received waveform as well as a resonance frequency of a previous geometry validated with a semi-analytical simplified model and (ii a probabilistic optimality criteria of the design based on inverse problem from the estimation of robust probability of detection (RPOD to maximize the detection of the pathology defined in terms of changes of shear stiffness. This study collects different options of design in two separated models, in transmission and contact, respectively. The main contribution of this work describes a framework to establish such as forward, inverse and optimization procedures to choose a set of appropriate parameters of a transducer. This methodological framework may be generalizable for other different applications.

  11. Skin and Soft Tissue Infections in Patients with Solid Tumours

    Diamantis P. Kofteridis


    Full Text Available Background. Skin and soft tissue infections (SSTIs in cancer patients represent a diagnostic challenge, as etiologic diagnosis is often missing, and clinical assessment of severity is difficult. Few studies have described (SSTIs in patients with solid tumours (STs. Patients and Methods. Records of patients with ST and SSTI, cared for at the University Hospital of Heraklion, from 2002 to 2006 were retrospectively studied. Results. A total of 81 episodes of SSTIs, occurring in 71 patients with ST, have been evaluated. Their median age was 65 years (34–82. The most common underlying malignancy was breast cancer in 17 patients (24%. Most episodes (89% occurred in nonneutropenics. Cellulitis/erysipelas was the most common clinical presentation (56; 69%. Bacterial cultures were possible in 29 (36% patients. All patients received antimicrobial therapy, while in 17 episodes (21% an incision and drainage was required. Treatment failure occurred in 20 episodes (25%. Five patients (7% died due to sepsis. None was neutropenic. Severe sepsis on admission (=0.002 and prior blood transfusion (=0.043 were independent predictors of treatment failure. Conclusion. SSTIs can be life threatening among patients with ST. Early diagnosis and appropriate treatment are of the utmost importance, since sepsis was proven a significant factor of unfavourable outcome.

  12. Combining Targeted Agents With Modern Radiotherapy in Soft Tissue Sarcomas

    Wong, Philip; Houghton, Peter; Kirsch, David G.; Finkelstein, Steven E.; Monjazeb, Arta M.; Xu-Welliver, Meng; Dicker, Adam P.; Ahmed, Mansoor; Vikram, Bhadrasain; Teicher, Beverly A.; Coleman, C. Norman; Machtay, Mitchell; Curran, Walter J.


    Improved understanding of soft-tissue sarcoma (STS) biology has led to better distinction and subtyping of these diseases with the hope of exploiting the molecular characteristics of each subtype to develop appropriately targeted treatment regimens. In the care of patients with extremity STS, adjunctive radiation therapy (RT) is used to facilitate limb and function, preserving surgeries while maintaining five-year local control above 85%. In contrast, for STS originating from nonextremity anatomical sites, the rate of local recurrence is much higher (five-year local control is approximately 50%) and a major cause of death and morbidity in these patients. Incorporating novel technological advancements to administer accurate RT in combination with novel radiosensitizing agents could potentially improve local control and overall survival. RT efficacy in STS can be increased by modulating biological pathways such as angiogenesis, cell cycle regulation, cell survival signaling, and cancer-host immune interactions. Previous experiences, advancements, ongoing research, and current clinical trials combining RT with agents modulating one or more of the above pathways are reviewed. The standard clinical management of patients with STS with pretreatment biopsy, neoadjuvant treatment, and primary surgery provides an opportune disease model for interrogating translational hypotheses. The purpose of this review is to outline a strategic vision for clinical translation of preclinical findings and to identify appropriate targeted agents to combine with radiotherapy in the treatment of STS from different sites and/or different histology subtypes. PMID:25326640

  13. Nasal Soft Tissue Change Following Bimaxillary Orthognathic Surgery.

    Jeong, Hye-In; Lee, Ho-Sung; Jung, Young-Soo; Park, Hyung-Sik; Jung, Hwi-Dong


    The purpose of this study is to identify the correlation between maxillary movement and nasal soft tissue changes on three-dimensional reconstructed cone beam computed tomography (CBCT) images after Le Fort I osteotomy. The authors also investigate the long-term change of alar base width (ABW) to determine the effect of cinch suture. The authors retrospectively studied 52 subjects (14 males and 38 females) who were treated by bimaxillary orthognathic surgery including Le Fort I osteotomy and mandibular ramus surgery. The landmarks and planes were established on three-dimensional reconstructed CBCT images. The authors measured each parameters preoperatively, 1 month postoperatively, and 1 year postoperatively. There was no significant correlation between the horizontal movement of A-point and the widening of ABW (P ABW (P ABW, nor was there a significant correlation between the nasal tip length and the vector of maxillary movement. There was no significant correlation between the ABW widening and the vector of surgical maxillary movement. The effect and stability of the alar base cinch suture is difficult to determine and require further investigation.

  14. Light ion irradiation for unfavorable soft tissue sarcoma

    Linstadt, D.; Castro, J.R.; Phillips, T.L.; Petti, P.L.; Collier, J.M.; Daftari, I.; Schoethaler, R.; Rayner, A.


    Between 1978 and 1989, 32 patients with unfavorable soft tissue sarcoma underwent light ion (helium, neon) irradiation with curative intent at Lawrence Berkeley Laboratory. The tumors were located in the trunk in 22 patients and head and neck in 10. Macroscopic tumor was present in 22 at the time of irradiation. Two patients had tumors apparently induced by previous therapeutic irradiation. Follow-up times for surviving patients ranged from 4 to 121 months (median 27 months). The overall 3-year actuarial local control rate was 62%; the corresponding survival rate was 50%. The 3-year actuarial control rate for patients irradiated with macroscopic tumors was 48%, while none of the patients with microscopic disease developed local recurrence (100%). The corresponding 3-year actuarial survival rates were 40% (macroscopic) and 78% (microscopic). Patients with retroperitoneal sarcoma did notably well; the local control rate and survival rate were 64% and 62%, respectively. Complications were acceptable; there were no radiation related deaths, while two patients (6%) required operations to correct significant radiation-related injuries. These results appear promising compared to those achieved by low -LET irradiation, and suggest that this technique merits further investigation.

  15. Bone and soft tissue tumors of hip and pelvis

    Bloem, Johan L., E-mail: [Leiden University Medical Center, Department of Radiology, PO Box 9600, 2300 RC Leiden (Netherlands); Reidsma, Inge I., E-mail: [Leiden University Medical Center, Department of Radiology, PO Box 9600, 2300 RC Leiden (Netherlands)


    Objective is to identify epidemiologic and radiologic criteria allowing specific diagnoses of tumors and tumor-like lesions in the hip region and pelvis, and to optimize pre-operative staging. Patients with pelvic tumors are usually older, and their tumors are larger relative to patients with tumors in extremities. The majority of tumors in the pelvis are malignant (metastases, myeloma, chondrosarcoma, Ewing-, osteo-, and MFH/fibrosarcoma), while those in the proximal femur are in majority benign (fibrous dysplasia, solitary bone cyst, and osteoid osteoma). Soft tissue masses in the thigh in the elderly are typically sarcomas without tumor specific signs. Common tumor-like lesions occurring in the hip and pelvis that can mimic neoplasm are: infections (including tuberculosis), insufficiency/avulsion fractures, cysts, fibrous dysplasia, aneurysmal bone cyst, Langerhans cell histiocytosis, and Paget's disease. Local MR staging is based on the compartmental anatomy. The psoas and gluteal muscles are easily invaded by sarcoma originating in the ileum. The pectineus muscle protects the neurovascular bundle at the level of the hip. The thigh is separated into three compartments, some structures (Sartorius muscle) cross borders between compartments. Immobile joints (SI-joints, osteoarthritic hip) are relatively easily crossed by sarcoma and giant cell tumor.

  16. Skin and soft-tissue infections caused by Aeromonas species.

    Chao, C M; Lai, C C; Tang, H J; Ko, W C; Hsueh, P-R


    This study investigated the clinical characteristics of patients with skin and soft-tissue infections (SSTIs) due to Aeromonas species. Patients with SSTIs caused by Aeromonas species during the period from January 2009 to December 2011 were identified from a computerized database of a regional hospital in southern Taiwan. The medical records of these patients were retrospectively reviewed. A total of 129 patients with SSTIs due to Aeromonas species were identified. A. hydrophila (n = 77, 59.7 %) was the most common pathogen, followed by A. veronii biovar sobria (n = 22, 17.1 %), A. veronii biovar veronii (n = 20, 15.5 %), A. caviae (n = 9, 7.0 %), and A. schubertii (n = 1, 0.8 %). The most common isolates obtained from patients with polymicrobial infections were Klebsiella species (n = 33), followed by Enterococcus spp. (n = 24), Enterobacter spp. (n = 21), Escherichia coli (n = 17), Staphylococcus spp. (n = 17), Streptococcus spp. (n = 17), and Acinetobacter spp. (n = 15). Liver cirrhosis and concomitant bacteremia were more common among patients with monomicrobial Aeromonas SSTIs than among patients with polymicrobial SSTIs. Nine (7 %) patients required limb amputations. The in-hospital mortality rate was 1.6 %. In conclusion, Aeromonas species should be considered as important causative pathogens of SSTIs, and most infections are polymicrobial. In addition, the clinical presentation differs markedly between patients with monomicrobial and those with polymicrobial Aeromonas SSTIs.

  17. Perforator propeller flaps for sacral and ischial soft tissue reconstruction

    Korambayil Pradeoth


    Full Text Available The perforator-based flaps in the sacral and ischial region is designed according to the localization of perforators that penetrate the gluteus maximus muscle, reach the intra-fascial and supra-fascial planes with the overlying skin forming a rich vascular plexus. The perforator-based flaps described in this article are highly vascularized, have minimal donor site morbidity, and do not require the sacrifice of the gluteus maximus muscle. In a period between April 2008 and March 2009, six patients with sacral pressure sore were reconstructed with propeller flap method based on superior gluteal and parasacral artery perforators. One flap loss was noted. Three cases of ischial pressure sore were reconstructed with longitudinal propeller flap cover, based on inferior gluteal artery perforator. One flap suffered wound infection and dehiscence. Two cases of pilonidal sinus were reconstructed with propeller flap based on parasacral perforators. Both the flaps survived without any complications. Donor sites were closed primarily. In the light of this, they can be considered among the first surgical choices to re-surface soft tissue defects of the sacral and ischial regions. In the series of 11 patients, two patients (18% suffered complications.

  18. Occurrence of Comorbidities before and after Soft Tissue Sarcoma Diagnosis

    Myrthe P. P. van Herk-Sukel


    Full Text Available Background. Data is limited on the burden of common comorbidities, such as cardiovascular disease (CVD, respiratory disease and diabetes, or comorbidities related to cancer and its treatment, such as anemia and depression, in patients with soft tissue sarcoma (STS. Patients and Methods. From the Dutch Pathology Registry linked to the PHARMO database (including data on drug use and hospitalizations, 533 patients with STS were selected during 2000–2007 and matched 1 : 10 to cancer-free controls. The occurrences of comorbidities were assessed in the 12 months before and after STS diagnosis. Results. STS patients were 2–4 times more likely to have comorbidities at diagnosis compared with cancer-free controls. The incidence of CVD, anemia, and depression after STS diagnosis differed significantly from cancer-free controls and decreased during followup from 40–124 per 1,000 person-years (py during the first six months to 11–38 per 1,000 py more than 12 months after diagnosis. The incidence of respiratory disease and diabetes among STS patients remained stable during followup (5–21 per 1,000 py and did not differ significantly from cancer-free controls. Conclusions. STS patients were more likely to have comorbidities before cancer diagnosis and to develop CVD, anemia, and depression after diagnosis compared to cancer-free controls.

  19. Neuroendocrine carcinoma of the pancreas with soft tissue metastasis

    Jie Chen; Qi Zheng; Zhe Yang; Xin-Yu Huang; Zhou Yuan; Juan Tang


    Neuroendocrine carcinoma (NEC) of the pancreas is rare.We report the case of a 34-year-old man with pancreatic NEC with soft tissue metastasis.The patient presented with right upper abdominal discomfort.Computed tomography revealed a low-density heterogeneous mass in the tail and body of the pancreas that encroached on the greater curvature of the stomach and spleen.We performed exploratory laparotomy and total pancreatectomy with splenectomy and total gastrectomy.Histopathological analysis showed spindleshaped cells with scanty cytoplasm and hyperchromatic nuclei,confirming a primary pancreatic NEC.One month after the surgery,the patient experienced leg swelling.Positron emission tomography-computed tomography revealed high uptake of fludeoxyglucose in the left leg,and the leg was amputated.Histopathological analysis confirmed metastasis of pancreatic NEC.The patient was followed up and received chemotherapy (etoposide and cisplatin).One month after amputation,the level of tumor marker neuron-specific enolase was 142.70 μg/L and computed tomography scan revealed an aggravated metastatic lesion.The patient suffered from unbearable pain and we treated him with odynolysis.Four months postoperatively,the patient died of respiratory failure.

  20. Evaluation of a porcine collagen matrix used to augment keratinized tissue and increase soft tissue thickness around existing dental implants.

    Schallhorn, Rachel A; McClain, Pamela K; Charles, Allan; Clem, Donald; Newman, Michael G


    Implant-supported prostheses often present with mucogingival deficiencies that may cause esthetic or hygienic issues. These issues may present as limited or no keratinized tissue, irregular soft tissue contour or concavity, and gray "showthrough" of the implant abutment and root forms. An interpositional soft tissue graft substitute that generates keratinized tissue and increases soft tissue thickness would be beneficial, as it would reduce donor site morbidity and be available in unlimited, off-the-shelf supply. Thirty patients were assessed as part of a multicenter, practice-based evaluation of the material. A xenogeneic collagen matrix was placed as an interpositional graft on the buccal aspect of implant sites; sites were reassessed at 6 months posttreatment. Results indicated that the collagen matrix increased tissue thickness and keratinized tissue around existing dental implants.

  1. Effect of bone-soft tissue friction on ultrasound axial shear strain elastography

    Tang, Songyuan; Chaudhry, Anuj; Kim, Namhee; Reddy, J. N.; Righetti, Raffaella


    Bone-soft tissue friction is an important factor affecting several musculoskeletal disorders, frictional syndromes and the ability of a bone fracture to heal. However, this parameter is difficult to determine using non-invasive imaging modalities, especially in clinical settings. Ultrasound axial shear strain elastography is a non-invasive imaging modality that has been used in the recent past to estimate the bonding between different tissue layers. As most elastography methods, axial shear strain elastography is primarily used in soft tissues. More recently, this technique has been proposed to assess the bone-soft tissue interface. In this paper, we investigate the effect of a variation in bone-soft tissue friction coefficient in the resulting axial shear strain elastograms. Finite element poroelastic models of bone specimens exhibiting different bone-soft tissue friction coefficients were created and mechanically analyzed. These models were then imported to an ultrasound elastography simulation module to assess the presence of axial shear strain patterns. In vitro experiments were performed to corroborate selected simulation results. The results of this study show that the normalized axial shear strain estimated at the bone-soft tissue interface is statistically correlated to the bone-soft tissue coefficient of friction. This information may prove useful to better interpret ultrasound elastography results obtained in bone-related applications and, possibly, monitor bone healing.

  2. Evaluation of soft tissue coverage over porous polymethylmethacrylate space maintainers within nonhealing alveolar bone defects.

    Kretlow, J.D.; Shi, M.; Young, S.; Spicer, P.P.; Demian, N.; Jansen, J.A.; Wong, M.E.; Kasper, F.K.; Mikos, A.G.


    Current treatment of traumatic craniofacial injuries often involves early free tissue transfer, even if the recipient site is contaminated or lacks soft tissue coverage. There are no current tissue engineering strategies to definitively regenerate tissues in such an environment at an early time poin

  3. Evaluation of soft tissue coverage over porous polymethylmethacrylate space maintainers within nonhealing alveolar bone defects.

    Kretlow, J.D.; Shi, M.; Young, S.; Spicer, P.P.; Demian, N.; Jansen, J.A.; Wong, M.E.; Kasper, F.K.; Mikos, A.G.


    Current treatment of traumatic craniofacial injuries often involves early free tissue transfer, even if the recipient site is contaminated or lacks soft tissue coverage. There are no current tissue engineering strategies to definitively regenerate tissues in such an environment at an early time


    sudaryanto -


    Full Text Available Mechanical neck pain has the same high prevalence with low back pain, and commonly found in many of physiotherapy practice. Combination of Mulligan technique and Soft Tissue Mobilization are one of manual therapy technique highly effective and efficient to care the case of mechanical neck pain but still very rarely used by physiotherapist in fields of practice. This study aimed to know the effectiveness between Mulligan technique – Soft Tissue Mobilization and only Soft Tissue Mobilization to the increasing range of motion extension, rotation and side flexion cervical on the mechanical neck pain. The study design was a pre test – post test control group design using two group of samples are control groups that given intervention Soft Tissue Mobilization and treatment groups that given a combination of Mulligan technique and Soft Tissue Mobilization. Measuring instrument used for data collection was goniometer, that the goniometer was used to measure the range of motion extension, rotation and lateral flexion of the cervical either before the intervention and after the intervention. Sample of this study was 32 people who divided into 2 groups of samples were 16 people in the control group and 16 people in the treatment group. Samples in the control group had a mean age of 35,69 with male of 7 people (43,8% and female of 9 people (56,2% as well as limitations of the right direction were 12 people (75% and left direction were 4 people (25%. Whereas in the treatment group had e mean age of 35,94 with male of 10 people (62,5% and female of 6 people (37,5% as well as limitations of the right direction were 11 people (62,5% and left direction were 5 people (31,2%. The results of hypothesis testing using independent sampel t-test showed a significant difference between the mean post-intervention ROM extension, rotation, lateral flexion of the control groups and the mean post-intervention ROM extension, rotation, lateral flexion of the treatment

  5. Combined soft and hard tissue augmentation for a localized alveolar ridge defect


    Ideal alveolar ridge width and height allows placement of a natural appearing pontic, which provides maintenance of a plaque-free environment. The contour of a partially edentulous ridge should be thoroughly evaluated before a fixed partial denture is undertaken. Localized alveolar ridge defect refers to a volumetric deficit of the limited extent of bone and soft-tissue within the alveolar process. These ridge defects can be corrected by hard tissue and/or soft-tissue augmentation. A 30-year-...

  6. Ribociclib and Doxorubicin in Treating Patients With Metastatic or Advanced Soft Tissue Sarcomas That Cannot Be Removed by Surgery


    Metastatic Angiosarcoma; Metastatic Epithelioid Sarcoma; Metastatic Fibrosarcoma; Metastatic Leiomyosarcoma; Metastatic Liposarcoma; Metastatic Malignant Peripheral Nerve Sheath Tumor; Metastatic Synovial Sarcoma; Metastatic Undifferentiated Pleomorphic Sarcoma; Myxofibrosarcoma; Pleomorphic Rhabdomyosarcoma; Stage III Soft Tissue Sarcoma; Stage IV Soft Tissue Sarcoma; Undifferentiated (Embryonal) Sarcoma

  7. Dynamic simulation of viscoelastic soft tissue in acoustic radiation force creep imaging.

    Zhao, Xiaodong; Pelegri, Assimina A


    Acoustic radiation force (ARF) creep imaging applies step ARF excitation to induce creep displacement of soft tissue, and the corresponding time-dependent responses are used to estimate soft tissue viscoelasticity or its contrast. Single degree of freedom (SDF) and homogeneous analytical models have been used to characterize soft tissue viscoelasticity in ARF creep imaging. The purpose of this study is to investigate the fundamental limitations of the commonly used SDF and homogeneous assumptions in ARF creep imaging. In this paper, finite element (FE) models are developed to simulate the dynamic behavior of viscoelastic soft tissue subjected to step ARF. Both homogeneous and heterogeneous models are studied with different soft tissue viscoelasticity and ARF configurations. The results indicate that the SDF model can provide good estimations for homogeneous soft tissue with high viscosity, but exhibits poor performance for low viscosity soft tissue. In addition, a smaller focal region of the ARF is desirable to reduce the estimation error with the SDF models. For heterogeneous media, the responses of the focal region are highly affected by the local heterogeneity, which results in deterioration of the effectiveness of the SDF and homogeneous simplifications.

  8. Thallium scintigraphy used in the evaluation of soft tissue sarcoma

    Pilloni, A.; Brooks, R. [Concord Repatriation Hospital, Concord, NSW (Australia). Department of Nuclear Medicine


    Full text: The use of thallium scintigraphy in tumour localisation is a promising diagnostic modality. Thallium has a good affinity for numerous tumour types including sarcomas. Its properties as a potassium analogue result in active uptake via the sodium- potassium ATP-ase pump enabling its use in evaluating tumour extent, viability, staging, localisation and treatment. This case illustrates the role of thallium in tumour staging. A 67-year-old woman with a fibrous histiocytoma resected from the right foot four months previously presented with pain in the ribs, lower back and feet. A bone scan was performed to assess the possibility of metastatic disease. Several abnormal foci were seen on the bone scan suggestive of metastatic disease. A thallium scan was performed to confirm the bone scan result after a subsequent CT scan showed no evidence of this extensive disease. Static images of the whole body were acquired on an Elscinct 400AG 20 minutes post i.v. injection of 3.5 mCi of thallium. Focal areas of increased thallium uptake were seen in the 11th rib posteriorly and in the left sacroiliac region corresponding with sites on the bone scan suggesting metastases. However, an extensive area of uptake was also observed in the right inguinal region which had no corresponding abnormalities in the bone study. This was thought to be tumour metastasis in an inguinal Iymph node, which was retrospectively confirmed on an earlier CT scan of the pelvis. This study demonstrates the usefulness of thallium in the detection of soft tissue tumours and metastases. Thallium also exhibits potential in the assessment of tumour extent and viability pre- and post-treatment. This potential needs to be explored further in patient management

  9. Soft and Hard Tissue Management in Implant Therapy—Part II: Prosthetic Concepts

    Paolo Francesco Manicone


    Full Text Available The ongoing pursuit of aesthetic excellence in the field of implant therapy has incorporated prosthetic concepts in the early treatment-planning phase, as well as the previously discussed surgical concepts. The literature has addressed these prosthetic and laboratory approaches required to enhance and perfect the soft and hard tissue management (SHTM. After surgically providing an acceptable hard tissue architecture and adequate timing of loading of the implant, the prosthetic phase is responsible for the soft tissue modeling, through correctly planned and executed procedures, which induce a satisfactory soft tissue profile by considering the microvasculature, the abutment connection and positioning, and the implementation of an adequate provisional phase. The objectives are the modeling of the soft tissues through the use of a conforming periorestorative interface which will produce desired and stable results.

  10. A Simulation Method of Soft Tissue Cutting In Virtual Environment with Haptics

    Prasad V. Suryawanshi


    Full Text Available Currently, virtual simulation has an increasing role in the medical field. Now virtual surgery simulation has been largely explored in medical field. Virtual surgery is a good complement to traditional Surgical Training. Modeling effects of soft tissue during cutting is quite complex, hence the concept of virtuality is used to develop realistic surgical instruments for providing exact force feedback to the surgeon during surgical operation and simulation of soft tissue processes. Scalpel is a basic instrument required for soft tissue simulation. Hence we will design a virtual organ to cut by using Scalpel in Haptic Environment.

  11. Soft-tissue tumors update: MR imaging features according to the WHO classification

    Vilanova, Joan C.; Barcelo, Joaquim; Villalon, Miguel [Clinica Girona, Department of Magnetic Resonance, Girona (Spain); Woertler, Klaus [Technische Universitaet Munich, Department of Radiology, Munich (Germany); Narvaez, Jose A. [Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Department of Radiology, Barcelona (Spain); Martinez, Salutario J. [Duke University Medical Center, Department of Radiology, Durham, North Carolina (United States); Miro, Josefina [Clinica Girona, Department of Pathology, Girona (Spain)


    Soft-tissue tumors are a large and heterogeneous group of neoplasms. Hence, classification is often difficult. The most effective management decisions are made when a working group participates in the same diagnostic standard criteria in the evaluation of soft-tissue tumors. The purpose of this pictorial review is to highlight the new and the less well-known features on magnetic resonance (MR) imaging of soft-tissue tumors according to the World Health Organization (WHO) classification established in 2002. The article depicts the major changes of the WHO classification since it was established in 2002 and the most significant findings on MR imaging, thereby providing an update. (orig.)

  12. Evaluating soft tissue simulation in maxillofacial surgery using pre and post-operative CT scan

    Chabanas, M; Chouly, F; Boutault, F; Payan, Y; Chabanas, Matthieu; Marecaux, Christophe; Chouly, Franz; Boutault, Franck; Payan, Yohan


    One of the most important issue in soft tissue modeling is to assess the quality of the simulations. A validation protocol is presented based on two CT scans of the patient acquired before and after cranio-maxillofacial surgery. The actual bones repositioning realized during the intervention are accurately measured and reproduced. A evaluation of the soft tissue deformation is then computed using a finite element model of the face. The simulations are therefore compared, qualitatively and quantitatively, with the actual outcome of the surgery. This protocol enable to rigorously evaluate different modeling methods, and to assess the clinical relevance of soft tissue simulation in maxillofacial surgery.

  13. Periprosthetic soft tissue recurrence of chondroblastoma after attempted en bloc excision from the proximal humerus

    Hammond, G.W.; Tehranzadeh, J.; Hoang, B.H. [University of California, Irvine, Department of Orthopaedic Surgery, Orange (United States); Gu, M. [University of California, Irvine, Department of Pathology, Orange (United States)


    A case of soft tissue recurrence of chondroblastoma after attempted en bloc excision and endoprosthetic replacement is described. This tumor in the proximal humerus recurred after initial curettage and was subsequently treated by attempted en bloc excision with positive microscopic margins. The patient then presented with a large soft tissue recurrence surrounding the endoprosthesis. This periprosthetic recurrence necessitated re-excision and revision of the endoprosthesis. Recurrence is not uncommon following curettage of chondroblastoma. However, less is known about soft tissue recurrence after en bloc resection of this tumor with positive margins. A subset of chondroblastoma may exist with more locally aggressive behavior. (orig.)

  14. [Lipomatous tumors of the skin and soft tissue. New entities and concepts].

    Mentzel, T


    Mesenchymal neoplasms of lipogenic differentiation are the most common soft-tissue neoplasms in adults. In recent years a number of "new" entities and variants have been described. Their recognition is important to avoid diagnostic pitfalls and inappropriate therapy. Chondroid lipoma, myolipoma, and purely cutaneous spindle-cell/pleomorphic lipoma are biologically benign neoplasms which may mimic sarcomas morphologically. Despite high-grade morphology cutaneous liposarcomas carry a favorable clinical prognosis. Spindle cell liposarcoma is a rare variant of atypical lipomatous tumour (well-differentiated liposarcoma) and must be distinguished from dedifferentiated liposarcoma with metastatic potential and benign spindle cell lipoma. The advent of cytogenetic and molecular investigations of lipomatous neoplasms has contributed to a better understanding of the biology of these neoplasms and led to a modification of conventional classification schemes.

  15. Epirubicin is not Superior to Doxorubicin in the Treatment of Advanced Soft Tissue Sarcomas.The Experience of the EORTC Soft Tissue and Bone Sarcoma Group

    Nielsen, Ole Steen; Dombernowsky, Per; Mouridsen, Henning T;


    Purpose. Doxorubicin (dox) still appears to be one of the most active drugs in the treatment of soft tissue sarcomas. However, treatment duration is limited due to cumulative cardiotoxicity. A number of small studies from single institutions have suggested activity of other analogues. In two...... studies the EORTC STBSG tested whether epirubicin (epi) is an alternative to standard dose dox in the treatment of chemonaive patients with advanced soft tissue sarcoma. The present report gives the final results of these studies.Patients/Methods. In the first study 210 patients were randomized to receive......, epi is not superior to dox in the treatment of patients with advanced soft tissue sarcomas. In addition, the results illustrate that the data from small studies of single institutions should always be confirmed by large multi-institutional studies before being taken for granted....

  16. Apparent diffusion coefficient measurements with diffusion-weighted imaging for differential diagnosis of soft-tissue tumor

    Yu Zou


    Conclusion: Our results provide strong evidence that patients diagnosed with malignant soft-tissue tumors have low ADC values of DWI compared to those with benign soft-tissue tumors. Therefore, ADC measurements with DWI may be reliable in differential diagnosis of soft-tissue tumors.

  17. [Soft tissues volumes changing in malar and cheek area after fat grafting].

    Nadtochiy, A G; Grischenko, S V; Malitskaya, O A


    To improve the predictability of facial soft tissues fat grafting results tissue thickness dynamics before and 1 year postoperatively was assessed by means of ultrasonic method in 58 patients under standardized position of the ultrasonic transducer, physical and technical scanning conditions. The study revealed direct correlation of soft tissues thickness increase after fat grafting with the initial thickness of recipient area tissues. One year after fat grafting 60-65% of additional thickness remained in the lower regions of malar-cheek area (with the greatest soft tissues thickness), and only 25-27% preserved in the upper regions with the minimal initial thickness of soft tissues. I.e. to achieve necessary correction volume in a zone with small initial soft tissues thickness it is necessary to increase the amount of fat grafting stages. As the rates of soft tissues thickness in correction area change during 3-4 months after fat grafting remaining stable after this period it is expedient to assess postoperative results and to carry out repeated fat grafting not earlier than 4 months after operation.

  18. Soft tissue profile changes following mandibular advancement surgery: predictability and long-term outcome.

    Mobarak, K A; Espeland, L; Krogstad, O; Lyberg, T


    The objectives of this cephalometric study were to assess long-term changes in the soft tissue profile following mandibular advancement surgery and to investigate the relationship between soft tissue and hard tissue movements. The sample consisted of 61 patients treated consecutively for mandibular retrognathism with orthodontic therapy combined with bilateral sagittal split osteotomy and rigid fixation. Lateral cephalograms were taken on 6 occasions: immediately before surgery, immediately after surgery, 2 and 6 months after surgery, and 1 and 3 years after surgery. Postsurgical changes in the upper and the lower lips and the mentolabial fold were more pronounced among low-angle cases compared with high-angle cases. In accordance with other studies, the soft tissue chin and the mentolabial fold were generally found to follow their underlying skeletal structures in a 1:1 ratio. Because of the strong influence skeletal relapse has on soft tissue profile changes, alternative ratios of soft tissue-to-hard tissue movement that accounted for mean relapse were also generated. It is suggested that if a more realistic long-term prediction of the postsurgical soft tissue profile is desirable, then ratios incorporating mean relapse should be used rather than estimates based on a 1:1 relationship.

  19. Comparative study of psychologtcal health conditions between elderly and young adult patients with facial soft tissue injury and analysis of the mode for the diagnosis and treatment%中青年与老年面部创伤患者心理状态比较及诊疗模式分析

    杨震; 亓发芝; 顾建英; 曹小曼


    Objective To compare the difference of psychological health conditions between eldedy and young adult patients with facial soft tissue injury.Methods The SDS,SAS and UCLA loneliness scale were applied to 88 patients with facial soft tissue injury.Results The score of anxiety and depression index in young adult patients were significantly higher than that in elderly adult patients[(50.96±6.21)vs(40.45±5.29),P<0.01;(0.58±0.06)vs(0.44±0.04),P<0.01].However,the loneliness score was notably lower than that in elderly adult patients[(60.62±5.43)vs(38.22±6.64)](P<0.01).Conclusion The facial injury patients of different ages suffered from different psychological symptoms and they should be treated differently.%目的 比较中青年与老年面部创伤患者心理状态.方法 采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、UCLA孤独量表等心理学量表对88例面部创伤患者的心理健康状况进行测量.结果 中青年患者焦虑评分[(50.96±6.21)分]、抑郁指数[(0.58±0.06)]明显高于老年患者[(40.45±5.29)分,(0.44±0.04)](P<0.01),老年患者的孤独评分[(60.62±5.43)分]明显高于中青年患者[(38.22±6.64)分](P<0.01).结论 不同年龄层次的面部创伤患者心理障碍情况有很大不同,在临床处理上应区别对待.

  20. Radiographic assessment of facial soft tissue thickness in South Indian population--An anthropologic study.

    Kotrashetti, Vijayalakshmi S; Mallapur, M D


    Facial reconstruction is a technique used in forensic anthropology to identify an unknown person. Various methods used for facial reconstruction are drawings, sculpture and computer aided image building which is mainly based on facial soft tissue thickness measurement. Several methods have been established for measuring facial soft tissue thickness (FSTT) with each one having certain limitations. There is limited data available on FSTT among South Indian population. Hence the present study was ventured to determine the FSTT among South Indian adults and also to find FSTT difference between male and female. 308 subjects of South Indian origin (18-27 years) having full set of permanent dentition who require orthodontic treatment were included in the study. Subjects were assessed for Body Mass Index (BMI) and diagnostic digital x-ray of lateral cephalogram (LC), Lateral oblique (LO) view and posterior-anterior (PA) view was obtained. The digital image was transferred to Adobe Photoshop CS4 software and 23 different soft tissue points were measured. Mean FSTT was more in males compared to females except for three landmarks. Statistically significant difference was observed in 20 landmarks when height and weight was compared in males, whereas in females only 12 landmarks showed significant difference. BMI showed good correlation with FSTT in both males and females, which was confirmed by linear regression. The best regressor in terms of estimating FSTT in association with age/sex/BMI were nasion, sub nasale, labial superioris, labrale inferius, gnathion, inferior border of zygomatic, right and left gonion. Stepwise discriminant analysis using all variables showed 94.8% of overall accuracy in sex determination. The observation of present study suggests that LO and PA view along with LC gives information regarding mean FSTT among South Indian population. Even though BMI plays a dominant role in determining FSTT, but age, sex, height and weight should also be considered

  1. Tedizolid: A New Oxazolidinone Antibiotic for Skin and Soft Tissue Infections.

    Chahine, Elias B; Sucher, Allana J; Knutsen, Shannon D


    To review the chemistry, pharmacology, microbiology, pharmacodynamics, pharmacokinetics, clinical efficacy, tolerability, drug interactions, dosing, and administration of tedizolid phosphate (TDZ). A search of PubMed using the terms "tedizolid," "torezolid," "TR-701," "TR-700," "DA-7157," and "DA-7218" was performed. The manufacturer's Web site was also reviewed to further identify relevant information. All English-language articles from 2006 to November 2014 appearing in these searches were reviewed for relevance to this paper. In addition, their bibliographies were reviewed to identify any articles not uncovered in the searches. TDZ is the second oxazolidinone antibiotic with a spectrum of activity targeted against gram-positive organisms including methicillin-resistant Staphylococcus aureus . It is administered via intravenous infusion or orally without regard to food. The primary route of elimination is fecal excretion. Advanced age, hepatic dysfunction, or renal impairment does not alter its disposition. Phase III clinical trials have demonstrated that TDZ 200 mg daily for 6 days is noninferior to linezolid 600 mg twice daily for 10 days in the treatment of adults with skin and soft tissue infections caused or suspected to be caused by gram-positive organisms. TDZ has a side effect profile similar to that of linezolid and a lower potential for drug interactions. TDZ has been shown to be safe and effective for the treatment of adults with skin and soft tissue infections. Further research is needed to refine its role, particularly for the treatment of patients requiring a longer duration of therapy and in those receiving concomitant serotonergic agents.

  2. Evaluation of minimal disseminated disease in cryopreserved ovarian tissue from bone and soft tissue sarcoma patients.

    Dolmans, M M; Iwahara, Y; Donnez, J; Soares, M; Vaerman, J L; Amorim, C A; Poirel, H


    What is the risk of finding malignant cells in cryopreserved ovarian tissue from sarcoma patients? Minimal disseminated disease (MDD) was not detected in frozen-thawed ovarian tissue from 26 patients by any of the sensitive methods applied. In case of leukemia, the risk of malignant cell transmission through the graft is well known and widely documented. However, for bone cancer, like Ewing sarcoma or osteosarcoma, only a small number of case reports, have been published. These cancers often affect prepubertal girls, in whom ovarian tissue cryopreservation and transplantation is the only option to preserve fertility. The presence of malignant cells in cryopreserved ovarian tissue from patients with bone/soft tissue sarcoma was investigated with disease-specific markers for each patient, using immunohistochemistry (IHC), FISH and real-time quantitative RT-PCR (qPCR), with the original tumor serving as a positive control. Forty-eight sarcoma patients were enrolled in the study, 12 of whom subsequently died. In each case, tissue from the primary tumor was investigated in order to identify markers (immunohistochemical and/or molecular) to analyze the ovarian tissue case by case. Ovarian tissue from osteosarcoma (n = 15), liposarcoma (n = 1) and undifferentiated sarcoma (n = 5) patients could not be evaluated, as no specific markers were detected by FISH or sensitive IHC in any of their primary tumoral tissue. One patient with Li-Fraumeni syndrome was also excluded from the study. IHC analyses were therefore performed on ovarian tissue from 26 patients and qPCR on 19. The primary tumors involved were Ewing sarcoma family of tumors (n = 14), rhabdomyosarcoma (n = 7), synovial sarcoma (n = 2), clear cell sarcoma (n = 2) and a malignant peripheral nerve sheath tumor (n = 1). MDD was not detected in any of the 26 analyzed samples using sensitive techniques in this largest reported series, even from patients who subsequently died and/or those who presented

  3. Comparison of soft tissue profile changes in serial extraction and late premolar extraction.

    Wilson, J R; Little, R M; Joondeph, D R; Doppel, D M


    To assess soft tissue profile changes through time, a comparison was made of patients treated by serial extraction without subsequent orthodontic treatment (n=28), patients treated with serial extraction and orthodontic treatment (n=30), and patients treated orthodontically with late extraction (n=30). Cephalometric radiographs were traced and digitized; linear and angular measurements were made with a custom computer program that allowed digitization of specific soft tissue points. Maxillary, mandibular, and overall cephalometric superimpositions and linear measurements of change from the superimpositions were done by hand. Statistical analyses were made to determine if significant differences existed within each group at each time period and between groups at each time period, as well as between males and females at each time period. Data were also analyzed to determine if significant correlations existed between any hard tissue variable and any soft tissue variable, or between any soft tissue variable and any other soft tissue variable. It was found that in those patients treated with late premolar extraction, the most labial point of the mandibular incisor was more posterior from pretreatment to posttreatment than in the serial extraction group. While a great number of associations existed between variables, no significant differences were found between the soft tissue profiles of these three groups of patients. The gender differences that were found to exist were most likely due to normal maturational changes, not the treatment itself.

  4. Necrotising Soft Tissue Infection–Risk Factors for Mortality

    V., Kalaivani; Hiremath, Bharati V.; V. A, Indumathi


    Necrotising Soft Tissue Infection is a rapidly progressing fatal disorder, the prognosis of which depends on early diagnosis and management. Objective: In this study, our objective was to assess the factors contributing to mortality due to NSTI. Methods: A retrospective review of the records of all patients with NSTI involving fascia, skin or muscle between January 2007 and December 2011, was performed. The atiology, predisposing factors, risk factors, causative microbiological organisms and the clinical outcomes associated with mortality were studied. Statistical Data: Descriptive statistics comprising of proportion(%) presented. Chi–square test was employed to assess the statistical significance in the distribution of various known risk factors between the survivors and non–survivors. A ‘p’ value less than 0.05 was considered significant. Results: Sixty patients records were reviewed. Fifty-one patients (85%) were males and nine (15%) were females. Mean age was 46.57 years (+/- 20.60) ranging from 15–83 years. All the patients were treated by debridement & wide spectrum antibiotics. Mono-microbial atiology being found in 27 patients (63.3%) and polymicrobial culture was isolated in 13 patients (36.7%), with E-coli and staphylococci being the most common organisms to be isolated. In most patients, multiple debridements were done. The overall mortality rate was estimated to be 25%. Age, aatiology, diabetes mellitus, hypoalbuminemia, alcohol, site of infection, bacteriology etc. were the risk factors associated with mortality, that were evaluated. Diabetes mellitus was the most common associated risk factor found in 32 patients (53.3%), though not statistically significant. Increasing age (>50 years, p value = 0.016), raised Serum Creatinine (>1.2mg/dl, p-value = 0.023) and delayed surgical intervention(>24 hours p value= 0.006) were the risk factors associated with Mortality in NSTI that were statistically significant. Conclusion: Despite the use of

  5. The Nanomechanics of Biomineralized Soft-Tissues and Organic Matrices

    Bezares-Chavez, Jiddu

    The research reported on in this dissertation is concerned with the macro-molecular constitution and geometrical organization of the soft-tissue comprising the matrix of the nacreous portion of the shell of Haliotis rufescens, the Red abalone. Nacre is one of literally legions of intricate biomineralized structures that exist in nature and has long served as a paradigm for elegant and optimized structural de-sign. Biomineralization involves, inter alia, the uptake and synthesis of elements and compounds from the environment and their incorporation into highly optimized functional structures. Nacre has a structure described as a brick wall like with a matrix of biopolymer layers that are preformed and serve as a template into which nanocrystalline tiles of CaCO3 precipitate. The matrix, or what are known as inter-lamellar layers, are of particular interest as they impart both toughness and strength to the composite ceramic nacre structure. The work first involved a histochemical mapping of the macromolecular structure of the interlamellar layers; this revealed the locations of proteins and functional molecular groups that serve as nucleation sites for the ceramic tiles. Parallel studies on the nacre of Nautilus pompilius, the Chambered Nautilus, revealed the generality of the findings. Of particular interest was determining both the content and layout of chitin within these layers. In fact it was determined that chitin was organized as mostly unidirectional architecture of fibrils, with a certain fraction of fibrils laying at cross directions. Most remarkably, it was found that the fibrils possessed a very long range connectivity that spanned many tiles. This was determined by systematic atomic force (afm) and analytical optical histochemical microscopy. These findings were further verified by a unique form of mechanical testing whereby tensile testing was conducted on groups of interlamellar layers extracted from nacre. Mechanical testing led to a quantitative

  6. Oral Soft Tissue Pathologies among Diabetic Patients in Rasht- 2005

    H Hassannia


    Full Text Available Introduction: Diabetes can affect organs including the oral mucosa. There is a disagreement about the prevalence of oral mucosal disease in diabetic patients. We therefore decided to investigate more about that. The aim of this study was to determine the prevalence of soft tissue pathologies by assessing burning mouth and xerostomia in diabetic patients on the basis of type of diabetes and control status of diabetes. Methods: This descriptive, analytic study was done by visiting 486 known diabetic patients who were referred to the Endocrine Clinic in summer of 2005. Their demographic information with history of systemic diseases accompanied by the amount of HbAIC and duration of disease was recorded in their questionnaire. Diagnosis of oral lesions was done by clinical examination. Burning mouth was assessed by visual analog scale in persons who suffered and subjective xerostomia was evaluated by standard questionnaire. Data collection was done by software SPSS 10, and statistical analysis was done by X2 and logistic regression test. Results: In this study, 34 patients were type I and 434 were type II patients with mean age of 47.84±9.77 years. Frequency of all candidasis lesions was 15.4% which included denture stomatitis 5.3%, angular cheilitis 4.1%, median rhomboid glossitis 1.5%and papillary atrophy of tongue 4.5%. Frequency of non-candidal lesions was 20.1%, which included fissured tongue 10.5%, geographic tongue 7.9% and lichen planus 1.7%. 6.2% of patients suffered from glossodyna. 15.6% of patients had xerestomia. By logistical regression test, we found that type of diabetes affects denture stomatitis, angular cheilitis, tongue atrophy and amount of HbA1c. Conclusion: All of the pathologies were greater in type I than type II diabetes patients. Level of HbA1c had an important role in appearance of oral lesions and level changes can cause problems in the mouth. Thus, patients should maintain their oral hygiene and control their glucose

  7. [Computer-aided analysis of maxillofacial soft tissue simulating with vertical dimensions of 4 different types

    Lu, E Y; Luo, J P; Chang, C Y


    In this study,33 parameters relating to vertical dimension of occlusion(VDO) of 19 subjects' maxilofacial soft tissue of four different vertical dimentsions(VDs) were measured.All of them were in intercusping position,with the technique of digital imaging analysis.The findings as follows:(1)A set of normal values of facial soft tissue's parameters of four different VDs was established,which was suitable for the age group of 21-24 years old.(2)When the VD was raised to the certain height(H4),it would affect the size of angle of the inferior soft tissue of lip distinctly,furthermore,the correlation analysis showed that there was a positive correlation between the variance of VDs would arouse the change of the inferior soft tissues of lip,especially its size of angle,is very correspondingly and obviously.

  8. Vertical Ridge Augmentation and Soft Tissue Reconstruction of the Anterior Atrophic Maxillae: A Case Series.

    Urban, Istvan A; Monje, Alberto; Wang, Hom-Lay


    Severe vertical ridge deficiency in the anterior maxilla represents one of the most challenging clinical scenarios in the bone regeneration arena. As such, a combination of vertical bone augmentation using various biomaterials and soft tissue manipulation is needed to obtain successful outcomes. The present case series describes a novel approach to overcome vertical deficiencies in the anterior atrophied maxillae by using a mixture of autologous and anorganic bovine bone. Soft tissue manipulation including, but not limited to, free soft tissue graft was used to overcome the drawbacks of vertical bone augmentation (eg, loss of vestibular depth and keratinized mucosa). By combining soft and hard tissue grafts, optimum esthetic and long-term implant prosthesis stability can be achieved and sustained.

  9. NIH scientists map gene changes driving tumors in common pediatric soft-tissue cancer

    Scientists have mapped the genetic changes that drive tumors in rhabdomyosarcoma, a pediatric soft-tissue cancer, and found that the disease is characterized by two distinct genotypes. The genetic alterations identified in this malignancy could be useful

  10. A Preliminary Study on Soft Tissue Cutting in Virtual Surgery Simulation

    JIA Shi-yu; PAN Zhen-kuan


    A method for simulation of cutting virtual soft tissue objects made of tetrahedron elements is developed. A linear isotropic elastic model is used for the soft tissue material properties and a tensor-mass model chosen for the physical deformation. The Verlet leapfrog method is used to perform time integration in solving the dynamic equations. Cutting is simulated by simply removing the tetrahedron elements that are intersected with the virtual scalpel. By making use of the spatial coherence, collision detection between soft tissue objects and the virtual scalpel is sped up. To facilitate the simulation, the soft tissue object is represented by linked lists of vertices, edges and tetra elements with pointers to the related neighboring features. The established software framework can serve as a base for the future development. Results of virtual experiments are shown and discussed. Possible future directions are also given.

  11. Facial paralysis reconstruction with Gore-Tex Soft-Tissue Patch.

    Konior, R J


    No procedure perfectly restores a face paralyzed by surgical ablation of the facial nerve. Although dynamic reconstructive procedures are preferred for treating patients with complete facial paralysis, various conditions contraindicate their use, making static suspension of the paralyzed face a reasonable surgical alternative. Expanded polytef soft-tissue patch (polytetrafluoroethylene; Gore-Tex Soft-Tissue Patch, Gore-Tex, W. L. Gore & Assoc Inc., Flagstaff, Ariz) was used to help correct midfacial and perioral asymmetries in 11 patients with complete unilateral facial paralysis. All patients had previous surgical ablation of the facial nerve and were not considered good candidates for dynamic facial reconstruction. Midfacial and perioral asymmetries were improved in all patients using this technique of static soft-tissue suspension. One postoperative infection and two cases of postoperative suture extrusion were observed in the patient population. Other complications associated with the use of Gore-Tex Soft-Tissue Patch for facial suspension were limited to technical factors.

  12. Pazopanib in advanced vascular sarcomas: an EORTC Soft Tissue and Bone Sarcoma Group (STBSG) retrospective analysis

    Kollar, A.; Jones, R.L.; Stacchiotti, S.; Gelderblom, H.; Guida, M.; Grignani, G.; Steeghs, N.; Safwat, A.; Katz, D.; Duffaud, F.; Sleijfer, S.; Graaf, W.T. van der; Touati, N.; Litiere, S.; Marreaud, S.; Gronchi, A.; Kasper, B.


    BACKGROUND: Pazopanib is a multitargeted tyrosine kinase inhibitor approved for the treatment of patients with selective subtypes of advanced soft tissue sarcoma (STS) who have previously received standard chemotherapy including anthracyclines. Data on the efficacy in vascular sarcomas are limited.

  13. Naming the Soft Tissue Layers of the Temporoparietal Region: Unifying Anatomic Terminology Across Surgical Disciplines

    K.M. Davidge; W.R. van Furth; A. Agur; M. Cusimano


    BACKGROUND: The complexity of temporoparietal anatomy is compounded by inconsistent nomenclature. OBJECTIVE: To provide a comprehensive review of the variations in terminology and anatomic descriptions of the temporoparietal soft tissue layers, with the aim of improving learning and communication ac

  14. Soft Tissue Augmentation Techniques in Implants Placed and Provisionalized Immediately: A Systematic Review

    Rojo, Rosa; Prados-Frutos, Juan Carlos; Manchón, Ángel; Rodríguez-Molinero, Jesús; Sammartino, Gilberto; Calvo Guirado, José Luis; Gómez-de Diego, Rafael


      The aim of this study was to evaluate the effectiveness of techniques for soft tissue augmentation in the placement of immediate implants with and without provisionalization and to assess the quality...

  15. Three-dimensional analysis of craniofacial bones and soft tissues in obstructive sleep apnea using cone beam computed tomography.

    Bruwier, Annick; Poirrier, Robert; Albert, Adelin; Maes, Nathalie; Limme, Michel; Charavet, Carole; Milicevic, Mladen; Raskin, Sylvianne; Poirrier, Anne-Lise


    A total of 154 adult patients with sleep complaints underwent a polysomnography and a craniofacial cone beam computed tomography (CBCT). OSA was defined as an apnea and hypopnea index (AHI) or an oxygen desaturation index (ODI) ≥ 10. Soft tissues and craniofacial bones volumes were prospectively measured by CBCT and collected blindly from sleep polysomnography. Among the study patients, 127 (83%) suffered from OSA and 27 (17%) did not. OSA patients demonstrated a narrower maxillo-palatine core volume (11.7±3.2 vs 14.6±4.9cm(3)) even when adjusting for age, gender, height, neck circumference and body mass index. These upper airway measures provide a comprehensive analysis of bony structures and soft tissues, which can be involved in OSA.

  16. Indeterminate soft-tissue tumors of the hand and wrist: a review based on a clinical series of 39 cases

    Sookur, Paul A. [West Middlesex University Hospital, Department of Radiology, Isleworth, Middlesex (United Kingdom); Saifuddin, Asif [The Royal National Orthopaedic Hospital, Department of Radiology, Stanmore (United Kingdom)


    Soft-tissue masses located at the hand and wrist are a frequent clinical presentation. The majority of these are ganglia, which have characteristic imaging features. Other common masses in which a diagnosis is suggested by imaging include hemangiomas, lipomas, and focal synovitis. The remainder are rare although a diagnosis may be attempted by considering the patients' age and the location. We reviewed 39 soft-tissue masses at the hand and wrist referred to our institution between September 1998 and January 2006 that had indeterminate imaging features. The majority were benign neoplastic lesions with the most common being a giant cell tumor of the tendon sheath, followed by angioleiomyoma, peripheral nerve sheath tumor, fibromatosis, fibroma of tendon sheath, and solitary fibrous tumor. These lesions tend to occur in young adults at the metacarpal level. However, there are no imaging features that can reliably differentiate between benign and malignant tumors. (orig.)

  17. Pediatric Oral/Maxillofacial Soft Tissue Sarcomas: A Clinicopathologic Report of Four Cases

    Joel C. Thompson


    Full Text Available Pediatric soft tissue sarcomas of the oral/maxillofacial region are rare neoplasms that present significant difficulty with respect to treatment and local control measures. We report four cases of pediatric oral/maxillofacial soft tissue sarcomas from our tertiary care pediatric hospital and emphasize the rarity of these malignancies and the challenges encountered in treating these lesions, and suggest areas for further research. We conclude that multimodal therapy and interdisciplinary cooperation are paramount to successful management of these lesions.

  18. Estimation of soft- and hard-tissue thickness at implant sites

    Anil Kumar; Rohan Mascarenhas; Akhter Husain


    Introduction: Anchorage control is a critical consideration when planning treatment for patients with dental and skeletal malocclusions. To obtain sufficient stability of implants, the thickness of the soft tissue and the cortical-bone in the placement site must be considered; so as to provide an anatomical map in order to assist the clinician in the placement of the implants. Objective: The aim of this study is to evaluate the thickness of soft- and hard-tissue. Materials and Methods: To mea...

  19. Magnetic resonance imaging of soft tissue changes in rheumatoid arthritis wrist joints

    Østergaard, Mikkel; Szkudlarek, Marcin


    An increasingly aggressive therapeutic strategy, improved treatment options, and encouraging preliminary results have attracted growing attention to the potential of magnetic resonance imaging (MRI) in the diagnosis, prognostication, and monitoring of rheumatoid arthritis (RA). MRI offers...... multiplanar imaging with unprecedented soft tissue contrast and high spatial resolution. Synovitis, the primary joint lesion in RA, can be detected and monitored. By contrast, conventional radiography shows only the late signs of preceding synovitis. Other soft tissue changes, such as tenosynovitis...

  20. Giant cell reparative granuloma in soft tissue of foot: A case report

    Park, Gyeong Min; Lee, Jihae; Kang, Mijin; Lee, Han Bee; Bae, Kyung Eun; Kim, Jae Hyung; Kim, Hyun Jung [Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)


    Giant cell reparative granuloma is a benign reactive process following intraosseous hemorrhage rather than a true tumor. This lesion most commonly affects the maxilla and mandible, followed by phalanges, hands, and feet. Local invasion of surrounding soft tissue is a typical feature of giant cell reparative granuloma in the bones of the upper and lower limbs. We present the rare case of giant cell reparative granuloma arising from soft tissue of the foot without erosion or engulfing of the adjacent bone.

  1. Measurements of the linear elastic properties of the face soft tissues using an aspiration device

    Luboz, Vincent; Promayon, Emmanuel; Payan, Yohan


    International audience; Maxillo-facial surgeries have a direct impact on the face shape and appearance. The anatomical variations in the face soft tissues (skin thickness, skin or muscle material parameters…) make it hard to predict the face final shape accurately. Biomechanical modeling could help in this prediction by simulating the soft tissue displacement following the bone remodeling and therefore the patient's face visible outcome. Measuring the variation of the skin properties across a...

  2. Invasive facial fungal infections: Orofacial soft-tissue infiltration in immunocompromised patients

    Jun, Peter; Russell, Matthew; El-Sayed, Ivan; Dillon, William; Glastonbury, Christine


    Invasive facial fungal infections affect the orofacial soft tissues in immunocompromised patients and can cause significant morbidity and mortality. Primary infection occurs from direct inoculation of the skin surface, while secondary infection occurs from extension from an adjacent sinonasal process. The imaging features of secondary infection are similar to acute fulminant invasive fungal sinusitis with infiltration of the orofacial soft tissues in combination with sinonasal disease. Howeve...

  3. Fabrication of low cost soft tissue prostheses with the desktop 3D printer

    Yong He; Guang-huai Xue; Jian-zhong Fu


    Soft tissue prostheses such as artificial ear, eye and nose are widely used in the maxillofacial rehabilitation. In this report we demonstrate how to fabricate soft prostheses mold with a low cost desktop 3D printer. The fabrication method used is referred to as Scanning Printing Polishing Casting (SPPC). Firstly the anatomy is scanned with a 3D scanner, then a tissue casting mold is designed on computer and printed with a desktop 3D printer. Subsequently, a chemical polishing method is used ...

  4. Cerebellar contributions to neurological soft signs in healthy young adults.

    Hirjak, Dusan; Thomann, Philipp A; Kubera, Katharina M; Stieltjes, Bram; Wolf, Robert C


    Neurological soft signs (NSS) are frequently found in psychiatric disorders of significant neurodevelopmental origin, e.g., in patients with schizophrenia and autism. Yet NSS are also present in healthy individuals suggesting a neurodevelopmental signature of motor function, probably as a continuum between health and disease. So far, little is known about the neural mechanisms underlying these motor phenomena in healthy persons, and it is even less known whether the cerebellum contributes to NSS expression. Thirty-seven healthy young adults (mean age = 23 years) were studied using high-resolution structural magnetic resonance imaging (MRI) and "resting-state" functional MRI at three Tesla. NSS levels were measured using the "Heidelberg Scale." Cerebellar gray matter volume was investigated using cerebellum-optimized voxel-based analysis methods. Cerebellar function was assessed using regional homogeneity (ReHo), a measure of local network strength. The relationship between cerebellar structure and function and NSS was analyzed using regression models. There was no significant relationship between cerebellar volume and NSS (p motor coordination" and "hard signs" NSS domains. A negative relationship was found between lobule VI activity and "complex motor task" domain (p < 0.005, uncorrected for height, p < 0.05 corrected for spatial extent). The data indicate that in healthy young adults, distinct NSS domains are related to cerebellar activity, specifically with activity of cerebellar subregions with known cortical somatomotor projections. In contrast, cerebellar volume is not predictive of NSS in healthy persons.

  5. Bone-anchored hearing device surgery: Linear incision without soft tissue reduction. A prospective study.

    Altuna, Xabier; Navarro, Juan José; Palicio, Idoia; Álvarez, Leire


    The classic surgical procedure for percutaneous bone-anchored hearing devices involves removal of a large area of subcutaneous tissue down to the periosteum. This leads to alopecia and raises the risk of devascularization of the overlying skin with the potential for infection and scarring. The objective of this study was to determine the results of implant placement using a single, linear incision with no underlying soft tissue reduction. A prospective study was conducted in our hospital over a period of 14 months in all consecutive surgeries performed using this technique in adults. Patients were reviewed regularly (week 1, week 3, weeks 4-6 and months 3, 6 and 12) to assess wound healing including evaluation with the Holgers scale. Corresponding to 34 patients, 34 cases were consecutively enrolled in this study. We found that 15% of the patients had minor skin reactions during the first visit (Holgers grade 1 or 2); this number raised to 20% in week 3, but at week 4 only 1 patient had a reaction score of 1 (which was solved by week 6). None of the cases required revision surgery and all skin reactions were treated topically. Our results suggest that the tissue preservation technique is a simple and effective insertion technique with a favourable healing process and cosmesis. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  6. Checklist and Scoring System for the Assessment of Soft Tissue Preservation in CT Examinations of Human Mummies

    Panzer, Stephanie; Mc Coy, Mark R.; Hitzl, Wolfgang; Piombino-Mascali, Dario; Jankauskas, Rimantas; Zink, Albert R.; Augat, Peter


    The purpose of this study was to develop a checklist for standardized assessment of soft tissue preservation in human mummies based on whole-body computed tomography examinations, and to add a scoring system to facilitate quantitative comparison of mummies. Computed tomography examinations of 23 mummies from the Capuchin Catacombs of Palermo, Sicily (17 adults, 6 children; 17 anthropogenically and 6 naturally mummified) and 7 mummies from the crypt of the Dominican Church of the Holy Spirit of Vilnius, Lithuania (5 adults, 2 children; all naturally mummified) were used to develop the checklist following previously published guidelines. The scoring system was developed by assigning equal scores for checkpoints with equivalent quality. The checklist was evaluated by intra- and inter-observer reliability. The finalized checklist was applied to compare the groups of anthropogenically and naturally mummified bodies. The finalized checklist contains 97 checkpoints and was divided into two main categories, “A. Soft Tissues of Head and Musculoskeletal System” and “B. Organs and Organ Systems”, each including various subcategories. The complete checklist had an intra-observer reliability of 98% and an inter-observer reliability of 93%. Statistical comparison revealed significantly higher values in anthropogenically compared to naturally mummified bodies for the total score and for three subcategories. In conclusion, the developed checklist allows for a standardized assessment and documentation of soft tissue preservation in whole-body computed tomography examinations of human mummies. The scoring system facilitates a quantitative comparison of the soft tissue preservation status between single mummies or mummy collections. PMID:26244862

  7. Ischiofemoral space on MRI in an asymptomatic population: Normative width measurements and soft tissue signal variations

    Maras Oezdemir, Zeynep; Goermeli, Cemile Ayse; Sagir Kahraman, Ayseguel [Inoenue University School of Medicine, Department of Radiology, Malatya (Turkey); Aydingoez, Uestuen [Hacettepe University School of Medicine, Department of Radiology, Ankara (Turkey)


    To make normative width measurements of the ischiofemoral (IF) space in an asymptomatic population and to record soft tissue MRI signal variations within the IF space in order to determine whether such variations are associated with IF space dimensions. Normative width measurements of the IF space were prospectively made in 418 hips on 1.5 T MR images of 209 asymptomatic volunteers. Quantitative and qualitative assessments of the IF soft tissues including the quadratus femoris (QF) muscle were also made. The mean IF space width was 2.56 ± 0.75 cm (right, 2.60 ± 0.75 cm; left, 2.53 ± 0.75 cm). Soft tissue MRI signal abnormalities were present within the IF space in 19 (9.1 %) of 209 volunteers. Soft tissue abnormalities within the IF space included oedema (3/209, 1.4 %) of the QF and/or surrounding soft tissue, and only fatty infiltration (16/209, 7.7 %) of the QF. Bilateral IF spaces are asymmetrical in asymptomatic persons. There is ≥10 % of width difference between right and left IF spaces in approximately half of asymptomatic individuals. Fatty infiltration and oedema can be present at the IF space in a small portion of the asymptomatic population, who also have narrower IF spaces than those without soft tissue MRI signal abnormalities. (orig.)

  8. A mummified duck-billed dinosaur with a soft-tissue cock's comb.

    Bell, Phil R; Fanti, Federico; Currie, Philip J; Arbour, Victoria M


    Among living vertebrates, soft tissues are responsible for labile appendages (combs, wattles, proboscides) that are critical for activities ranging from locomotion to sexual display [1]. However, soft tissues rarely fossilize, and such soft-tissue appendages are unknown for many extinct taxa, including dinosaurs. Here we report a remarkable "mummified" specimen of the hadrosaurid dinosaur Edmontosaurus regalis from the latest Cretaceous Wapiti Formation, Alberta, Canada, that preserves a three-dimensional cranial crest (or "comb") composed entirely of soft tissue. Previously, crest function has centered on the hypertrophied nasal passages of lambeosaurine hadrosaurids, which acted as resonance chambers during vocalization [2-4]. The fleshy comb in Edmontosaurus necessitates an alternative explanation most likely related to either social signaling or sexual selection [5-7]. This discovery provides the first view of bizarre, soft-tissue signaling structures in a dinosaur and provides additional evidence for social behavior. Crest evolution within Hadrosaurinae apparently culminated in the secondary loss of the bony crest at the terminal Cretaceous; however, the new specimen indicates that cranial ornamentation was in fact not lost but substituted in Edmontosaurus by a fleshy display structure. It also implies that visual display played a key role in the evolution of hadrosaurine crests and raises the possibility of similar soft-tissue structures among other dinosaurs.

  9. Imaging of benign and malignant soft tissue masses of the foot

    Waldt, Simone; Rummeny, Ernst J.; Woertler, Klaus [Department of Radiology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaninger Strasse 22, 81675 Munich (Germany); Rechl, Hans [Department of Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaninger Strasse 22, 81675 Munich (Germany)


    The foot is a relatively uncommon site of neoplastic and non-neoplastic soft tissue tumors. Although it contains a relatively small amount of somatic soft tissue elements, the foot is considerably rich in tendons, fasciae, retinaculae, and synovium. Corresponding to this distribution of soft tissue elements, some soft tissue lesions, such as giant cell tumor of tendon sheath, fibromatosis, and synovial sarcoma, are commonly seen in this location. Vascular tumors represent common soft tissue masses of the foot as well. Magnetic resonance imaging is the modality of choice in the assessment of soft tissue tumors. The presence of a suspected lesion can be confirmed and tumor margins can be defined accurately. In general, MRI does not provide histologic specificity, but considering some MR features may often help in correctly distinguishing benign from malignant lesions. In addition, characteristic features of the most common benign tumors (i.e., fibromatosis, cavernous hemangioma) and reactive processes of the foot (ganglion cyst, Morton's neuroma) often suggest a specific diagnosis. (orig.)

  10. Peno-scrotal soft tissue loss:a need for multidisciplinary and multimodal integration

    Pradeoth Korambayil Mukundan; Prashanth Varkey Ambookan; Ragu Angappan; Vinoth Kumar Dilliraj


    Aim: Scrotal soft tissue loss is a part of the challenging conditions for plastic surgeon. The non-availability of adequate nearby healthy soft tissue and its probability of frequent contamination by excretory substances make the issue of reconstruction complicated. The authors present their experience with penoscrotal soft tissue loss with hyperbaric oxygen therapy as an adjunct. Methods: This retrospective study was undertaken in the department of plastic surgery, over a period of 2 years. Nine patients with scrotal or penile injury and infection were enrolled in the study. Age of the patients ranged 20-60 years. Five patients had traumatic loss of scrotal skin and 4 resulted following necrotizing soft tissue infection. All patients underwent hyperbaric oxygen therapy before and following surgery.Results: Healing was complete in all patients with minor complications as partial skin graft loss in 2 patients. Five patients (55.5%) had sustained the soft tissue loss due to trauma. The cause of necrotizing fasciitis was found in 4 patients (44.4%). The mean length of hospital stay was 42.5 days.Conclusion:Management of soft tissue loss of penoscrotal region requires an organized approach and the utilization of newer modalities for early recovery of these injuries is of primary need. Operating surgeons should know the various reconstructive pathways and use of adjunct measures like hyperbaric therapy for early recovery.

  11. Esthetic solution to malpositioned implants with remodeling of soft tissue: a case report.

    Valente, Mariana Lima da Costa; Marcantonio, Elcio; Faeda, Rafael Silveira; de Paula, Wagner Nunes; Dos Reis, Andréa Cândido


    This article describes a clinical case of gingival conditioning with provisional fixed prostheses to improve the esthetics of the soft tissues adjacent to fixed prostheses placed on malpositioned implants. Gradual application of pressure to the tissues is an easy, nontraumatic technique for inducing formation of papillae and reestablishing the appropriate shape and contour of the gingival tissues, thereby improving esthetics and phonetics. The proposed treatment proved to be effective in remodeling the surrounding soft tissues, providing suitable contours, and restoring esthetics and function lost due to surgical treatment with malpositioned implants.

  12. Delayed Soft Tissue Reconstruction with a Horizontal Rectus Abdominis Musculocutaneous Flap following Hip Exarticulation

    Jes Christian Rødgaard


    Full Text Available Coverage of large soft tissue defects at the hip region constitutes a challenge for plastic surgeons. We report the case of a 43-year-old female with necrotizing fasciitis of the right thigh, necessitating hip exarticulation and substantial debridement of necrotic tissue. An ipsilateral horizontal rectus abdominis myocutaneous (HRAM flap was used to cover the defect. The reconstruction was carried out after the attempt of local tissue rearrangement. In light of the successful outcome, we propose that this flap be considered in the future planning of soft tissue reconstruction at the hip region.

  13. Evaluation of Soft Tissue Landmark Reliability between Manual and Computerized Plotting Methods.

    Kasinathan, Geetha; Kommi, Pradeep B; Kumar, Senthil M; Yashwant, Aniruddh; Arani, Nandakumar; Sabapathy, Senkutvan


    The aim of the study is to evaluate the reliability of soft tissue landmark identification between manual and digital plot-tings in both X and Y axes. A total of 50 pretreatment lateral cephalograms were selected from patients who reported for orthodontic treatment. The digital images of each cephalogram were imported directly into Dolphin software for onscreen digi-talization, while for manual tracing, images were printed using a compatible X-ray printer. After the images were standardized, and 10 commonly used soft tissue landmarks were plotted on each cephalogram by six different professional observers, the values obtained were plotted in X and Y axes. Intraclass correlation coefficient was used to determine the intrarater reliability for repeated landmark plotting obtained by both the methods. The evaluation for reliability of soft tissue landmark plottings in both manual and digital methods after subjecting it to interclass correlation showed a good reliability, which was nearing complete homogeneity in both X and Y axes, except for Y axis of throat point in manual plotting, which showed moderate reliability as a cephalometric variable. Intraclass correlation of soft tissue nasion had a moderate reliability along X axis. Soft tissue pogonion shows moderate reliability in Y axis. Throat point exhibited moderate reliability in X axis. The interclass correlation in X and Y axes shows high reliability in both hard tissue and soft tissue except for throat point in Y axis, when plotted manually. The intraclass correlation is more consistent and highly reliable for soft tissue landmarks and the hard tissue landmark identification is also consistent. The results obtained for manual and digital methods were almost similar, but the digital landmark plotting has an added advantage in archiving, retrieval, transmission, and can be enhanced during plotting of lateral cephalograms. Hence, the digital method of landmark plotting could be preferred for both daily use and

  14. Neo-adjuvant chemotherapy alone or with regional hyperthermia for localised high-risk soft-tissue sarcoma: a randomised phase 3 multicentre study

    Issels, Rolf D; Lindner, Lars H; Verweij, Jaap;


    The optimum treatment for high-risk soft-tissue sarcoma (STS) in adults is unclear. Regional hyperthermia concentrates the action of chemotherapy within the heated tumour region. Phase 2 studies have shown that chemotherapy with regional hyperthermia improves local control compared with chemother...

  15. Dynamic simulation of viscoelastic soft tissues in harmonic motion imaging application.

    Shan, Baoxiang; Kogit, Megan L; Pelegri, Assimina A


    A finite element model was built to simulate the dynamic behavior of soft tissues subjected to sinusoidal excitation during harmonic motion imaging. In this study, soft tissues and tissue-like phantoms were modeled as isotropic, viscoelastic, and nearly incompressible media. A 3D incompressible mixed u-p element of eight nodes, S1P0, was developed to accurately calculate the stiffness matrix for soft tissues. The finite element equations of motion were solved using the Newmark method. The Voigt description for tissue viscosity was applied to estimate the relative viscous coefficient from the phase shift between the response and excitation in a harmonic case. After validating our model via ANSYS simulation and experiments, a MATLAB finite element program was then employed to explore the effect of excitation location, viscosity, and multiple frequencies on the dynamic displacement at the frequency of interest.

  16. Approach to the management of soft tissue tumors of the foot and ankle.

    DeGroot, Henry


    To properly treat soft tissue tumors, the foot and ankle surgeon must start with an adequate fund of knowledge and follow a systematic approach. Some malignant soft tumors have a predilection for the foot and ankle, and they may mimic common musculoskeletal conditions, leading to a trap for the unwary clinician. This review will familiarize the practitioner with the common soft tissue tumors that occur in the foot and ankle along with their presentations. A systematic approach to the workup is outlined, which is designed to establish the diagnosis with a significant degree of certainty before the surgical treatment of the tumor is planned. A practical and reliable method of distinguishing benign tumors from those that are potentially malignant is presented. Finally, the techniques for surgical management of the common soft tissue tumors are summarized.

  17. Cirurgia conservadora, radioterapia externa e reforço de dose com braquiterapia de alta taxa de dose: uma nova perspectiva no tratamento de sarcomas de partes moles do adulto Limb-sparing surgery, external beam radiotherapy and boost with high-dose rate brachytherapy: a new perspective for the treatment of soft tissue sarcomas in adults

    Antonio Cássio Assis Pellizzon


    Full Text Available OBJETIVO: Avaliar a influência no controle local de pacientes adultos e portadores de sarcoma de partes moles em extremidades e submetidos a cirurgia conservadora do membro, com braquiterapia de alta taxa de dose (BATD como reforço para a radioterapia externa (RT. MATERIAL E MÉTODOS: Foram avaliados 16 pacientes tratados, de 1993 até 1999. A RT foi utilizada com finalidade pré ou pós-operatória (30--55 Gy e BATD com dose de 18--36 Gy (fx 3--6 Gy BID. Com base no modelo linear quadrático calculou-se a dose efetiva biológica ("biological effective dose" - BED para o tumor e comparou-se seu valor a dados da literatura internacional, que utiliza tratamentos com RT e braquiterapia de baixa taxa de dose (BBTD. RESULTADOS: Os valores médios e medianos da BED para os sarcomas de partes moles foram de 78,5 Gy7 e 80 Gy7. A análise univariada mostrou que a BED para o tumor, quando utilizada BATD, era semelhante ao valor de 83 Gy7 quando utilizada BBTD (p = 0,008. As taxas de controle local, sobrevida livre de doença e sobrevida global atuarial em cinco anos foram de 83,2%, 75% e 93,7%, respectivamente. CONCLUSÕES: A BATD, quando utilizada como método complementar no reforço de dose da RT no tratamento conservador dos sarcomas de partes moles, apresenta taxas de controle local equiparáveis às da literatura internacional; no entanto, estudos com número maior de pacientes e período maior de seguimento são ainda necessários para determinar o verdadeiro potencial da BATD em substituir a BBTD.PURPOSE: To evaluate the influence on local control in adult patients with soft tissue sarcomas of the limbs that underwent limb-sparing surgery and high-dose rate brachytherapy (HDRB in association with teletherapy. MATERIAL AND METHODS: Sixteen patients treated from 1993 to 1999 were reviewed. Teletherapy was used pre- or postoperatively (30--55 Gy in association with HDRB in a dose range of 18--36 Gy (fx 3--6 Gy BID. The linear quadratic model was

  18. A nonlinear-elastic constitutive model for soft connective tissue based on a histologic description: Application to female pelvic soft tissue.

    Brieu, Mathias; Chantereau, Pierre; Gillibert, Jean; de Landsheere, Laurent; Lecomte, Pauline; Cosson, Michel


    To understand the mechanical behavior of soft tissues, two fields of science are essential: biomechanics and histology. Nonetheless, those two fields have not yet been studied together often enough to be unified by a comprehensive model. This study attempts to produce such model. Biomechanical uniaxial tension tests were performed on vaginal tissues from 7 patients undergoing surgery. In parallel, vaginal tissue from the same patients was histologically assessed to determine the elastic fiber ratio. These observations demonstrated a relationship between the stiffness of tissue and its elastin content. To extend this study, a mechanical model, based on an histologic description, was developed to quantitatively correlate the mechanical behavior of vaginal tissue to its elastic fiber content. A satisfactory single-parameter model was developed assuming that the mechanical behavior of collagen and elastin was the same for all patients and that tissues are only composed of collagen and elastin. This single-parameter model showed good correlation with experimental results. The single-parameter mechanical model described here, based on histological description, could be very useful in helping to understand and better describe soft tissues with a view to their characterization. The mechanical behavior of a tissue can thus be determined thanks to its elastin content without introducing too many unidentified parameters.

  19. 两种不同拔牙方式矫治成人骨性反牙合的硬软组织改变的对比研究%Study on two different extraction methods for adult skeletal Class III malocclusion of the hard and soft tissue contrast

    宁芳; 段银钟; 袁东辉


    Objective:To investigate the hard and soft tissue changes of single mandibular extraction with bimaxillary extraction orthodontic treatment of adult skeletal Class III malocclusion. Method:adult skeletal Class III malocclusion pa-tients with 31 cases,the extraction of four premolars in 13 cases(group A),single extraction of mandibular two premolars in 18 cases (group B). Application of X-ray cephalometric technique on the hard and soft tissue changes before and after treatment was measured,the measurement results were analysis. Result:there was no significant difference on SNA,SNB and ANB in two groups before and after treatment. Changes of lower anterior teeth and lip retraction in group A were more prominent,also the facial profile changes were significantly more than group B. Conclusion:single lower extraction mode for mild to moderate skeletal Class III cases with no crowd or mild crowd in the maxillary;bimaxillary extraction model suitable for maxillary with moderate or severe congestion in skeletal Class III malocclusion patients.%目的:探讨下颌单颌拔牙与双颌拔牙矫治成人骨性反牙合的硬软组织改变的差异。方法:选取成人骨性反牙合患者31例,其中拔除4个前磨牙矫治(甲组)13例,下颌单颌拔除2个前磨牙矫治(乙组)18例。应用X线头影测量对矫治前后的硬软组织变化进行测量。结果:两组SNA、SNB、ANB矫治前后的变化无明显差异。甲组下切牙内收与下唇的变化更为显著,下唇凸度明显减小,甲组面型侧貌改变较乙组更为显著。结论:单颌拔牙模式适用于上颌无拥挤或轻度拥挤的轻中度骨性反牙合患者;双颌拔牙模式适用于上颌伴中重度拥挤的中度骨性反牙合患者。

  20. Simulation and experiment of soft-tissue deformation in prostate brachytherapy.

    Liang, Dong; Jiang, Shan; Yang, Zhiyong; Wang, Xingji


    Soft-tissue deformation is one of the major reasons for the inaccurate positioning of percutaneous needle insertion process. In this article, simulations and experiments of the needle insertion soft-tissue process are both applied to study soft-tissue deformation. A needle deflection model based on the mechanics is used to calculate the needle deflection during the interaction process. The obtained needle deflection data are applied into finite element analysis process as the system input. The uniaxial tensile strength tests, compression tests, and static indentation experiments are used to obtain the soft-tissue parameters and choose the best strain-energy function to model in the simulation. Magnetic resonance imaging is used to reconstruct the prostate, establishing both prostate three-dimensional finite element model and artificial prostate model. The needle-soft tissue interaction simulation results are compared with those of the needle insertion experiment. The displacement data of the mark point in the experiment are comparable to the simulation results. It is concluded that, using this simulation method, the surgeon can predict the deformation of the tissue and the displacement of the target in advance.

  1. Scaffold Sheet Design Strategy for Soft Tissue Engineering

    Liping Tang


    Full Text Available Creating heterogeneous tissue constructs with an even cell distribution and robust mechanical strength remain important challenges to the success of in vivo tissue engineering. To address these issues, we are developing a scaffold sheet tissue engineering strategy consisting of thin (~200 μm, strong, elastic, and porous crosslinked urethane- doped polyester (CUPE scaffold sheets that are bonded together chemically or through cell culture. Suture retention of the tissue constructs (four sheets fabricated by the scaffold sheet tissue engineering strategy is close to the surgical requirement (1.8 N rendering their potential for immediate implantation without a need for long cell culture times. Cell culture results using 3T3 fibroblasts show that the scaffold sheets are bonded into a tissue construct via the extracellular matrix produced by the cells after 2 weeks of in vitro cell culture.

  2. Polymer structure-property requirements for stereolithographic 3D printing of soft tissue engineering scaffolds.

    Mondschein, Ryan J; Kanitkar, Akanksha; Williams, Christopher B; Verbridge, Scott S; Long, Timothy E


    This review highlights the synthesis, properties, and advanced applications of synthetic and natural polymers 3D printed using stereolithography for soft tissue engineering applications. Soft tissue scaffolds are of great interest due to the number of musculoskeletal, cardiovascular, and connective tissue injuries and replacements humans face each year. Accurately replacing or repairing these tissues is challenging due to the variation in size, shape, and strength of different types of soft tissue. With advancing processing techniques such as stereolithography, control of scaffold resolution down to the μm scale is achievable along with the ability to customize each fabricated scaffold to match the targeted replacement tissue. Matching the advanced manufacturing technique to polymer properties as well as maintaining the proper chemical, biological, and mechanical properties for tissue replacement is extremely challenging. This review discusses the design of polymers with tailored structure, architecture, and functionality for stereolithography, while maintaining chemical, biological, and mechanical properties to mimic a broad range of soft tissue types. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. In vitro assessment of the soft tissue/implant interface using porcine gingival explants.

    Abdulmajeed, Aous A; Willberg, Jaana; Syrjänen, Stina; Vallittu, Pekka K; Närhi, Timo O


    The biologic seal of peri-implant soft tissue is crucial for long-term prognosis of oral implants. This in vitro study describes a novel tissue culture model using porcine gingival explants to evaluate the soft tissue/implant interface. Two different types of substrates were investigated: (a) plain polymer: BisGMA-TEGDMA (50-50 %) and (b) unidirectional fiber-reinforced composite (FRC). Porcine gingival explants were obtained from a local slaughterhouse. The experimental implants (n = 4) were inserted into the middle of freshly excised porcine gingival explants and cultured at the air/liquid interface up to 14 days. Porcine gingival explants with no implants served as baseline controls. The specimens were fixed and processed for the preparation of undecalcified samples. Histological analysis of the soft tissue/implant interface was carried out using a light-microscope. Microscopic evaluation suggests that the gingival explants established epithelial and connective tissue attachment to both implant types over the incubation period. FRC surfaces seemed to have a favorable tissue response with a sign of an outward epithelial migration. However, tissue degeneration was observed at the end of the experiment. In conclusion, this in vitro model maintains mucosal viability and ability to histologically evaluate soft tissue attachment to biomaterials rendering it a time efficient and cost effective model that may reduce the need for animal experiments.

  4. Indentation and Observation of Anisotropic Soft Tissues Using an Indenter Device

    Parinaz ASHRAFI


    Full Text Available Soft tissues of human body have complex structures and different mechanical behaviors than those of traditional engineering materials. There is a great urge to understand tissue behavior of human body. Experimental data is needed for improvement of soft tissue modeling and advancement in implants and prosthesis, as well as diagnosis of diseases. Mechanical behavior and responses change when tissue loses its liveliness and viability. One of the techniques for soft tissue testing is indentation, which is applied on live tissue in its physiological environment. Indentation affords several advantages over other types of tests such as uniaxial tension, biaxial tension, and simple shear and suction, thus it is of interest to develop new indentation techniques from which more valid data can be extracted. In this study a new indenter device was designed and constructed. Displacement and force rate cyclic loading, and relaxation experiments were conducted on human arm. The in-vivo force rate controlled cyclic loading test method which is novel is compared with the traditional displacement controlled cyclic loading tests. Anisotropic behavior of tissue cannot be determined by axisymmetric tips, therefore ellipsoid tips were used for examining anisotropy and inplane material direction of bulk soft tissues

  5. Soft tissue integration versus early biofilm formation on different dental implant materials

    Zhao, Bingran; van der Mei, Henderina; Subbiahdoss, Guruprakash; de Vries, Joop; Rustema-Abbing, Minie; Kuijer, Roel; Busscher, Henk J.; Qu-Ren, Yijin


    OBJECTIVE: Dental implants anchor in bone through a tight fit and osseo-integratable properties of the implant surfaces, while a protective soft tissue seal around the implants neck is needed to prevent bacterial destruction of the bone-implant interface. This tissue seal needs to form in the unster

  6. A rate-jump method for characterization of soft tissues using nanoindentation techniques

    Tang, Bin


    The biomechanical properties of soft tissues play an important role in their normal physiological and physical function, and may possibly relate to certain diseases. The advent of nanomechanical testing techniques, such as atomic force microscopy (AFM), nano-indentation and optical tweezers, enables the nano/micro-mechanical properties of soft tissues to be investigated, but in spite of the fact that biological tissues are highly viscoelastic, traditional elastic contact theory has been routinely used to analyze experimental data. In this article, a novel rate-jump protocol for treating viscoelasticity in nanomechanical data analysis is described. © 2012 The Royal Society of Chemistry.

  7. Cross polarization optical coherence tomography for diagnosis of oral soft tissues

    Gladkova, Natalia; Karabut, Maria; Kiseleva, Elena; Robakidze, Natalia; Muraev, Alexander; Fomina, Julia


    We consider the capabilities of cross-polarization OCT (CP OCT) focused on comparison of images resulting from cross-polarization and co-polarization scattering simultaneously for diagnosis of oral soft tissues. CP OCT was done for 35 patients with dental implants and 30 patients with inflammatory intestine diseases. Our study showed good diagnostic capabilities of CP OCT for detecting soft tissue pathology in the oral cavity. The cross-polarized images demonstrate the ability of tissue to depolarize. CP OCT demonstrates clinical capabilities for early diagnosis of inflammatory intestine diseases by the state of oral cavity mucosa and for early detection of gingivitis in patients above implant.

  8. Physical Mechanisms of Soft Tissue Injury from Penetrating Ballistic Impact


    2008; 64(6):1420-1426. 18. Gryth D, Rocksen D, Persson JK, Arborelius UP, Drobin D, Bursell J, Olsson LG, Kjellstrom BT. Severe lung contusion and...elastic tissues such as lungs and muscle, where the tissue tends to spring back into place with little damage from temporary stretch, most a study comparing penetrating thoracic wounds caused by stab injuries to those caused by gunshot injuries, the occurrence of lung


    V. S. Mel'nikov


    Full Text Available Objective: to determine the capabilities and perspectives of island and perforator flaps for soft tissue reconstruction of the hand. Material and methods. Results of treatment of 41 patients with defects of the soft tissue of the hand, treated at the in the period from 2010 to 2013 and operated using the island flaps and perforator flaps (DAP flap. Results and conclusion. In all cases the authors have received positive functional and cosmetic results, which were evaluated using a questionnaire DASH, the average score was 12.3. Digital artery perforator flaps allow close defect covering tissue any surface fingers. The use of perforator flaps allows reconstructing soft tissue defect with the skin of the same anatomical region as identical morphologically lost. The second important advantage is that the DAP flap is not included in the magisterial arteries, allows its use as a recipient for subsequent microsurgical reconstructions.

  10. Magnetic resonance imaging of soft-tissue tumors of the extremities: A practical approach

    Wing; P; Chan


    Diagnosis of extremity soft-tissue tumors can be challenging.Characteristics of tumor margins can help precisely identify locally aggressive or non-aggressive behavior for surgical planning,but cannot differentiate benign from malignant lesions.Most malignant tumors can have inhomogeneous signals on T2-weighted images.Although a uniform signal on T2-weighted images can be a reliable indication of a benign lesion,a well-defined mass with homogeneous internal signal intensity does not definitively identify a benign lesion.Some common and distinctive soft-tissue lesions can have specific clinical and imaging features allowing a diagnosis without biopsy.These are known as determinate lesions.This illustrative report presents a diagnostic guide for extremity soft-tissue tumors based on tissue signal and morphological characteristics on magnetic resonance images.It is important for clinicians to be familiar with the imaging characteristics of common determinate lesions.

  11. Ionizing radiation exposure and the development of soft-tissue sarcomas in atomic-bomb survivors.

    Samartzis, Dino; Nishi, Nobuo; Cologne, John; Funamoto, Sachiyo; Hayashi, Mikiko; Kodama, Kazunori; Miles, Edward F; Suyama, Akihiko; Soda, Midori; Kasagi, Fumiyoshi


    Very high levels of ionizing radiation exposure have been associated with the development of soft-tissue sarcoma. The effects of lower levels of ionizing radiation on sarcoma development are unknown. This study addressed the role of low to moderately high levels of ionizing radiation exposure in the development of soft-tissue sarcoma. Based on the Life Span Study cohort of Japanese atomic-bomb survivors, 80,180 individuals were prospectively assessed for the development of primary soft-tissue sarcoma. Colon dose in gray (Gy), the excess relative risk, and the excess absolute rate per Gy absorbed ionizing radiation dose were assessed. Subject demographic, age-specific, and survival parameters were evaluated. One hundred and four soft-tissue sarcomas were identified (mean colon dose = 0.18 Gy), associated with a 39% five-year survival rate. Mean ages at the time of the bombings and sarcoma diagnosis were 26.8 and 63.6 years, respectively. A linear dose-response model with an excess relative risk of 1.01 per Gy (95% confidence interval [CI]: 0.13 to 2.46; p = 0.019) and an excess absolute risk per Gy of 4.3 per 100,000 persons per year (95% CI: 1.1 to 8.9; p = 0.001) were noted in the development of soft-tissue sarcoma. This is one of the largest and longest studies (fifty-six years from the time of exposure to the time of follow-up) to assess ionizing radiation effects on the development of soft-tissue sarcoma. This is the first study to suggest that lower levels of ionizing radiation may be associated with the development of soft-tissue sarcoma, with exposure of 1 Gy doubling the risk of soft-tissue sarcoma development (linear dose-response). The five-year survival rate of patients with soft-tissue sarcoma in this population was much lower than that reported elsewhere.

  12. Changes in soft tissue profile following the treatment using a Herbst appliance: A photographic analysis

    Nedeljković Nenad


    Full Text Available Background/Aim. Aesthetics is the reason for most of the class II malocclusion patients to opt for orthodontic treatment. In order to regulate retrognathic profile Herbst appliance for anterior movement of the mandible can be a treatment of choice. The aim of this study was to determine the soft tissue profile changes following Herbst appliance therapy on before and after treatment photos, using the computer program. Methods. This investigation was performed on profile photographs of 20 class II patients (12 females and 8 males aged 18-23 years. Analysis of the changes in soft tissue facial structure relationships evident on the photographs before and after the Herbst appliance therapy was performed using Bentley Micro Station program. The first contour of the soft tissue profile was marked. The following reference lines were subsequently traced: Ricketts aesthetic E line and Juanita line. The area enclosed by these two lines included the nose, upper and lower lip, chin and free space in front of the lips. Using the computer program, the surfaces of the soft tissue structures and free space defined by the reference lines and profile contours were measured. Calculation of the relative proportion of surfaces was done for each photograph. The data obtained were then compared for each patient before and after the treatment. Skeletal and dentoalveolar treatment effects that support soft tissue changes were presented by the profile cephalometric parameters of sagital occlusion (SO analysis. Results. A reduction in the relative surface of the upper lip in males (p < 0.01 and females (p < 0.05 was shown by the pictures. The space occupied by the chin was reduced after the treatment for females only (p < 0.05. The relative surface of the nasal soft tissues, that was included in the reference space was increased (p < 0.01 in both genders. The relationship between the soft tissue and empty surface was changed in favor of the empty surface (p < 0.05 in

  13. Deformation of Soft Tissue and Force Feedback Using the Smoothed Particle Hydrodynamics

    Liu, Xuemei; Wang, Ruiyi; Li, Yunhua; Song, Dongdong


    We study the deformation and haptic feedback of soft tissue in virtual surgery based on a liver model by using a force feedback device named PHANTOM OMNI developed by SensAble Company in USA. Although a significant amount of research efforts have been dedicated to simulating the behaviors of soft tissue and implementing force feedback, it is still a challenging problem. This paper introduces a kind of meshfree method for deformation simulation of soft tissue and force computation based on viscoelastic mechanical model and smoothed particle hydrodynamics (SPH). Firstly, viscoelastic model can present the mechanical characteristics of soft tissue which greatly promotes the realism. Secondly, SPH has features of meshless technique and self-adaption, which supply higher precision than methods based on meshes for force feedback computation. Finally, a SPH method based on dynamic interaction area is proposed to improve the real time performance of simulation. The results reveal that SPH methodology is suitable for simulating soft tissue deformation and force feedback calculation, and SPH based on dynamic local interaction area has a higher computational efficiency significantly compared with usual SPH. Our algorithm has a bright prospect in the area of virtual surgery. PMID:26417380

  14. X-Ray Scatter Correction on Soft Tissue Images for Portable Cone Beam CT

    Sorapong Aootaphao


    Full Text Available Soft tissue images from portable cone beam computed tomography (CBCT scanners can be used for diagnosis and detection of tumor, cancer, intracerebral hemorrhage, and so forth. Due to large field of view, X-ray scattering which is the main cause of artifacts degrades image quality, such as cupping artifacts, CT number inaccuracy, and low contrast, especially on soft tissue images. In this work, we propose the X-ray scatter correction method for improving soft tissue images. The X-ray scatter correction scheme to estimate X-ray scatter signals is based on the deconvolution technique using the maximum likelihood estimation maximization (MLEM method. The scatter kernels are obtained by simulating the PMMA sheet on the Monte Carlo simulation (MCS software. In the experiment, we used the QRM phantom to quantitatively compare with fan-beam CT (FBCT data in terms of CT number values, contrast to noise ratio, cupping artifacts, and low contrast detectability. Moreover, the PH3 angiography phantom was also used to mimic human soft tissues in the brain. The reconstructed images with our proposed scatter correction show significant improvement on image quality. Thus the proposed scatter correction technique has high potential to detect soft tissues in the brain.

  15. Impact of plasma fibrinogen levels in benign and malignant soft tissue tumors.

    Asanuma, Kunihiro; Matsumine, Akihiko; Nakamura, Tomoki; Matsubara, Takao; Asanuma, Yumiko; Oi, Toru; Goto, Mikinobu; Okuno, Kazuma; Kakimoto, Takuya; Yada, Yuuki; Sudo, Akihiro


    Fibrinogen, a 340 kDa glycoprotein synthesized in the liver, is known to be involved in tumor angiogenesis, enlargement, and metastasis. Elevated plasma fibrinogen levels are associated with tumor progression in many cancer patients. However, there are no reports about differences in fibrinogen levels between benign and malignant soft tissue tumors. The purpose of this study was to clarify whether preoperative plasma fibrinogen levels can be used for differential diagnosis of benign or malignant soft tissue tumors. The plasma fibrinogen levels from 102 primary soft tissue tumor patients were measured before biopsy or treatment. Fibrinogen levels were analyzed and compared to various clinical parameters. According to receiver operating characteristic (ROC) curve analysis, a threshold of serum fibrinogen of 315 mg/dL identified malignant patients with 60.9% sensitivity and 87.5% specificity. The diagnostic accuracy was evaluated by area under the curve (AUC: 0.805). Over 315 mg/dL of fibrinogen was associated with a significantly increased risk of malignancy by multiple logistic regression analysis (OR: 6.452, p= 0.0004). We demonstrated that plasma fibrinogen levels have a relationship with tumor malignancy of soft tissue tumors. High fibrinogen levels can be a helpful subsidiary tool for the prediction of malignant soft tissue tumors with other diagnostic tools.

  16. The operative treatment of complex pilon fractures: A strategy of soft tissue control

    Xianfeng He


    Full Text Available Background: Pilon fractures are challenging to manage because of the complexity of the injury pattern and the risk of significant complications. The soft tissue injury and handling of the soft tissue envelope are crucial in pilon fracture outcomes. The purpose of this study was to evaluate the early rate of complications using the strategy of "soft tissue control" for operative treatment of complex pilon fractures. Materials and Methods: 36 complex pilon fractures were treated with the "soft tissue control" strategy. Patients followed the standard staged protocol, anterolateral approach to the distal tibia, the "no-touch" technique and incisional negative pressure wound therapy for pilon fractures. Patients were examined clinically at 2-3 weeks and then 8 weeks for complications associated with the surgical technique. Results: All fractures were AO/OTA (Orthopaedic Trauma Association type C fractures (61% C3, 22% C2 and 16% C1. Only one patient developed superficial infection and resolved with antibiotics and local wound care. None developed deep infection. Conclusions: The strategy of soft tissue control for treatment of pilon fractures resulted in relatively low incidence of early wound complications in patients with complex pilon fractures.

  17. [Application of skin and soft tissue expansion in treatment of burn injury].

    Wang, N Z; Shen, Z Y; Ma, C X


    To evaluate the application of skin and soft tissue expansion in the treatment of deformity due to extensive severe burn injury and repair of severe deep electrical burned scalp and skull with fresh wound. From 1988, 83 cases of application of skin and soft tissue expansion were reported. In those patients with deformity due to severe burn of large area and with whole nasal defect, soft tissue expander was used under the forehead skin graft and venter frontalis, followed by reconstruction of nose with the expanded vascularized skin flap and carved cartilago costalis as nasal frame. In patients of severe deep electrical burned scalp and skull with fresh wound, skin and soft tissue expansion were used to repair the wound simultaneously with scalp burn alopecia, anesthetics and antibiotics injected into the extracapsular space of the expander in case of pain and infection. All of the cases were successfully treated with little pain and minimized infection. Skin and soft tissue expansion in a safe and reliable measure in the treatment of deformity due to extensive severe burn injury and repair of severe deep electrical burned scalp and skull with fresh wound.

  18. Patient specific finite element model of the face soft tissues for computer-assisted maxillofacial surgery.

    Chabanas, Matthieu; Luboz, Vincent; Payan, Yohan


    This paper addresses the prediction of face soft tissue deformations resulting from bone repositioning in maxillofacial surgery. A generic 3D Finite Element model of the face soft tissues was developed. Face muscles are defined in the mesh as embedded structures, with different mechanical properties (transverse isotropy, stiffness depending on muscle contraction). Simulations of face deformations under muscle actions can thus be performed. In the context of maxillofacial surgery, this generic soft-tissue model is automatically conformed to patient morphology by elastic registration, using skin and skull surfaces segmented from a CT scan. Some elements of the patient mesh could be geometrically distorted during the registration, which disables Finite Element analysis. Irregular elements are thus detected and automatically regularized. This semi-automatic patient model generation is robust, fast and easy to use. Therefore it seems compatible with clinical use. Six patient models were successfully built, and simulations of soft tissue deformations resulting from bone displacements performed on two patient models. Both the adequation of the models to the patient morphologies and the simulations of post-operative aspects were qualitatively validated by five surgeons. Their conclusions are that the models fit the morphologies of the patients, and that the predicted soft tissue modifications are coherent with what they would expect.

  19. Measurement of facial soft tissues thickness using 3D computed tomographic images

    Jeong, Ho Gul; Kim, Kee Deog; Shin, Dong Won; Hu, Kyung Seok; Lee, Jae Bum; Park, Hyok; Park, Chang Seo [Yonsei Univ. Hospital, Seoul (Korea, Republic of); Han, Seung Ho [Catholic Univ. of Korea, Seoul (Korea, Republic of)


    To evaluate accuracy and reliability of program to measure facial soft tissue thickness using 3D computed tomographic images by comparing with direct measurement. One cadaver was scanned with a Helical CT with 3 mm slice thickness and 3 mm/sec table speed. The acquired data was reconstructed with 1.5 mm reconstruction interval and the images were transferred to a personal computer. The facial soft tissue thickness were measured using a program developed newly in 3D image. For direct measurement, the cadaver was cut with a bone cutter and then a ruler was placed above the cut side. The procedure was followed by taking pictures of the facial soft tissues with a high-resolution digital camera. Then the measurements were done in the photographic images and repeated for ten times. A repeated measure analysis of variance was adopted to compare and analyze the measurements resulting from the two different methods. Comparison according to the areas was analyzed by Mann-Whitney test. There were no statistically significant differences between the direct measurements and those using the 3D images(p>0.05). There were statistical differences in the measurements on 17 points but all the points except 2 points showed a mean difference of 0.5 mm or less. The developed software program to measure the facial soft tissue thickness using 3D images was so accurate that it allows to measure facial soft tissue thickness more easily in forensic science and anthropology.

  20. Expanded polytetrafluoroethylene (Gore-Tex soft-tissue patch) in facial augmentation.

    Maas, C S; Gnepp, D R; Bumpous, J


    Expanded polytetrafluoroethylene (EPTFE) (Gore-Tex soft-tissue patch) has received favorable clinical reports for use in facial augmentation procedures. We evaluated the EPTFE soft-tissue patch in short-term (3-week), intermediate-term (6-month), and long-term (12-month) animal models. Nine pathogen-free male and female New Zealand white rabbits weighing 2 to 4 kg were used. After implantation of the EPTFE soft-tissue patch, the animals were carefully observed on a daily basis for signs of wound infection, seroma, or hematoma formation. The stability of the implant was evaluated and graded after the animals were killed. Tissue specimens, including skin, implant, and underlying bone, were removed en bloc. These blocks were sectioned and stained for histologic evaluation. A portion of these blocks were used for scanning electron microscopy. The material increased in stability over time and showed minimal inflammatory cell response and only a delicate fibrous capsule, even in long-term implants. Ultrastructural analysis demonstrated close apposition of the material to tissue, suggesting good interface bioactivity. The EPTFE soft-tissue patch appears to be safe and reliable material for augmentation, demonstrating high biocompatibility, low tissue reactivity, and increasing stability over time.

  1. Optimization of Method to Extract Collagen from "Emperor" Tissue of Soft-shelled Turtles.

    Yamamoto, Tetsushi; Uemura, Kentaro; Sawashi, Yuki; Mitamura, Kuniko; Taga, Atsushi


    Soft-shelled turtles (Pelodiscus sinensis) are widely distributed in some Asian countries, and parts of this turtle contain abundant collagen. In this study, we optimized a method for extracting collagen from the soft-shelled turtle. We used three types of solvent and four extraction conditions to determine an effective collagen extraction method, which was extraction at 37°C with acetic acid after hydrochloric acid pretreatment. Next, we extracted collagen from three regions in the soft-shelled turtle: muscle, skin, and an area of soft tissue in the periphery of the turtle shell known in Japan and China as the "emperor." We determined that emperor tissue yielded the highest concentration and purity of collagen. We then optimized the pretreatment method for extraction from emperor tissue by using formic acid instead of hydrochloric acid, and the amount of extracted collagen increased by approximately 1.3-fold. Finally, we identified the optimal solvent out of four types of organic acid for collagen extraction from emperor tissue; the amount of extracted collagen from emperor tissue increased approximately 3-fold when citric acid was used as the extraction solvent instead of acetic acid. Emperor tissue can regenerate; thus, it is possible to obtain collagen from the emperor repeatedly without killing the turtle. Our findings suggest that the emperor tissue of softshelled turtles may be a good source of collagen for pharmaceutical and cosmetic applications.

  2. Combined soft and hard tissue augmentation for a localized alveolar ridge defect

    Ritu Rana


    Full Text Available Ideal alveolar ridge width and height allows placement of a natural appearing pontic, which provides maintenance of a plaque-free environment. The contour of a partially edentulous ridge should be thoroughly evaluated before a fixed partial denture is undertaken. Localized alveolar ridge defect refers to a volumetric deficit of the limited extent of bone and soft-tissue within the alveolar process. These ridge defects can be corrected by hard tissue and/or soft-tissue augmentation. A 30-year-old male patient was referred to the Department of Periodontology for correction of Seibert′s Class III ridge defect in the lower anterior region. Granulation tissue/connective tissue present at the base of the defect was removed after elevation of full thickness flap. MucoMatrixX, an animal derived, collagen based soft-tissue graft was sutured to the labial flap and bone graft was placed into the defect. If a soft-tissue graft material could be used to replace the palatal grafts, then all the possible complications associated with donor site would be eliminated and above all periodontal plastic surgery and ridge augmentation would be better accepted by patients.

  3. Combined soft and hard tissue augmentation for a localized alveolar ridge defect.

    Rana, Ritu; Ramachandra, Srinivas Sulugodu; Lahori, Manesh; Singhal, Reetika; Jithendra, K D


    Ideal alveolar ridge width and height allows placement of a natural appearing pontic, which provides maintenance of a plaque-free environment. The contour of a partially edentulous ridge should be thoroughly evaluated before a fixed partial denture is undertaken. Localized alveolar ridge defect refers to a volumetric deficit of the limited extent of bone and soft-tissue within the alveolar process. These ridge defects can be corrected by hard tissue and/or soft-tissue augmentation. A 30-year-old male patient was referred to the Department of Periodontology for correction of Seibert's Class III ridge defect in the lower anterior region. Granulation tissue/connective tissue present at the base of the defect was removed after elevation of full thickness flap. MucoMatrixX, an animal derived, collagen based soft-tissue graft was sutured to the labial flap and bone graft was placed into the defect. If a soft-tissue graft material could be used to replace the palatal grafts, then all the possible complications associated with donor site would be eliminated and above all periodontal plastic surgery and ridge augmentation would be better accepted by patients.

  4. Oral soft tissue biopsies in Oporto, Portugal: An eight year retrospective analysis

    Guedes, Manuel Moreira; Albuquerque, Rui; Monteiro, Marta; Lopes, Carlos Alberto; Amaral, José Barbas do; Pacheco, José Júlio; Monteiro, Luís Silva


    Background The diseases that affect the oral cavity are wide and diverse, comprising a broad spectrum of either benign or malignant lesions. However, few histological-based studies were performed for the evaluation of oral cavity lesions, and very few directed to oral soft tissue pathology. The aim of this study was to carry out pioneering research, within a Portuguese population, to determine the frequency and characteristics of oral malignancies, potential malignant disorders, and soft beni...

  5. Correlation Between Bone and Soft Tissue Thickness in Maxillary Anterior Teeth

    Nasrin Esfahanizadeh


    Full Text Available Objectives: The purpose of this study was to determine buccal bone and soft tissue thicknesses and their correlation in the maxillary anterior region using cone beam computed tomography (CBCT.Materials and Methods: In this cross sectional study, 330 sound maxillary incisors in 60 patients with a mean age of 37.5 years were assessed by CBCT scans. For better visualization of soft tissue, patients were asked to use plastic retractors in order to retract their lips and cheeks away from the gingival tissue before taking the scans. Measurements were made in three different positions: at the crest and at 2 and 5mm apical to the crest. The cementoenamel junction‒crest distance was measured. for data analyses, the Pearson’s correlation coefficient, ANOVA and intraclass correlation coefficient were used.Results: There were mildly significant linear associations between labial soft tissue and bone thickness in the canines and incisors (r<0.40, P<0.05, but no association was found for the lateral incisors. The mean thickness of buccal bone differed significantly in the maxillary anterior teeth, being greater for the lateral incisors (P<0.05. For soft tissue thickness, the results were the same, and the least thickness was recorded for the canines. There was a mild association between labial soft tissue and bone thickness in canines and incisors (r=0.2, P=0.3, but no such linear association was seen for the lateral incisors.Conclusions: The mean thickness of buccal bone and soft tissue in the anterior maxilla was <1mm and there was a mild linear correlation between them.Keywords: Facial Bones; Cone-Beam Computed Tomography; Maxilla; Esthetics, Dental

  6. Long-term room temperature preservation of corpse soft tissue: an approach for tissue sample storage

    Caputo Mariela


    Full Text Available Abstract Background Disaster victim identification (DVI represents one of the most difficult challenges in forensic sciences, and subsequent DNA typing is essential. Collected samples for DNA-based human identification are usually stored at low temperature to halt the degradation processes of human remains. We have developed a simple and reliable procedure for soft tissue storage and preservation for DNA extraction. It ensures high quality DNA suitable for PCR-based DNA typing after at least 1 year of room temperature storage. Methods Fragments of human psoas muscle were exposed to three different environmental conditions for diverse time periods at room temperature. Storage conditions included: (a a preserving medium consisting of solid sodium chloride (salt, (b no additional substances and (c garden soil. DNA was extracted with proteinase K/SDS followed by organic solvent treatment and concentration by centrifugal filter devices. Quantification was carried out by real-time PCR using commercial kits. Short tandem repeat (STR typing profiles were analysed with 'expert software'. Results DNA quantities recovered from samples stored in salt were similar up to the complete storage time and underscored the effectiveness of the preservation method. It was possible to reliably and accurately type different genetic systems including autosomal STRs and mitochondrial and Y-chromosome haplogroups. Autosomal STR typing quality was evaluated by expert software, denoting high quality profiles from DNA samples obtained from corpse tissue stored in salt for up to 365 days. Conclusions The procedure proposed herein is a cost efficient alternative for storage of human remains in challenging environmental areas, such as mass disaster locations, mass graves and exhumations. This technique should be considered as an additional method for sample storage when preservation of DNA integrity is required for PCR-based DNA typing.

  7. Comparison of conventional and microwave histo-processing of various oral soft tissue specimens

    Shankargouda Patil; Rao, Roopa S; Amrutha Nagaraja; Sanketh D. Sharath Kumar


    Background and Aim: While a number of pathologists have reviewed the techniques and results of microwave-facilitated tissue fixation and processing, there has been no record of any previous studies where specific tissues were chosen and compared. Hence, the aim of the present study was to specifically evaluate and compare the diagnostic ability of selective oral soft tissue specimens processed and stained by the conventional and microwave method. Materials and Methods: The study group compris...

  8. Reproducibility of Facial Soft Tissue Thickness Measurements Using Cone-Beam CT Images According to the Measurement Methods.

    Hwang, Hyeon-Shik; Choe, Seon-Yeong; Hwang, Ji-Sup; Moon, Da-Nal; Hou, Yanan; Lee, Won-Joon; Wilkinson, Caroline


    The purpose of this study was to establish the reproducibility of facial soft tissue (ST) thickness measurements by comparing three different measurement methods applied at 32 landmarks on three-dimensional cone-beam computed tomography (CBCT) images. Two observers carried out the measurements of facial ST thickness of 20 adult subjects using CBCT scan data, and inter- and intra-observer reproducibilities were evaluated. The measurement method of "perpendicular to bone" resulted in high inter- and intra-observer reproducibility at all 32 landmarks. In contrast, the "perpendicular to skin" method and "direct" method, which measures a distance between one point on bone and the other point on skin, presented low reproducibility. The results indicate that reproducibility could be increased by identifying the landmarks on hard tissue images, rather than on ST images, and the landmark description used in this study can be used in the establishment of reliable tissue depth data using CBCT images.

  9. Candida Albicans Infection Masquerading as a Soft Tissue Tumour Diagnosed by Fine Needle Aspiration Cytology

    Govind, Abhishek Mandya; Pechiat, Tony; Manchaih, Sanjay; Shankar, Shivshankar Vijay


    A 60-year-old male, diabetic presented with a soft tissue mass over the right forearm of 15 days duration. The swelling was 5 x 3 cm and a clinical diagnosis of neurofibroma was made. Fine Needle Aspiration Cytology (FNAC) was done using standard technique. Smears showed predominantly suppurative inflammation, foreign body giant cells, granulomas and fungal hyphae. KOH mount, culture and germ tube test was positive. Final diagnosis of fungal granuloma was made. Fungal infections should be included in the differential diagnosis of a soft tissue mass lesion. All soft tissue suppurative inflammatory lesions should be diligently screened to look for pathogens if any. Diagnostics in medicine have taken a major leap with advent of molecular technologies. Despite this, simple old traditional methods like FNAC supplemented by other basic laboratory techniques like KOH mount and culture still form the cream of a diagnostic laboratory and can come as a savior for the pathologist, the clinicians and the patients.

  10. Soft tissue balance changes depending on joint distraction force in total knee arthroplasty.

    Nagai, Kanto; Muratsu, Hirotsugu; Matsumoto, Tomoyuki; Miya, Hidetoshi; Kuroda, Ryosuke; Kurosaka, Masahiro


    The influence of joint distraction force on intraoperative soft tissue balance was evaluated using Offset Repo-Tensor® for 78 knees that underwent primary posterior-stabilized total knee arthroplasty. The joint center gap and varus ligament balance were measured between osteotomized surfaces using 20, 40 and 60 lbs of joint distraction force. These values were significantly increased at extension and flexion as the distraction force increased. Furthermore, lateral compartment stiffness was significantly lower than medial compartment stiffness. Thus, larger joint distraction forces led to larger varus ligament balance and joint center gap, because of the difference in soft tissue stiffness between lateral and medial compartments. These findings indicate the importance of the strength of joint distraction force in the assessment of soft tissue balance, especially when using gap-balancing technique.

  11. Bone And Soft Tissue Changes In Patients With Spinal Cord Injury And Multiple Sclerosis

    Dionyssiotis Yannis


    Full Text Available In patients with spinal cord injury and multiple sclerosis, deterioration of body composition (changes in bone, fat and muscle mass is associated with increased risk for diseases such as coronary artery heart disease, non-insulin dependent diabetes mellitus, lipid metabolism abnormalities, and osteoporotic fractures in these patients. Immobility leads to a changing pattern of loading in the paralyzed areas, and secondary alteration in structure. However, bone and soft tissue changes in these patients are usually neglected. The purpose of this article is to update on the pathophysiological mechanisms leading to bone and soft tissue changes, and to increase the awareness of the treating physicians with respect to bone, muscle and fat loss and their consequences aiming to obtain measures to prevent bone and soft tissue loss in these patients.

  12. Primary hydatid cyst in the soft tissue of the face: An exceptional occurrence

    Cherry Bansal


    Full Text Available To emphasize that solitary hydatid cyst can be localized in the soft tissue and present as a soft tissue mass even in an unusual site like face, we report the case of a 42-year-old male patient presenting with a slowly growing mass in right temporal region. Computed tomography (CT scan showed an encapsulated mass with multiple cysts. Histopathological examination revealed the characteristic findings, which were consistent with soft-tissue hydatid disease. In the absence of visceral organ involvement, this is the first reported case of a primary subcutaneous hydatid cyst in the skin of face in India. In the English literature, only one case of this kind has been reported till date. When imaging methods confirm cystic nature of a swelling, even in unusual sites, one should always keep a possibility of hydatid cyst and manage accordingly during surgery to avoid precipitation of acute anaphylaxis.

  13. Biomechanical validation of medial pie-crusting for soft-tissue balancing in knee arthroplasty.

    Mihalko, William M; Woodard, Erik L; Hebert, Casey T; Crockarell, John R; Williams, John L


    Balancing a varus knee is traditionally accomplished by releasing the medial soft-tissue sleeve off the tibia. Recently, "pie-crusting" (PC) medial structures has been described. In a biomechanical cadaver study we compared PC to traditional release (TR) to determine their effects on flexion and extension gaps. PC was done in five specimens along the anterior half of the medial soft-tissue sleeve and five along the posterior half, followed by a traditional release. In 90° flexion, valgus laxity after TR was significantly greater than after PC alone. PC of the anterior or posterior aspect of the medial soft-tissue sleeve can effect changes more in flexion than in extension, respectively. Complete TR did not provide more gap opening than PC in extension, but produced more effect in flexion.

  14. Soft tissue metastases from differentiated thyroid cancer diagnosed by {sup 18}F FDG PET-CT

    Califano, Ines; Quildrian, Sergio; Otero, Jose; Coduti, Martin; Califano, Leonardo; Rojas Bilbao, Erica, E-mail: [Instituto de Oncologia Angel H. Roffo, Universidad de Buenos Aires (Argentina)


    Distant metastases of differentiated thyroid cancer are unusual; lung and bones are the most frequently affected sites. Soft tissue metastases (STM) are extremely rare. We describe two cases of patients with differentiated thyroid cancer metastasizing to soft tissues. Both patients had widespread metastatic disease; clinically asymptomatic soft tissue metastases were found by 18-Fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F FDG PET-CT), and confirmed by cytological and/or histopathological studies. These findings underscore the ability of {sup 18}F FDG PET-CT in accurately assessing the extent of the disease, as well as the utility of the method to evaluate regions of the body that are not routinely explored. (author)

  15. Hamstring tendon harvesting--Effect of harvester on tendon characteristics and soft tissue disruption; cadaver study.

    Charalambous, C P; Alvi, F; Phaltankar, P; Gagey, O


    The purpose of this study was to determine whether the type of hamstring tendon harvester used can influence harvested tendon characteristics and soft tissue disruption. We compared two different types of tendon harvesters with regard to the length of tendon obtained and soft tissue disruption during hamstring tendon harvesting. Thirty six semitendinosus and gracilis tendons were harvested using either a closed stripper or a blade harvester in 18 paired knees from nine human fresh cadavers. Use of the blade harvester gave longer lengths of usable tendon whilst minimising the stripping of muscle and of any non-usable tendon. Our results suggest that the type of harvester per se can influence the length of tendon harvested as well as soft tissue disruption. Requesting such data from the industry prior to deciding which harvester to use seems desirable.

  16. First experiences with simultaneous skeletal and soft tissue reconstruction of noma-related facial defects.

    Giessler, Goetz A; Borsche, André; Lim, Paul K; Schmidt, Andreas B; Cornelius, C-Peter


    Noma victims suffer from a three-dimensional facial soft-tissue loss. Some may also develop complex viscerocranial defects, due to acute osteitis, chronic exposure, or arrested skeletal growth. Reconstruction has mainly focused on soft tissue so far, whereas skeletal restoration was mostly avoided. After successful microvascular soft tissue free flap reconstruction, we now included skeletal restoration and mandibular ankylosis release into the initial step of complex noma surgery. One free rib graft and parascapular flap, one microvascular osteomyocutaneous flap from the subscapular system, and two sequential chimeric free flaps including vascularized bone were used as the initial steps for facial reconstruction. Ankylosis release could spare the temporomandibular joint. Complex noma reconstruction should include skeletal restoration. Avascular bone is acceptable in cases with complete vascularized graft coverage. Microsurgical chimeric flaps are preferable as they can reduce the number and complexity of secondary operations and provide viable, infection-resistant bone supporting facial growth.

  17. Modelling of global boundary effects on harmonic motion imaging of soft tissues.

    Zhao, Xiaodong; Pelegri, Assimina A


    Biomechanical imaging techniques have been developed for soft tissue characterisation and detection of breast tumours. Harmonic motion imaging (HMI) uses a focused ultrasound technology to generate a harmonic radiation force in a localised region inside a soft tissue. The resulting dynamic response is used to map the local distribution of the mechanical properties of the tissue. In this study, a finite element (FE) model is developed to investigate the effect of global boundary conditions on the dynamic response of a soft tissue during HMI. The direct-solution steady-state dynamic analysis procedure is used to compute the harmonic displacement amplitude in FE simulations. The model is parameterised in terms of boundary conditions and viscoelastic properties, and the corresponding raster-scan displacement amplitudes are captured to examine its response. The effect of the model's global dimensions on the harmonic response is also investigated. It is observed that the dynamic response of soft tissue with high viscosity is independent of the global boundary conditions for regions remote to the boundary; thus, it can be subjected to local analysis to estimate the underlying mechanical properties. However, the dynamic response is sensitive to global boundary conditions for tissue with low viscosity or regions located near to the boundary.

  18. Non-O1, non-O139 Vibrio cholerae bacteremic skin and soft tissue infections.

    Maraki, Sofia; Christidou, Athanasia; Anastasaki, Maria; Scoulica, Efstathia


    Non-O1, non-O139 Vibrio cholerae can cause sporadic cases of gastroenteritis and extra-intestinal invasive infections, following exposure to contaminated seawater or freshwater or after consumption of raw seafood. Bacteremic infections with skin and soft tissue manifestations are uncommon and in most cases are associated with liver cirrhosis, haematologic malignancies, diabetes mellitus and other immunosuppressed conditions. The medical literature was reviewed and we found 47 published cases of non-O1, non-O139 Vibrio cholerae bacteremic skin and soft tissue infections. A fatal case of bacteremia with bullous cellulitis in a 43-year-old patient with liver cirrhosis is described, which is the first reported in Greece. From January 1974 to May 2015, a total of 48 patients with non-O1, non-O139 Vibrio cholerae bacteremia with skin and soft tissue infections were reported. Males predominated. Liver cirrhosis, chronic liver disease and alcohol abuse were common comorbidities. The soft tissue lesions most commonly described were localised cellulitis, with or without bullous and haemorrhagic lesions (66.7%), while necrotising fasciitis was more rare (29.2%). Of the 48 patients with non-O1, non-O139 V. cholerae bacteremic skin and soft tissue infections, 20 (41.7%) died despite treatment. Although rarely encountered, non-O1, non-O139 Vibrio cholerae should be included in the differential diagnosis of bacteremic skin and soft tissue infections in patients with underlying illnesses and epidemiologic risk factors. Timely and appropriate antibiotic and surgical treatments are important in the management of the infection.

  19. Prevalence of Malignant Soft Tissue Tumors inExtremities: An Epidemiological Study in Syria

    Habib Reshadi


    Full Text Available Background:   Although the majority of soft tissue masses are benign, it is important to consider malignancy in differential diagnoses. Because most soft tissue sarcomas present as a painless mass, clinicians must watch for signs suggestive of malignancy, including large size, rapid growth, and site deep into the deep fascia.The purpose of this study was to determine the relative prevalence according to sex and age, site of tumor, skeletal distribution, and treatment (surgery, chemotherapy and radiotherapy before and after surgery, and ascertain the relative frequency of these tumors in specific anatomic sites and age groups based on pathological studies. Methods: A total of 308 patients, with a musculoskeletal tumor were evaluated retrospectively. All of the patients enrolled into this study were referred to the Beirouni Hospital of Damascus University with a proven diagnosis of alignant soft tissue tumors from the beginning of January 2008 until the end of 2010. The prevalence of the malignant soft tissue tumors in these patients was analyzed. For purposes of analysis, all lesions were placed in 1 of 9 categories: hand and wrist, forearm, humorous (arm, proximal limb girdle (axilla and shoulder, foot and ankle, thigh, hip and buttocks region, trunk, and other lesions. Age and sex also were recorded. Results: Malignant tumors consisted of seven diagnostic categories: malignant fibrous histiocytoma (23%, liposarcoma (22%, rhabdomyosarcoma (9%, leiomyosarcoma (8%, malignant schwannoma (5%, dermatofibrosarcoma protuberans (5%, synovial sarcoma (10%, fibrosarcoma (13%, extraskeletal chondrosarcoma (1%, and extraskeletal Ewing sarcoma (4%. Conclusions: Despite the multitude of pathologic possibilities, most malignant soft-tissue tumors are classified into a small number of diagnoses. These may be further defined when the site of the lesion and the age of the patient are considered. Knowledge of tumor prevalence will assist radiologists in

  20. Prevalence of Malignant Soft Tissue Tumors inExtremities: An Epidemiological Study in Syria

    Habib Reshadi


    Full Text Available Background:   Although the majority of soft tissue masses are benign, it is important to consider malignancy in differential diagnoses. Because most soft tissue sarcomas present as a painless mass, clinicians must watch for signs suggestive of malignancy, including large size, rapid growth, and site deep into the deep fascia.The purpose of this study was to determine the relative prevalence according to sex and age, site of tumor, skeletal distribution, and treatment (surgery, chemotherapy and radiotherapy before and after surgery, and ascertain the relative frequency of these tumors in specific anatomic sites and age groups based on pathological studies. Methods: A total of 308 patients, with a musculoskeletal tumor were evaluated retrospectively. All of the patients enrolled into this study were referred to the Beirouni Hospital of Damascus University with a proven diagnosis of alignant soft tissue tumors from the beginning of January 2008 until the end of 2010. The prevalence of the malignant soft tissue tumors in these patients was analyzed. For purposes of analysis, all lesions were placed in 1 of 9 categories: hand and wrist, forearm, humorous (arm, proximal limb girdle (axilla and shoulder, foot and ankle, thigh, hip and buttocks region, trunk, and other lesions. Age and sex also were recorded. Results: Malignant tumors consisted of seven diagnostic categories: malignant fibrous histiocytoma (23%, liposarcoma (22%, rhabdomyosarcoma (9%, leiomyosarcoma (8%, malignant schwannoma (5%, dermatofibrosarcoma protuberans (5%, synovial sarcoma (10%, fibrosarcoma (13%, extraskeletal chondrosarcoma (1%, and extraskeletal Ewing sarcoma (4%. Conclusions: Despite the multitude of pathologic possibilities, most malignant soft-tissue tumors are classified into a small number of diagnoses. These may be further defined when the site of the lesion and the age of the patient are considered. Knowledge of tumor prevalence will assist radiologists in

  1. Soft Tissue Masses in the Extremities: The Accuracy of an Ultrasonographic Diagnosis

    An, Ji Young; Park, So Young; Park, Ji Seon; Jin, Wook; Ryu, Kyung Nam [Kyung Hee University Medical Center, Seoul (Korea, Republic of)


    We wanted to retrospectively determine the accuracy of an ultrasonographic diagnosis of superficial soft tissue masses in the extremities by using the histologic results as the reference standard. From January 2005 to June 2010, 154 patients with soft tissue masses in the extremities and who underwent ultrasonographic evaluation followed by biopsy or resection were retrospectively evaluated. The ultrasonographic and histologic diagnoses of the soft tissue masses were lipoma, ganglion cyst, hemangioma, neurogenic tumor, giant cell tumor of the tendon sheath, epidermoid cyst, fibroma, glomus tumor, Baker's cyst and neurofibromatosis. Out of 154 patients, 114 (74%) patients showed concordance between the histologic diagnosis and the ultrasonographic diagnosis, and the remaining 40 (26%) patients did not. The diagnostic accuracy of each soft tissue mass was 95% for lipoma, 83% for ganglion cyst, 75% for hemangioma, 72% for neurogenic tumor, 50% for giant cell tumor of the tendon sheath, 43% for epidermoid cyst, 33% for fibroma and 100% each for glomus tumor, fibromatosis and Baker's cyst. Aside from these tumors, there were also sarcoma, malignant melanoma, elastofibroma, Kimura disease and pilomatricoma. Among the cases that showed discordance between the histologic diagnosis and the ultrasonographic diagnosis, three of them were notable; pilomatricoma being misdiagnosed as dermatofibroma protuberans, angiolipoma being misdiagnosed as vascular leiomyoma and malignant fibrous histiocytoma being misdiagnosed as a malignant soft tissue mass. The accuracy of an ultrasonographic diagnosis for soft tissue masses in the extremities varies greatly according to each type of mass. Lipoma, ganglion cyst, hemangioma, glomus tumor, neurogenic tumor and Baker's cyst showed a relatively high rate of concordance between the ultrasonographic diagnosis and the histologic diagnosis, but epidermoid cyst and fibroma showed a relatively lower rate of concordance

  2. Clinical usefulness of facial soft tissues thickness measurement using 3D computed tomographic images

    Jeong, Ho Gul; Kim, Kee Deog; Hu, Kyung Seok; Lee, Jae Bum; Park, Hyok [Maxtron Inc., Seoul (Korea, Republic of); Han, Seung Ho [Catholic Univ. of Korea, Seoul (Korea, Republic of); Choi, Seong Ho; Kim, Chong Kwan; Park, Chang Seo [Yonsei Univ., Seoul (Korea, Republic of)


    To evaluate clinical usefulness of facial soft tissue thickness measurement using 3D computed tomographic images. One cadaver that had sound facial soft tissues was chosen for the study. The cadaver was scanned with a Helical CT under following scanning protocols about slice thickness and table speed: 3 mm and 3 mm/sec, 5 mm and 5 mm/sec, 7 mm and 7 mm/sec. The acquired data were reconstructed 1.5, 2.5, 3.5 mm reconstruction interval respectively and the images were transferred to a personal computer. Using a program developed to measure facial soft tissue thickness in 3D image, the facial soft tissue thickness was measured. After the ten-time repeation of the measurement for ten times, repeated measure analysis of variance (ANOVA) was adopted to compare and analyze the measurements using the three scanning protocols. Comparison according to the areas was analysed by Mann-Whitney test. There were no statistically significant intraobserver differences in the measurements of the facial soft tissue thickness using the three scanning protocols (p>0.05). There were no statistically significant differences between measurements in the 3 mm slice thickness and those in the 5 mm, 7 mm slice thickness (p>0.05). There were statistical differences in the 14 of the total 30 measured points in the 5 mm slice thickness and 22 in the 7 mm slice thickness. The facial soft tissue thickness measurement using 3D images of 7 mm slice thickness is acceptable clinically, but those of 5 mm slice thickness is recommended for the more accurate measurement.

  3. Bone and Soft Tissue Changes after Two-Jaw Surgery in Cleft Patients

    Yung Sang Yun


    Full Text Available BackgroundOrthognathic surgery is required in 25% to 35% of patients with a cleft lip and palate, for whom functional recovery and aesthetic improvement after surgery are important. The aim of this study was to examine maxillary and mandibular changes, along with concomitant soft tissue changes, in cleft patients who underwent LeFort I osteotomy and sagittal split ramus osteotomy (two-jaw surgery.MethodsTwenty-eight cleft patients who underwent two-jaw surgery between August 2008 and November 2013 were included. Cephalometric analysis was conducted before and after surgery. Preoperative and postoperative measurements of the bone and soft tissue were compared.ResultsThe mean horizontal advancement of the maxilla (point A was 6.12 mm, while that of the mandible (point B was -5.19 mm. The mean point A-nasion-point B angle was -4.1° before surgery, and increased to 2.5° after surgery. The mean nasolabial angle was 72.7° before surgery, and increased to 88.7° after surgery. The mean minimal distance between Rickett's E-line and the upper lip was 6.52 mm before surgery and 1.81 mm after surgery. The ratio of soft tissue change to bone change was 0.55 between point A and point A' and 0.93 between point B and point B'.ConclusionsPatients with cleft lip and palate who underwent two-jaw surgery showed optimal soft tissue changes. The position of the soft tissue (point A' was shifted by a distance equal to 55% of the change in the maxillary bone. Therefore, bone surgery without soft tissue correction can achieve good aesthetic results.

  4. Investigation of soft tissue movement during level walking: translations and rotations of skin markers.

    Gao, Bo; Zheng, Naiquan Nigel


    Skin marker-based stereophotogrammetry is the most widely used technique for human motion analysis but its accuracy is mainly limited by soft tissue artifact (STA) which reflects the non-rigidity of human body segments during activities. To compensate for the effects of STA and improve the accuracy of motion analysis, it is critical to understand the behavior and characteristics of soft tissue movement. By using a non-invasive approach, this study investigated the soft tissue movement on the thigh and shank of twenty healthy subjects during level walking which is one of the most important human daily activities and the basic content of clinical gait analysis. With the measurement of inter-marker translations and rotations on each segment, a 4D picture (3D space and time) of soft tissue deformation on the thigh and shank during walking was quantified in terms of the positional and orientational change between different skin locations. Soft tissue deformation showed nonuniform distribution at different locations as well as along different directions. The range of inter-marker movement was found to be up to 19.1mm/19.6 degrees on the thigh and 9.3mm/8.6 degrees on the shank. Results in this study provide useful information for understanding soft tissue movement behavior and exploring better marker configurations. Inter-marker movement exhibited similar patterns across subjects. This finding suggests the possibility that STA has inter-subject similarity, which is contrary to the prevailing opinion. This new insight may lead to more effective STA compensation strategies for skin marker-based motion analysis.

  5. Benign soft tissue masses of the wrist and hand: MRI appearances

    Miller, T.T. (Depts. of Radiology and Nuclear Medicine, Hospital for Special Surgery, Cornell Univ. Medical Coll., New York, NY (United States)); Potter, H.G. (Depts. of Radiology and Nuclear Medicine, Hospital for Special Surgery, Cornell Univ. Medical Coll., New York, NY (United States)); McCormack, R.R. Jr. (Dept. of Orthopedic Surgery, Hospital for Special Surgery, Cornell Univ. Medical Coll., New York, NY (United States))


    We reviewed 20 cases of soft tissue masses of the hand and wrist, and compared the impressions from the original magnetic resonance (MR) imaging reports with the preoperative clinical impression and postoperative pathological diagnoses. The most commonly occurring masses were ganglia, lipomas, and giant cell tumors of tendon sheaths. MR imaging suggested the correct diagnosis in 16 of the 20 cases, whereas the clinical impression was correct in 10 instances. Confident preoperative diagnosis may be made with MR imaging due to the characteristic appearances of many benign soft tissue tumors. (orig.)

  6. Preliminary Experience Using Dynamic MRI at 3.0 Tesla for Evaluation of Soft Tissue Tumors


    Objective We aimed to evaluate the use of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) at 3.0 T for differentiating the benign from malignant soft tissue tumors. Also we aimed to assess whether the shorter length of DCE-MRI protocols are adequate, and to evaluate the effect of temporal resolution. Materials and Methods Dynamic contrast-enhanced magnetic resonance imaging, at 3.0 T with a 1 second temporal resolution in 13 patients with pathologically confirmed soft tissue tu...

  7. Case presentation of soft tissue parapharyngeal chondroma in a pediatric patient.

    Smith, Erin J; Rezeanu, Luminita; Carron, Jeffrey


    Soft tissue chondromas are uncommon benign tumors found mostly in the hands and feet and rarely reported in the pediatric population. In this case presentation we describe a 10 year old boy who had an MRI for facial paralysis due to Ramsey Hunt Syndrome, which incidentally revealed a parapharyngeal mass. He underwent transoral resection of the mass without complication, and histopathology confirmed the diagnosis of soft tissue chondroma. This case is unique due to the unusual location of the tumor and its presentation in a child. © 2013 Elsevier Inc. All rights reserved.

  8. Soft Tissue Structure Modelling for Use in Orthopaedic Applications and Musculoskeletal Biomechanics

    E. A. Audenaert


    Full Text Available We present our methodology for the three-dimensional anatomical and geometrical description of soft tissues, relevant for orthopaedic surgical applications and musculoskeletal biomechanics. The technique involves the segmentation and geometrical description of muscles and neurovascular structures from high-resolution computer tomography scanning for the reconstruction of generic anatomical models. These models can be used for quantitative interpretation of anatomical and biomechanical aspects of different soft tissue structures. This approach should allow the use of these data in other application fields, such as musculoskeletal modelling, simulations for radiation therapy, and databases for use in minimally invasive, navigated and robotic surgery.

  9. Soft tissue assessment in midface advancement: the use of regional flaps to enhance facial projection.

    Chavanne, Juan Martin; Steinberg, Diego; Houssay, Alfredo; Margaride, Luis A


    Classically, soft tissue repair when indicated is done before or after the skeletal mobilization especially in those cases that present midface deficiency with severe midline soft tissue restriction by scars or congenital affectation. The distraction osteogenesis method has contributed to improve substantially this problem elongating bones, muscles, and ligaments, but some situations need specific and more precise reconstruction of the subunits to gain in aesthetics. The labial-columella junction, the tip of the nose, and the more projecting point of the cheeks are one of these exigent anatomic areas, where only sophisticated reconstruction by flaps can improve facial proportions and projections.

  10. [Complex outpatient care to patients with osteoarthrosis and degenerative-dystrophic diseases of juxtaarticular soft tissues].

    Saks, L A


    The aim of the article is an evaluation of effectiveness of the complex outpatient care to patients with osteoarthrosis and degenerative-dystrophic diseases ofjuxtaarticular soft tissues. Recent researches showed that the key factors of the pathogenesis of diseases were degenerative-dystrophic and inflammatory changes in the synovio-entheseal complex ofparaarticular muscles' tendon. 411 patients with osteoarthrosis of 531 synovial joints and degenerative-dystrophic diseases of periarticular soft tissues underwent sequential corticosteroid therapy combined with hyaluronic acid injections. In 84% of cases positive results were observed.

  11. Unusual late sequel of ruptured distal tendon of biceps brachii mimicking a soft-tissue tumor

    Qureshi, Sajid S.; Puri, Ajay; Agarwal, Manish [Department of Bone and Soft Tissue, Tata Memorial Hospital, E. Borges Road, Parel, Bombay (India); Merchant, N.H.; Sheth, Tanuja; Jambhekar, Nirmala [Department of Radiology, Tata Memorial Hospital, Bombay (India)


    We report a rare case of chronic, neglected rupture of the distal biceps brachii which presented with gradually increasing swelling over the left lower arm. Fine-needle aspiration cytology was reported as indicative of a soft-tissue neoplasm. Computed tomography and magnetic resonance imaging were unable to rule out a neoplastic mass. Final histopathology after surgical excision revealed a reparative process. Such a presentation of ruptured biceps brachii wherein the clinicoradiological features are misleading and suggestive of a soft-tissue tumor is quite unusual. (orig.)

  12. Validation of SPAMM Tagged MRI Based Measurement of 3D Soft Tissue Deformation

    Moerman, Kevin M; Simms, Ciaran K; Lamerichs, Rolf M; Stoker, Jaap; Nederveen, Aart J


    This study presents and validates a novel (non-ECG-triggered) MRI sequence based on SPAtial Modulation of the Magnetization (SPAMM) to non-invasively measure 3D (quasi-static) soft tissue deformations using only six acquisitions (three static and three indentations). In current SPAMM tagged MRI approaches data is typically constructed from many repeated motion cycles. This has so far restricted its application to the measurement of highly repeatable and periodic movements (e.g. cardiac deformation). In biomechanical applications where soft tissue deformation is artificially induced, often by indentation, significant repeatability constraints exist and, for clinical applications, discomfort and health issues generally preclude a large number of repetitions.

  13. Ischiogluteal bursitis mimicking soft-tissue metastasis from a renal cell carcinoma

    Voelk, M.; Gmeinwieser, J.; Manke, C.; Strotzer, M. [Department of Radiology, University Hospital, Regensburg (Germany); Hanika, H. [Department of Urology, St. Josef Hospital, Regensburg (Germany)


    We report a case of ischiogluteal bursitis mimicking a soft-tissue metastasis from a renal cell carcinoma. A 66-year-old woman suffered from pain over the left buttock 6 months after she was operated on for renal cell carcinoma of the left kidney. CT of the abdomen and pelvis revealed a tumor-like lesion adjacent to the left os ischii, which was suspected to be a soft-tissue metastasis. Percutaneous biopsy revealed no evidence of malignancy, but the histopathological diagnosis of chronic bursitis. (orig.) With 2 figs., 8 refs.

  14. Soft Tissue Schwannomas of the Hard Palate and the Mandibular Mentum

    Cennet Neslihan Eroglu


    Full Text Available Schwannomas are benign, slow growing, encapsulated tumours that originate from the Schwann cells. Intraoral schwannomas are rare, and most of these tumours involve the tongue. They are rarely located in the hard palate or in the facial soft tissue. Herein, we present the clinical and histological features as well as the prognoses of two male patients with schwannoma, one of which was localized to the hard palate and the other to the facial soft tissue around the mandibular mentum and caused swelling.

  15. Analysis of mechanical interaction between human gluteal soft tissue and body supports.

    Then, C; Menger, J; Benderoth, G; Alizadeh, M; Vogl, T J; Hübner, F; Silber, G


    Pressure sores are the most common complication associated with patient immobilization. They develop through sustained localized tissue strain and stress, primarily caused by body supports. Modifying support design can reduce the risk and extent of pressure sore development with computational simulations helping to provide insight into tissue stress-strain distribution. Appropriate material parameters for human soft tissue and support material, as well as precise anatomical modelling, are indispensable in this process. A finite element (FE) model of the human gluteal region based on magnetic resonance imaging (MRI) data has been developed. In vivo human gluteal skin/fat and muscle long-term material parameters as well as open-cell polyurethane foam support long-term material parameters have been characterised. The Ogden form for slightly compressible materials was employed to describe human gluteal soft tissue behaviour. Altering support geometries and support materials, effects on human gluteal soft tissue could be quantified. FE-analysis indicated maximal tissue stress at the muscle-bone interface, not at the skin. Shear strain maxima were found in the muscle layer near the fat-muscle interface. Maximum compressive stress magnitude at the sacral bone depended strongly on the behaviour of the pelvic diaphragm musculature. We hypothesize that the compliance of the muscles forming the pelvic diaphragm govern the relative motion of the buttock tissue to the adjacent bone structure under compression, thus influencing tissue stress magnitudes.

  16. Stem Cell Therapy for Healing Wounded Skin and Soft Tissues


    thoracotomy. Wounds were immersed in 1 0% zinc -fom1alin for fixation. Histological and immunochemical analysis of wounds Formalin-fixed wounds were...stem cells from different anatomic sites in rabbits. Cells Tissues Organs. 2012;196:13-22. 47. Roldan M, Macias-Gonzalez M, Garcia R, et al. Obesity

  17. Reliability of soft tissue references for anteroposterior measurement of dental bases.

    Ferrario, V F; Sforza, C; Serrao, G; Colombo, A; Ciusa, V; Bignotto, M


    The aims of the present investigation were to devise a new anteroposterior measurement of maxillomandibular discrepancies that would consider both hard and soft tissue contributions, and to verify the correlation of this measurement to a well-established linear assessment of anteroposterior discrepancy. On the pretreatment lateral cephalographs of 300 orthodontic patients (162 males, 138 females) aged between 6 and 50 years, the Wits appraisal and a new "soft tissue" Wits appraisal (linear distance between the projections of soft tissue A and B points on the bisecting occlusal plane) were measured. In the analyzed sample, the former was more variable than the latter. The two measurements were significantly correlated to each other without sex- or age-characteristic patterns. From the correlation, reference values for the new measurement were estimated and found to be between -1.9 mm and 5.4 mm for individuals with a normal occlusion. The new measurement could allow a more careful evaluation of the soft tissue drape together with the underlying hard tissue structure.

  18. Temporal sequence of hard and soft tissue healing around titanium dental implants.

    Salvi, Giovanni E; Bosshardt, Dieter D; Lang, Niklaus P; Abrahamsson, Ingemar; Berglundh, Tord; Lindhe, Jan; Ivanovski, Saso; Donos, Nikos


    The objective of the present review was to summarize the evidence available on the temporal sequence of hard and soft tissue healing around titanium dental implants in animal models and in humans. A search was undertaken to find animal and human studies reporting on the temporal dynamics of hard and soft tissue integration of titanium dental implants. Moreover, the influence of implant surface roughness and chemistry on the molecular mechanisms associated with osseointegration was also investigated. The findings indicated that the integration of titanium dental implants into hard and soft tissue represents the result of a complex cascade of biological events initiated by the surgical intervention. Implant placement into alveolar bone induces a cascade of healing events starting with clot formation and continuing with the maturation of bone in contact with the implant surface. From a genetic point of view, osseointegration is associated with a decrease in inflammation and an increase in osteogenesis-, angiogenesis- and neurogenesis-associated gene expression during the early stages of wound healing. The attachment and maturation of the soft tissue complex (i.e. epithelium and connective tissue) to implants becomes established 6-8 weeks following surgery. Based on the findings of the present review it can be concluded that improved understanding of the mechanisms associated with osseointegration will provide leads and targets for strategies aimed at enhancing the clinical performance of titanium dental implants. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. A constrained von Mises distribution to describe fiber organization in thin soft tissues.

    Gouget, Cecile L M; Girard, Michael J; Ethier, C Ross


    The semi-circular von Mises distribution is widely used to describe the unimodal planar organization of fibers in thin soft tissues. However, it cannot accurately describe the isotropic subpopulation of fibers present in such tissues, and therefore an improved mathematical description is needed. We present a modified distribution, formed as a weighted mixture of the semi-circular uniform distribution and the semi-circular von Mises distribution. It is described by three parameters: β, which weights the contribution from each mixture component; k, the fiber concentration factor; and θ ( p ), the preferred fiber orientation. This distribution was used to fit data obtained by small-angle light scattering experiments from various thin soft tissues. Initial use showed that satisfactory fits of fiber distributions could be obtained (error generally constrained 2-parameter fiber distribution. Compared to the 3-parameter distribution, the constrained 2-parameter distribution fits experimental data well (error generally constrained 2-parameter approach was more robust to experimental noise. The constrained 2-parameter fiber distribution can replace the semi-circular von Mises distribution to describe unimodal planar organization of fibers in thin soft tissues. Inclusion of such a function in constitutive models for finite element simulations should provide better quantitative estimates of soft tissue biomechanics under normal and pathological conditions.

  20. 山东地区成人正常殆软组织侧貌唇突度6种分析法的X线头影测量研究%Cephalometric study of the horizontal lip position in Shandong adults with normal occlusion by the six different soft tissue analyses

    寇波; 李爱群; 李民; 王春玲


    Objective To obtain the norms of lip position in six different soft tissue analyses in Shandong adults with normal occlusion. Methods 123 subjects (male 60, female 63), age range 19~26 years old, were chosen from 3700 students in Shandong University. Lateral cephalogramsof each patient was taken by the same operator. Distance of S1UL, S1LL, EUL, ELL, BUL, BLL, S2UL,S2LL, HLL, H angle and Z angle from Steiner(S1), Ricketts (E), Burstone(B), Sushner(S2),Holdaway(H), Merrifield(Z) analysis, were measured. Results The norms on lip position of six different soft tissue analyses in Shandong adults with normal occlusion were obtained. There was no significant difference between male and female in each measurement except S2UL and H angle,Conclusions There are some regional characteristics on lip position in Shandong adults with normal occlusion, and significant differences between male and female are noted in several measurements.%目的 建立山东地区成人正常(牙合)软组织侧貌唇突度6种分析法的X线头影测量正常值范围.方法 按照同一标准严格筛选出山东地区成人正常骀123名,男性60名,女性63名,年龄19~26岁.拍摄X线头颅定位侧位片.测量包括Steiner(S1),Ricketts(E),Burstone(B),Sushner(S2),Holdaway(H),Merrifield(Z)6种分析法的11项测量指标-S1UL,S1LL;EUL,ELL;BUL,BLL;S2UL,S2LL;HLL,H角;Z角.计算各测量指标的均数与标准差,对男性与女性样本间进行t检验.所有数据采用SPSS10.0统计软件包进行统计学分析.结果 建立了山东地区成人正常(牙合)软组织侧貌唇突度6种分析法的X线头影测量正常值范围;男性与女性相比,仅在S2UL和H角两项指标上存在显著性差异,且男性大于女性.结论 山东地区成人正常胎软组织侧貌唇突度具有其地域性特点,部分测量指标具有男女性别间差异.

  1. Changes in the classification and management of skin and soft tissue infections.

    Koerner, Roland; Johnson, Alan P


    Although skin and soft tissue infections (SSTIs) are extremely common in both primary and secondary care, there is a lack of validated evidence-based schemes for the classification of clinical presentation or severity, and there are few data available on treatment outcomes. The commonly used 'Eron classification' is based on the consensus views of an expert panel, while the Clinical Resource Efficiency Support Team (CREST) 'Guidelines on the Management of Cellulitis in Adults' have not been validated in clinical trials. In the current issue of JAC, investigators at Ninewells Hospital in Dundee, Scotland, report a retrospective study of patients with SSTIs who were treated with antibiotics. The patients were stratified into four classes of clinical severity, based on the presence or absence of sepsis and co-morbidity, and their standardized early warning score. The empirical treatment received by patients in each class was compared with the recommendations of the CREST guidelines. The findings do not make comfortable reading. Overall, 43% of patients (and 65% at the mildest end of the clinical spectrum) were overtreated, while mortality (at 30 days) and inadequate antimicrobial therapy increased with severity class. Strikingly, 35 different empirical antimicrobial prescribing regimens were noted. These findings, which are likely to reflect the situation in many hospitals, show that SSTIs remain a significant cause of mortality and that empirical therapy is bordering on the haphazard, with significant under treatment of severely ill patients.

  2. Quantitative diagnostics of soft tissue through viscoelastic characterization using time-based instrumented palpation.

    Palacio-Torralba, Javier; Hammer, Steven; Good, Daniel W; Alan McNeill, S; Stewart, Grant D; Reuben, Robert L; Chen, Yuhang


    Although palpation has been successfully employed for centuries to assess soft tissue quality, it is a subjective test, and is therefore qualitative and depends on the experience of the practitioner. To reproduce what the medical practitioner feels needs more than a simple quasi-static stiffness measurement. This paper assesses the capacity of dynamic mechanical palpation to measure the changes in viscoelastic properties that soft tissue can exhibit under certain pathological conditions. A diagnostic framework is proposed to measure elastic and viscous behaviors simultaneously using a reduced set of viscoelastic parameters, giving a reliable index for quantitative assessment of tissue quality. The approach is illustrated on prostate models reconstructed from prostate MRI scans. The examples show that the change in viscoelastic time constant between healthy and cancerous tissue is a key index for quantitative diagnostics using point probing. The method is not limited to any particular tissue or material and is therefore useful for tissue where defining a unique time constant is not trivial. The proposed framework of quantitative assessment could become a useful tool in clinical diagnostics for soft tissue.

  3. Negative pressure wound therapy for soft tissue injuries around the foot and ankle

    Oh Jong-Keon


    Full Text Available Abstract Background This study was performed to evaluate the results of negative pressure wound therapy (NPWT in patients with open wounds in the foot and ankle region. Materials and methods Using a NPWT device, 16 patients were prospectively treated for soft tissue injuries around the foot and ankle. Mean patient age was 32.8 years (range, 3–67 years. All patients had suffered an acute trauma, due to a traffic accident, a fall, or a crush injury, and all had wounds with underlying tendon or bone exposure. Necrotic tissues were debrided before applying NPWT. Dressings were changed every 3 or 4 days and treatment was continued for 18.4 days on average (range, 11–29 days. Results Exposed tendons and bone were successfully covered with healthy granulation tissue in all cases except one. The sizes of soft tissue defects reduced from 56.4 cm2 to 42.9 cm2 after NPWT (mean decrease of 24%. In 15 of the 16 cases, coverage with granulation tissue was achieved and followed by a skin graft. A free flap was needed to cover exposed bone and tendon in one case. No major complication occurred that was directly attributable to treatment. In terms of minor complications, two patients suffered scar contracture of grafted skin. Conclusion NPWT was found to facilitate the rapid formation of healthy granulation tissue on open wounds in the foot and ankle region, and thus, to shorten healing time and minimize secondary soft tissue defect coverage procedures.

  4. ABO blood grouping from hard and soft tissues of teeth by modified absorption-elution technique

    B K Ramnarayan


    Full Text Available Background: Teeth have always been known as stable tissue that can be preserved both physically and chemically for long periods of time. Blood group substances have been known to be present in both the hard and soft tissues of the teeth. Objectives: This study aimed at detection of ABO blood group substances from soft and hard tissues of teeth and also to evaluate the reliability of teeth stored for a relatively long period as a source of blood group substances by absorption-elution technique with some modifications. Results: Blood group obtained from the teeth was compared with those obtained from the blood sample. Pulp showed a very large correlation in both fresh and long-standing teeth though it decreased slightly in the latter. Hard tissue showed a large correlation in both the groups indicating that hard tissue is quite reliable to detect blood group and that there is no much difference in the reliability in both the groups. However, combining pulp and hard tissue, correlation is moderate. Correlation of blood grouping with the age, sex, and jaw distribution was carried out. Conclusion: Blood group identification from hard and soft tissues of teeth aids in the identification of an individual.

  5. Long-term stability of peri-implant tissues after bone or soft tissue augmentation. Effect of zirconia or titanium abutments on peri-implant soft tissues. Summary and consensus statements. The 4th EAO Consensus Conference 2015

    Sicilia, Alberto; Quirynen, Marc; Fontolliet, Alain; Francisco, Helena; Friedman, Anton; Linkevicius, Tomas; Lutz, Rainer; Meijer, Henny J.; Rompen, Eric; Rotundo, Roberto; Schwarz, Frank; Simion, Massimo; Teughels, Wim; Wennerberg, Ann; Zuhr, Otto


    Introduction: Several surgical techniques and prosthetic devices have been developed in the last decades, aiming to improve aesthetic, hygienic and functional outcomes that may affect the peri-implant tissues, such as procedures of bone and soft tissue augmentation and the use of custom-made abutmen

  6. Use of Artelon® Cosmetic in soft tissue augmentation in dentistry

    Ko YK


    Full Text Available Youngkyung Ko, NamRyang Kim, Seojin Park, Jun-Beom ParkDepartment of Periodontics, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, KoreaBackground: Soft tissue augmentation is a widely used procedure in partially and fully edentulous patients to increase soft tissue volume. Polyurethanes have been used for scaffolds in a variety of implantable devices. Artelon® is a degradable polyurethane that has been manufactured as fibers, films, and porous scaffolds to be used for various purposes. In this review, the characteristics of Artelon are described, and its clinical applications in orthopedics, dermatology, cardiovascular medicine, and dentistry are also discussed.Methods: A Medline (PubMed search was conducted, and articles published in English were included. Keywords, including “Artelon”, “polyurethanes”, “soft tissue augmentation”, “biocompatibility”, “resorption”, “mechanical stability”, and “complications” were used in different combinations. Titles and abstracts were screened, and full text article analyses were performed.Results: Most of the studies reported orthopedic, dermal, and myocardial applications. There were only a few reports related to dental and implant applications. Artelon has been successfully used for reinforcement of soft tissues, including the rotator cuff, Achilles, patellar, biceps, and quadriceps tendons in orthopedic surgery, and is used clinically for the treatment of osteoarthritis in the hand, wrist, and foot. One type of Artelon material, Artelon Cosmetic, has been used in the dental field to increase soft tissue volume, and stable results are achieved for up to 6 months. This material is reported to be easily handled when cut to the desired shape, with little additional time needed for manipulation during surgery, eliminates the need for connective tissue autografts, and thereby decreases patient morbidity and postoperative discomfort, with increased likelihood of a

  7. Experience With Esthetic Reconstruction of Complex Facial Soft Tissue Trauma; Application of the Pulsed Dye Laser



    Full Text Available Background Facial soft tissue injury can be one of the most challenging cases presenting to the plastic surgeon. The life quality and self-esteem of the patients with facial injury may be compromised temporarily or permanently. Immediate reconstruction of most defects leads to better restoration of form and function as well as early rehabilitation. Objectives The aim of this study was to present our experience in management of facial soft tissue injuries from different causes. Patients and Methods We prospectively studied patients treated by plastic surgeons from 2010 to 2012 suffering from different types of blunt or sharp (penetrating facial soft tissue injuries to the different areas of the face. All soft tissue injuries were treated primarily. Photography from all patients before, during, and after surgical reconstruction was performed and the results were collected. We used early pulsed dye laser (PDL post-operatively. Results In our study, 63 patients including 18 (28.5% women and 45 (71.5% men aged 8-70 years (mean 47 years underwent facial reconstruction due to soft tissue trauma in different parts of the face. Sharp wounds were seen in 15 (23% patients and blunt trauma lacerations were seen in 52 (77% patients. Overall, 65% of facial injuries were repaired primary and the remainder were reconstructed with local flaps or skin graft from adjacent tissues. Postoperative PDL therapy done two weeks following surgery for all scars yielded good results in our cases. Conclusions Analysis of the injury including location, size, and depth of penetration as well as presence of associated injuries can aid in the formulation of a proper surgical plan. We recommend PDL in the early post operation period (two weeks after suture removal for better aesthetic results.

  8. Soft tissue thickness of face profile conditioning by dento-skeletal anomalies

    Tanić Tatjana


    Full Text Available Introduction. Orthodontic treatment of dento-skeletal anomalies is generally based on the correction of teeth and jaws relationship, while it is expected that soft facial tissue spontaneously adapts to therapeutically achieved relationship and to accompany hard tissue changes. Objective. To establish facial soft tissue thickness conditioning by the presence of dento-skeletal anomalies. Methods. The study was performed at the Dental Clinic of Niš, and involved the analysis of cephalometric rendgenograms in 121 patients, aged 12-18 years, with no previous orthodontical treatment. According to dento-skeletal relationship between teeth and jaws the patients were divided into four groups; class I (control group, class II of division 1, class II of division 2 and class III. The standard analysis of dento-skeletal profile was done according to Steiner and soft tissue profile according to Burstone was done in all. Results. The patients of class II/1 had a significantly thinner upper lip (t=2.650; p<0.05 and thinner upper lip sulcus (t=1.999; p<0.05. The patients of class II/2 had a significantly thicker upper lip (t=2.912; p<0.01, while those of class III had a significantly thinner lower lip (t=3.900; p<0.001. Conclusion. The thickness of facial soft tissue considerably influences facial profile appearance in persons with a dento-skeletal anomaly. Not only do soft tissues adapt to the existing jaws relationship, but can also camouflage present anomalies.

  9. Clinical Management of Skin and Soft Tissue Infections in the U.S. Emergency Departments

    Rakesh D. Mistry


    Full Text Available Introduction: Community-associated methicillin resistant Staphylococcus aureus (CA-MRSA has emerged as the most common cause of skin and soft-tissue infections (SSTI in the United States. A nearly three-fold increase in SSTI visit rates had been documented in the nation’s emergency departments (ED. The objective of this study was to determine characteristics associated with ED performance of incision and drainage (I+D and use of adjuvant antibiotics in the management of skin and soft tissue infections (SSTI. Methods: Cross-sectional study of the National Hospital Ambulatory Medical Care Survey, a nationally representative database of ED visits from 2007-09. Demographics, rates of I+D, and adjuvant antibiotic therapy were described. We used multivariable regression to identify factors independently associated with use of I+D and adjuvant antibiotics. Results: An estimated 6.8 million (95% CI: 5.9-7.8 ED visits for SSTI were derived from 1,806 sampled visits; 17% were for children <18 years of age and most visits were in the South (49%. I+D was performed in 27% (95% CI 24-31 of visits, and was less common in subjects <18 years compared to adults 19-49 years (p<0.001, and more common in the South. Antibiotics were prescribed for 85% of SSTI; there was no relationship to performance of I+D (p=0.72. MRSA-active agents were more frequently prescribed after I+D compared to non-drained lesions (70% versus 56%, p<0.001. After multivariable adjustment, I+D was associated with presentation in the South (OR 2.36; 95% CI 1.52-3.65 compared with Northeast, followed by West (OR 2.13; 1.31-3.45, and Midwest (OR 1.96; 1.96-3.22. Conclusion:Clinical management of most SSTIs in the U.S. involves adjuvant antibiotics, regardless of I+D. Although not necessarily indicated, CA-MRSA effective therapy is being used for drained SSTI. [West J Emerg Med. 2014;15(4:491–498.

  10. Soft tissue expansion before vertical ridge augmentation: Inflatable silicone balloons or self-filling osmotic tissue expanders?

    Prasad Vijayrao Dhadse


    Full Text Available Recent advances in periodontal plastic surgical procedures allow the clinician to reconstruct deficient alveolar ridges in more predictable ways than previously possible. Placement of implant/s in resorbed ridges poses numerous challenges to the clinician for successful esthetic and functional rehabilitation. The reconstruction frequently utilizes one or combination of periodontal plastic surgical procedures in conjunction with autogenous bone grafting, allogenic bone block grafting, ridge split techniques, distraction osteogenesis, or guided bone regeneration (GBR for most predictable outcomes. Current surgical modalities used in reconstruction of alveolar ridge (horizontal and/or vertical component often involve the need of flap transfer. Moreover, there is compromise in tissue integrity and color match owing to different surgical site and the tissue utilized is insufficient in quantity leading to post surgical graft exposition and/or loss of grafted bone. Soft tissue expansion (STE by implantation of inflatable silicone balloon or self filling osmotic tissue expanders before reconstructive surgery can overcome these disadvantages and certainly holds a promise for effective method for generation of soft tissue thereby achieving predictable augmentation of deficient alveolar ridges for the implant success. This article focuses and compares these distinct tissue expanders for their clinical efficacy of achieving excess tissue that predominantly seems to be prerequisite for ridge augmentation which can be reasonably followed by successful placement of endosseous fixtures.

  11. The differentiation of oral soft- and hard tissues using laser induced breakdown spectroscopy - a prospect for tissue specific laser surgery.

    Rohde, Maximilian; Mehari, Fanuel; Klämpfl, Florian; Adler, Werner; Neukam, Friedrich-Wilhelm; Schmidt, Michael; Stelzle, Florian


    Compared to conventional techniques, Laser surgery procedures provide a number of advantages, but may be associated with an increased risk of iatrogenic damage to important anatomical structures. The type of tissue ablated in the focus spot is unknown. Laser-Induced Breakdown-Spectroscopy (LIBS) has the potential to gain information about the type of material that is being ablated by the laser beam. This may form the basis for tissue selective laser surgery. In the present study, 7 different porcine tissues (cortical and cancellous bone, nerve, mucosa, enamel, dentine and pulp) from 6 animals were analyzed for their qualitative and semiquantitative molecular composition using LIBS. The so gathered data was used to first differentiate between the soft- and hard-tissues using a Calcium-Carbon emission based classifier. The tissues were then further classified using emission-ratio based analysis, principal component analysis (PCA) and linear discriminant analysis (LDA). The relatively higher concentration of Calcium in the hard tissues allows for an accurate first differentiation of soft- and hard tissues (100% sensitivity and specificity). The ratio based statistical differentiation approach yields results in the range from 65% (enamel-dentine pair) to 100% (nerve-pulp, cancellous bone-dentine, cancellous bone-enamel pairs) sensitivity and specificity. Experimental LIBS measuring setup. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Development of a Kinematic 3D Carpal Model to Analyze In Vivo Soft-Tissue Interaction Across Multiple Static Postures

    Marai, G. Elisabeta; Crisco, Joseph J.; Laidlaw, David H.


    We developed a subject-specific kinematic model to analyze in vivo soft-tissue interaction in the carpus in static, unloaded postures. The bone geometry was extracted from a reference computed tomography volume image. The soft-tissue geometry, including cartilage and ligament tissues, was computationally modeled based on kinematic constraints; the constraints were extracted from multiple computed tomography scans corresponding to different carpal postures. The data collected in vivo was next coupled with numerical simulation in order to analyze the role of soft-tissues in different postures. The resulting model extends the state of biomecanical modeling by incorporating soft-tissue constraints across the carpus range of motion, while successfully using only physiological constraints. The model results suggest that soft-tissue wrapping constraints have substantial impact on carpus stability. PMID:19965271

  13. Unified viscoelasticity: Applying discrete element models to soft tissues with two characteristic times.

    Anssari-Benam, Afshin; Bucchi, Andrea; Bader, Dan L


    Discrete element models have often been the primary tool in investigating and characterising the viscoelastic behaviour of soft tissues. However, studies have employed varied configurations of these models, based on the choice of the number of elements and the utilised formation, for different subject tissues. This approach has yielded a diverse array of viscoelastic models in the literature, each seemingly resulting in different descriptions of viscoelastic constitutive behaviour and/or stress-relaxation and creep functions. Moreover, most studies do not apply a single discrete element model to characterise both stress-relaxation and creep behaviours of tissues. The underlying assumption for this disparity is the implicit perception that the viscoelasticity of soft tissues cannot be described by a universal behaviour or law, resulting in the lack of a unified approach in the literature based on discrete element representations. This paper derives the constitutive equation for different viscoelastic models applicable to soft tissues with two characteristic times. It demonstrates that all possible configurations exhibit a unified and universal behaviour, captured by a single constitutive relationship between stress, strain and time as: σ+Aσ̇+Bσ¨=Pε̇+Qε¨. The ensuing stress-relaxation G(t) and creep J(t) functions are also unified and universal, derived as [Formula: see text] and J(t)=c2+(ε0-c2)e(-PQt)+σ0Pt, respectively. Application of these relationships to experimental data is illustrated for various tissues including the aortic valve, ligament and cerebral artery. The unified model presented in this paper may be applied to all tissues with two characteristic times, obviating the need for employing varied configurations of discrete element models in preliminary investigation of the viscoelastic behaviour of soft tissues. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Linear Elastic Properties of the Facial Soft Tissues Using an Aspiration Device: Towards Patient Specific Characterization.

    Luboz, Vincent; Promayon, Emmanuel; Payan, Yohan


    International audience; Biomechanical modeling of the facial soft tissue behavior is needed in aesthetic or maxillo-facial surgeries where the simulation of the bone displacements cannot accurately predict the visible outcome on the patient's face. Because these tissues have different nature and elastic properties across the face, depending on their thickness, and their content in fat or muscle, individualizing their mechanical parameters could increase the simulation accuracy. Using a specif...

  15. Benefits of low-power lasers on oral soft tissue

    Eduardo, Carlos d. P.; Cecchini, Silvia C. M.; Cecchini, Renata C.


    The last five years have represented a great advance in relation to laser development. Countries like Japan, United States, French, England, Israel and others, have been working on the association of researches and clinical applications, in the field of laser. Low power lasers like He-Ne laser, emitting at 632,8 nm and Ga-As-Al laser, at 790 nm, have been detached acting not only as a coadjutant but some times as an specific treatment. Low power lasers provide non thermal effect at wavelengths believed to stimulate circulation and cellular activity. These lasers have been used to promote wound healing and reduce inflammation edema and pain. This work presents a five year clinical study with good results related to oral tissue healing. Oral cavity lesions, like herpes and aphthous ulcers were irradiated with Ga-Al- As laser. In both cases, an excellent result was obtained. The low power laser application decrease the painful sintomatology immediately and increase the reparation process of these lesions. An excellent result was obtained with application of low power laser in herpetic lesions associated with a secondary infection situated at the lip commissure covering the internal tissue of the mouth. The healing occurred after one week. An association of Ga-Al-As laser and Nd:YAG laser have been also proven to be good therapy for these kind of lesions. This association of low and high power laser has been done since 1992 and it seems to be a complement of the conventional therapies.

  16. Esthetic prevention with soft tissue and biomaterial grafts

    Rogério Margonar

    Full Text Available Gingival recessions are periodontal defects that may need the association of surgical techniques in order to be successfully treated. The absence of treatment of these defects may lead to local esthetics being compromised, patient dissatisfaction, and reduced time and duration of treatment. When dealing with dental implants, the esthetic condition is no different, with the aggravating factor that the lack of this protective tissue may accelerate vestibular bone loss and lead to loss of the implant. The clinical case presented report the performance of a conjunctive tissue grafting technique, associated with vestibular filling with biomaterial, to prevent a gingival recession in an immediate implant with immediate loading. The aim of the procedure was to prevent gingival recession, which would lead to a severe esthetic defect, and also to reinforce the vestibular bone wall. After three years of follow-up of the case, it was possible to conclude that the association of thetechniques had predictable and satisfactory results for preventing periimplant gingival recession.

  17. Evaluation of the linearity of soft- to hard-tissue movement after orthognathic surgery

    Chew, Ming Tak; Sandham, John; Wong, Hwee Bee


    Introduction: Our aim in this study was to investigate whether a linear relationship exists between soft- to hard-tissue changes for both maxillary and mandibular landmarks over a wide range of skeletal changes. Methods: The sample consisted of 30 Chinese patients with Class III malocclusion treated

  18. Accuracy of three-dimensional soft tissue simulation in bimaxillary osteotomies

    Liebregts, J.; Xi, T.; Timmermans, M.; Koning, M.J.J. de; Berge, S.J.; Hoppenreijs, T.J.M.; Maal, T.J.


    The purpose of this study was to evaluate the accuracy of an algorithm based on the mass tensor model (MTM) for computerized 3D simulation of soft-tissue changes following bimaxillary osteotomy, and to identify patient and surgery-related factors that may affect the accuracy of the simulation. Sixty

  19. Strain Elastography for Prediction of Malignancy in Soft Tissue Tumours--Preliminary Results

    Riishede, I; Ewertsen, C; Carlsen, J;


    PURPOSE: To evaluate the ability of strain elastography to predict malignancy in patients with soft tissue tumors, and to compare three evaluation methods of strain elastography: strain ratios, strain histograms and visual scoring. MATERIALS AND METHODS: 60 patients with 61 tumors were analyzed i...

  20. The treatment of acute soft tissue trauma in Danish emergency rooms

    Johannsen, F; Langberg, Henning


    Rest, ice, compression, elevation (RICE) is the most recommended treatment for acute traumatic soft tissue injuries. A questionnaire was given to all Danish emergency rooms (n = 5) regarding their routines for acute treatment of ankle sprains and muscle contusions. Complete answers were received ...

  1. Combined soft and skeletal tissue modelling of normal and dysmorphic midface postnatal development.

    Ibrahim, Amel; Suttie, Michael; Bulstrode, Neil W; Britto, Jonathan A; Dunaway, David; Hammond, Peter; Ferretti, Patrizia


    Midface hypoplasia as exemplified by Treacher Collins Syndrome (TCS) can impair appearance and function. Reconstruction involves multiple invasive surgeries with variable long-term outcomes. This study aims to describe normal and dysmorphic midface postnatal development through combined modelling of skeletal and soft tissues and to develop a surgical evaluation tool. Midface skeletal and soft tissue surfaces were extracted from computed tomography scans of 52 control and 14 TCS children, then analysed using dense surface modelling. The model was used to describe midface growth, morphology, and asymmetry, then evaluate postoperative outcomes. Parameters responsible for the greatest variation in midface size and shape showed differences between TCS and controls with close alignment between skeletal and soft tissue models. TCS children exhibited midface dysmorphology and hypoplasia when compared with controls. Asymmetry was also significantly higher in TCS midfaces. Combined modelling was used to evaluate the impact of surgery in one TCS individual who showed normalisation immediately after surgery but reversion towards TCS dysmorphology after 1 year. This is the first quantitative analysis of postnatal midface development using combined modelling of skeletal and soft tissues. We also provide an approach for evaluation of surgical outcomes, laying the foundations for future development of a preoperative planning tool. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  2. Vibration transmission to lower extremity soft tissues during whole-body vibration.

    Friesenbichler, Bernd; Lienhard, Karin; Vienneau, Jordyn; Nigg, Benno M


    In order to evaluate potential risks of whole-body vibration (WBV) training, it is important to understand the transfer of vibrations from the WBV platform to the muscles. Therefore, the purpose of this study was to quantify the transmissibility of vibrations from the WBV platform to the triceps surae and quadriceps soft tissue compartments. Sixteen healthy, male participants were exposed to side-altering WBV at 2.5mm amplitude and frequencies of 10, 17 and 28 Hz. Acceleration signals were measured at the platform and at the soft tissue compartments using tri-axial accelerometers. Transmissibility of peak acceleration and peak amplitude for both tested soft tissue compartments was high at 10 Hz (2.1-2.3), moderate at 17 Hz (1.1-1.9) and low at 28 Hz (0.5-1.2). The average peak acceleration was 125.4 ms(-2) and 46.5 ms(-2) for the triceps surae and quadriceps at 28 Hz, respectively. The muscles' vibration frequency was equal to the input frequency of the WBV platform (ptriceps surae was higher than the corresponding accelerations related to soft tissue injury in animal studies but neither existing regulations nor the comparison to available animal studies seem appropriate to make inferences on injury risk. More realistic animal or computational muscle models may use the current data to evaluate potentially unwanted side effects of WBV training.

  3. Recurrent, multiple, calcified soft tissue metastases from osteogenic sarcoma without pulmonary involvement

    Wolf, R; Wolf, RFE; Hoekstra, HJ


    Osteosarcoma (osteogenic sarcoma) metastasizes primarily to the lung. With the introduction of neoadjuvant chemotherapy as part of the treatment, the overall and disease-free survival rates have dramatically improved. In this case report, a young man with multiple soft tissue and bone metastases,

  4. Childhood Bone and Soft Tissue ...


    the developing countries, one child out of two with cancer will die because of this disease mostly because they ... and soft tissue tumours in children was done in the Surgery Departments of University. Teaching Hospitals .... rays already had pulmonary metastases on ... Four deaths had Osteosarcoma, one had. Ewing's ...

  5. A Review of the Literature Refuting the Concept of Minor Impact Soft Tissue Injury

    Christopher J Centeno


    Full Text Available BACKGROUND: Minor impact soft tissue (MIST is an insurance industry concept that seeks to identify late whiplash as a psychosocial phenomenon. However, the medical literature in this area has not been systematically reviewed since the Quebec Task Force's review in 1995.

  6. Imaging of soft tissue tumors: general imaging strategy and technical considerations.

    Van Dyck, P; Gielen, J; Vanhoenacker, F M; De Schepper, A M; Parizel, P M


    This paper reviews the imaging strategy and protocol for detection, grading and staging, and posttherapeutic follow-up of soft tissue tumors (STT), used in our institution. The role of each imaging technique, with emphasis on magnetic resonance imaging, is highlighted.

  7. Soft tissue response to zirconia and titanium implant abutments : an in vivo within-subject comparison

    van Brakel, Ralph; Meijer, Gert J.; Verhoeven, Jan Willem; Jansen, John; de Putter, Cornelis; Cune, Marco S.


    Aim To compare the health of the soft tissues towards zirconia and titanium abutments in man, as observed using histological data. Material and Methods Twenty patients received two mandibular implants with either a zirconia or titanium abutment (split mouth study design, left-right randomization). A

  8. Soft tissue response to zirconia and titanium implant abutments: an in vivo within-subject comparison.

    Brakel, R. van; Meijer, G.J.; Verhoeven, J.W.; Jansen, J.A.; Putter, C. de; Cune, M.S.


    AIM: To compare the health of the soft tissues towards zirconia and titanium abutments in man, as observed using histological data. MATERIAL AND METHODS: Twenty patients received two mandibular implants with either a zirconia or titanium abutment (split mouth study design, left-right randomization).

  9. Routine bone scintigraphy in primary staging of soft tissue sarcoma - Is it worthwhile?

    Jager, PL; Hoekstra, HJ; Leeuw, JA; van der Graaf, WTA; de Vries, EGE; Piers, DA


    BACKGROUND. The incidence of bone metastases in soft tissue sarcoma (STS) patients seems to be low but has not been studied separately. In this study, the authors aimed to determine the value of routine radionuclide bone scanning in preoperative staging of STS patients. METHODS. Preoperative bone

  10. Soft tissue mesenchymal tumour – a case report with review of literature

    Debkumar Chowdhury


    Conclusion: Our case is unique due to location of the tumour and its immunohistochemistry findings which required frequent and extensive discussion at our national sarcoma soft tissue meeting. The importance of surgeons working with histopathologists was also highlighted in our case.

  11. Recurrent, multiple, calcified soft tissue metastases from osteogenic sarcoma without pulmonary involvement

    Wolf, R; Wolf, RFE; Hoekstra, HJ


    Osteosarcoma (osteogenic sarcoma) metastasizes primarily to the lung. With the introduction of neoadjuvant chemotherapy as part of the treatment, the overall and disease-free survival rates have dramatically improved. In this case report, a young man with multiple soft tissue and bone metastases, in

  12. Hypoxia-Inducible Factors: Mediators of Cancer Progression; Prognostic and Therapeutic Targets in Soft Tissue Sarcomas

    Sadri, Navid; Zhang, Paul J., E-mail: [Anatomic Pathology, Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, 6th Floor Founders Building, Philadelphia, PA 19104 (United States)


    Soft-tissue sarcomas remain aggressive tumors that result in death in greater than a third of patients due to either loco-regional recurrence or distant metastasis. Surgical resection remains the main choice of treatment for soft tissue sarcomas with pre- and/or post-operational radiation and neoadjuvant chemotherapy employed in more advanced stage disease. However, in recent decades, there has been little progress in the average five-year survival for the majority of patients with high-grade soft tissue sarcomas, highlighting the need for improved targeted therapeutic agents. Clinical and preclinical studies demonstrate that tumor hypoxia and up-regulation of hypoxia-inducible factors (HIFs) is associated with decreased survival, increased metastasis, and resistance to therapy in soft tissue sarcomas. HIF-mediated gene expression regulates many critical aspects of tumor biology, including cell survival, metabolic programming, angiogenesis, metastasis, and therapy resistance. In this review, we discuss HIFs and HIF-mediated genes as potential prognostic markers and therapeutic targets in sarcomas. Many pharmacological agents targeting hypoxia-related pathways are in development that may hold therapeutic potential for treating both primary and metastatic sarcomas that demonstrate increased HIF expression.

  13. Routine bone scintigraphy in primary staging of soft tissue sarcoma - Is it worthwhile?

    Jager, PL; Hoekstra, HJ; Leeuw, JA; van der Graaf, WTA; de Vries, EGE; Piers, DA


    BACKGROUND. The incidence of bone metastases in soft tissue sarcoma (STS) patients seems to be low but has not been studied separately. In this study, the authors aimed to determine the value of routine radionuclide bone scanning in preoperative staging of STS patients. METHODS. Preoperative bone sc

  14. EWSR1-ATF1 chimeric transcript in a myoepithelial tumor of soft tissue : a case report

    Flucke, Uta; Mentzel, Thomas; Verdijk, Marian A.; Slootweg, Pieter J.; Creytens, David H.; Suurmeijer, Albert J. H.; Tops, Bastiaan B. J.


    Soft tissue myoepithelial tumors, a recently defined entity, include benign and malignant lesions showing a considerable morphological and immunohistochemical heterogeneity. EWSR1 rearrangements are well recognized in this tumor type, and some of the partner genes have been identified. Herein we des

  15. Myoepithelial neoplasms of soft tissue: an updated review of the clinicopathologic, immunophenotypic, and genetic features.

    Jo, Vickie Y; Fletcher, Christopher D M


    Myoepithelial tumors in skin and soft tissue are uncommon but have been increasingly characterized over the past decade. Men and women are equally affected across all age groups and lesions arise most frequently on the extremities and limb girdles. Approximately 20 % of cases occur in pediatric patients, in whom they are frequently malignant. Similar to their salivary gland counterparts, myoepithelial tumors of soft tissue demonstrate heterogeneous morphologic and immunophenotypic features. Tumors are classified as mixed tumor/chondroid syringoma, myoepithelioma, and myoepithelial carcinoma; in soft tissue, tumors having at least moderate cytologic atypia are classified as malignant. Mixed tumor and myoepithelioma show a benign clinical course, with recurrence in up to 20 % (typically secondary to incomplete excision), and do not metastasize. In contrast, myoepithelial carcinoma shows more aggressive behavior with recurrence and metastasis in up to 40-50 % of cases. The majority of myoepithelial neoplasms typically coexpress epithelial antigens (cytokeratin and/or EMA) and S-100 protein; GFAP and p63 are frequently positive and a subset of malignant neoplasms lose INI1 expression. Up to 45 % of myoepitheliomas and myoepithelial carcinomas harbor EWSR1 gene rearrangements, unlike mixed tumor/chondroid syringoma which is characterized by PLAG1 gene rearrangement. While mixed tumor/chondroid syringoma are likely related to primary salivary myoepithelial tumors, soft tissue myoepithelioma and myoepithelial carcinoma appear to be pathologically distinct neoplasms.

  16. EWSR1-ATF1 chimeric transcript in a myoepithelial tumor of soft tissue: a case report.

    Flucke, U.; Mentzel, T.; Verdijk, M.A.J.; Slootweg, P.J.; Creytens, D.H.; Suurmeijer, A.J.H.; Tops, B.B.J.


    Soft tissue myoepithelial tumors, a recently defined entity, include benign and malignant lesions showing a considerable morphological and immunohistochemical heterogeneity. EWSR1 rearrangements are well recognized in this tumor type, and some of the partner genes have been identified. Herein we des

  17. Complications of radical soft-tissue mobilization procedure as a primary closure of exstrophy.

    Purves, J Todd; Gearhart, John P


    The radical soft-tissue mobilization procedure was developed as a component of the staged closure of classical bladder exstrophy to improve continency rates without having to perform pelvic osteotomies. The authors describe complications following this procedure and discuss possible etiologies and subsequent management. We extracted from an institutionally approved exstrophy database the records of patients evaluated for complications following radical soft-tissue mobilization repair from 1999 to 2002. Four patients were referred to our institution following closure of exstrophy with the radical soft-tissue mobilization technique; two boys and two girls. Complications included ischemic penile injuries in both males, failed exstrophy closure in one female, incontinence with need for bladder neck transection and diversion in two patients, and upper tract deterioration in two patients of whom one required cystectomy and incontinent diversion. Omission of osteotomies when employing the radical soft-tissue mobilization repair appears to result in complications that could otherwise be prevented. Additionally, the complex dissection of the pelvic musculature, innervation and vasculature performed during radical mobilization has great potential to injure the pelvic structures and genitalia, as has been seen with the cases presented herein.



    To study mechanisms involved in evolution of soft tissue sarcomas, we compared DNA ploidy and karyotypes at different stages of their disease in two patients with myxoid liposarcomas (MLS), one with a fibrosarcoma (FS), and two with rhabdomyosarcomas (RMS). None of the MLS samples revealed clearcut

  19. Isolated limb perfusion of soft tissue sarcomas : A comprehensive review of literature

    Seinen, Jojanneke M.; Hoekstra, Harald J.


    Patients with primary irresectable, locally advanced soft tissue sarcomas of the limbs form a challenging group for the treating physician. Multimodality treatment is necessary to guarantee optimal limb salvage and survival rates. Since the introduction of isolated limb perfusion in the late fifties

  20. Efficacy of trabectedin in advanced soft tissue sarcoma: beyond lipo- and leiomyosarcoma [Corrigendum

    De Sanctis R


    Full Text Available Dr De Sanctis, Efficacy of trabectedin in advanced soft tissue sarcoma: beyond lipo- and leiDe Sanctis R, Marrari A, Marchetti S, et al. Drug Des Devel Ther. 2015;9:5785–5791.The authors note that on page 5787, Figure 1, the bottom bar is missing the label “liposarcoma”.Read the original article

  1. Efficacy of trabectedin in advanced soft tissue sarcoma: beyond lipo- and leiomyosarcoma [Corrigendum

    De Sanctis R; Marrari A; Marchetti S; Mussi C; Balzarini L.; Lutman FR; Daolio P; Bastoni S; Bertuzzi AF; Quagliuolo V; Santoro A.


    Dr De Sanctis, Efficacy of trabectedin in advanced soft tissue sarcoma: beyond lipo- and leiDe Sanctis R, Marrari A, Marchetti S, et al. Drug Des Devel Ther. 2015;9:5785–5791.The authors note that on page 5787, Figure 1, the bottom bar is missing the label “liposarcoma”.Read the original article

  2. Maxillofacial trauma with emphasis on soft-tissue injuries in Malaysia.

    Hussaini, H M; Rahman, N A; Rahman, R A; Nor, G M; Ai Idrus, S M; Ramli, R


    Soft-tissue injuries with or without facial bone involvement are the most common presentation following maxillofacial trauma. The objective of this study was to look at the distribution, pattern and type of soft-tissue injury in relation to aetiology. Records of patients over a period of 5 years (1998-2002), who sustained maxillofacial injuries and were treated at Kajang Hospital, a secondary referral hospital, were reviewed. Out of 313 patients with maxillofacial injuries, 295 patients sustained soft-tissue injuries. Males (79%) between 21 and 30 years old (34%) were the majority of patients. Road-traffic accident was the main cause of soft-tissue injuries (75%) with motorcycle accident being the most frequent (40%). The upper lips (23%) and the lower lips (18%) were the most common extraoral site involved, while the labial mucosa and sulcular areas, both accounting for 21%, were the most common intraoral sites. Stringent road-traffic regulations should be practiced in developing countries, as morbidity arising from road-traffic accidents poses a national economic and social problem.

  3. Safety and effectiveness of a synthetic hemostatic patch for intraoperative soft tissue bleeding.

    Schuhmacher, Christoph; Pratschke, Johann; Weiss, Sascha; Schneeberger, Stefan; Mihaljevic, André L; Schirren, Rebekka; Winkler, Michael; Emmanouilidis, Nikos


    Continuous bleeding after using conventional hemostatic methods involving energy, sutures, or clips, is a serious and costly surgical complication. Many topical agents have been developed to promote intraoperative hemostasis, but improvement is needed in both decreasing time to hemostasis and increasing ease of use. Veriset™ hemostatic patch is CE-marked for controlling bleeding on the liver and in soft tissue. In the current study, we aimed to gather further evidence for the safety and effectiveness of Veriset™ hemostatic patch in soft tissue bleeding during a variety of surgical procedures. Thirty patients scheduled for nonemergency surgery, each with an intraoperative soft tissue bleeding site, were treated with Veriset™ hemostatic patch. Time to hemostasis was monitored, and adverse events were assessed during the 90 days after surgery. When Veriset™ hemostatic patch was used, hemostasis occurred within 5 minutes in 29/30 (96.7%) subjects and within 1 minute in 21/30 (70.0%) subjects. No device-related serious adverse events were recorded during the 30 days after surgery, and no reoperations for device-related bleeding complications were performed during the 5 days after surgery. Veriset™ hemostatic patch is a safe and effective hemostat for controlling soft tissue bleeding during a variety of surgical procedures.

  4. Accuracy of three-dimensional soft tissue simulation in bimaxillary osteotomies

    Liebregts, J.; Xi, T.; Timmermans, M.; Koning, M.J.J. de; Berge, S.J.; Hoppenreijs, T.J.M.; Maal, T.J.


    The purpose of this study was to evaluate the accuracy of an algorithm based on the mass tensor model (MTM) for computerized 3D simulation of soft-tissue changes following bimaxillary osteotomy, and to identify patient and surgery-related factors that may affect the accuracy of the simulation. Sixty

  5. Effect of head position on cephalometric evaluation of the soft-tissue facial profile

    Hoogeveen, R.C.; Sanderink, G.C.H.; Berkhout, W.E.R.


    Objectives: During a cone beam CT scan, the patient is in an upright or supine position. This position depends on the brand and type of the scanner. The aims of this study are: (1) to investigate if the head position has an effect on cephalometric evaluation of the soft-tissue facial profile, compar

  6. [Production of interleukin-2 by peripheral blood lymphocytes from patients with soft tissue sarcomas].

    Berezhnaia, N M; Goretskiĭ, B A; Konovalenko, V F; Palivets, A Iu; Tolstopiatov, B A


    Interleukin-2 (IL-2) production of phytohemagglutinin-stimulated peripheral blood lymphocytes (PBL) was studied in 9 healthy subjects and 19 patients with soft tissue sarcomas. Mean IL-2 production by PBL in 19 patients was significantly diminished as compared with the control. Surgery leads to an increase of IL-2 production, however, the levels observed in the control do not restore completely.

  7. Radioisotopic methods for the study of bone sarcoma and soft tissue neoplasms

    Gongora, R.


    Radioisotopic methods are widely applied to investigations of bone sarcoma and soft tissue neoplasms. We have at our disposal molecules with osseous, tumoral or vascular tropism. Their use, as single agents or combination, is helpful in positive and differential diagnosis and provides nosological informations. They are also useful in treatment monitoring and in long-term follow-up.

  8. Quality of life after hyperthermic isolated limb perfusion for locally advanced extremity soft tissue sarcoma

    Thijssens, KMJ; Hoekstra-Weebers, JEHM; van Ginkel, RJ; Hoekstra, HJ


    Background: Quality of life (QoL) and posttraumatic stress symptoms (PTSS) were studied in patients with soft tissue sarcoma (STS) of the extremities treated with isolated limb perfusion and delayed resection, with or without adjuvant irradiation. Methods: Forty-one patients received a questionnaire

  9. Radiotherapy for Management of Extremity Soft Tissue Sarcomas: Why, When, and Where?

    Haas, Rick L.M., E-mail: [Department of Radiotherapy, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); DeLaney, Thomas F. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); O' Sullivan, Brian [Department of Radiation Oncology, Princess Margaret Hospital, Toronto, ON (Canada); Keus, Ronald B. [Department of Radiotherapy, Arnhems Radiotherapeutisch Instituut, Arnhem (Netherlands); Le Pechoux, Cecile [Department of Radiotherapy, Institut Gustave-Roussy, Villejuif (France); Olmi, Patricia [Department of Radiotherapy, Istituto Nazionale per lo Studio e la cura dei Tumori, Milan (Italy); Poulsen, Jan-Peter [Department of Radiotherapy, Norwegian Radium Hospital-Oslo University Hospital, Oslo (Norway); Seddon, Beatrice [Department of Radiotherapy, University College London Hospitals, London (United Kingdom); Wang, Dian [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States)


    This critical review will focus on published data on the indications for radiotherapy in patients with extremity soft tissue sarcomas and its role in local control, survival, and treatment complications. The differences between pre- and postoperative radiotherapy will be discussed and consensus recommendations on target volume delineation proposed.

  10. Mandibular Bone and Soft Tissues Necrosis Caused by an Arsenical Endodontic Preparation Treated with Piezoelectric Device

    A. Giudice


    Full Text Available This paper describes a case of wide mandibular bone necrosis associated with significant soft tissues injury after using an arsenical endodontic preparation in the right lower second molar for endodontic purpose. Authors debate about the hazardous effects of the arsenic paste and the usefulness of piezosurgery for treatment of this drug related bone necrosis.

  11. Enhancing the soft tissue seal around intraosseous transcutaneous amputation prostheses using silanized fibronectin titanium alloy

    Chimutengwende-Gordon, M; Pendegrass, C; Blunn, G, E-mail: [Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College London, Brockley Hill, Stanmore, HA7 4LP (United Kingdom)


    The success of intraosseous transcutaneous amputation prostheses (ITAP) relies on achieving a tight seal between the soft tissues and the implant in order to avoid infection. Fibronectin (Fn) may be silanized onto titanium alloy (Ti-6Al-4V) in order to promote soft-tissue attachment. The silanization process includes passivation with sulphuric acid, which alters surface characteristics. This study aimed to improve in vitro fibroblast adhesion to silanized fibronectin (SiFn) titanium alloy by omitting the passivation stage. Additionally, the study assessed the effects of SiFn on in vivo dermal attachment, comparing the results with adsorbed Fn, hydroxyapatite (HA), Fn adsorbed onto HA (HAFn) and uncoated controls. Surface topography was assessed using scanning electron microscopy, profilometry and contact angle measurement. Anti-vinculin antibodies were used to immunolocalize fibroblast adhesion sites. A histological assessment of soft-tissue attachment and cell alignment relative to implants in an in vivo ovine model was performed. Passivation resulted in rougher, more hydrophobic, microcracked surfaces and was associated with poorer fibroblast adhesion than unpassivated controls. SiFn and HAFn surfaces resulted in more favourable cell alignment in vivo, implying that dermal attachment was enhanced. These results suggest that SiFn and HAFn surfaces could be useful in optimizing the soft tissue seal around ITAP.

  12. Different effects of bleeding and soft-tissue trauma on pulmonary platelet trapping in pigs

    Blomquist, S.; Thoerne, J.E.; Elmer, O.


    Immediate reactions to different types of trauma have been the object of several studies recently. It has been shown that pulmonary platelet trapping (PPT) occurs within minutes after both septic shock and soft-tissue trauma. The purpose of this study was to investigate whether hypovolemia induced by hypoperfusion might trigger platelet trapping in the lungs in the same way as soft-tissue trauma. Platelets labelled with indium-oxine were reinfused in anesthetized and mechanically ventilated pigs 4 hours before either induction of standardized hypovolemia caused by bleeding to the amount of 20% of the estimated blood volume (n = 6) or a standardized soft-tissue trauma to the hind limbs (n = 7). Platelet sequestration in the lungs was recorded dynamically by means of scintigraphy for 15 minutes before and 90 min after the start of the trauma and bleeding episodes. Central hemodynamics were recorded using a Swan-Ganz catheter. Soft-tissue trauma induced a marked PPT; in the animals subjected to bleeding alone there was no such effect despite a hemodynamic deterioration of greater magnitude than in the trauma group. The PPT was accompanied by a reduction in the number of platelets and leukocytes in peripheral blood. Our results indicate that immediate trapping of platelets in the lungs after trauma occurs as a response to factors other than those related to simple hypovolemic hypoperfusion.

  13. Evaluation of the linearity of soft- to hard-tissue movement after orthognathic surgery

    Chew, Ming Tak; Sandham, John; Wong, Hwee Bee


    Introduction: Our aim in this study was to investigate whether a linear relationship exists between soft- to hard-tissue changes for both maxillary and mandibular landmarks over a wide range of skeletal changes. Methods: The sample consisted of 30 Chinese patients with Class III malocclusion treated

  14. Carpal Tunnel Cross-Sectional Area Affected by Soft Tissues Abutting the Carpal Bones.

    Gabra, Joseph N; Li, Zong-Ming


    The carpal tunnel accommodates free movement of its contents, and the tunnel's cross-sectional area is a useful morphological parameter for the evaluation of the space available for the carpal tunnel contents and of potential nerve compression in the tunnel. The osseous boundary of the carpal bones as the dorsal border of the carpal tunnel is commonly used to determine the tunnel area, but this boundary contains soft tissues such as numerous intercarpal ligaments and the flexor carpi radialis tendon. The aims of this study were to quantify the thickness of the soft tissues abutting the carpal bones and to investigate how this soft tissue influences the calculation of the carpal tunnel area. Magnetic resonance images were analyzed for eight cadaveric specimens. A medical balloon with a physiological pressure was inserted into an evacuated tunnel to identify the carpal tunnel boundary. The balloon-based (i.e. true carpal tunnel) and osseous-based carpal tunnel boundaries were extracted and divided into regions corresponding to the hamate, capitate, trapezoid, trapezium, and transverse carpal ligament (TCL). From the two boundaries, the overall and regional soft tissue thicknesses and areas were calculated. The soft tissue thickness was significantly greater for the trapezoid (3.1±1.2mm) and trapezium (3.4±1.0mm) regions than for the hamate (0.7±0.3mm) and capitate (1.2±0.5mm) regions. The carpal tunnel area using the osseous boundary (243.0±40.4mm(2)) was significantly larger than the balloon-based area (183.9±29.7mm(2)) with a ratio of 1.32. In other words, the carpal tunnel area can be estimated as 76% (= 1/1.32) of the osseous-based area. The abundance of soft tissue in the trapezoid and trapezium regions can be attributed mainly to the capitate-trapezium ligament and the flexor carpi radialis tendon. Inclusion of such soft tissue leads to overestimations of the carpal tunnel area. Correct quantification of the carpal tunnel area aids in examining carpal

  15. Accurate optical flow field estimation using mechanical properties of soft tissues

    Mehrabian, Hatef; Karimi, Hirad; Samani, Abbas


    A novel optical flow based technique is presented in this paper to measure the nodal displacements of soft tissue undergoing large deformations. In hyperelasticity imaging, soft tissues maybe compressed extensively [1] and the deformation may exceed the number of pixels ordinary optical flow approaches can detect. Furthermore in most biomedical applications there is a large amount of image information that represent the geometry of the tissue and the number of tissue types present in the organ of interest. Such information is often ignored in applications such as image registration. In this work we incorporate the information pertaining to soft tissue mechanical behavior (Neo-Hookean hyperelastic model is used here) in addition to the tissue geometry before compression into a hierarchical Horn-Schunck optical flow method to overcome this large deformation detection weakness. Applying the proposed method to a phantom using several compression levels proved that it yields reasonably accurate displacement fields. Estimated displacement results of this phantom study obtained for displacement fields of 85 pixels/frame and 127 pixels/frame are reported and discussed in this paper.

  16. Thoracodorsal artery perforator fasciocutaneous flap: A versatile alternative for coverage of various soft tissue defects

    Celalettin Sever


    Full Text Available Objective: The thoracodorsal artery perforator (TDAP flap has contributed to the efficient reconstruction of tissue defects that require a large amount of cutaneous tissue. The optimal reconstruction method should provide thin, and well-vascularized tissue with minimal donor-site morbidity. The indications for the use of this particular flap with other flaps are discussed in this article. Materials and Methods: Thirteen patients underwent soft tissue reconstruction using TDAP flaps between 2009 and 2011. Of those, there were four cases of antecubital burn contracture, three cases of axillary burn contracture, two cases of giant hair cell nevus of upper extremity, two cases of axillary reconstruction following severe recurrent hidradenitis, and two cases of crush injury. All patients were male and their ages ranged from 20 to 23 (average, 21 years. The mean follow-up period was 8 months (range, 4-22 months. Results: All reconstructive procedures were completed without any major complications. Minor complications related to transfered flaps were wound dehiscence in one case, transient venous congestion in two cases. Minor complication related to the donor site was seroma in one case. The success rate was 100%, with satisfactory cosmetic results. Conclusions: The TDAP flap is a safe and extremely versatile flap that offers significant advantages in acute and delayed reconstruction. Although the vascular anatomy may be variable, free and pedicled TDAP flap is a versatile alternative for soft tissue defects. It adapts very well to the soft tissue defects with acceptable donor site scar.

  17. Bacterial biofilm formation and treatment in soft tissue fillers

    Alhede, Morten; Er, Ozge; Eickhardt, Steffen


    fraction these. We developed a novel mouse model and evaluated hyaluronic acid gel, calcium hydroxyl apatite microspheres and polyacrylamide hydrogel for their potential for sustaining bacterial infections and their possible treatments. We were able to culture Pseudomonas aeruginosa, Staphylococcus...... epidermidis and Probionibacterium acnes in all three gels. When contaminated gels were left for 7 days in a mouse model, we found sustainment of bacterial infection with the permanent gel, less with the semi-permanent gel and no growth within the temporary gel. Evaluation of treatment strategies showed...... that once the bacteria had settled (into biofilms) within the gels, even succesive treatments with high concentrations of relevant antibiotics were not effective. Our data substantiate bacteria as a cause of adverse reactions reported when using tissue fillers, and the sustainability of these infections...

  18. Implant hygiene and soft tissue management: Dentist′s perspective

    S Meenakshi


    Full Text Available Osseointegration is the treatment modality opted in the rehabilitation of partially or fully edentulous patients. However, the surrounding tissues may be subject to inflammatory conditions, similar to periodontal disease, and so requires maintenance. The dental personnel should have current knowledge about methods of safely instrumenting implants and knowledge of available products, which could be safely recommended to patients to initiate effective home care of implants. It can be challenging to achieve effective oral hygiene around dental implants over the long term, and the patient, dentist, and dental hygienist must exercise considerable effort to achieve the desired results. This article discusses the background, etiology, diagnosis of peri-implant diseases, maintenance, care of osseointegrated implants.

  19. 拔牙矫治对 AngleⅡ1错牙合成年女性面部软组织正貌的影响%Impacts of orthodontic treatment with tooth extraction on the frontal view of facial soft tissue in adult fe-males with class Ⅱ division 1 malocclusion

    谢妹洪; 劳柯杰; 覃昌焘; 马琴琴; 莫水学


    目的:探讨 AngleⅡ1错成年女性拔牙矫治后面部软组织正貌的改变。方法:采用直接活体测量法,测量51例成年女性 AngleⅡ1错患者矫治前后面部软组织正貌美学指标的改变,其中拔牙组30例,非拔牙对照组21例,并对矫治前后的变化量进行统计学分析。结果:拔牙组矫治后 N-Me、Sn-Me、Sn-UL、LL-Sm、Sto-M、Ch-Ch 增大(P <0.05),UL-LL 减小(P<0.05),Zy-Zy、Go-Go 无明显变化(P >0.05)。非拔牙组矫治后各指标均无明显变化(P >0.05)。组间比较中 Sn-UL、LL-Sm、UL-LL 差异有统计学意义(P <0.01),其余各项无统计学意义(P >0.05)。结论:成年女性 AngleⅡ1错患者通过拔牙矫治,主要表现为口周软组织的变化,开唇露齿明显改善,上下唇形态更趋协调;对面高及面宽无明显影响。%Objective:To explore the changes of orthodontic therapy with tooth extraction on frontal view of facial soft tissue in adult females with Class Ⅱ division 1 malocclusion.Methods:Frontal view of facial soft tissue aesthetic charaeteristics of 30 with and 21 without tooth extraction adult females with Class Ⅱ division 1 malocclusion were measured with direct anthropometry before and after orthodontic treatment.Results:After the extraction treatment,the distance of N-Me,Sn-Me,Sn-UL,LL-Sm,Sto-Me,Ch-Ch in-creased(P 0.05).There was no sig-nificant change in each parameter in nonextraction group(P >0.05).Between the 2 groups Sn-UL,LL-Sm and UL-LL showed differ-ence(P 0.05).Conclusion:Orthodontic treatment with tooth for the fe-males with Class Ⅱ division 1 malocclusion can improve the incompetent lips,and recover the coordination between the upper and lower lips.There is little change on facial height and width.

  20. [Value of core needle biopsy in preoperative diagnostics of soft tissue tumors: possibilities and limitations].

    Agaimy, A


    The differential diagnosis of soft tissue swellings encompasses a variety of benign, intermediate, low-grade malignant and high-grade neoplastic lesions in addition to tumor-like reactive processes. As treatment of these heterogeneous conditions varies greatly from conservative observation and simple local excision up to extensive radical surgical resection, treatment decisions are based mainly on a precise preoperative histological diagnosis on limited biopsy material. Even for clinically unequivocal sarcomas, the importance of the preoperative histological diagnosis has been increasingly emphasized as different therapeutic regimens have been established for different sarcoma types and the indications for preoperative treatment is influenced by the tumor grade and by the entity itself. Other factors positively influencing the increasing use of core needle biopsy for preoperative tumor diagnosis in soft tissue pathology are the availability of modern high-resolution imaging modalities as well as the establishment of several new second generation immunohistochemical markers and the discovery of entity-specific translocations detected by fluorescence in situ hybridization (FISH) in several sarcoma subtypes. In this review it will be shown that a targeted approach for processing core needle biopsies oriented towards the characteristic topographical, demographic, cytomorphological and architectural features of soft tissue lesions facilitates a precise diagnosis of soft tissue neoplasms in most cases. However, profound knowledge of the different aspects of soft tissue tumor diagnostics and familiarity with the frequent as well as the less common and rare tumor entities and variants is a prerequisite for appropriate interpretation of core needle biopsy findings and for selecting a limited but well-suited marker panel. The utilization of modern immunohistochemistry and/or FISH methods is highly useful for establishing the diagnosis of rare and unusual neoplasms in core

  1. [Individualized three-dimensional finite element model of facial soft tissue and preliminary application in orthodontics].

    Chen, Si; Xu, Tian-min; Lou, Hang-di; Rong, Qi-guo


    To get individualized facial three-dimensional finite element (FE) model from transformation of a generic one to assist orthodontic analysis and prediction of treatment-related morphological change of facial soft tissue. A generic three-dimensional FE model of craniofacial soft and hard tissue was constructed based on a volunteer's spiral CT data. Seven pairs of main peri-oral muscles were constructed based on a combination of CT image and anatomical method. Individualized model could be obtained through transformation of the generic model based on selection of corresponding anatomical landmarks and radial basis functions (RBF) method. Validation was analyzed through superimposition of the transformed model and cone-beam CT (CBCT) reconstruction data. Pre- and post-treatment CBCT data of two patients were collected, which were superimposed to gain the amount of anterior teeth retraction and anterior alveolar surface remodeling that could be used as boundary condition. Different values of Poisson ratio ν and Young's modulus E were tested during simulation. Average deviation was 0.47 mm and 0.75 mm in the soft and hard tissue respectively. It could be decreased to a range of +0.29 mm and -0.21 mm after a second transformation at the lip-mouth region. The best correspondence between simulation and post-treatment result was found with elastic properties of soft tissues defined as follows. Poisson ratio ν for skin, muscle and fat being set as 0.45 while Young's modulus being set as 90.0 kPa, 6.2 kPa and 2.0 kPa respectively. Individualized three-dimensional facial FE model could be obtained through mathematical model transformation. With boundary condition defined according to treatment plan such FE model could be used to analyze the effect of orthodontic treatment on facial soft tissue.

  2. Anti-adhesion effects of liquid-infused textured surfaces on high-temperature stainless steel for soft tissue

    Zhang, Pengfei; Chen, Huawei; Zhang, Liwen; Zhang, Deyuan


    Soft tissue adhesion on the electrosurgical instruments can induce many serious complications, such as failure of hemostasis and damage to the surrounding soft tissue. The soft tissue adhesion is mainly caused by the high temperature on the instrument surface generally made of stainless steel. Nepenthes inspired liquid-infused surfaces (LIS), highly promising for anti-adhesion, have attracted considerable interests. In this paper, we investigated the anti-adhesion effects of LIS on high-temperature stainless steel for soft tissue for the first time, aiming to develop a new approach to solve the soft tissue adhesion problem. The textured surface, acting as the holding structures, was fabricated by photolithography-assisted chemical etching. Silicone oil, with good biocompatibility and high-temperature resistance, was chosen as the infused liquid. The adhesion force measurements for soft tissue on the LIS at high temperatures indicated that the soft tissue adhesion force was decreased by approximately 80% at 250 °C. Besides, the cycle tests of soft tissue adhesion force demonstrated the excellent stability of prepared LIS. We anticipate that LIS will be of great promise for practical applications on the electrosurgical instruments.

  3. Ultrasound and clinical evaluation of soft-tissue versus hardware biceps tenodesis: is hardware tenodesis worth the cost?

    Elkousy, Hussein; Romero, Jose A; Edwards, T Bradley; Gartsman, Gary M; O'Connor, Daniel P


    This study assesses the failure rate of soft-tissue versus hardware fixation of biceps tenodesis by ultrasound to determine if the expense of a hardware tenodesis technique is warranted. Seventy-two patients that underwent arthroscopic biceps tenodesis over a 3-year period were evaluated using postoperative ultrasonography and clinical examination. The tenodesis technique employed was either a soft-tissue technique with sutures or an interference screw technique using hardware based on surgeon preference. Patient age was 57.9 years on average with ultrasound and clinical examination done at an average of 9.3 months postoperatively. Thirty-one patients had a hardware technique and 41 a soft-tissue technique. Overall, 67.7% of biceps tenodesis done with hardware were intact, compared with 75.6% for the soft-tissue technique by ultrasound (P = .46). Clinical evaluation indicated that 80.7% of hardware techniques and 78% of soft-tissue techniques were intact. Average material cost to the hospital for the hardware technique was $514.32, compared with $32.05 for the soft-tissue technique. Biceps tenodesis success, as determined by clinical deformity and ultrasound, was not improved using hardware as compared to soft-tissue techniques. Soft-tissue techniques are equally efficacious and more cost effective than hardware techniques.

  4. Controlled Clinical Trial on Bone-anchored Hearing Implants and a Surgical Technique With Soft-tissue Preservation

    Besten, C.A. den; Bosman, A.J.; Nelissen, R.C.; Mylanus, E.A.M.; Hol, M.K.S.


    OBJECTIVE: To compare the clinical and audiological outcomes after linear incision with soft-tissue preservation and standard linear incision with soft-tissue reduction for placement of percutaneous bone-anchored hearing implants. STUDY DESIGN: Clinical trial with historical control-group from a

  5. On ultrasound waves guided by bones with coupled soft tissues: a mechanism study and in vitro calibration.

    Chen, Jiangang; Su, Zhongqing


    The influence of soft tissues coupled with cortical bones on precision of quantitative ultrasound (QUS) has been an issue in the clinical bone assessment in conjunction with the use of ultrasound. In this study, the effect arising from soft tissues on propagation characteristics of guided ultrasound waves in bones was investigated using tubular Sawbones phantoms covered with a layer of mimicked soft tissue of different thicknesses and elastic moduli, and an in vitro porcine femur in terms of the axial transmission measurement. Results revealed that presence of soft tissues can exert significant influence on the propagation of ultrasound waves in bones, leading to reduced propagation velocities and attenuated wave magnitudes compared with the counterparts in a free bone in the absence of soft tissues. However such an effect is not phenomenally dependent on the variations in thickness and elastic modulus of the coupled soft tissues, making it possible to compensate for the coupling effect regardless of the difference in properties of the soft tissues. Based on an in vitro calibration, this study proposed quantitative compensation for the effect of soft tissues on ultrasound waves in bones, facilitating development of high-precision QUS.

  6. Efficacy of soft tissue augmentation around dental implants and in partially edentulous areas: a systematic review.

    Thoma, Daniel S; Buranawat, Borvornwut; Hämmerle, Christoph H F; Held, Ulrike; Jung, Ronald E


    To review the dental literature in terms of efficacy of soft tissue augmentation procedures around dental implants and in partially edentulous sites. A Medline search was performed for human studies augmenting keratinized mucosa (KM) and soft tissue volume around implants and in partially edentulous areas. Due to heterogeneity in between the studies, no meta-analyses could be performed. Nine (KM) and eleven (volume) studies met the inclusion criteria. An apically positioned flap/vestibuloplasty (APF/V) plus a graft material [free gingival graft (FGG)/subepithelial connective tissue graft (SCTG)/collagen matrix (CM)] resulted in an increase of keratinized tissue (1.4-3.3 mm). Statistically significantly better outcomes were obtained for APF/V plus FGG/SCTG compared with controls (APF/V alone; no treatment) (p < 0.05). For surgery time and patient morbidity, statistically significantly more favourable outcomes were reported for CM compared to SCTGs (p < 0.05) in two randomized controlled clinical trials (RCTs), even though rendering less keratinized tissue. SCTGs were the best-documented method for gain of soft tissue volume at implant sites and partially edentulous sites. Aesthetically at immediate implant sites, better papilla fill and higher marginal mucosal levels were obtained using SCTGs compared to non-grafted sites. An APF/V plus FGG/SCTG was the best-documented and most successful method to increase the width of KM. APF/V plus CM demonstrated less gain in KM, but also less patient morbidity and surgery time compared to APF/V plus SCTG based on two RCTs. Autogenous grafts (SCTG) rendered an increase in soft tissue thickness and better aesthetics compared to non-grafted sites. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Fabrication of low cost soft tissue prostheses with the desktop 3D printer.

    He, Yong; Xue, Guang-huai; Fu, Jian-zhong


    Soft tissue prostheses such as artificial ear, eye and nose are widely used in the maxillofacial rehabilitation. In this report we demonstrate how to fabricate soft prostheses mold with a low cost desktop 3D printer. The fabrication method used is referred to as Scanning Printing Polishing Casting (SPPC). Firstly the anatomy is scanned with a 3D scanner, then a tissue casting mold is designed on computer and printed with a desktop 3D printer. Subsequently, a chemical polishing method is used to polish the casting mold by removing the staircase effect and acquiring a smooth surface. Finally, the last step is to cast medical grade silicone into the mold. After the silicone is cured, the fine soft prostheses can be removed from the mold. Utilizing the SPPC method, soft prostheses with smooth surface and complicated structure can be fabricated at a low cost. Accordingly, the total cost of fabricating ear prosthesis is about $30, which is much lower than the current soft prostheses fabrication methods.

  8. Fabrication of low cost soft tissue prostheses with the desktop 3D printer

    He, Yong; Xue, Guang-Huai; Fu, Jian-Zhong


    Soft tissue prostheses such as artificial ear, eye and nose are widely used in the maxillofacial rehabilitation. In this report we demonstrate how to fabricate soft prostheses mold with a low cost desktop 3D printer. The fabrication method used is referred to as Scanning Printing Polishing Casting (SPPC). Firstly the anatomy is scanned with a 3D scanner, then a tissue casting mold is designed on computer and printed with a desktop 3D printer. Subsequently, a chemical polishing method is used to polish the casting mold by removing the staircase effect and acquiring a smooth surface. Finally, the last step is to cast medical grade silicone into the mold. After the silicone is cured, the fine soft prostheses can be removed from the mold. Utilizing the SPPC method, soft prostheses with smooth surface and complicated structure can be fabricated at a low cost. Accordingly, the total cost of fabricating ear prosthesis is about $30, which is much lower than the current soft prostheses fabrication methods.

  9. Serious soft tissue infections of the head and neck

    Herr, R.D.; Murdock, R.T.; Davis, R.K. (University of Utah School of Medicine, Salt Lake City (USA))


    The head and neck contain a number of spaces that can be invaded by organisms of the mouth or by spread of cervical osteomyelitis. Infection in these spaces may progress from superficial infection to cellulitis to the formation of an abscess requiring immediate drainage. Spread of infection between spaces depends on anatomic location. Most patients require hospitalization and intravenous antibiotic therapy. Because a deep space infection may be occult, a high index of suspicion is required for diagnosis. Early recognition is necessary to avoid tissue damage, bacteremia or airway compromise. The possibility of deep space infection should be considered in any patient who does not respond to the usual treatment of an abscessed tooth or tonsillitis. This type of infection also should be considered in a toxic patient who has a fever of unknown origin, with or without blood cultures that show anaerobic organisms. Computed tomography or magnetic resonance imaging is usually necessary to locate the infection and to detect suppuration that will be amenable to surgical exploration and drainage. 25 references.

  10. In-vivo measurement of the human soft tissues constitutive laws. Applications to Computer Aided Surgery

    Schiavone, Patrick; Ohayon, J; Payan, Y


    In the 80's, biomechanicians were asked to work on Computer Aided Surgery applications since orthopaedic surgeons were looking for numerical tools able to predict risks of fractures. More recently, biomechanicians started to address soft tissues arguing that most of the human body is made of such tissues that can move as well as deform during surgical gestures [1]. An intra-operative use of a continuous Finite Element (FE) Model of a given tissue mainly faces two problems: (1) the numerical simulations have to be "interactive", i.e. sufficiently fast to provide results during surgery (which can be a strong issue in the context of hyperelastic models for example) and (2) during the intervention, the surgeon needs a device that can be used to provide to the model an estimation of the patient-specific constitutive behaviour of the soft tissues. This work proposes an answer to the second point, with the design of a new aspiration device aiming at characterizing the in vivo constitutive laws of human soft tissues....

  11. Comparative evaluation among different materials to replace soft tissue in oral radiology studies

    Maria de Paula Caldas


    Full Text Available OBJECTIVE: The aim of this study was to establish which materials afford better simulation of soft tissues in Oral Radiology studies. MATERIAL AND METHODS: The sample was composed of four materials in eleven different thicknesses to simulate the soft tissues of the face. The mean values of the relative amounts of radiographic contrast of the materials were determined and compared to a gold standard value, which was obtained from 20 patients who were referred to have periapical radiographs taken of the left mandibular molars. Data were subjected to statistical analysis with Dunnett's test (p<0.05. RESULTS: The mean value of the relative amounts of contrast encountered in the patients was 0.47, with a range between 0.36 and 0.64 for all 44 material/thickness combinations. The majority of the tested materials showed values close to those of the patients' tissues, without statistically signifcant differences among them. The values of only three materials/thickness combinations differed statistically from those of the patients' tissues. CONCLUSIONS: Based on the results of the present study, it may be concluded that except for utility wax (4 mm and 8 mm and water (4 mm, all materials tested at different thickness could be used as soft tissue substitute materials in Oral Radiology studies.

  12. Using uniaxial pseudorandom stress stimuli to develop soft tissue constitutive equations.

    Hoffman, Allen H; Grigg, Peter


    A nonlinear systems identification method was used to develop constitutive equations for soft tissue specimens under uniaxial tension. The constitutive equations are developed from a single test by applying a pseudorandom Gaussian (PGN) stress input to the specimen, measuring the resulting strain, and calculating the Volterra-Wiener kernels. First and second order kernels were developed for two tissues with widely different properties, rat medial collateral knee ligaments, and rat skin. These kernels were used to predict the strain response to a variety of sinusoidal stress inputs. These predicted strains were compared with the measured strain response using the normalized mean squared error (NMSE). Results showed NMSEs in the range of 0.01-0.08 provided that the magnitudes of the applied stresses were present in the original PGN stress input. Overall, the method provides a means to develop soft tissue constitutive equations that can predict both nonlinear and viscoelastic behavior over a wide range of stress inputs.

  13. Forced orthodontic eruption for augmentation of soft and hard tissue prior to implant placement

    Rafael Scaf de Molon


    Full Text Available Forced orthodontic eruption (FOE is a non-surgical treatment option that allows modifying the osseous and gingival topography. The aim of this article is to present a clinical case of a FOE, which resulted in an improvement of the amount of available bone and soft-tissues for implant site development. Patient was referred for treatment of mobility and unesthetic appearance of their maxillary incisors. Clinical and radiographic examination revealed inflamed gingival tissue, horizontal and vertical tooth mobility and interproximal angular bone defects. It was chosen a multidisciplinary treatment approach using FOE, tooth extraction, and immediate implant placement to achieve better esthetic results. The use of FOE, in periodontally compromised teeth, promoted the formation of a new bone and soft-tissue in a coronal direction, without additional surgical procedures, enabling an esthetic, and functional implant-supported restoration.

  14. Simple Empirical Model for Identifying Rheological Properties of Soft Biological Tissues

    Kobayashi, Yo; Miyashita, Tomoyuki; Fujie, Masakatsu G


    Understanding the rheological properties of soft biological tissue is a key issue for mechanical systems used in the healthcare field. We propose a simple empirical model using Fractional Dynamics and Exponential Nonlinearity (FDEN) to identify the rheological properties of soft biological tissue. The model is derived from detailed material measurements using samples isolated from porcine liver. We conducted dynamic viscoelastic and creep tests on liver samples using a rheometer. The experimental results indicated that biological tissue has specific properties: i) power law increases in storage elastic modulus and loss elastic modulus with the same slope; ii) power law gain decrease and constant phase delay in the frequency domain over two decades; iii) log-log scale linearity between time and strain relationships under constant force; and iv) linear and log scale linearity between strain and stress relationships. Our simple FDEN model uses only three dependent parameters and represents the specific propertie...

  15. Palpation force modulation strategies to identify hard regions in soft tissue organs

    Konstantinova, Jelizaveta; Cotugno, Giuseppe; Dasgupta, Prokar; Althoefer, Kaspar; Nanayakkara, Thrishantha


    This paper presents experimental evidence for the existence of a set of unique force modulation strategies during manual soft tissue palpation to locate hard abnormalities such as tumors. We explore the active probing strategies of defined local areas and outline the role of force control. In addition, we investigate whether the applied force depends on the non-homogeneity of the soft tissue. Experimental results on manual palpation of soft silicone phantoms show that humans have a well defined force control pattern of probing that is used independently of the non-homogeneity of the soft tissue. We observed that the modulations of lateral forces are distributed around the mean frequency of 22.3 Hz. Furthermore, we found that the applied normal pressure during probing can be modeled using a second order reactive autoregressive model. These mathematical abstractions were implemented and validated for the autonomous palpation for different stiffness parameters using a robotic probe with a rigid spherical indentation tip. The results show that the autonomous robotic palpation strategy abstracted from human demonstrations is capable of not only detecting the embedded nodules, but also enhancing the stiffness perception compared to static indentation of the probe. PMID:28199349

  16. Consumption of soft drinks and health-related quality of life in the adult population

    LANA, A.; Lopez-Garcia, E.; Rodríguez-Artalejo, F


    BACKGROUND/OBJECTIVES: Despite the accumulated evidence on the health risks associated with sugar-sweetened beverages (SSB), the industry has funded mass communication strategies promoting the idea that soft drinks, including SSB, may represent a source of well-being. This study assessed the association between consumption of soft drinks and health-related quality of life (HRQL), as a proxy of well-being, in the adult population of Spain. SUBJECTS/METHODS: The cohort was established ...

  17. Estimation of soft- and hard-tissue thickness at implant sites

    Anil Kumar


    Full Text Available Introduction: Anchorage control is a critical consideration when planning treatment for patients with dental and skeletal malocclusions. To obtain sufficient stability of implants, the thickness of the soft tissue and the cortical-bone in the placement site must be considered; so as to provide an anatomical map in order to assist the clinician in the placement of the implants. Objective: The aim of this study is to evaluate the thickness of soft- and hard-tissue. Materials and Methods: To measure soft tissue and cortical-bone thicknesses, 12 maxillary cross-sectional specimens were obtained from the cadavers, which were made at three maxillary mid-palatal suture areas: The interdental area between the first and second premolars (Group 1, the second premolar and the first molar (Group 2, and the first and second molars (Group 3. Sectioned samples along with reference rulers were digitally scanned. Scanned images were calibrated and measurements were made with image-analysis software. We measured the thickness of soft and hard-tissues at five sectional areas parallel to the buccopalatal cementoenamel junction (CEJ line at 2-mm intervals and also thickness of soft tissue at the six landmarks including the incisive papilla (IP on the palate. The line perpendicular to the occlusal plane was made and measurement was taken at 4-mm intervals from the closest five points to IP. Results: (1 Group 1:6 mm from CEJ in buccal side and 2 mm from CEJ in palatal side. (2 Group 2:8 mm from CEJ in buccal side and 4 mm from CEJ in palatal side. (3 Group 3:8 mm from CEJ in buccal side and 8 mm from CEJ in palatal side. Conclusions: The best site for placement of implant is with thinnest soft tissue and thickest hard tissue, which is in the middle from CEJ in buccal side and closest from CEJ in palatal side in Group 1 and faraway from CEJ in buccal side and closest from CEJ in palatal side in Group 2 and faraway from CEJ in buccal side and faraway from CEJ in palatal

  18. The effect of mechanical strains in soft tissues of the shoulder during load carriage.

    Hadid, Amir; Belzer, Noa; Shabshin, Nogah; Zeilig, Gabi; Gefen, Amit; Epstein, Yoram


    Soldiers and recreational backpackers are often required to carry heavy loads during military operations or hiking. Shoulder strain appears to be one of the limiting factors of load carriage due to skin and underlying soft tissue deformations, trapped nerves, or obstruction of blood vessels. The present study was aimed to determine relationships between backpack weights and the state of loads in the shoulder׳s inner tissues, with a special focus on the deformations in the brachial plexus. Open-MRI scans were used for developing and then verifying a three-dimensional, non-linear, large deformation, finite element model of the shoulder. Loads were applied at the strap-shoulder contact surfaces of the model by pulling the strap towards the shoulder until the desired load was reached. Increasing the strap tensile forces up to a load that represents 35kg backpack resulted in gradual increase in strains within the underlying soft tissues: the maximal tensile strain in the brachial plexus for a 25kg backpack was 12%, and while carrying 35kg, the maximal tensile strain increased to 16%. The lateral aspect of the brachial plexus was found to be more vulnerable to deformation-inflicted effects than the medial aspect. This is due to the anatomy of the clavicle that poorly shields the plexus from compressive loads applied during load carriage, while the neural tissue in the medial aspect of the shoulder is better protected by the clavicle. The newly developed model can serve as a tool to estimate soft tissue deformations in the brachial plexus for heavy backpack loads, up to 35kg. This method will allow further development of new strap structures and materials for alleviating the strains applied on the shoulder soft tissues.

  19. The rationale for soft-tissue grafting and vestibuloplasty in association with endosseous implants: a literature review.

    Hoelscher, D C; Simons, A M


    Significant soft-tissue complications have been reported around endosseous implant permucosal abutments. Peri-implants with associated bone loss can have a negative effect on the long-term prognosis of the implant reconstruction. The rationale for soft-tissue grafting and vestibuloplasty techniques is presented in the form of a literature review. The implant sulcular epithelium, permucosal seal, and the peri-implant connective tissues are discussed. The etiology of soft-tissue complications as well as the significance of attached gingiva surrounding implant abutments are presented along with techniques for surgical intervention.

  20. Methodology to determine failure characteristics of planar soft tissues using a dynamic tensile test.

    Jacquemoud, C; Bruyere-Garnier, K; Coret, M


    Predicting the injury risk in automotive collisions requires accurate knowledge of human tissues, more particularly their mechanical properties under dynamic loadings. The present methodology aims to determine the failure characteristics of planar soft tissues such as skin, hollow organs and large vessel walls. This consists of a dynamic tensile test, which implies high-testing velocities close to those in automotive collisions. To proceed, I-shaped tissue samples are subjected to dynamic tensile tests using a customized tensile device based on the drop test principle. Data acquisition has especially been adapted to heterogeneous and soft biological tissues given that standard measurement systems (considered to be global) have been completed with a non-contact and full-field strain measurement (considered to be local). This local measurement technique, called the Image Correlation Method (ICM) provides an accurate strain analysis by revealing strain concentrations and avoids damaging the tissue. The methodology has first been applied to human forehead skin and can be further expanded to other planar soft tissues. The failure characteristics for the skin in terms of ultimate stress are 3 MPa +/- 1.5 MPa. The ultimate global longitudinal strains are equal to 9.5%+/-1.9% (Green-Lagrange strain), which contrasts with the ultimate local longitudinal strain values of 24.0%+/-5.3% (Green-Lagrange strain). This difference is a consequence of the tissue heterogeneity, clearly illustrated by the heterogeneous distribution of the local strain field. All data will assist in developing the tissue constitutive law that will be implemented in finite element models.