Sample records for advanced soft tissue

  1. [Systemic therapy and hyperthermia for locally advanced soft tissue sarcoma]. (United States)

    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. Soft tissue profile changes following mandibular advancement surgery: predictability and long-term outcome. (United States)

    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.

  3. Diode laser soft-tissue surgery: advancements aimed at consistent cutting, improved clinical outcomes. (United States)

    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.

  4. 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

    DEFF Research Database (Denmark)

    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....

  5. Necrotizing soft tissue infection (United States)

    Necrotizing fasciitis; Fasciitis - necrotizing; Flesh-eating bacteria; Soft tissue gangrene; Gangrene - soft tissue ... 2014:chap 137. Pasternack MS, Swartz MN. Cellulitis, necrotizing fasciitis, and subcutaneous tissue infections. In: Bennett JE, Dolin ...

  6. Soft Tissue Sarcoma (United States)

    ... other body structures. The soft tissues include muscle, fat, blood vessels, nerves, tendons and the lining of your joints. Many types of soft tissue sarcoma exist. Some types are more likely to ...

  7. 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

    DEFF Research Database (Denmark)

    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...

  8. Clinical Benefit of Second-Line Palliative Chemotherapy in Advanced Soft-Tissue Sarcoma

    Directory of Open Access Journals (Sweden)

    Anna Minchom


    Full Text Available Background. This paper aimed to assess the utility of second-line chemotherapy in patients with advanced soft-tissue sarcoma. Materials and Methods. A retrospective search of a prospectively maintained database identified patients treated between 1991 and 2005. Patients with gastrointestinal stromal tumours, small round cell tumours, and Ewing's sarcoma were excluded. Response was assessed using WHO and RECIST. Patients who achieved stable disease for 6 months or more were classified as having disease control. Results. Three hundred and seventy-nine patients received second-line chemotherapy. Eighty-six (22.7% achieved disease control. Median duration of response was 11 months (95% CI: 9–13. On multivariate analysis, pathological subtype, absence of lung metastases, and the use of combination chemotherapy were independent predictors of disease control. Twenty-eight (16.1% patients who failed to respond to first-line therapy achieved disease control. Eight (2.1% patients had sufficient downstaging to enable complete surgical resection. Progression-free survival was 23% at 6 months. Median overall survival was 8 months (95% CI: 7–10 months. On multivariate analysis, synovial histology and absence of lung metastases were associated with improved survival. Conclusion. Second-line chemotherapy can provide clinical benefit in over 20% of soft-tissue sarcoma patients.

  9. Doxorubicin alone versus intensified doxorubicin plus ifosfamide for first-line treatment of advanced or metastatic soft-tissue sarcoma

    DEFF Research Database (Denmark)

    Judson, Ian; Verweij, Jaap; Gelderblom, Hans;


    routinely is still controversial. We assessed whether dose intensification of doxorubicin with ifosfamide improves survival of patients with advanced soft-tissue sarcoma compared with doxorubicin alone. METHODS: We did this phase 3 randomised controlled trial (EORTC 62012) at 38 hospitals in ten countries...

  10. FDG-PET to evaluate response to hyperthermic isolated limb perfusion for locally advanced soft-tissue sarcoma

    NARCIS (Netherlands)

    vanGinkel, RJ; Hoekstra, HJ; Pruim, J; Nieweg, OE; Molenaar, WM; Paans, AMJ; Willemsen, ATM; Vaalburg, W; Schraffordt Koops, H.


    We investigated FDG-PET in patients undergoing hyperthermic isolated limb perfusion (HILP) with rTNF-alpha, rIFN-gamma and melphalan for locally advanced soft-tissue sarcoma of the extremities. Methods: Twenty patients (11 women, 9 men; aged 18-80 yr, mean age 49 yr) were studied, FDG-PET studies we

  11. Symptom Burden, Survival and Palliative Care in Advanced Soft Tissue Sarcoma

    Directory of Open Access Journals (Sweden)

    Nicholas J. Gough


    Full Text Available Introduction. The symptom burden and role of palliative care (PC in patients with advanced soft tissue sarcoma (STS are not well defined. Methods. This study retrospectively reviewed both symptoms and PC involvement in patients known to an STS referral centre who died in one calendar year. Results. 81 patients met inclusion criteria of which 27% had locally advanced disease and 73% metastases at initial referral. The median number of symptoms was slowly progressive ranging from 2 (range 0–5 before first-line chemotherapy (=50 to 3 (range 1–6 at the time of best supportive care (BSC decision (=48. Pain and dyspnoea were the commonest symptoms. Median overall survival from BSC decision was 3.4 weeks. 88% had PC involvement (either hospital, community, or both with median time from first PC referral to death of 16 (range 0–110 weeks. Conclusions. Patients with metastatic STS have a significant symptom burden which justifies early PC referral. Pain, including neuropathic pain, is a significant problem. Dyspnoea is common, progressive and appears to be undertreated. Time from BSC decision to death is short, and prospective studies are required to determine whether this is due to overtreatment or very rapid terminal disease progression.

  12. Soft tissue assessment in midface advancement: the use of regional flaps to enhance facial projection. (United States)

    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.

  13. Chemotherapy for Soft Tissue Sarcomas (United States)

    ... 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 ...

  14. Quality of life after hyperthermic isolated limb perfusion for locally advanced extremity soft tissue sarcoma

    NARCIS (Netherlands)

    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

  15. Soft Tissue Extramedullary Plasmacytoma

    Directory of Open Access Journals (Sweden)

    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.

  16. Hypoelastic Soft Tissues (United States)

    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

  17. Combined surgical resective and regenerative therapy for advanced peri-implantitis with concomitant soft tissue volume augmentation: a case report. (United States)

    Schwarz, Frank; John, Gordon; Sahm, Narja; Becker, Jürgen


    This case report presents a 3-year follow-up of the clinical outcomes of a combined surgical therapy for advanced peri-implantitis with concomitant soft tissue volume augmentation using a collagen matrix. One patient suffering from advanced peri-implantitis and a thin mucosal biotype underwent access flap surgery, implantoplasty at buccally and supracrestally exposed implant parts, and augmentation of the intrabony components using a natural bone mineral and a native collagen membrane after surface decontamination. A collagen matrix was applied to the wound area to increase soft tissue volume and support transmucosal healing. The following clinical parameters were recorded over a period of 3 years: bleeding on probing (BOP), probing depth (PD), mucosal recession (MR), clinical attachment level (CAL), and width of keratinized mucosa (KM). At 36 months, the combined surgical procedure was associated with a clinically important reduction in mean BOP (100%), PD (4.3 ± 0.5 mm), and CAL (4.4 ± 0.4 mm). Site-level analysis of the buccal aspects pointed to an increase in MR (-1.0 ± 0.4 mm) and a decrease in KM (-1.3 ± 0.5 mm) values at 12 months. However, a regain in mucosal height and KM was noted at 24 months, even reaching respective baseline values after 36 months of healing. The presented combined surgical procedure was effective in controlling an advanced peri-implantitis lesion without compromising the overall esthetic outcome in the long term.

  18. Genital soft tissue tumors. (United States)

    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.

  19. Myoepithelioma of soft tissue

    Directory of Open Access Journals (Sweden)

    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.

  20. 软组织肉瘤治疗现状%Advances of the treatment of soft tissue sarcoma

    Institute of Scientific and Technical Information of China (English)

    刘宏炜; 牛晓辉; 徐海荣


    Soft tissue sarcomas (STS) are a heterogeneous group of tumors of mesodermal origin. Although they are rare, nearly half of patients diagnosed will die from the disease at last, which almost has not been changed in recent decades. STS can occur any where in the body, but the majority of primary tumors originate in extremities. Accurate pretreatment evaluation is critical and the management requires a multidisciplinary approach which includes various combinations of surgery, radiotherapy, and chemotherapy. Treatment aims to ensure long term survival, avoid local recurrence, and maximize patient function while minimizing morbidity. Surgery is the mainstay of treatment in patients with localized disease and ideal primary therapy for resectable tumors. Limb salvage surgery is the standard of care for most patients with soft tissue sarcoma of the extremities. But in many cases, there exist large primary tumors, bulky recurrent tumors, tumors invading critical neurovascular structures, tumor cells which have already transferred to other parts of the body and so on, other treatments like radiotherapy or chemotherapy may be needed. Controversy still exists for isolated limb perfusion (ILP) in the treatment of unresectable extremity sarcomas. ILP has been widely used in European countries already, but it is still in the clinical trial in America at present. This overview is intended as a review of current understanding and treatment of STS, with an emphasis on recent advances.

  1. Soft tissue lipoleiomyoma. (United States)

    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.

  2. Flexible adult flatfoot: soft tissue procedures. (United States)

    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.

  3. Isolated limb perfusion with tumor necrosis factor alpha and melphalan for locally advanced soft tissue sarcoma : Three time periods at risk for amputation

    NARCIS (Netherlands)

    van Ginkel, Robert J.; Thijssens, Katja M. J.; Pras, Elisabeth; Van der Graaf, Winette T. A.; Suurmeijer, Albert J. H.; Hoekstra, Harald J.


    Background: The aim of this study was to investigate the long-term limb salvage rate and overall survival after isolated limb perfusion (ILP) with tumor necrosis factor alpha and melphalan for locally advanced soft tissue sarcoma (STS). Methods: From 1991 to 2003, 73 patients (36 men, 37 women, medi

  4. Isolated limb perfusion with tumor necrosis factor and melphalan for limb salvage in 186 patients with locally advanced soft tissue extremity sarcomas. The cumulative multicenter European experience

    NARCIS (Netherlands)

    A.M.M. Eggermont (Alexander); P.M. Schlag; D. Lienard; A.N. van Geel (Albert); F.J. Lejeune; H.J. Hoekstra; I. Meller; J.C. Pector; O.E. Nieweg (Omgo); G. Ben-Ari; C. Kettelhack; H. Schraffordt Koops; J.M. Klausner; B.B. Kroon


    textabstractOBJECTIVE: The objective of the study was to achieve limb salvage in patients with locally advanced soft tissue sarcomas that can only be treated by amputation or functionally mutilating surgery by performing an isolated limb perfusion (ILP) with tumor necro

  5. A phase IIb multicentre study comparing the efficacy of trabectedin to doxorubicin in patients with advanced or metastatic untreated soft tissue sarcoma : The TRUSTS trial

    NARCIS (Netherlands)

    Bui-Nguyen, B.; Butrynski, J. E.; Penel, N.; Blay, J. Y.; Isambert, N.; Milhem, M.; Kerst, J. M.; Reyners, A. K. L.; Litiere, S.; Marreaud, S.; Collin, F.; van der Graaf, W. T. A.


    Purpose: To evaluate whether trabectedin as first-line chemotherapy for advanced/metastatic soft tissue sarcoma prolongs progression-free survival (PFS), compared to doxorubicin and, in the phase IIb part here, to select the most appropriate trabectedin treatment schedule (3-hour or 24-hour infusion

  6. A phase IIb multicentre study comparing the efficacy of trabectedin to doxorubicin in patients with advanced or metastatic untreated soft tissue sarcoma: The TRUSTS trial

    NARCIS (Netherlands)

    Bui-Nguyen, B.; Butrynski, J.E.; Penel, N.; Blay, J.Y.; Isambert, N.; Milhem, M.; Kerst, J.M.; Reyners, A.K.; Litiere, S.; Marreaud, S.; Collin, F.; Graaf, W.T.A. van der


    PURPOSE: To evaluate whether trabectedin as first-line chemotherapy for advanced/metastatic soft tissue sarcoma prolongs progression-free survival (PFS), compared to doxorubicin and, in the phase IIb part here, to select the most appropriate trabectedin treatment schedule (3-hour or 24-hour infusion

  7. Utility Values for Advanced Soft Tissue Sarcoma Health States from the General Public in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Julian F. Guest


    Full Text Available Soft tissue sarcomas are a rare type of cancer generally treated with palliative chemotherapy when in the advanced stage. There is a lack of published health utility data for locally advanced “inoperable”/metastatic disease (ASTS, essential for calculating the cost-effectiveness of current and future treatments. This study estimated time trade-off (TTO and standard gamble (SG preference values associated with four ASTS health states (progressive disease, stable disease, partial response, complete response among members of the general public in the UK (n=207. The four health states were associated with decreases in preference values from full health. Complete response was the most preferred health state (mean utility of 0.60 using TTO. The second most preferred health state was partial response followed by stable disease (mean utilities were 0.51 and 0.43, respectively, using TTO. The least preferred health state was progressive disease (mean utility of 0.30 using TTO. The utility value for each state was significantly different from one another (P<0.001. This study demonstrated and quantified the impact that different treatment responses may have on the health-related quality of life of patients with ASTS.

  8. Radiation Therapy for Soft Tissue Sarcomas (United States)

    ... 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, ...

  9. A model to predict deflection of bevel-tipped active needle advancing in soft tissue. (United States)

    Datla, Naresh V; Konh, Bardia; Honarvar, Mohammad; Podder, Tarun K; Dicker, Adam P; Yu, Yan; Hutapea, Parsaoran


    Active needles are recently being developed to improve steerability and placement accuracy for various medical applications. These active needles can bend during insertion by actuators attached to their bodies. The bending of active needles enables them to be steered away from the critical organs on the way to target and accurately reach target locations previously unachievable with conventional rigid needles. These active needles combined with an asymmetric bevel-tip can further improve their steerability. To optimize the design and to develop accurate path planning and control algorithms, there is a need to develop a tissue-needle interaction model. This work presents an energy-based model that predicts needle deflection of active bevel-tipped needles when inserted into the tissue. This current model was based on an existing energy-based model for bevel-tipped needles, to which work of actuation was included in calculating the system energy. The developed model was validated with needle insertion experiments with a phantom material. The model predicts needle deflection reasonably for higher diameter needles (11.6% error), whereas largest error was observed for the smallest needle diameter (24.7% error).

  10. Isolated limb perfusion with TNF-alpha and melphalan in locally advanced soft tissue sarcomas of the extremities

    NARCIS (Netherlands)

    Grunhagen, D.J.; Wilt, J.H.W. de; Geel, A.N. van; Verhoef, C.; Eggermont, A.M.M.


    Limb-sparing surgery has become all the more important in soft tissue sarcoma (STS) of the extremities since we learned that amputation does not improve survival of these patients. In bulky tumours, however, preoperative strategies to reduce tumour size are then required. Isolated limb perfusion (IL

  11. [Soft tissue rheumatism in erderly]. (United States)

    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.

  12. Biomechanical properties of soft tissues

    Institute of Scientific and Technical Information of China (English)

    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.

  13. Treatment of advanced soft-tissue sarcomas using a combined strategy of high-dose ifosfamide, high-dose doxorubicin and salvage therapies. (United States)

    Leyvraz, S; Herrmann, R; Guillou, L; Honegger, H P; Christinat, A; Fey, M F; Sessa, C; Wernli, M; Cerny, T; Dietrich, D; Pestalozzi, B


    Having determined in a phase I study the maximum tolerated dose of high-dose ifosfamide combined with high-dose doxorubicin, we now report the long-term results of a phase II trial in advanced soft-tissue sarcomas. Forty-six patients with locally advanced or metastatic soft-tissue sarcomas were included, with age or =3 neutropenia in 59%, thrombopenia in 39% and anaemia in 27% of cycles. Three patients experienced grade 3 neurotoxicity and one patient died of septic shock. This high-dose regimen is toxic but nonetheless feasible in multicentre settings in non elderly patients with good performance status. A high response rate was obtained. Prolonged survival was mainly a function of salvage therapies.

  14. Soft tissue tumours: imaging strategy

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  15. Phase contrast imaging of cochlear soft tissue.

    Energy Technology Data Exchange (ETDEWEB)

    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.

  16. 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

    DEFF Research Database (Denmark)

    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...

  17. Advances in Soft Matter Mechanics

    CERN Document Server

    Li, Shaofan


    "Advances in Soft Matter Mechanics" is a compilation and selection of recent works in soft matter mechanics by a group of active researchers in the field. The main objectives of this book are first to disseminate the latest developments in soft matter mechanics in the field of applied and computational mechanics, and second to introduce soft matter mechanics as a sub-discipline of soft matter physics. As an important branch of soft matter physics, soft matter mechanics has developed rapidly in recent years. A number of the novel approaches discussed in this book are unique, such as the coarse grained finite element method for modeling colloidal adhesion, entropic elasticity, meshfree simulations of liquid crystal elastomers, simulations of DNA, etc. The book is intended for researchers and graduate students in the field of mechanics, condensed matter physics and biomaterials. Dr. Shaofan Li is a professor of the University of California-Berkeley, U.S.A; Dr. Bohua Sun is a professor of Cape Peninsula Universit...

  18. Treatment Option Overview (Adult Soft Tissue Sarcoma) (United States)

    ... 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 ...

  19. Treatment Options for Adult Soft Tissue Sarcoma (United States)

    ... 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 ...

  20. Immunotherapy for Bone and Soft Tissue Sarcomas

    Directory of Open Access Journals (Sweden)

    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.

  1. 软组织肉瘤的靶向治疗进展%A review on the advance of individualized therapy targeting soft tissue sarcomas

    Institute of Scientific and Technical Information of China (English)

    任志午; 王国文


    Soft tissue sarcomas are malignant tumors derived from mesenchymal tissues and ectodermal neural tissues, with wide distribution and multi subtypes. Traditional treatment method of soft tissue sarcomas includes surgery, radiotherapy and chemotherapy. The treatment aims to control primary tumors and prevent the transfer of tumors. At present, molecular targeted drugs obtain positive effects in the treatment of common cancers such like non-small cell lung cancer, colorectal cancer, etc. Targeted therapeutic strategies suddenly become a new ifeld of cancer treatment. Antitumor drugs inhibit tumor growth by retarding tumor cell proliferation with the interference of tumor development and specific protein essential for the growth. Tumor-targeting drugs have fewer side effects and well tolerance. Currently, there are a variety of targeted drugs used in soft tissue sarcoma treatment. The individualized therapy provides different solutions according to the different tumor subtypes. It will be the future development trend of soft tissue sarcomas treatment.

  2. Imaging of musculoskeletal soft tissue infections

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  3. Cephalometric soft tissue facial analysis. (United States)

    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)?

  4. 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)

    DEFF Research Database (Denmark)

    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...

  5. Nasal Soft-Tissue Triangle Deformities. (United States)

    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.

  6. Multidisciplinary Management of Soft Tissue Sarcoma

    Directory of Open Access Journals (Sweden)

    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.

  7. Sequential Dose-Dense Doxorubicin and Ifosfamide in Advanced Soft-Tissue Sarcoma Patients in an Out-Patient-Basis Schedule

    Directory of Open Access Journals (Sweden)

    G. F. G. Almeida


    Full Text Available Aims. This phase II study explored activity/safety of front-line dose-dense chemotherapy in high-grade STS (soft tissue sarcoma patients and tested ezrin as prognostic factor. Patients and Methods. The protocol consisted of three cycles of doxorubicin (DOXO 30 mg/m2 on days 1–3 every 2 weeks, followed by three cycles of ifosfamide (IFO 2.5 g/m2 two hours a day on days 1–5 every 3 weeks, with GCSF support. Ezrin was assessed immunohistochemically. Results. Twenty patients, 13 metastatic and 7 locally advanced, were enrolled. Median age was 39 years (25–60. Median dose intensities were 42 mg/m2/week and 3.6 g/m2/week for DOXO and IFO, respectively. Grade 3/4 toxicities occurred in 18 patients. Response rate was 15% (3 of 20 by RECIST. Patients younger than 45 years with locally advanced disease and synovial histology presented longer survival. A trend towards longer survival was observed among ezrin-positive patients. Conclusions. This dose-dense schedule should not be routinely used due to its high frequency of toxic events; however, a sequential strategy with DOXO and IFO may benefit selected patients and should be further explored with lower doses. The role of ezrin as a prognostic marker should be confirmed in a larger group of patients.

  8. Nonspecificity of Chronic Soft Tissue Pain Syndromes

    Directory of Open Access Journals (Sweden)

    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.

  9. Combination of Trabectedin and Gemcitabine for Advanced Soft Tissue Sarcomas: Results of a Phase I Dose Escalating Trial of the German Interdisciplinary Sarcoma Group (GISG

    Directory of Open Access Journals (Sweden)

    Bernd Kasper


    Full Text Available Background: Evaluation of the potential efficacy and safety of combination therapies for advanced soft tissue sarcomas (STS has increased substantially after approval of trabectedin and pazopanib. Trabectedin's introduction in Europe in 2007 depended mainly on its activity in so-called L-sarcomas (liposarcoma and leiomyosarcoma; combination of trabectedin with other chemotherapies used in STS seems of particular interest. Methods: We initiated within the German Interdisciplinary Sarcoma Group (GISG a phase I dose escalating trial evaluating the combination of trabectedin and gemcitabine in patients with advanced and/or metastatic L-sarcomas (GISG-02; NCT01426633. Patients were treated with increasing doses of trabectedin and gemcitabine. The primary endpoint was to determine the maximum tolerated dose. Results: Five patients were included in the study. Two patients were treated on dose level 1 comprising trabectedin 0.9 mg/m2 on day 1 and gemcitabine 700 mg/m2 on days 1 + 8, every 3 weeks. Due to dose-limiting toxicity (DLT in both patients (elevated transaminases and thrombocytopenia, an additional three patients were treated on dose level −1 with trabectedin 0.7 mg/m2 plus gemcitabine 700 mg/m2. Of these three patients, two demonstrated another DLT; therefore, the trial was stopped and none of the dose levels could be recommended for phase II testing. Conclusion: The GISG-02 phase I study was stopped with the conclusion that the combination of gemcitabine and trabectedin is generally not recommended for the treatment of patients with advanced and/or metastatic leiomyosarcoma or liposarcoma. Also, this phase I study strongly supports the necessity for careful evaluation of combination therapies.

  10. The advantage of deep-inspiration breath-hold and cone-beam CT based soft-tissue registration for locally advanced lung cancer radiotherapy

    DEFF Research Database (Denmark)

    Ottosson, Wiviann; Rahma, Fatma; Sjöström, David;


    were calculated. Results: For the spine, the smallest residual misalignments were observed in FB, independently of registration method. For GTV-T and GTV-N, soft-tissue registrations were superior to bony registration, independently of FB or DIBH. Compared to FB, PTV-Totals were during DIBH reduced...... uncertainties compared to FB, DIBH resulted in smaller PTV-Totals for all registration methods. Soft-tissue registrations were superior to bony registration, independently of FB and DIBH. During DIBH, undesirable arching of the back was identified. Daily CBCT pre-treatment target verification is advised....

  11. Drugs Approved for Soft Tissue Sarcoma (United States)

    ... 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 ...

  12. Rehabilitation of esthetics in advanced periodontal cases using orthodontics for vertical hard and soft tissue regeneration prior to implants - a report of 2 challenging cases treated with an interdisciplinary approach. (United States)

    Mankoo, Tidu; Frost, Laura


    The esthetic rehabilitation of advanced periodontal cases remains a challenge, despite the numerous advances in treatment of periodontitis and regenerative therapies. Whilst understanding of periodontal diseases deepens with advances in cell biology, cell signaling, and genomic research, the restoration of the gingival tissues to anatomical norms remains a considerable challenge in advanced cases. The improvements in diagnosis and treatment of disease certainly enable successful management of disease and stabilization of the compromised and failing dentition. Nonetheless, effective "esthetic" rehabilitation of patients with advanced disease affecting teeth in the esthetic zone, where significant asymmetrical bone loss and tissue recession are present, still constitutes a significant dilemma. An interdisciplinary approach involving vertical augmentation of bone and soft tissues by means of orthodontic extrusion of severely compromised periodontally involved teeth to reconstitute esthetics, as well as ideal bone and soft tissue volume prior to immediate implant placement and restoration, may be a particularly useful treatment option in patients suffering advanced periodontal disease with asymmetrical bone and tissue loss in the esthetic zone. This paper discusses the concepts and illustrates its use in two complex and demanding cases.

  13. Extramedullary Plasmacytoma of Soft Tissues and Gingiva

    Directory of Open Access Journals (Sweden)

    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.

  14. Injectable silk foams for soft tissue regeneration. (United States)

    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.

  15. Pediatric rhabdomyosarcomas and nonrhabdomyosarcoma soft tissue sarcoma

    Directory of Open Access Journals (Sweden)

    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

  16. Treatment Option Overview (Childhood Soft Tissue Sarcoma) (United States)

    ... first formed. This summary is about the following types of soft tissue sarcoma: Fat tissue tumors Liposarcoma . This is a rare cancer of the fat cells. Liposarcoma usually forms in the fat layer just under the skin. In ... types of liposarcoma. Myxoid liposarcoma is usually low grade ...

  17. General Information about Childhood Soft Tissue Sarcoma (United States)

    ... first formed. This summary is about the following types of soft tissue sarcoma: Fat tissue tumors Liposarcoma . This is a rare cancer of the fat cells. Liposarcoma usually forms in the fat layer just under the skin. In ... types of liposarcoma. Myxoid liposarcoma is usually low grade ...

  18. Treatment Options for Childhood Soft Tissue Sarcoma (United States)

    ... first formed. This summary is about the following types of soft tissue sarcoma: Fat tissue tumors Liposarcoma . This is a rare cancer of the fat cells. Liposarcoma usually forms in the fat layer just under the skin. In ... types of liposarcoma. Myxoid liposarcoma is usually low grade ...

  19. Stages of Childhood Soft Tissue Sarcoma (United States)

    ... first formed. This summary is about the following types of soft tissue sarcoma: Fat tissue tumors Liposarcoma . This is a rare cancer of the fat cells. Liposarcoma usually forms in the fat layer just under the skin. In ... types of liposarcoma. Myxoid liposarcoma is usually low grade ...

  20. Quantification and validation of soft tissue deformation

    DEFF Research Database (Denmark)

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


    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...... 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...

  1. Soft tissue growth of the oropharynx. (United States)

    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.

  2. The Italian registry of soft tissue tumors. (United States)

    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.

  3. Review of soft tissue augmentation in the face

    Directory of Open Access Journals (Sweden)

    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

  4. Soft tissue biotype affects implant success. (United States)

    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.

  5. Soft tissue sarcoma of the extremity.

    LENUS (Irish Health Repository)

    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.

  6. A decision tree for soft tissue grafting. (United States)

    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.

  7. Equine model for soft-tissue regeneration. (United States)

    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.

  8. Soft tissue trauma and scar revision. (United States)

    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.

  9. Biomimetic 3D tissue printing for soft tissue regeneration. (United States)

    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.


    Directory of Open Access Journals (Sweden)

    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.

  11. Resistance and perspectives in soft tissue sarcomas

    NARCIS (Netherlands)

    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

  12. Adverse reactions to injectable soft tissue fillers

    DEFF Research Database (Denmark)

    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...

  13. Biomarkers of necrotising soft tissue infections

    DEFF Research Database (Denmark)

    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...

  14. Biodegradable elastomeric scaffolds for soft tissue engineering

    NARCIS (Netherlands)

    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

  15. MRI evaluation of soft tissue hydatid disease

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  16. Results of a phase II trial with second-line cystemustine at 60 mg/m{sup 2} in advanced soft tissue sarcoma: A trial of the EORTC early clinical studies group

    Energy Technology Data Exchange (ETDEWEB)

    Chollet, P. [Centre Jean Perrin and Inserm U71, 58 rue Montalembert, B.P. 392, 63011 Clermont-Ferrand Cedex 1 (France); Fumoleau, P. [Centre Rene Gauducheau, Site Hospitalier Nord, Boulevard Jacques Monod, 44805 Saint-Herblain Cedex (France); Lentz, M.A. [EORTC Data Center, Avenue E. Mounier, 83-B. 11, 1200 Brussels (Belgium); Chevallier, B. [Centre Henri Becquerel, Rue d' Amiens, 76038 Rouen Cedex (France); Roche, H. [Centre Claudius Regaud, 20-24 rue du Pont-Saint-Pierre, 31052 Toulouse Cedex (France); Kerbrat, P. [Centre Eugene Marquis, Rue de la bataille Flandre-Dunkerque, B.P. 6279, 35062 Rennes Cedex (France); Tubiana, N. [C.H.U. Dupuytren, 2 avenue Martin Luther King, 87042 Limoges Cedex (France); Adenis, A. [Centre Oscar Lambret, Rue Frederic Combemale, B.P. 307, 59020 Lille Cedex (France); Krakowski, I. [Centre Alexis Vautrin, Avenue de Bourgogne, 54511 Vandoeuvre-les-Nancy Cedex (France); Cure, H. [Centre Jean Perrin and Inserm U71, 58 rue Montalembert, B.P. 392, 63011 Clermont-Ferrand Cedex 1 (France)


    The aim of this phase II trial was to examine the efficacy of a new nitrosourea, cystemustine, in soft tissue sarcoma. Between January 1990 and March 1991, 32 pretreated patients with advanced soft tissue sarcoma were enrolled. Cystemustine was given every 2 weeks at 60 mg/m{sup 2} via a 15-min i.v. infusion. All eligible patients were considered evaluable for response and toxicity (WHO criteria). Of the 32 enrolled patients, 4 were ineligible, leaving 28 evaluable patients. All but 1 had been pretreated: 6 with adjuvant chemotherapy, 18 patients with first-line palliative chemotherapy without nitrosourea, 3 with both treatments, and 18 had received radiotherapy. Median age was 54 years (range 20-73) and median performance status was 1 (0-2). One partial response (PR, duration 12 weeks), 2 stable disease and 25 progressions were observed, giving an overall response rate of 3.57% (confidence interval: 0.1-18.4%). Toxicity was mild, and was mainly neutropenia (no grade 3 or 4), thrombocytopenia (3.57% grade 3 and grade 4) and nausea-vomiting (no grade 3 or 4). It should be noted that the treatment for the patient who obtained a PR was third line with no previous response. Cystemustine with this schedule appears to have a low clinical activity and toxicity in advanced soft tissue sarcoma. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  17. Soft tissue twisting injuries of the knee

    Energy Technology Data Exchange (ETDEWEB)

    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

  18. Advance Trends in Soft Computing

    CERN Document Server

    Kreinovich, Vladik; Kacprzyk, Janusz; WCSC 2013


    This book is the proceedings of the 3rd World Conference on Soft Computing (WCSC), which was held in San Antonio, TX, USA, on December 16-18, 2013. It presents start-of-the-art theory and applications of soft computing together with an in-depth discussion of current and future challenges in the field, providing readers with a 360 degree view on soft computing. Topics range from fuzzy sets, to fuzzy logic, fuzzy mathematics, neuro-fuzzy systems, fuzzy control, decision making in fuzzy environments, image processing and many more. The book is dedicated to Lotfi A. Zadeh, a renowned specialist in signal analysis and control systems research who proposed the idea of fuzzy sets, in which an element may have a partial membership, in the early 1960s, followed by the idea of fuzzy logic, in which a statement can be true only to a certain degree, with degrees described by numbers in the interval [0,1]. The performance of fuzzy systems can often be improved with the help of optimization techniques, e.g. evolutionary co...

  19. Multiscale mechanical modeling of soft biological tissues (United States)

    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.

  20. Soft tissue infections and the diabetic foot. (United States)

    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.

  1. Hard-Soft Tissue Interface Engineering. (United States)

    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.

  2. Imaging of the pediatric hand: Soft tissue abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    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.

  3. Lung Cancer Presenting as a Soft-Tissue Metastasis

    Directory of Open Access Journals (Sweden)

    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.

  4. Soft tissue augmentation in dermatology - 2009 update

    Directory of Open Access Journals (Sweden)

    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.

  5. Soft computing in advanced robotics

    CERN Document Server

    Kobayashi, Ichiro; Kim, Euntai


    Intelligent system and robotics are inevitably bound up; intelligent robots makes embodiment of system integration by using the intelligent systems. We can figure out that intelligent systems are to cell units, while intelligent robots are to body components. The two technologies have been synchronized in progress. Making leverage of the robotics and intelligent systems, applications cover boundlessly the range from our daily life to space station; manufacturing, healthcare, environment, energy, education, personal assistance, logistics. This book aims at presenting the research results in relevance with intelligent robotics technology. We propose to researchers and practitioners some methods to advance the intelligent systems and apply them to advanced robotics technology. This book consists of 10 contributions that feature mobile robots, robot emotion, electric power steering, multi-agent, fuzzy visual navigation, adaptive network-based fuzzy inference system, swarm EKF localization and inspection robot. Th...

  6. Collecting and Storing Tissue, Blood, and Bone Marrow Samples From Patients With Rhabdomyosarcoma or Other Soft Tissue Sarcoma (United States)


    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

  7. Immunoglobulin for necrotising soft tissue infections (INSTINCT)

    DEFF Research Database (Denmark)

    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...

  8. Longitudinal nonlinear wave propagation through soft tissue. (United States)

    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

  9. Soft-tissue rheumatism: diagnosis and treatment. (United States)

    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.

  10. Microwave soft tissue ablation (Invited Paper) (United States)

    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.

  11. Isolating stem cells from soft musculoskeletal tissues. (United States)

    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.

  12. Ion induced deformation of soft tissue. (United States)

    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.

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

    CERN Document Server

    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.


    Directory of Open Access Journals (Sweden)

    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.

  15. Contemporary Management of Retroperitoneal Soft Tissue Sarcomas. (United States)

    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.

  16. Advances in tissue engineering

    Institute of Scientific and Technical Information of China (English)


    Tissue engineering is a newly developed specialty involved in the construction of tissues and organs either in vitro or in vivo. Tremendous progress has been achieved over the past decade in tisse construction as well as in other related areas, such as bone marrow stromal cells, embryonic stem cells and tissue progenitor cells. In our laboratory, tissues of full-thickness skin, bone, cartilage and tendon have been successfully engineered, and the engineered tissues have repaired full-thickness skin wound, cranial bone defects, articular cartilage defects and tendon defects in animals. In basic research areas, bone marrow stromal cells have been induced and transformed into osteoblasts and chondrocytes in vitro. Mouse embryo stem cell lines we established have differentiated into neuron precursor, cardiac muscle cells and epithelial cells. Genetic modifications of seed cells for promoting cell proliferation, delaying cell aging and inducing immune tolerance have also been investigated.

  17. Late Consequential Surgical Bed Soft Tissue Necrosis in Advanced Oropharyngeal Squamous Cell Carcinomas Treated With Transoral Robotic Surgery and Postoperative Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Lukens, J. Nicholas [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Lin, Alexander, E-mail: [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Gamerman, Victoria; Mitra, Nandita [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Grover, Surbhi; McMenamin, Erin M. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Weinstein, Gregory S.; O' Malley, Bert W. [Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Cohen, Roger B. [Department of Hematology Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Orisamolu, Abimbola; Ahn, Peter H. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Quon, Harry, E-mail: [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Johns Hopkins University, Baltimore, Maryland (United States)


    Purpose: A subset of patients with oropharyngeal squamous cell carcinoma (OP-SCC) managed with transoral robotic surgery (TORS) and postoperative radiation therapy (PORT) developed soft tissue necrosis (STN) in the surgical bed months after completion of PORT. We investigated the frequency and risk factors. Materials and Methods: This retrospective analysis included 170 consecutive OP-SCC patients treated with TORS and PORT between 2006 and 2012, with >6 months' of follow-up. STN was defined as ulceration of the surgical bed >6 weeks after completion of PORT, requiring opioids, biopsy, or hyperbaric oxygen therapy. Results: A total of 47 of 170 patients (28%) had a diagnosis of STN. Tonsillar patients were more susceptible than base-of-tongue (BOT) patients, 39% (41 of 104) versus 9% (6 of 66), respectively. For patients with STN, median tumor size was 3.0 cm (range 1.0-5.6 cm), and depth of resection was 2.2 cm (range 1.0-5.1 cm). Median radiation dose and dose of fraction to the surgical bed were 6600 cGy and 220 cGy, respectively. Thirty-one patients (66%) received concurrent chemotherapy. Median time to STN was 2.5 months after PORT. All patients had resolution of STN after a median of 3.7 months. Multivariate analysis identified tonsillar primary (odds ratio [OR] 4.73, P=.01), depth of resection (OR 3.12, P=.001), total radiation dose to the resection bed (OR 1.51 per Gy, P<.01), and grade 3 acute mucositis (OR 3.47, P=.02) as risk factors for STN. Beginning May 2011, after implementing aggressive avoidance of delivering >2 Gy/day to the resection bed mucosa, only 8% (2 of 26 patients) experienced STN (all grade 2). Conclusions: A subset of OP-SCC patients treated with TORS and PORT are at risk for developing late consequential surgical bed STN. Risk factors include tonsillar location, depth of resection, radiation dose to the surgical bed, and severe mucositis. STN risk is significantly decreased with carefully avoiding a radiation dosage of >2 Gy/day to

  18. Soft matter models of developing tissues and tumors. (United States)

    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.

  19. What Are the Risk Factors for Soft Tissue Sarcoma? (United States)

    ... 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 ...

  20. Porous decellularized adipose tissue foams for soft tissue regeneration. (United States)

    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.


    Directory of Open Access Journals (Sweden)



    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.

  2. Soft tissue chondromyxoid fibroma of the foot: sonographic findings. (United States)

    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.

  3. Validation of new soft tissue software in orthognathic surgery planning. (United States)

    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.

  4. Molecular cytogenetics and its applications to soft tissue tumor analysis. (United States)

    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.

  5. MR Histoanatomical Distribution of 290 Soft-tissue Tumors

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  7. Soft Tissue Biomechanical Modeling for Computer Assisted Surgery

    CERN Document Server


      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 ...

  8. Soft-tissue lasers in orthodontics: an overview. (United States)

    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

    DEFF Research Database (Denmark)

    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. Malar Reconstruction Using Y-V Advancement Flaps after Tissue Expansion in Treacher Collins Syndrome. (United States)

    Ueda, Koichi; Nuri, Takashi; Shigemura, Yuka


    The Treacher Collins syndrome is characterized by both soft and hard tissue deficiencies. To reconstruct malar hypoplasia with both soft and hard tissues, we designed a new method using cartilage grafts, Y-V advancement flaps, and Z plasty with tissue expansion.

  11. Interdigitated interdigital transducer for surface elastometry of soft damping tissue. (United States)

    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.

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

    Institute of Scientific and Technical Information of China (English)

    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


    Institute of Scientific and Technical Information of China (English)

    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.


    Directory of Open Access Journals (Sweden)

    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.

  15. How to use PRICE treatment for soft tissue injuries. (United States)

    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:

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

    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.

  17. Estimation of Soft Tissue Mechanical Parameters from Robotic Manipulation Data. (United States)

    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.

  18. 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...

  19. 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 ...

  20. Soft tissues store and return mechanical energy in human running. (United States)

    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.

  1. Soft Tissue Wounds and Principles of Healing (United States)


    tissues, the hemodynamic status, and the effects of sub- stances such as cortisone , vitamins A and C, and zinc [21]. Nutrition is a fac- tor that...plays a dominant role in hemostasis. In the tissues that are exposed from wounds involving the brain, lung , placenta, heart, and uterus, a tissue complex

  2. Prognostic relevance of {sup 18}F-FDG PET uptake in patients with locally advanced, extremity soft tissue sarcomas undergoing neoadjuvant isolated limb perfusion with TNF-α and melphalan

    Energy Technology Data Exchange (ETDEWEB)

    Andreou, Dimosthenis [Muenster University Hospital, Department of General Orthopedics and Tumor Orthopedics, Muenster (Germany); HELIOS Klinikum Berlin-Buch, Department of Orthopedic Oncology, Sarcoma Center Berlin-Brandenburg, Berlin (Germany); Boldt, Henrike [HELIOS Klinikum Berlin-Buch, Department of Nuclear Medicine, Berlin (Germany); Pink, Daniel [HELIOS Klinikum Bad Saarow, Department of Hematology, Oncology and Palliative Care, Sarcoma Center Berlin-Brandenburg, Bad Saarow (Germany); Jobke, Bjoern [HELIOS Klinikum Berlin-Buch, Department of Radiology, Berlin (Germany); Werner, Mathias [HELIOS Klinikum Emil von Behring, Department of Pathology, Sarcoma Center Berlin-Brandenburg, Berlin (Germany); Schuler, Markus [University Hospital Carl Gustav Carus Dresden, Department of Internal Medicine I, Dresden (Germany); Reichardt, Peter [HELIOS Klinikum Berlin-Buch, Department of Interdisciplinary Oncology, Sarcoma Center Berlin-Brandenburg, Berlin (Germany); Tunn, Per-Ulf [HELIOS Klinikum Berlin-Buch, Department of Orthopedic Oncology, Sarcoma Center Berlin-Brandenburg, Berlin (Germany)


    The objective of this study was to determine whether {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET) can adequately assess the risk of systemic disease progression in patients with primary, localized, high-grade soft tissue sarcomas of the extremities undergoing neoadjuvant isolated limb perfusion (ILP) with tumour necrosis factor and melphalan. This was a retrospective analysis of the files of 35 patients who underwent a PET or PET/CT scan prior to and after ILP followed by surgical resection with curative intent between 2006 and 2012. SUV{sub max1} was defined as the maximum standardized uptake value (SUV) at diagnosis, SUV{sub max2} as the maximum SUV after ILP and ΔSUV{sub max} as the percentage difference between SUV{sub max1} and SUV{sub max2}. The median follow-up was 40 months for all patients. The median SUV{sub max1} amounted to 7.6, while the median SUV{sub max2} was 4.7. The median ΔSUV{sub max} was -44 %. Overall survival (OS) probability at 2 and 5 years amounted to 78 and 70 %, respectively, while metastasis-free survival (MFS) probability at 2 and 5 years was 67 and 64 %, respectively. Receiver-operating characteristic (ROC) curve analysis showed that both SUV{sub max2} and ΔSUV{sub max} could predict systemic disease progression, while SUV{sub max1} could not adequately identify patients who went on to develop metastatic disease. The optimal cut-off value was 6.9 for SUV{sub max2} and -31 % for ΔSUV{sub max}. Patients with an SUV{sub max2} <6.9 had a 2-year MFS of 80 %, compared to 31 % for patients with an SUV{sub max2} ≥ 6.9 (p < 0.001). Patients with a ΔSUV{sub max} < -31 %, i.e. patients with a higher metabolic response, had an MFS of 76 % at 2 years, compared to 42 % for patients with a ΔSUV{sub max} ≥ -31 % (p = 0.050). SUV{sub max} after ILP for primary, locally advanced, non-metastatic high-grade soft tissue sarcomas of the extremities appears to be significantly correlated with prognosis. Whether patients

  3. Isolated limb perfusion of soft tissue sarcomas : A comprehensive review of literature

    NARCIS (Netherlands)

    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

  4. Revisiting peri-implant soft tissue – histopathological study of the peri-implant soft tissue (United States)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  6. A Temporal View of Soft Tissue Quantitative Ultrasound (United States)

    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.

  7. Management of facial soft tissue injuries in children. (United States)

    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.

  8. Combining Targeted Agents With Modern Radiotherapy in Soft Tissue Sarcomas (United States)

    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

  9. Simulation and experiment of soft-tissue deformation in prostate brachytherapy. (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  12. Trajectory generation for robotic needle insertion in soft tissue. (United States)

    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.

  13. Bioimpedance of soft tissue under compression. (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Gunshot wounds: epidemiology, wound ballistics, and soft-tissue treatment. (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Cytohistopathological and immunohistochemical correlation of soft tissue tumors

    Directory of Open Access Journals (Sweden)

    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

  18. Is Three-Dimensional Soft Tissue Prediction by Software Accurate? (United States)

    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.

  19. Investigation of some radiation shielding parameters in soft tissue

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Age Changes of Jaws and Soft Tissue Profile

    Directory of Open Access Journals (Sweden)

    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.

  2. [Fast neutrons in the treatment of soft tissue sarcomas]. (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Soft Tissue Mineralization in Captive 2-Toed Sloths. (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Soft tissue artifact in canine kinematic gait analysis

    NARCIS (Netherlands)

    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

  7. The effect of bone displacement operations on facial soft tissues. (United States)

    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.

  8. Fat-containing soft-tissue masses in children

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  9. Fat-containing soft-tissue masses in children. (United States)

    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.

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

    NARCIS (Netherlands)

    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

  11. Bacterial biofilm formation and treatment in soft tissue fillers

    DEFF Research Database (Denmark)

    Alhede, Morten; Er, Ozge; Eickhardt, Steffen


    Injection of soft tissue fillers plays an important role in facial reconstruction and aesthetic treatments such as cosmetic surgery for lip augmentation and wrinkle smoothening. Adverse events are an increasing problem and recently it has been suggested that bacteria are the cause of a vast...

  12. Biofilm in group A streptococcal necrotizing soft tissue infections

    DEFF Research Database (Denmark)

    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...

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

    Directory of Open Access Journals (Sweden)

    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

  14. Mechanics of Flexible Needles Robotically Steered through Soft Tissue

    NARCIS (Netherlands)

    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

  15. Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application (United States)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  17. Medical ultrasound: imaging of soft tissue strain and elasticity. (United States)

    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.

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


    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

  19. Soft Tissue Engineering with Micronized-Gingival Connective Tissues. (United States)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  1. [Research progress in peri-implant soft tissue engineering augmentation method]. (United States)

    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.

  2. Hypoelastic Soft Tissues: Part II: In-Plane Biaxial Experiments. (United States)

    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.

  3. [Microbiological diagnosis of infections of the skin and soft tissues]. (United States)

    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,

  4. Hypoxia-Inducible Factors: Mediators of Cancer Progression; Prognostic and Therapeutic Targets in Soft Tissue Sarcomas

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  6. Micromechanics and constitutive modeling of connective soft tissues. (United States)

    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.

  7. Photoacoustic imaging in both soft and hard biological tissue

    Energy Technology Data Exchange (ETDEWEB)

    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.

  8. Delayed phlegmon with gallstone fragments masquerading as soft tissue sarcoma (United States)

    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

  9. MIB-1 expression and iododeoxyuridine labelling in soft tissue sarcomas

    DEFF Research Database (Denmark)

    Jensen, V; Høyer, M; Sørensen, Flemming Brandt;


    We investigated the relationship between immunohistochemical estimates of proliferative activity and expression of bcl-2 protein and mutant p53 protein in 23 cases of soft tissue sarcoma. Furthermore, the reproducibility of estimates of proliferative activity was analysed and correlations between...... the variables and with mitotic score were investigated. Proliferative activity was assessed by use of monoclonal antibody MIB-1 and staining for iododeoxyuridine (IdUrd), and evaluated in multiple, random, systematically sampled fields of vision. MIB-1 indices were higher than those of IdUrd but for each case...... improve the accuracy of conventional malignancy grading of soft tissue sarcomas. Furthermore, the results indicate that neither mutant p53 protein nor bcl-2 oncogene alone are sufficient to induce increased proliferation in these sarcomas....

  10. Soft tissue expansion before vertical ridge augmentation: Inflatable silicone balloons or self-filling osmotic tissue expanders?

    Directory of Open Access Journals (Sweden)

    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. Soft tissue infection caused by Kingella kingae in a child. (United States)

    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.

  12. Magnetic resonance imaging of benign soft tissue neoplasms in adults. (United States)

    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.

  13. Realistic soft tissue deformation strategies for real time surgery simulation. (United States)

    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.

  14. Wilms tumor arising in extracoelomic paravertebral soft tissues.

    LENUS (Irish Health Repository)

    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.

  15. Oncogenic osteomalacia associated with soft tissue chondromyxoid fibroma

    Energy Technology Data Exchange (ETDEWEB)

    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.

  16. 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...

  17. 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...

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  19. Post-treatment complications of soft tissue tumours

    Energy Technology Data Exchange (ETDEWEB)

    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

  20. Enterobacter asburiae and Aeromonas hydrophila: soft tissue infection requiring debridement. (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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 ...

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

    Energy Technology Data Exchange (ETDEWEB)

    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.).

  3. Surface and interfacial creases in a bilayer tubular soft tissue (United States)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  5. Soft Tissue Surgical Procedures for Optimizing Anterior Implant Esthetics

    Directory of Open Access Journals (Sweden)

    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.

  6. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module VIII. Soft Tissue Injuries. (United States)

    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;…

  7. Photothermal lesions in soft tissue induced by optical fiber microheaters. (United States)

    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.

  8. Soft tissue morphology of the naso-maxillary complex following surgical correction of maxillary hypoplasia. (United States)

    Ubaya, T; Sherriff, A; Ayoub, A; Khambay, B


    Orthognathic surgery is undergone to improve facial and dental aesthetics and to improve function. Three dimensional (3D) soft tissue analysis based on stereophotogrammetry provides a realistic measurement of facial morphology. There is a need for objective assessment of surgery outcomes. The study aim was to evaluate the 3D naso-maxillary complex soft tissue morphology following Le Fort I maxillary advancement and compare the findings with a local reference group. 3D images of 112 volunteers were captured using stereophotogrammetry and viewed by 8 lay people; 40 images (16 males and 24 females) were chosen as the reference group to have harmonious facial appearance. The linear and angular measurements of this group were compared with 35 patients (19 female and 16 male) who had maxillary advancement in the post-surgical group. Facial morphology post-surgery was similar to the reference group, except the nasal base width which was wider by 2.3mm in males and 2.6mm in females. In the orthognathic group, the females had a smaller nasolabial angle by 9.7° than the reference group. In conclusion, 3D imaging is a sensitive tool for analysing facial appearance. Compared with a control group, statistical differences were identified in soft tissue morphology which should be considered in surgical planning and patient consent.

  9. Navigation in endoscopic soft tissue surgery: perspectives and limitations. (United States)

    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.

  10. Treatment of Calcaneal Fracture With Severe Soft Tissue Injury and Osteomyelitis: A Case Report. (United States)

    Karns, Michael; Dailey, Steven K; Archdeacon, Michael T


    Advancements in surgical technique have resulted in the ability to reconstruct lower extremity injuries that would have previously been treated by amputation. Currently, a paucity of data is available specifically addressing limb amputation versus reconstruction for calcaneal fractures with severe soft tissue compromise. Reconstruction leaves the patient with their native limb; however, multiple surgeries, infections, chronic pain, and a poor functional outcome are very real possibilities. We present the case of a complex calcaneal fracture complicated by soft tissue injury and osteomyelitis that highlights the importance of shared decision-making between patient and surgeon when considering reconstruction versus amputation. This case exemplifies the need for open communication concerning the risks and benefits of treatment modalities while simultaneously considering the patient's expectations and desired outcomes.

  11. Facial Soft Tissue Measurement in Microgravity-induces Fluid Shifts (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  13. The soft-tissue manifestations of neurofibromatosis type 1

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  16. Computational model of soft tissues in the human upper airway. (United States)

    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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  18. The role of vitamin K in soft-tissue calcification. (United States)

    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

  19. First cosmic-ray images of bone and soft tissue (United States)

    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.

  20. Massive osteoradionecrosis of facial bones and soft tissues. (United States)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  2. Effects of energy drinks on soft tissue healing. (United States)

    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.

  3. Soft tissue strain measurement using an optical method (United States)

    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.

  4. Biomedical advances from tissue culture


    Okamoto, Tetsuji; Sato, J. Denry; Barnes, David W.; Sato, Gordon H.


    The demonstration that the “dedifferentiation” of cells commonly observed in the early days of tissue culture was due to selective overgrowth of fibroblasts led to enrichment culture techniques (alternate animal and culture passage) designed to give a selective advantage to functionally differentiated tumor cells. These experiments resulted in the derivation of a large number of functionally differentiated clonal strains of a range of cell types. These results gave rise to the hypothesis that...

  5. Bones - joints - soft tissues II. 7. rev. ed. Knochen - Gelenke - Weichteile II

    Energy Technology Data Exchange (ETDEWEB)

    Dihlmann, W. (Roentgeninstitut, Allgemeines Krankenhaus Barmbek, Hamburg (Germany)); Frommhold, W. (Radiologische Klinik, Tuebingen Univ. (Germany)) (eds.)


    With the publication of the 2nd part to Volume VI, 'Bones - joints - soft tissues', the 7th edition of 'Diagnostic radiology in the hospital and medical practice' is complete. The advances made particularly during the past decade in the field of diagnostic radiology have made it neccesary for all the individual sections to be completely revised. Recently developed methods of imaging like sonography, computed tomography and magnetic resonance tomography are increasingly used as a replacement for or, at least, an adjunct to conventional X-ray procedures. Owing to the development and continuous refinement of related methods of intervention the gap between mere diagnostic applications and therapeutic uses of radiology could eventually be closed. The issues mainly discussed in this volume are bone fractures and healing, bone transplantation, osteopathy and osteoarthropathy, fibrous dyplasia or Albright's disease, Pagetoid osteitis, genetically transmitted constitutional disorders of the skeleton and soft tissue changes. While in the key sections on bone fractures and healing, osteopathy and osteoarthropathy as well as constitutional genetic disorders X-ray techniques are still described as the prevailing method of diagnosis, diseases of soft tissues now are much more commonly diagnosed using magnetic resonance imaging. (orig./MG) With 2248 figs., 59 tabs.

  6. Development and characterization of a novel hydrogel adhesive for soft tissue applications (United States)

    Sanders, Lindsey Kennedy

    With laparoscopic and robotic surgical techniques advancing, the need for an injectable surgical adhesive is growing. To be effective, surgical adhesives for internal organs require bulk strength and compliance to avoid rips and tears, and adhesive strength to avoid leakage at the application site, while not hindering the natural healing process. Although a number of tissue adhesives and sealants approved by the FDA for surgical use are currently available, attaining a useful balance in all of these qualities has proven difficult, particularly when considering applications involving highly expandable tissue, such as bladder and lung. The long-term goal of this project is to develop a hydrogel-based tissue adhesive that provides proper mechanical properties to eliminate the need for sutures in various soft tissue applications. Tetronic (BASF), a 4-arm poly(propylene oxide)-poly(ethylene oxide) (PPO-PEO) block copolymer, has been selected as the base material for the adhesive hydrogel system. Solutions of Tetronic T1107 can support reverse thermal gelation at physiological temperatures, which can be combined with covalent crosslinking to achieve a "tandem gelation" process making it ideal for use as a tissue adhesive. The objective of this doctoral thesis research is to improve the performance of the hydrogel based tissue adhesive developed previously by Cho and co-workers by applying a multi-functionalization of Tetronic. Specifically, this research aimed to improve bonding strength of Tetronic tissue adhesive using bi-functional modification, incorporate hemostatic function to the bi-functional Tetronic hydrogel, and evaluate the safety of bi-functional Tetronic tissue adhesive both in vitro and in vivo. In summary, we have developed a fast-curing, mechanically strong hemostatic tissue adhesive that can control blood loss in wet conditions during wound treatment applications (bladder, liver and muscle). Specifically, the bi-functional Tetronic adhesive (TAS) with a

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  8. Advances in data representation for hard/soft information fusion (United States)

    Rimland, Jeffrey C.; Coughlin, Dan; Hall, David L.; Graham, Jacob L.


    Information fusion is becoming increasingly human-centric. While past systems typically relegated humans to the role of analyzing a finished fusion product, current systems are exploring the role of humans as integral elements in a modular and extensible distributed framework where many tasks can be accomplished by either human or machine performers. For example, "participatory sensing" campaigns give humans the role of "soft sensors" by uploading their direct observations or as "soft sensor platforms" by using mobile devices to record human-annotated, GPS-encoded high quality photographs, video, or audio. Additionally, the role of "human-in-the-loop", in which individuals or teams using advanced human computer interface (HCI) tools such as stereoscopic 3D visualization, haptic interfaces, or aural "sonification" interfaces can help to effectively engage the innate human capability to perform pattern matching, anomaly identification, and semantic-based contextual reasoning to interpret an evolving situation. The Pennsylvania State University is participating in a Multi-disciplinary University Research Initiative (MURI) program funded by the U.S. Army Research Office to investigate fusion of hard and soft data in counterinsurgency (COIN) situations. In addition to the importance of this research for Intelligence Preparation of the Battlefield (IPB), many of the same challenges and techniques apply to health and medical informatics, crisis management, crowd-sourced "citizen science", and monitoring environmental concerns. One of the key challenges that we have encountered is the development of data formats, protocols, and methodologies to establish an information architecture and framework for the effective capture, representation, transmission, and storage of the vastly heterogeneous data and accompanying metadata -- including capabilities and characteristics of human observers, uncertainty of human observations, "soft" contextual data, and information pedigree

  9. 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 ...

  10. Effect of hydralazine on duration of soft tissue local anesthesia following dental treatment: a randomized clinical trial. (United States)

    Fakheran Esfahani, Omid; Pouraboutaleb, Mohammad Fazel; Khorami, Behnam


    Prolonged numbness following routine dental treatments can cause difficulties in speaking and swallowing and may result in inadvertent biting of soft tissues. Local injection of vasodilator agents may represent a solution to this problem. The aim of this study was to evaluate the effect of submucosal injection of hydralazine hydrochloride (HCl) on the duration of oral soft tissue anesthesia after routine dental treatment. This randomized, single-blinded, controlled clinical trial included 50 patients who received inferior alveolar nerve block (2% lidocaine with 1:100,000 epinephrine) for simple restorative treatment. Upon completion of the dental treatment, patients randomly received a hydralazine HCl or sham injection in the same site as the local anesthetic injection. The reversal time to normal sensation of soft tissues (lips, tongue, and perioral skin) was evaluated and reported every 5 minutes by the patients, who followed an assessment protocol that they were taught in advance of treatment. Median recovery times in the hydralazine group and the sham group were 81.4 (SD, 3.6) and 221.8 (SD, 6.3) minutes, respectively. Based on Kaplan-Meier survival analysis, the duration of soft tissue anesthesia in the 2 groups was significantly different (P local anesthetic-induced soft tissue numbness and the related functional problems.

  11. Suction based mechanical characterization of superficial facial soft tissues. (United States)

    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.

  12. Soft tissue changes after a mandibular osteotomy for symmetric skeletal class III malocclusion. (United States)

    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.

  13. A technique to replicate soft tissues around fixed restoration pontics on working casts. (United States)

    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.

  14. Modelling soft tissue for kinematic analysis of multi-segment human body models. (United States)

    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.

  15. Chondromyxoid fibroma of the acromium with soft tissue extension

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    Directory of Open Access Journals (Sweden)

    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

  17. Soft computing in design and manufacturing of advanced materials (United States)

    Cios, Krzysztof J.; Baaklini, George Y; Vary, Alex


    The potential of fuzzy sets and neural networks, often referred to as soft computing, for aiding in all aspects of manufacturing of advanced materials like ceramics is addressed. In design and manufacturing of advanced materials, it is desirable to find which of the many processing variables contribute most to the desired properties of the material. There is also interest in real time quality control of parameters that govern material properties during processing stages. The concepts of fuzzy sets and neural networks are briefly introduced and it is shown how they can be used in the design and manufacturing processes. These two computational methods are alternatives to other methods such as the Taguchi method. The two methods are demonstrated by using data collected at NASA Lewis Research Center. Future research directions are also discussed.

  18. Engineering cellular fibers for musculoskeletal soft tissues using directed self-assembly. (United States)

    Schiele, Nathan R; Koppes, Ryan A; Chrisey, Douglas B; Corr, David T


    Engineering strategies guided by developmental biology may enhance and accelerate in vitro tissue formation for tissue engineering and regenerative medicine applications. In this study, we looked toward embryonic tendon development as a model system to guide our soft tissue engineering approach. To direct cellular self-assembly, we utilized laser micromachined, differentially adherent growth channels lined with fibronectin. The micromachined growth channels directed human dermal fibroblast cells to form single cellular fibers, without the need for a provisional three-dimensional extracellular matrix or scaffold to establish a fiber structure. Therefore, the resulting tissue structure and mechanical characteristics were determined solely by the cells. Due to the self-assembly nature of this approach, the growing fibers exhibit some key aspects of embryonic tendon development, such as high cellularity, the rapid formation (within 24 h) of a highly organized and aligned cellular structure, and the expression of cadherin-11 (indicating direct cell-to-cell adhesions). To provide a dynamic mechanical environment, we have also developed and characterized a method to apply precise cyclic tensile strain to the cellular fibers as they develop. After an initial period of cellular fiber formation (24 h postseeding), cyclic strain was applied for 48 h, in 8-h intervals, with tensile strain increasing from 0.7% to 1.0%, and at a frequency of 0.5 Hz. Dynamic loading dramatically increased cellular fiber mechanical properties with a nearly twofold increase in both the linear region stiffness and maximum load at failure, thereby demonstrating a mechanism for enhancing cellular fiber formation and mechanical properties. Tissue engineering strategies, designed to capture key aspects of embryonic development, may provide unique insight into accelerated maturation of engineered replacement tissue, and offer significant advances for regenerative medicine applications in tendon

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

    KAUST Repository

    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.

  20. Laser surgery for selected small animal soft-tissue conditions (United States)

    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.

  1. The role of radiotherapy in the management of localized soft tissue sarcomas (United States)

    Tiong, Siaw Sze; Dickie, Colleen; Haas, Rick L.; O’Sullivan, Brian


    The combination of radiotherapy (RT) and function-preserving surgery is the most usual contemporary approach in the management of soft tissue sarcomas (STS). Pre- and postoperative RT result in similar local control rates, as shown by a landmark trial in extremity STS. In this review, the role of RT in the management of extremity STS will be discussed, but STS in other sites, including retroperitoneal STS, will also be addressed. The focus will consider various aspects of RT including strategies to reduce the volume of tissue being irradiated, dose, scheduling, and the possible of omission of RT in selected cases. Finally, technology advances through the use of intensity-modulated radiotherapy (IMRT), image-guided IMRT, intraoperative radiotherapy (IORT) and particle therapy will also be discussed. PMID:27807504

  2. The role of radiotherapy in the management of localized soft tissue sarcomas

    Institute of Scientific and Technical Information of China (English)

    Siaw Sze Tiong; Colleen Dickie; Rick L Haas; Brian OSullivan


    The combination of radiotherapy (RT) and function-preserving surgery is the most usual contemporary approach in the management of soft tissue sarcomas (STS). Pre- and postoperative RT result in similar local control rates, as shown by a landmark trial in extremity STS. In this review, the role of RT in the management of extremity STS will be discussed, but STS in other sites, including retroperitoneal STS, will also be addressed. The focus will consider various aspects of RT including strategies to reduce the volume of tissue being irradiated, dose, scheduling, and the possible of omission of RT in selected cases. Finally, technology advances through the use of intensity-modulated radiotherapy (IMRT), image-guided IMRT, intraoperative radiotherapy (IORT) and particle therapy will also be discussed.

  3. Cranial Base Superimposition for 3D Evaluation of Soft Tissue Changes (United States)

    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

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

    NARCIS (Netherlands)

    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

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

    NARCIS (Netherlands)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  8. Reconstruction of soft tissue defects at the foot and ankle after oncological resection

    Directory of Open Access Journals (Sweden)

    Andrej eRing


    Full Text Available Introduction: Solid malignancies at the foot and ankle region are rare and include mainly soft tissue sarcomas, bone sarcomas and skin malignancies. Complete surgical resection with clear margins still remains the mainstay of therapy in these malignancies. However, attainment of negative surgical margins in patients with locally advanced tumors of the foot and ankle region may require extensive surgery and could result in loss of extremity function. In these circumstances, plastic surgical techniques can frequently reduce functional impairment and cover soft tissue defects, particularly in cases of large tumor size or localization adjacent to critical anatomic structures, thereby improving the quality of life for these patients. The aim of this article is to illustrate the various treatment options of plastic surgery in the multimodal therapy of patients with malignant tumors of the foot and ankle region.Material und methods: This article is based on the review of the current literature and the evaluation of the author’s own patient database.Results: The local treatment of malignant extremity tumors has undergone major changes over the last few decades. Primary amputations have been increasingly replaced by limb-sparing techniques, preserving extremity function as much as possible. Although defect coverage at the foot and ankle region is demanding due to complex anatomical features and functional requirements, several plastic surgical treatment options can be implemented in the curative treatment of patients with malignant solid tumors in this area. Soft tissue defects after tumor resection can be covered by a variety of local flaps. If local flaps are not applicable, free flap transfers, such as the anterolateral thigh (ALT flap, parascapular flap or latissimus dorsi flap, can be utilized to cover nearly all kinds of defects in the foot and ankle region. Conclusion: Soft tissue reconstruction in the foot and ankle region is a vital component

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

    Directory of Open Access Journals (Sweden)

    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.

  10. TU-B-210-01: MRg HIFU - Bone and Soft Tissue Tumor Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Ghanouni, P. [Stanford University (United States)


    MR guided focused ultrasound (MRgFUS), or alternatively high-intensity focused ultrasound (MRgHIFU), is approved for thermal ablative treatment of uterine fibroids and pain palliation in bone metastases. Ablation of malignant tumors is under active investigation in sites such as breast, prostate, brain, liver, kidney, pancreas, and soft tissue. Hyperthermia therapy with MRgFUS is also feasible, and may be used in conjunction with radiotherapy and for local targeted drug delivery. MRI allows in situ target definition and provides continuous temperature monitoring and subsequent thermal dose mapping during HIFU. Although MRgHIFU can be very precise, treatment of mobile organs is challenging and advanced techniques are required because of artifacts in MR temperature mapping, the need for intercostal firing, and need for gated HIFU or tracking of the lesion in real time. The first invited talk, “MR guided Focused Ultrasound Treatment of Tumors in Bone and Soft Tissue”, will summarize the treatment protocol and review results from treatment of bone tumors. In addition, efforts to extend this technology to treat both benign and malignant soft tissue tumors of the extremities will be presented. The second invited talk, “MRI guided High Intensity Focused Ultrasound – Advanced Approaches for Ablation and Hyperthermia”, will provide an overview of techniques that are in or near clinical trials for thermal ablation and hyperthermia, with an emphasis of applications in abdominal organs and breast, including methods for MRTI and tracking targets in moving organs. Learning Objectives: Learn background on devices and techniques for MR guided HIFU for cancer therapy Understand issues and current status of clinical MRg HIFU Understand strategies for compensating for organ movement during MRgHIFU Understand strategies for strategies for delivering hyperthermia with MRgHIFU CM - research collaboration with Philips.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  12. Scale-up of nature's tissue weaving algorithms to engineer advanced functional materials. (United States)

    Ng, Joanna L; Knothe, Lillian E; Whan, Renee M; Knothe, Ulf; Tate, Melissa L Knothe


    We are literally the stuff from which our tissue fabrics and their fibers are woven and spun. The arrangement of collagen, elastin and other structural proteins in space and time embodies our tissues and organs with amazing resilience and multifunctional smart properties. For example, the periosteum, a soft tissue sleeve that envelops all nonarticular bony surfaces of the body, comprises an inherently "smart" material that gives hard bones added strength under high impact loads. Yet a paucity of scalable bottom-up approaches stymies the harnessing of smart tissues' biological, mechanical and organizational detail to create advanced functional materials. Here, a novel approach is established to scale up the multidimensional fiber patterns of natural soft tissue weaves for rapid prototyping of advanced functional materials. First second harmonic generation and two-photon excitation microscopy is used to map the microscopic three-dimensional (3D) alignment, composition and distribution of the collagen and elastin fibers of periosteum, the soft tissue sheath bounding all nonarticular bone surfaces in our bodies. Then, using engineering rendering software to scale up this natural tissue fabric, as well as multidimensional weaving algorithms, macroscopic tissue prototypes are created using a computer-controlled jacquard loom. The capacity to prototype scaled up architectures of natural fabrics provides a new avenue to create advanced functional materials.

  13. Evaluation of a porcine collagen matrix used to augment keratinized tissue and increase soft tissue thickness around existing dental implants. (United States)

    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.

  14. Expression of SIRT1 and DBC1 is associated with poor prognosis of soft tissue sarcomas.

    Directory of Open Access Journals (Sweden)

    Jung Ryul Kim

    Full Text Available Recently, the roles of SIRT1 and deleted in breast cancer 1 (DBC1 in human cancer have been extensively studied and it has been demonstrated that they are involved in many human carcinomas. However, their clinical significance for soft-tissue sarcomas has not been examined. In this study, we evaluated the expression and prognostic significance of the expression of SIRT1, DBC1, P53, β-catenin, cyclin D1, and KI67 in 104 cases of soft-tissue sarcomas.Immunohistochemical expression of SIRT1, DBC1, P53, β-catenin, and cyclin D1 were seen in 71%, 74%, 53%, 48%, and 73% of sarcomas, respectively. The expression of SIRT1, DBC1, P53, β-catenin, and cyclin D1 were significantly correlated with advanced clinicopathological parameters such as higher clinical stage, higher histological grade, increased mitotic counts, and distant metastasis. The expression of SIRT1, DBC1, P53, β-catenin, cyclin D1, and KI67 were significantly correlated with each other and positive expression of all of these predicted shorter overall survival and event-free survival by univariate analysis. Multivariate analysis revealed the expression of SIRT1 as an independent prognostic indicator for overall survival and event-free survival of sarcoma patients. In conclusion, this study demonstrates that SIRT1- and DBC1-related pathways may be involved in the progression of soft-tissue sarcomas and can be used as clinically significant prognostic indicators for sarcoma patients. Moreover, the SIRT1- and DBC1-related pathways could be new therapeutic targets for the treatment of sarcomas.

  15. Prognostic impact of lymphocytes in soft tissue sarcomas.

    Directory of Open Access Journals (Sweden)

    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.

  16. Fabrication of pliable biodegradable polymer foams to engineer soft tissues. (United States)

    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.

  17. Light ion irradiation for unfavorable soft tissue sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    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.

  18. Bone and soft tissue tumors of hip and pelvis

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Skin and soft-tissue infections caused by Aeromonas species. (United States)

    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.

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

    LENUS (Irish Health Repository)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Neuroendocrine carcinoma of the pancreas with soft tissue metastasis

    Institute of Scientific and Technical Information of China (English)

    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.

  5. Additive Biomanufacturing: An Advanced Approach for Periodontal Tissue Regeneration. (United States)

    Carter, Sarah-Sophia D; Costa, Pedro F; Vaquette, Cedryck; Ivanovski, Saso; Hutmacher, Dietmar W; Malda, Jos


    Periodontitis is defined as a chronic inflammatory condition, characterized by destruction of the periodontium, composed of hard (i.e. alveolar bone and cementum) and soft tissues (i.e. gingiva and periodontal ligament) surrounding and supporting the teeth. In severe cases, reduced periodontal support can lead to tooth loss, which requires tissue augmentation or procedures that initiate a repair, yet ideally a regenerative response. However, mimicking the three-dimensional complexity and functional integration of the different tissue components via scaffold- and/or matrix-based guided tissue engineering represents a great challenge. Additive biomanufacturing, a manufacturing method in which objects are designed and fabricated in a layer-by-layer manner, has allowed a paradigm shift in the current manufacturing of medical devices and implants. This shift from design-to-manufacture to manufacture-to-design, seen from a translational research point of view, provides the biomedical engineering and periodontology communities a technology with the potential to achieve tissue regeneration instead of repair. In this review, the focus is put on additively biomanufactured scaffolds for periodontal applications. Besides a general overview of the concept of additive biomanufacturing within this field, different developed scaffold designs are described. To conclude, future directions regarding advanced biomaterials and additive biomanufacturing technologies for applications in regenerative periodontology are highlighted.

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

    NARCIS (Netherlands)

    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

  7. Distilling complexity to advance cardiac tissue engineering


    Ogle, Brenda M.; Bursac, Nenad; Domian, Ibrahim; Huang, Ngan F.; Menasché, Philippe; Murry, Charles; Pruitt, Beth; Radisic, Milica; Wu, Joseph C; Wu, Sean M.; Zhang, Jianyi; Zimmermann, Wolfram-Hubertus; Vunjak-Novakovic, Gordana


    The promise of cardiac tissue engineering is in the ability to recapitulate in vitro the functional aspects of healthy heart and disease pathology as well as to design replacement muscle for clinical therapy. Parts of this promise have been realized; others have not. In a meeting of scientists in this field, five central challenges or “big questions” were articulated that, if addressed, could substantially advance the current state-of-the-art in modeling heart disease and realizing heart repa...


    Directory of Open Access Journals (Sweden)

    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

  9. 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-...

  10. Elective amputation and bionic substitution restore functional hand use after critical soft tissue injuries (United States)

    Aszmann, Oskar C.; Vujaklija, Ivan; Roche, Aidan D.; Salminger, Stefan; Herceg, Malvina; Sturma, Agnes; Hruby, Laura A.; Pittermann, Anna; Hofer, Christian; Amsuess, Sebastian; Farina, Dario


    Critical soft tissue injuries may lead to a non-functional and insensate limb. In these cases standard reconstructive techniques will not suffice to provide a useful outcome, and solutions outside the biological arena must be considered and offered to these patients. We propose a concept which, after all reconstructive options have been exhausted, involves an elective amputation along with a bionic substitution, implementing an actuated prosthetic hand via a structured tech-neuro-rehabilitation program. Here, three patients are presented in whom this concept has been successfully applied after mutilating hand injuries. Clinical tests conducted before, during and after the procedure, evaluating both functional and psychometric parameters, document the benefits of this approach. Additionally, in one of the patients, we show the possibility of implementing a highly functional and natural control of an advanced prosthesis providing both proportional and simultaneous movements of the wrist and hand for completing tasks of daily living with substantially less compensatory movements compared to the traditional systems. It is concluded that the proposed procedure is a viable solution for re-gaining highly functional hand use following critical soft tissue injuries when existing surgical measures fail. Our results are clinically applicable and can be extended to institutions with similar resources. PMID:27721419

  11. Scale-up of nature’s tissue weaving algorithms to engineer advanced functional materials (United States)

    Ng, Joanna L.; Knothe, Lillian E.; Whan, Renee M.; Knothe, Ulf; Tate, Melissa L. Knothe


    We are literally the stuff from which our tissue fabrics and their fibers are woven and spun. The arrangement of collagen, elastin and other structural proteins in space and time embodies our tissues and organs with amazing resilience and multifunctional smart properties. For example, the periosteum, a soft tissue sleeve that envelops all nonarticular bony surfaces of the body, comprises an inherently “smart” material that gives hard bones added strength under high impact loads. Yet a paucity of scalable bottom-up approaches stymies the harnessing of smart tissues’ biological, mechanical and organizational detail to create advanced functional materials. Here, a novel approach is established to scale up the multidimensional fiber patterns of natural soft tissue weaves for rapid prototyping of advanced functional materials. First second harmonic generation and two-photon excitation microscopy is used to map the microscopic three-dimensional (3D) alignment, composition and distribution of the collagen and elastin fibers of periosteum, the soft tissue sheath bounding all nonarticular bone surfaces in our bodies. Then, using engineering rendering software to scale up this natural tissue fabric, as well as multidimensional weaving algorithms, macroscopic tissue prototypes are created using a computer-controlled jacquard loom. The capacity to prototype scaled up architectures of natural fabrics provides a new avenue to create advanced functional materials.

  12. Dynamic simulation of viscoelastic soft tissue in acoustic radiation force creep imaging. (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    CERN Document Server

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

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    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.)

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

    Directory of Open Access Journals (Sweden)

    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.

  18. [Soft tissues volumes changing in malar and cheek area after fat grafting]. (United States)

    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.

  19. The study on facial soft tissue thickness using Han population in Xinjiang. (United States)

    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.

  20. Comparison of soft tissue profile changes in serial extraction and late premolar extraction. (United States)

    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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  2. Vertical Ridge Augmentation and Soft Tissue Reconstruction of the Anterior Atrophic Maxillae: A Case Series. (United States)

    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.

  3. NIH scientists map gene changes driving tumors in common pediatric soft-tissue cancer (United States)

    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

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

    NARCIS (Netherlands)

    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

  5. The Nanomechanics of Biomineralized Soft-Tissues and Organic Matrices (United States)

    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

    Directory of Open Access Journals (Sweden)

    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. Necrotising Soft Tissue Infection–Risk Factors for Mortality (United States)

    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

  8. 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...

  9. 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...

  10. 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 ...

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

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    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.

  12. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Non-rhabdomyosarcoma soft-tissue sarcomas in children: Contemporary appraisal and experience from a single centre (United States)

    Qureshi, Sajid S.; Bhagat, Monica


    Nonrhabdmyosarcoma soft tissue sarcomas (NRSTS) include a cluster of different types of soft tissue sarcomas clubbed together due to the rarity of individual subtypes. The diagnostic accuracy is lately reinforced due to the availability of immunohistochemical and molecular markers. Surgery is the central modality of treatment since many of them are insensitive to chemotherapy. With the availability of rational risk stratification system, efforts are in progress to evaluate the role of neoadjuvant chemotherapy and radiotherapy to improve outcomes especially for the locally advanced disease. The survival remains dismal for metastatic disease. This review highlights the current status of NRSTS and also describes the experience from a single centre in treatment of NRSTS. PMID:26628806

  15. Non-rhabdomyosarcoma soft-tissue sarcomas in children: Contemporary appraisal and experience from a single centre

    Directory of Open Access Journals (Sweden)

    Sajid S Qureshi


    Full Text Available Nonrhabdmyosarcoma soft tissue sarcomas (NRSTS include a cluster of different types of soft tissue sarcomas clubbed together due to the rarity of individual subtypes. The diagnostic accuracy is lately reinforced due to the availability of immunohistochemical and molecular markers. Surgery is the central modality of treatment since many of them are insensitive to chemotherapy. With the availability of rational risk stratification system, efforts are in progress to evaluate the role of neoadjuvant chemotherapy and radiotherapy to improve outcomes especially for the locally advanced disease. The survival remains dismal for metastatic disease. This review highlights the current status of NRSTS and also describes the experience from a single centre in treatment of NRSTS.

  16. Endoluminal non-contact soft tissue ablation using fiber-based Er:YAG laser delivery (United States)

    Kundrat, Dennis; Fuchs, Alexander; Schoob, Andreas; Kahrs, Lüder A.; Ortmaier, Tobias


    The introduction of Er:YAG lasers for soft and hard tissue ablation has proven promising results over the last decades due to strong absorption at 2.94 μm wavelength by water molecules. An extension to endoluminal applications demands laser delivery without mirror arms due to dimensional constraints. Therefore, fiber-based solutions are advanced to provide exible access while keeping space requirements to a minimum. Conventional fiber-based treatments aim at laser-tissue interactions in contact mode. However, this procedure is associated with disadvantages such as advancing decrease in power delivery due to particle coverage of the fiber tip, tissue carbonization, and obstructed observation of the ablation progress. The objective of this work is to overcome aforementioned limitations with a customized fiber-based module for non-contact robot-assisted endoluminal surgery and its associated experimental evaluation. Up to the authors knowledge, this approach has not been presented in the context of laser surgery at 2.94 μm wavelength. The preliminary system design is composed of a 3D Er:YAG laser processing unit enabling automatic laser to fiber coupling, a GeO2 solid core fiber, and a customized module combining collimation and focusing unit (focal length of 20 mm, outer diameter of 8 mm). The performance is evaluated with studies on tissue substitutes (agar-agar) as well as porcine samples that are analysed by optical coherence tomography measurements. Cuts (depths up to 3mm) with minimal carbonization have been achieved under adequate moistening and sample movement (1.5mms-1). Furthermore, an early cadaver study is presented. Future work aims at module miniaturization and integration into an endoluminal robot for scanning and focus adaptation.

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

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    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.)

  19. A mummified duck-billed dinosaur with a soft-tissue cock's comb. (United States)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  1. Terrestrial neutron-induced soft errors in advanced memory devices

    CERN Document Server

    Nakamura, Takashi; Ibe, Eishi; Yahagi, Yasuo; Kameyama, Hideaki


    Terrestrial neutron-induced soft errors in semiconductor memory devices are currently a major concern in reliability issues. Understanding the mechanism and quantifying soft-error rates are primarily crucial for the design and quality assurance of semiconductor memory devices. This book covers the relevant up-to-date topics in terrestrial neutron-induced soft errors, and aims to provide succinct knowledge on neutron-induced soft errors to the readers by presenting several valuable and unique features. Sample Chapter(s). Chapter 1: Introduction (238 KB). Table A.30 mentioned in Appendix A.6 on

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Esthetic solution to malpositioned implants with remodeling of soft tissue: a case report. (United States)

    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.

  4. Advances in soft computing, intelligent robotics and control

    CERN Document Server

    Fullér, Robert


    Soft computing, intelligent robotics and control are in the core interest of contemporary engineering. Essential characteristics of soft computing methods are the ability to handle vague information, to apply human-like reasoning, their learning capability, and ease of application. Soft computing techniques are widely applied in the control of dynamic systems, including mobile robots. The present volume is a collection of 20 chapters written by respectable experts of the fields, addressing various theoretical and practical aspects in soft computing, intelligent robotics and control. The first part of the book concerns with issues of intelligent robotics, including robust xed point transformation design, experimental verification of the input-output feedback linearization of differentially driven mobile robot and applying kinematic synthesis to micro electro-mechanical systems design. The second part of the book is devoted to fundamental aspects of soft computing. This includes practical aspects of fuzzy rule ...

  5. A nonlinear-elastic constitutive model for soft connective tissue based on a histologic description: Application to female pelvic soft tissue. (United States)

    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.

  6. SCHEME (Soft Control Human error Evaluation MEthod) for advanced MCR HRA

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Inseok; Jung, Wondea [KAERI, Daejeon (Korea, Republic of); Seong, Poong Hyun [KAIST, Daejeon (Korea, Republic of)


    The Technique for Human Error Rate Prediction (THERP), Korean Human Reliability Analysis (K-HRA), Human Error Assessment and Reduction Technique (HEART), A Technique for Human Event Analysis (ATHEANA), Cognitive Reliability and Error Analysis Method (CREAM), and Simplified Plant Analysis Risk Human Reliability Assessment (SPAR-H) in relation to NPP maintenance and operation. Most of these methods were developed considering the conventional type of Main Control Rooms (MCRs). They are still used for HRA in advanced MCRs even though the operating environment of advanced MCRs in NPPs has been considerably changed by the adoption of new human-system interfaces such as computer-based soft controls. Among the many features in advanced MCRs, soft controls are an important feature because the operation action in NPP advanced MCRs is performed by soft controls. Consequently, those conventional methods may not sufficiently consider the features of soft control execution human errors. To this end, a new framework of a HRA method for evaluating soft control execution human error is suggested by performing the soft control task analysis and the literature reviews regarding widely accepted human error taxonomies. In this study, the framework of a HRA method for evaluating soft control execution human error in advanced MCRs is developed. First, the factors which HRA method in advanced MCRs should encompass are derived based on the literature review, and soft control task analysis. Based on the derived factors, execution HRA framework in advanced MCRs is developed mainly focusing on the features of soft control. Moreover, since most current HRA database deal with operation in conventional type of MCRs and are not explicitly designed to deal with digital HSI, HRA database are developed under lab scale simulation.

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Composite Tissue Transplantation: A Rapidly Advancing Field (United States)

    Ravindra, K.V.; Wu, S.; Bozulic, L.; Xu, H.; Breidenbach, W.C.; Ildstad, S.T.


    Composite tissue allotransplantation (CTA) is emerging as a potential treatment for complex tissue defects. It is currently being performed with increasing frequency in the clinic. The feasibility of the procedure has been confirmed through 30 hand transplantation, 3 facial reconstructions, and vascularized knee, esophageal, and tracheal allografts. A major drawback for CTA is the requirement for lifelong immunosuppression. The toxicity of these agents has limited the widespread application of CTA. Methods to reduce or eliminate the requirement for immunosuppression and promote CTA acceptance would represent a significant step forward in the field. Multiple studies suggest that mixed chimerism established by bone marrow transplantation promotes tolerance resulting in allograft acceptance. This overview focuses on the history and the exponentially expanding applications of the new frontier in CTA transplantation: immunology associated with CTA; preclinical animal models of CTA; clinical experience with CTA; and advances in mixed chimerism–induced tolerance in CTA. Additionally, some important hurdles that must be overcome in using bone marrow chimerism to induce tolerance to CTA are also discussed. PMID:18589081

  10. In vitro assessment of the soft tissue/implant interface using porcine gingival explants. (United States)

    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.

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

    NARCIS (Netherlands)

    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

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

    KAUST Repository

    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.

  13. Cross polarization optical coherence tomography for diagnosis of oral soft tissues (United States)

    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.

  14. Scaffold Sheet Design Strategy for Soft Tissue Engineering

    Directory of Open Access Journals (Sweden)

    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.

  15. CFH Y402H confers similar risk of soft drusen and both forms of advanced AMD.

    Directory of Open Access Journals (Sweden)

    Kristinn P Magnusson


    Full Text Available BACKGROUND: Age-related macular degeneration (AMD is the most common cause of irreversible visual impairment in the developed world. The two forms of advanced AMD, geographic atrophy and neovascular AMD, represent different pathological processes in the macula that lead to loss of central vision. Soft drusen, characterized by deposits in the macula without visual loss, are considered to be a precursor of advanced AMD. Recently, it has been proposed that a common missense variant, Y402H, in the Complement Factor H (CFH gene increases the risk for advanced AMD. However, its impact on soft drusen, GA, or neovascular AMD--or the relationship between them--is unclear. METHODS AND FINDINGS: We genotyped 581 Icelandic patients with advanced AMD (278 neovascular AMD, 203 GA, and 100 with mixed neovascular AMD/GA, and 435 with early AMD (of whom 220 had soft drusen. A second cohort of 431 US patients from Utah, 322 with advanced AMD (244 neovascular AMD and 78 GA and 109 early-AMD cases with soft drusen, were analyzed. We confirmed that the CFH Y402H variant shows significant association to advanced AMD, with odds ratio of 2.39 in Icelandic patients (p = 5.9 x 10(-12 and odds ratio of 2.14 in US patients from Utah (p = 2.0 x 10(-9 with advanced AMD. Furthermore, we show that the Y402H variant confers similar risk of soft drusen and both forms of advanced AMD (GA or neovascular AMD. CONCLUSION: Soft drusen occur prior to progression to advanced AMD and represent a histological feature shared by neovascular AMD and GA. Our results suggest that CFH is a major risk factor of soft drusen, and additional genetic factors and/or environmental factors may be required for progression to advanced AMD.

  16. CFH Y402H Confers Similar Risk of Soft Drusen and Both Forms of Advanced AMD.

    Directory of Open Access Journals (Sweden)


    Full Text Available BACKGROUND: Age-related macular degeneration (AMD is the most common cause of irreversible visual impairment in the developed world. The two forms of advanced AMD, geographic atrophy and neovascular AMD, represent different pathological processes in the macula that lead to loss of central vision. Soft drusen, characterized by deposits in the macula without visual loss, are considered to be a precursor of advanced AMD. Recently, it has been proposed that a common missense variant, Y402H, in the Complement Factor H (CFH gene increases the risk for advanced AMD. However, its impact on soft drusen, GA, or neovascular AMD-or the relationship between them-is unclear. METHODS AND FINDINGS: We genotyped 581 Icelandic patients with advanced AMD (278 neovascular AMD, 203 GA, and 100 with mixed neovascular AMD/GA, and 435 with early AMD (of whom 220 had soft drusen. A second cohort of 431 US patients from Utah, 322 with advanced AMD (244 neovascular AMD and 78 GA and 109 early-AMD cases with soft drusen, were analyzed. We confirmed that the CFH Y402H variant shows significant association to advanced AMD, with odds ratio of 2.39 in Icelandic patients (p = 5.9 x 10(-12 and odds ratio of 2.14 in US patients from Utah (p = 2.0 x 10(-9 with advanced AMD. Furthermore, we show that the Y402H variant confers similar risk of soft drusen and both forms of advanced AMD (GA or neovascular AMD. CONCLUSION: Soft drusen occur prior to progression to advanced AMD and represent a histological feature shared by neovascular AMD and GA. Our results suggest that CFH is a major risk factor of soft drusen, and additional genetic factors and/or environmental factors may be required for progression to advanced AMD.

  17. Magnetic resonance imaging of soft-tissue tumors of the extremities: A practical approach

    Institute of Scientific and Technical Information of China (English)

    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.


    Directory of Open Access Journals (Sweden)

    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.

  19. Physical Mechanisms of Soft Tissue Injury from Penetrating Ballistic Impact (United States)


    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

  20. Changes in soft tissue profile following the treatment using a Herbst appliance: A photographic analysis

    Directory of Open Access Journals (Sweden)

    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

  1. Patient specific finite element model of the face soft tissues for computer-assisted maxillofacial surgery. (United States)

    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.

  2. Measurement of facial soft tissues thickness using 3D computed tomographic images

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Deformation of Soft Tissue and Force Feedback Using the Smoothed Particle Hydrodynamics (United States)

    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

  5. The operative treatment of complex pilon fractures: A strategy of soft tissue control

    Directory of Open Access Journals (Sweden)

    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.

  6. Tannerella forsythia infection-induced calvarial bone and soft tissue transcriptional profiles. (United States)

    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.

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

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    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.

  8. Combined soft and hard tissue augmentation for a localized alveolar ridge defect. (United States)

    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.

  9. Optimization of Method to Extract Collagen from "Emperor" Tissue of Soft-shelled Turtles. (United States)

    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.

  10. 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...

  11. Long-term room temperature preservation of corpse soft tissue: an approach for tissue sample storage

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    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.

  12. 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...

  13. Correlation Between Bone and Soft Tissue Thickness in Maxillary Anterior Teeth

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    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

  14. Primary hydatid cyst in the soft tissue of the face: An exceptional occurrence

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    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.

  15. Bone And Soft Tissue Changes In Patients With Spinal Cord Injury And Multiple Sclerosis

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    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.

  16. Soft tissue metastases from differentiated thyroid cancer diagnosed by {sup 18}F FDG PET-CT

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    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)

  17. Hamstring tendon harvesting--Effect of harvester on tendon characteristics and soft tissue disruption; cadaver study. (United States)

    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.

  18. Biomechanical validation of medial pie-crusting for soft-tissue balancing in knee arthroplasty. (United States)

    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.

  19. Soft tissue balance changes depending on joint distraction force in total knee arthroplasty. (United States)

    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.

  20. First experiences with simultaneous skeletal and soft tissue reconstruction of noma-related facial defects. (United States)

    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.

  1. Clinical usefulness of facial soft tissues thickness measurement using 3D computed tomographic images

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    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.

  2. Prevalence of Malignant Soft Tissue Tumors inExtremities: An Epidemiological Study in Syria

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    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

  3. Prevalence of Malignant Soft Tissue Tumors inExtremities: An Epidemiological Study in Syria

    Directory of Open Access Journals (Sweden)

    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

  4. Soft Tissue Masses in the Extremities: The Accuracy of an Ultrasonographic Diagnosis

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    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

  5. Investigation of soft tissue movement during level walking: translations and rotations of skin markers. (United States)

    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.

  6. Analysis of mechanical interaction between human gluteal soft tissue and body supports. (United States)

    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.

  7. [Complex outpatient care to patients with osteoarthrosis and degenerative-dystrophic diseases of juxtaarticular soft tissues]. (United States)

    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.

  8. 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...

  9. Soft Tissue Structure Modelling for Use in Orthopaedic Applications and Musculoskeletal Biomechanics

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    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.

  10. Ischiogluteal bursitis mimicking soft-tissue metastasis from a renal cell carcinoma

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    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.

  11. Soft Tissue Schwannomas of the Hard Palate and the Mandibular Mentum

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    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.

  12. Validation of SPAMM Tagged MRI Based Measurement of 3D Soft Tissue Deformation

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    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. Stem Cell Therapy for Healing Wounded Skin and Soft Tissues (United States)


    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

  14. Temporal sequence of hard and soft tissue healing around titanium dental implants. (United States)

    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.

  15. Reliability of soft tissue references for anteroposterior measurement of dental bases. (United States)

    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.

  16. 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

    NARCIS (Netherlands)

    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

  17. Quantitative diagnostics of soft tissue through viscoelastic characterization using time-based instrumented palpation. (United States)

    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.

  18. ABO blood grouping from hard and soft tissues of teeth by modified absorption-elution technique

    Directory of Open Access Journals (Sweden)

    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.

  19. Negative pressure wound therapy for soft tissue injuries around the foot and ankle

    Directory of Open Access Journals (Sweden)

    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.

  20. Advanced tissue engineering in periodontal Regeneration


    Seyed Ali Banihashemrad


    The old wishes of people were to regenerate lost tissues of periodontium that this fact is achieved by gen and cell therapy .Periodontal disease is a chronic inflammation around the tooth by microbes that causes destruction of supporting structure of tissue of tooth such as alveolar bone, cementum and periodontal ligament. For treatment of periodontal diseases we can use the biomaterials which help to regenerate the periodontal tissues like; autogenous bone grafts, allograft, guided tissue re...

  1. Towards Advanced Data Analysis by Combining Soft Computing and Statistics

    CERN Document Server

    Gil, María; Sousa, João; Verleysen, Michel


    Soft computing, as an engineering science, and statistics, as a classical branch of mathematics, emphasize different aspects of data analysis. Soft computing focuses on obtaining working solutions quickly, accepting approximations and unconventional approaches. Its strength lies in its flexibility to create models that suit the needs arising in applications. In addition, it emphasizes the need for intuitive and interpretable models, which are tolerant to imprecision and uncertainty. Statistics is more rigorous and focuses on establishing objective conclusions based on experimental data by analyzing the possible situations and their (relative) likelihood. It emphasizes the need for mathematical methods and tools to assess solutions and guarantee performance. Combining the two fields enhances the robustness and generalizability of data analysis methods, while preserving the flexibility to solve real-world problems efficiently and intuitively.

  2. The Use of Positron Emission Tomography in Soft Tissue Sarcoma Patients under Therapy with Trabectedin

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    Gerlinde Egerer


    Full Text Available Background: We used 2-deoxy-2-[18F] fluoro-D-glucose (FDG positron emission tomography (PET to evaluate the FDG uptake in patients with advanced and/or metastatic soft tissue sarcoma (STS undergoing therapy with Ecteinascidin-743 (ET-743, Trabectedin, YondelisTM. Patients and Methods: The pilot study included nine patients with metastatic STS receiving a minimum of one cycle of treatment with trabectedin. Patients were examined using PET prior to onset of therapy and after completion of one or three cycles of trabectedin. Restaging according to Response Evaluation Criteria in Solid Tumours (RECIST was performed in parallel using computed tomography (CT and/or magnetic resonance imaging (MRI and served for reference. Results: Clinical outcome of nine evaluable patients was as follows: one patient with partial remission (PR, three patients with stable disease (SD, and five patients with progressive disease (PD. A more than 40% decrease of the standardized uptake value (SUV of sequential PET examination could be demonstrated for the responding patient (PR, whereas patients with SD or PD showed a stable SUV, but no increase in SUV. Conclusion: To our knowledge, this is the first small series of patients being treated with trabectedin and monitored using sequential PET imaging demonstrating SUV stabilization in nearly all monitored patients.

  3. Comparison of an Imaging Software and Manual Prediction of Soft Tissue Changes after Orthognathic Surgery

    Directory of Open Access Journals (Sweden)

    M. S. Ahmad Akhoundi


    Full Text Available Objective: Accurate prediction of the surgical outcome is important in treating dentofacial deformities. Visualized treatment objectives usually involve manual surgical simulation based on tracing of cephalometric radiographs. Recent technical advancements have led to the use of computer assisted imaging systems in treatment planning for orthognathic surgical cases. The purpose of this study was to examine and compare the ability and reliability of digitization using Dolphin Imaging Software with traditional manual techniques and to compare orthognathic prediction with actual outcomes.Materials and Methods: Forty patients consisting of 35 women and 5 men (32 class III and 8 class II with no previous surgery were evaluated by manual tracing and indirect digitization using Dolphin Imaging Software. Reliability of each method was assessed then the two techniques were compared using paired t test.Result: The nasal tip presented the least predicted error and higher reliability. The least accurate regions in vertical plane were subnasal and upper lip, and subnasal and pogonion in horizontal plane. There were no statistically significant differences between the predictions of groups with and without genioplasty.Conclusion: Computer-generated image prediction was suitable for patient education and communication. However, efforts are still needed to improve accuracy and reliability of the prediction program and to include changes in soft tissue tension and muscle strain.

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

    Directory of Open Access Journals (Sweden)

    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

  5. Use of Artelon® Cosmetic in soft tissue augmentation in dentistry

    Directory of Open Access Journals (Sweden)

    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

  6. Additive Biomanufacturing : An Advanced Approach for Periodontal Tissue Regeneration

    NARCIS (Netherlands)

    Carter, Sarah-Sophia D; Vaquette, Cedryck; Ivanovski, Saso; Hutmacher, Dietmar W; Malda, Jos


    Periodontitis is defined as a chronic inflammatory condition, characterized by destruction of the periodontium, composed of hard (i.e. alveolar bone and cementum) and soft tissues (i.e. gingiva and periodontal ligament) surrounding and supporting the teeth. In severe cases, reduced periodontal suppo

  7. Soft tissue thickness of face profile conditioning by dento-skeletal anomalies

    Directory of Open Access Journals (Sweden)

    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.

  8. Experience With Esthetic Reconstruction of Complex Facial Soft Tissue Trauma; Application of the Pulsed Dye Laser

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    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.

  9. Articular soft tissue anatomy of the archosaur hip joint: Structural homology and functional implications. (United States)

    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

  10. Development of a Kinematic 3D Carpal Model to Analyze In Vivo Soft-Tissue Interaction Across Multiple Static Postures (United States)

    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

  11. 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...

  12. Effect of head position on cephalometric evaluation of the soft-tissue facial profile

    NARCIS (Netherlands)

    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

  13. Enhancing the soft tissue seal around intraosseous transcutaneous amputation prostheses using silanized fibronectin titanium alloy

    Energy Technology Data Exchange (ETDEWEB)

    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.

  14. Radiotherapy for Management of Extremity Soft Tissue Sarcomas: Why, When, and Where?

    Energy Technology Data Exchange (ETDEWEB)

    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.

  15. Maxillofacial trauma with emphasis on soft-tissue injuries in Malaysia. (United States)

    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.

  16. EWSR1-ATF1 chimeric transcript in a myoepithelial tumor of soft tissue : a case report

    NARCIS (Netherlands)

    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

  17. Myoepithelial neoplasms of soft tissue: an updated review of the clinicopathologic, immunophenotypic, and genetic features. (United States)

    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.

  18. EWSR1-ATF1 chimeric transcript in a myoepithelial tumor of soft tissue: a case report.

    NARCIS (Netherlands)

    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

  19. Routine bone scintigraphy in primary staging of soft tissue sarcoma - Is it worthwhile?

    NARCIS (Netherlands)

    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

  20. NIH researchers use gene therapy to treat a soft tissue tumor (United States)

    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.

  1. Radioisotopic methods for the study of bone sarcoma and soft tissue neoplasms

    Energy Technology Data Exchange (ETDEWEB)

    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.

  2. [Production of interleukin-2 by peripheral blood lymphocytes from patients with soft tissue sarcomas]. (United States)

    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.

  3. Strain Elastography for Prediction of Malignancy in Soft Tissue Tumours--Preliminary Results

    DEFF Research Database (Denmark)

    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...

  4. Vibration transmission to lower extremity soft tissues during whole-body vibration. (United States)

    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.

  5. Accuracy of three-dimensional soft tissue simulation in bimaxillary osteotomies

    NARCIS (Netherlands)

    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

  6. Recurrent, multiple, calcified soft tissue metastases from osteogenic sarcoma without pulmonary involvement

    NARCIS (Netherlands)

    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

  7. Soft tissue response to zirconia and titanium implant abutments : an in vivo within-subject comparison

    NARCIS (Netherlands)

    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.

    NARCIS (Netherlands)

    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. A Review of the Literature Refuting the Concept of Minor Impact Soft Tissue Injury

    Directory of Open Access Journals (Sweden)

    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.

  10. The treatment of acute soft tissue trauma in Danish emergency rooms

    DEFF Research Database (Denmark)

    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 ...

  11. Evaluation of the linearity of soft- to hard-tissue movement after orthognathic surgery

    NARCIS (Netherlands)

    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

  12. Different effects of bleeding and soft-tissue trauma on pulmonary platelet trapping in pigs

    Energy Technology Data Exchange (ETDEWEB)

    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. Esthetic prevention with soft tissue and biomaterial grafts

    Directory of Open Access Journals (Sweden)

    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.

  14. Accurate optical flow field estimation using mechanical properties of soft tissues (United States)

    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.

  15. Carpal Tunnel Cross-Sectional Area Affected by Soft Tissues Abutting the Carpal Bones. (United States)

    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

  16. Implant hygiene and soft tissue management: Dentist′s perspective

    Directory of Open Access Journals (Sweden)

    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.

  17. Latest advances in soft X-ray spectromicroscopy at SSRF

    Institute of Scientific and Technical Information of China (English)

    张立娟; 李俊琴; 陈振华; 王勇; 邰仁忠; 许子健; 张祥志; 于怀娜; 邹鹰; 郭智; 甄香君; 曹杰峰; 孟祥雨


    The BL08U1A beamline is established as a sophisticated platform at Shanghai Synchrotron Radiation Facility (SSRF), taking advantage of its high spatial resolution (10 000), for studying properties of solid, liquid, gas, film and other forms of materials at sub-micron scale. In this paper, we present a review on newly implemented techniques, such as total electron yield (TEY), dual energy contrast imaging, nano-CT, soft X-ray excited optical luminance (SXEOL), and coherent diffraction imaging (CDI) under development. Several research cases in nanomaterials, environmental science and biology are presented to demonstrate capabilities of the beamline.

  18. [Value of core needle biopsy in preoperative diagnostics of soft tissue tumors: possibilities and limitations]. (United States)

    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

  19. Ultrasound and clinical evaluation of soft-tissue versus hardware biceps tenodesis: is hardware tenodesis worth the cost? (United States)

    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.

  20. Anti-adhesion effects of liquid-infused textured surfaces on high-temperature stainless steel for soft tissue (United States)

    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.

  1. On ultrasound waves guided by bones with coupled soft tissues: a mechanism study and in vitro calibration. (United States)

    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.

  2. Fabrication of low cost soft tissue prostheses with the desktop 3D printer. (United States)

    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.

  3. Fabrication of low cost soft tissue prostheses with the desktop 3D printer (United States)

    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.

  4. Serious soft tissue infections of the head and neck

    Energy Technology Data Exchange (ETDEWEB)

    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.

  5. Comparative evaluation among different materials to replace soft tissue in oral radiology studies

    Directory of Open Access Journals (Sweden)

    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.

  6. In-vivo measurement of the human soft tissues constitutive laws. Applications to Computer Aided Surgery

    CERN Document Server

    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....

  7. Forced orthodontic eruption for augmentation of soft and hard tissue prior to implant placement

    Directory of Open Access Journals (Sweden)

    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.

  8. Using uniaxial pseudorandom stress stimuli to develop soft tissue constitutive equations. (United States)

    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.

  9. Simple Empirical Model for Identifying Rheological Properties of Soft Biological Tissues

    CERN Document Server

    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...

  10. Palpation force modulation strategies to identify hard regions in soft tissue organs (United States)

    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

  11. The effect of mechanical strains in soft tissues of the shoulder during load carriage. (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  13. Advanced Materials for Use in Soft Self-Healing Devices. (United States)

    Huynh, Tan-Phat; Sonar, Prashant; Haick, Hossam


    Devices integrated with self-healing ability can benefit from long-term use as well as enhanced reliability, maintenance and durability. This progress report reviews the developments in the field of self-healing polymers/composites and wearable devices thereof. One part of the progress report presents and discusses several aspects of the self-healing materials chemistry (from non-covalent to reversible covalent-based mechanisms), as well as the required main approaches used for functionalizing the composites to enhance their electrical conductivity, magnetic, dielectric, electroactive and/or photoactive properties. The second and complementary part of the progress report links the self-healing materials with partially or fully self-healing device technologies, including wearable sensors, supercapacitors, solar cells and fabrics. Some of the strong and weak points in the development of each self-healing device are clearly highlighted and criticized, respectively. Several ideas regarding further improvement of soft self-healing devices are proposed.

  14. Composite Tissue Transplantation: A Rapidly Advancing Field


    Ravindra, K.V.; Wu, S.; Bozulic, L.; Xu, H.; Breidenbach, W.C.; Ildstad, S.T.


    Composite tissue allotransplantation (CTA) is emerging as a potential treatment for complex tissue defects. It is currently being performed with increasing frequency in the clinic. The feasibility of the procedure has been confirmed through 30 hand transplantation, 3 facial reconstructions, and vascularized knee, esophageal, and tracheal allografts. A major drawback for CTA is the requirement for lifelong immunosuppression. The toxicity of these agents has limited the widespread application o...

  15. Achieving high-resolution soft-tissue imaging with cone-beam CT: a two-pronged approach for modulation of x-ray fluence and detector gain (United States)

    Graham, S. A.; Siewerdsen, J. H.; Moseley, D. J.; Keller, H.; Shkumat, N. A.; Jaffray, D. A.


    Cone-beam computed tomography (CBCT) presents a highly promising and challenging advanced application of flat-panel detectors (FPDs). The great advantage of this adaptable technology is in the potential for sub-mm 3D spatial resolution in combination with soft-tissue detectability. While the former is achieved naturally by CBCT systems incorporating modern FPD designs (e.g., 200 - 400 um pixel pitch), the latter presents a significant challenge due to limitations in FPD dynamic range, large field of view, and elevated levels of x-ray scatter in typical CBCT configurations. We are investigating a two-pronged strategy to maximizing soft-tissue detectability in CBCT: 1) front-end solutions, including novel beam modulation designs (viz., spatially varying compensators) that alleviate detector dynamic range requirements, reduce x-ray scatter, and better distribute imaging dose in a manner suited to soft-tissue visualization throughout the field of view; and 2) back-end solutions, including implementation of an advanced FPD design (Varian PaxScan 4030CB) that features dual-gain and dynamic gain switching that effectively extends detector dynamic range to 18 bits. These strategies are explored quantitatively on CBCT imaging platforms developed in our laboratory, including a dedicated CBCT bench and a mobile isocentric C-arm (Siemens PowerMobil). Pre-clinical evaluation of improved soft-tissue visibility was carried out in phantom and patient imaging with the C-arm device. Incorporation of these strategies begin to reveal the full potential of CBCT for soft-tissue visualization, an essential step in realizing broad utility of this adaptable technology for diagnostic and image-guided procedures.

  16. Prevalence, extension and characteristics of fluid-fluid levels in bone and soft tissue tumors

    Energy Technology Data Exchange (ETDEWEB)

    Dyck, P. van; Venstermans, C.; Gielen, J.; Parizel, P.M. [University Hospital Antwerp, Department of Radiology, Edegem (Belgium); Vanhoenacker, F.M. [University Hospital Antwerp, Department of Radiology, Edegem (Belgium); AZ St-Maarten, Department of Radiology, Duffel/Mechelen (Belgium); Vogel, J. [Leiden University Medical Centre, Department of Orthopedics, Leiden (Netherlands); Kroon, H.M.; Bloem, J.L. [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Schepper, A.M.A. de [University Hospital Antwerp, Department of Radiology, Edegem (Belgium); Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands)


    The purpose of this study was to determine the prevalence, extension and signal characteristics of fluid-fluid levels in a large series of 700 bone and 700 soft tissue tumors. Out of a multi-institutional database, MRI of 700 consecutive patients with a bone tumor and MRI of 700 consecutive patients with a soft tissue neoplasm were retrospectively reviewed for the presence of fluid-fluid levels. Extension (single, multiple and proportion of the lesion occupied by fluid-fluid levels) and signal characteristics on magnetic resonance imaging of fluid-fluid levels were determined. In all patients, pathologic correlation was available. Of 700 patients with a bone tumor, 19 (10 male and 9 female; mean age, 29 years) presented with a fluid-fluid level (prevalence 2.7%). Multiple fluid-fluid levels occupying at least one half of the total volume of the lesion were found in the majority of patients. Diagnoses included aneurysmal bone cyst (ten cases), fibrous dysplasia (two cases), osteoblastoma (one case), simple bone cyst (one case), telangiectatic osteosarcoma (one case), ''brown tumor'' (one case), chondroblastoma (one case) and giant cell tumor (two cases). Of 700 patients with a soft tissue tumor, 20 (9 males and 11 females; mean age, 34 years) presented with a fluid-fluid level (prevalence 2.9%). Multiple fluid-fluid levels occupying at least one half of the total volume of the lesion were found in the majority of patients. Diagnoses included cavernous hemangioma (12 cases), synovial sarcoma (3 cases), angiosarcoma (1 case), aneurysmal bone cyst of soft tissue (1 case), myxofibrosarcoma (1 case) and high-grade sarcoma ''not otherwise specified'' (2 cases). In our series, the largest reported in the literature to the best of our knowledge, the presence of fluid-fluid levels is a rare finding with a prevalence of 2.7 and 2.9% in bone and soft tissue tumors, respectively. Fluid-fluid levels remain a non-specific finding and can

  17. Surgical Removal of Neglected Soft Tissue Foreign Bodies by Needle-Guided Technique

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    Ali Ebrahimi


    Full Text Available Introduction: The phenomenon of neglected foreign bodies is a significant cause of morbidity in soft tissue injuries and may present to dermatologists as delayed wound healing, localized cellulitis and inflammation, abscess formation, or foreign body sensation. Localization and removal of neglected soft tissue foreign bodies (STFBs is complex due to possible inflammation, indurations, granulated tissue, and fibrotic scar. This paper describes a simple method for the quick localization and (surgical removal of neglected STFBs using two 23-gauge needles without ultrasonographic or fluoroscopic guidance.  Materials and Methods: A technique based on the use of two 23-gauge needles was used in 41 neglected STFBs in order to achieve proper localization and fixation of foreign bodies during surgery.  Results:    Surgical removal was successful in 38 of 41 neglected STFBs (ranging from 2–13mm in diameter.  Conclusion: The cross-needle-guided technique is an office-based procedure that allows the successful surgical removal of STFBs using minimal soft tissue exploration and dissection via proper localization, fixation, and propulsion of the foreign body toward the surface of the skin.

  18. A Bayesian approach for characterization of soft tissue viscoelasticity in acoustic radiation force imaging. (United States)

    Zhao, Xiaodong; Pelegri, Assimina A


    Biomechanical imaging techniques based on acoustic radiation force (ARF) have been developed to characterize the viscoelasticity of soft tissue by measuring the motion excited by ARF non-invasively. The unknown stress distribution in the region of excitation limits an accurate inverse characterization of soft tissue viscoelasticity, and single degree-of-freedom simplified models have been applied to solve the inverse problem approximately. In this study, the ARF-induced creep imaging is employed to estimate the time constant of a Voigt viscoelastic tissue model, and an inverse finite element (FE) characterization procedure based on a Bayesian formulation is presented. The Bayesian approach aims to estimate a reasonable quantification of the probability distributions of soft tissue mechanical properties in the presence of measurement noise and model parameter uncertainty. Gaussian process metamodeling is applied to provide a fast statistical approximation based on a small number of computationally expensive FE model runs. Numerical simulation results demonstrate that the Bayesian approach provides an efficient and practical estimation of the probability distributions of time constant in the ARF-induced creep imaging. In a comparison study with the single degree of freedom models, the Bayesian approach with FE models improves the estimation results even in the presence of large uncertainty levels of the model parameters.

  19. Factors influencing the predictability of soft tissue profile changes following mandibular setback surgery. (United States)

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


    The objective of this cephalometric study was to assess long-term changes in the soft tissue profile following mandibular setback surgery and investigate the presence of factors that may influence the soft tissue response to skeletal repositioning. The subjects enrolled were 80 consecutive mandibular prognathism patients operated with bilateral sagittal split osteotomy and rigid fixation. Lateral cephalograms were taken at 6 occasions: immediate presurgical, immediate postsurgical, 2 and 6 months postsurgical, and 1 and 3 years postsurgical. The subjects were grouped according to gender and magnitude of setback. Ratios of soft tissue to hard tissue movements were calculated for the subgroups. Females generally demonstrated greater ratios than males with a statistically significant difference for the upper lip and chin (P < .05). Postsurgical alterations in the profiles were more predictable in patients with larger setbacks compared to patients with smaller ones. Skeletal relapse had a profound influence on long-term profile changes. Based on these findings, it is proposed that the database used in prediction software be adjusted to account for such factors in an attempt to improve the accuracy of computerized treatment simulations.

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

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    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. (United States)

    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. Engineered skeletal muscle tissue for soft robotics: fabrication strategies, current applications, and future challenges. (United States)

    Duffy, Rebecca M; Feinberg, Adam W


    Skeletal muscle is a scalable actuator system used throughout nature from the millimeter to meter length scales and over a wide range of frequencies and force regimes. This adaptability has spurred interest in using engineered skeletal muscle to power soft robotics devices and in biotechnology and medical applications. However, the challenges to doing this are similar to those facing the tissue engineering and regenerative medicine fields; specifically, how do we translate our understanding of myogenesis in vivo to the engineering of muscle constructs in vitro to achieve functional integration with devices. To do this researchers are developing a number of ways to engineer the cellular microenvironment to guide skeletal muscle tissue formation. This includes understanding the role of substrate stiffness and the mechanical environment, engineering the spatial organization of biochemical and physical cues to guide muscle alignment, and developing bioreactors for mechanical and electrical conditioning. Examples of engineered skeletal muscle that can potentially be used in soft robotics include 2D cantilever-based skeletal muscle actuators and 3D skeletal muscle tissues engineered using scaffolds or directed self-organization. Integration into devices has led to basic muscle-powered devices such as grippers and pumps as well as more sophisticated muscle-powered soft robots that walk and swim. Looking forward, current, and future challenges include identifying the best source of muscle precursor cells to expand and differentiate into myotubes, replacing cardiomyocytes with skeletal muscle tissue as the bio-actuator of choice for soft robots, and vascularization and innervation to enable control and nourishment of larger muscle tissue constructs.

  3. 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 ...

  4. Viable Group A Streptococci in Macrophages during Acute Soft Tissue Infection.

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    Full Text Available BACKGROUND: Group A streptococcal severe soft tissue infections, such as necrotizing fasciitis, are rapidly progressive infections associated with high mortality. Group A streptococcus is typically considered an extracellular pathogen, but has been shown to reside intracellularly in host cells. METHODS AND FINDINGS: We characterized in vivo interactions between group A streptococci (GAS and cells involved in innate immune responses, using human biopsies (n = 70 collected from 17 patients with soft tissue infections. Immunostaining and in situ image analysis revealed high amounts of bacteria in the biopsies, even in those collected after prolonged antibiotic therapy. Viability of the streptococci was assessed by use of a bacterial viability stain, which demonstrated viable bacteria in 74% of the biopsies. GAS were present both extracellularly and intracellularly within phagocytic cells, primarily within macrophages. Intracellular GAS were predominantly noted in biopsies from newly involved tissue characterized by lower inflammation and bacterial load, whereas purely extracellular GAS or a combination of intra- and extracellular GAS dominated in severely inflamed tissue. The latter tissue was also associated with a significantly increased amount of the cysteine protease streptococcal pyrogenic exotoxin SpeB. In vitro studies confirmed that macrophages serve as reservoirs for viable GAS, and infection with a speB-deletion mutant produced significantly lower frequencies of cells with viable GAS following infection as compared to the wild-type bacteria. CONCLUSIONS: This is the first study to demonstrate that GAS survive intracellularly in macrophages during acute invasive infections. This intracellular presence may have evolved as a mechanism to avoid antibiotic eradication, which may explain our finding that high bacterial load is present even in tissue collected after prolonged intravenous antibiotic therapy. This new insight into the pathogenesis

  5. Viable group A streptococci in macrophages during acute soft tissue infection.

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    Pontus Thulin


    Full Text Available BACKGROUND: Group A streptococcal severe soft tissue infections, such as necrotizing fasciitis, are rapidly progressive infections associated with high mortality. Group A streptococcus is typically considered an extracellular pathogen, but has been shown to reside intracellularly in host cells. METHODS AND FINDINGS: We characterized in vivo interactions between group A streptococci (GAS and cells involved in innate immune responses, using human biopsies (n = 70 collected from 17 patients with soft tissue infections. Immunostaining and in situ image analysis revealed high amounts of bacteria in the biopsies, even in those collected after prolonged antibiotic therapy. Viability of the streptococci was assessed by use of a bacterial viability stain, which demonstrated viable bacteria in 74% of the biopsies. GAS were present both extracellularly and intracellularly within phagocytic cells, primarily within macrophages. Intracellular GAS were predominantly noted in biopsies from newly involved tissue characterized by lower inflammation and bacterial load, whereas purely extracellular GAS or a combination of intra- and extracellular GAS dominated in severely inflamed tissue. The latter tissue was also associated with a significantly increased amount of the cysteine protease streptococcal pyrogenic exotoxin SpeB. In vitro studies confirmed that macrophages serve as reservoirs for viable GAS, and infection with a speB-deletion mutant produced significantly lower frequencies of cells with viable GAS following infection as compared to the wild-type bacteria. CONCLUSIONS: This is the first study to demonstrate that GAS survive intracellularly in macrophages during acute invasive infections. This intracellular presence may have evolved as a mechanism to avoid antibiotic eradication, which may explain our finding that high bacterial load is present even in tissue collected after prolonged intravenous antibiotic therapy. This new insight into the pathogenesis

  6. Simulation of planar soft tissues using a structural constitutive model: Finite element implementation and validation. (United States)

    Fan, Rong; Sacks, Michael S


    Computational implementation of physical and physiologically realistic constitutive models is critical for numerical simulation of soft biological tissues in a variety of biomedical applications. It is well established that the highly nonlinear and anisotropic mechanical behaviors of soft tissues are an emergent behavior of the underlying tissue microstructure. In the present study, we have implemented a structural constitutive model into a finite element framework specialized for membrane tissues. We noted that starting with a single element subjected to uniaxial tension, the non-fibrous tissue matrix must be present to prevent unrealistic tissue deformations. Flexural simulations were used to set the non-fibrous matrix modulus because fibers have little effects on tissue deformation under three-point bending. Multiple deformation modes were simulated, including strip biaxial, planar biaxial with two attachment methods, and membrane inflation. Detailed comparisons with experimental data were undertaken to insure faithful simulations of both the macro-level stress-strain insights into adaptations of the fiber architecture under stress, such as fiber reorientation and fiber recruitment. Results indicated a high degree of fidelity and demonstrated interesting microstructural adaptions to stress and the important role of the underlying tissue matrix. Moreover, we apparently resolve a discrepancy in our 1997 study (Billiar and Sacks, 1997. J. Biomech. 30 (7), 753-756) where we observed that under strip biaxial stretch the simulated fiber splay responses were not in good agreement with the experimental results, suggesting non-affine deformations may have occurred. However, by correctly accounting for the isotropic phase of the measured fiber splay, good agreement was obtained. While not the final word, these simulations suggest that affine fiber kinematics for planar collagenous tissues is a reasonable assumption at the macro level. Simulation tools such as these are

  7. Classification and Tie2 mutations in spinal and soft tissue vascular anomalies. (United States)

    Zhou, Mei; Jiang, Renbing; Zhao, Gang; Wang, Lisha; Wang, Hua; Li, Wenting; Li, Yiqun; Du, Xiang; Bai, Jingping


    Vascular anomalies included hemangiomas and vascular malformations (VMs). VMs are mediated by mutations in the endothelial cell-specific receptor tyrosine kinase Tie2 (TEK),which is essential for angiogenesis and vascular stabilization. We identified five types of Tie2 mutations in 80 patients with soft tissue or spinal VMs by PCR including the previously detected missense mutations 2690A>G (Y897C), 2740C>T (L914F), 2743C>T (R915C), and two nonsense mutations 2763G>A, 2688C>T, we identified Tie2 mutation in primary spinal VMs for the first time. Tie2 mutations were found to be absent in 33 patients with hemangiomas and DNA samples of VMs. In addition, we showed that Tie2 mRNA expression in spinal VMs was similar to soft tissue VMs, but obviously lower than infant hemangiomas (PVMs, the association of Tie2 and vascular anomalies needs to be further discussed.

  8. [Primitive neuroectodermal tumour of soft tissue of the index finger in an adult. A case report]. (United States)

    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.

  9. Nondestructive X-ray imaging of inner structure of soft tissues in phase contrast

    Institute of Scientific and Technical Information of China (English)

    XIAO Ti-Qiao; ZHANG Gui-Lin; XU Hong-Jie; TIAN Yu-Lian; HUANG Wan-Xia; ZHU Pei-Ping


    An experimental study on nondestructive X-ray imaging of inner structure of soft tissues in phase con-trast has been conducted with Beijing Synchrotron Radiation Facility (BSRF). Modification to the beamline setupwas made to enlarge the X-ray beam section and consequently larger samples could be imaged. In-line setup was em-ployed for experiments. Results on a series of samples were given and soft-tissue details of less than 50 μm inside afresh goldfish were obtained. Diagnosis of tumor in its early stage was also investigated taking SD rats as the model.Tumor at the size of ~ 100μm was observed. Potential of this technique in clinic diagnosis was discussed.

  10. Unilateral hypertrophy of tensor fascia lata: a soft tissue tumor simulator

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    Ilaslan, H. [Department of Radiology, Mayo Clinic, 200 First Street, 55905, SW Rochester, MN (United States); Department of Radiology A21, Cleveland Clinic, Cleveland, OH (United States); Wenger, D.E. [Department of Radiology, Mayo Clinic, 200 First Street, 55905, SW Rochester, MN (United States); Shives, T.C. [Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN (United States); Unni, K.K. [Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (United States)


    To describe the imaging findings in eight cases of unilateral tensor fascia lata (TFL) hypertrophy presenting as soft tissue masses. Imaging studies and medical charts of eight patients were reviewed retrospectively. The imaging studies included five radiographs, five computed tomography (CT) and six magnetic resonance imaging (MRI) examinations. The majority of patients (seven of eight) presented with a palpable proximal anterior thigh mass. One patient was asymptomatic and incidentally diagnosed. There were six females and two males. Ages ranged from 27 to 86 years old (mean 61). MRI and CT showed unilateral enlargement of the TFL muscle in all cases. TFL muscle hypertrophy is an uncommon clinical entity, which can simulate a soft tissue tumor. The characteristic appearance on CT or MRI allows a confident diagnosis of muscle hypertrophy to be made, avoiding unnecessary biopsy or surgical intervention. (orig.)


    Directory of Open Access Journals (Sweden)

    Amitabh Das


    Full Text Available Fat embolism syndrome (FES, without evidence of bone or soft tissue injury is uncommon, and in absence of validated diagnostic criteria, its diagnosis is mainly dependent on treating clinician, who should have high index of suspicion. Treatment is predominantly supportive, and apart from some mortality, recovery is generally seen. Present article is a case report of a boy who suffered blunt injury due to fall from height, had no objective evidence of bone or soft tissue injury, but diagnosed as a case of fat embolism syndrome, using Gurd-Wilson and Schonfeld’s criteria, treated by pulmonary support and aggressive resuscitation, but he died after 4 days of admission to hospital.

  12. Facial soft tissue depths in French adults: variability, specificity and estimation. (United States)

    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.

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

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    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. Soft tissue decomposition of submerged, dismembered pig limbs enclosed in plastic bags. (United States)

    Pakosh, Caitlin M; Rogers, Tracy L


    This study examines underwater soft tissue decomposition of dismembered pig limbs deposited in polyethylene plastic bags. The research evaluates the level of influence that disposal method has on underwater decomposition processes and details observations specific to this scenario. To our knowledge, no other study has yet investigated decomposing, dismembered, and enclosed remains in water environments. The total sample size consisted of 120 dismembered pig limbs, divided into a subsample of 30 pig limbs per recovery period (34 and 71 days) for each treatment. The two treatments simulated non-enclosed and plastic enclosed disposal methods in a water context. The remains were completely submerged in Lake Ontario for 34 and 71 days. In both recovery periods, the non-enclosed samples lost soft tissue to a significantly greater extent than their plastic enclosed counterparts. Disposal of remains in plastic bags therefore results in preservation, most likely caused by bacterial inhibition and reduced oxygen levels.

  15. Cytological diagnosis of Castleman′s disease of the soft tissue

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    Manmeet Kaur Gill


    Full Text Available Castleman′s disease (CD, a rare benign disease is characterized by lymphoid hyperplasia of uncertain etiology that may present as a nodal or extranodal mass. We describe herein a rare case of CD occurring in the soft-tissue of right arm in a 55-year-old woman. The present case is instructive in the differential diagnosis of primary soft-tissue tumors, for which the possibility of CD should be considered. On clinical examination as well as gross examination, this disease mimics lymphomas and tuberculosis. Since cytological appearances vary depending on the type and extent of hyperplasia, fine needle aspiration cytology findings may not always be conclusive in all cases. We studied aspirates which revealed reactive hyperplasia with increased vascularity. Excision confirmed the diagnosis.

  16. Ultrasound-based transient elastography compared to magnetic resonance elastography in soft tissue-mimicking gels

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    Oudry, Jennifer; Vappou, Jonathan; Willinger, Remy [Institut de mecanique des fluides et des solides, CNRS-Universite Louis Pasteur, UMR 7507, Strasbourg (France); Choquet, Philippe; Constantinesco, Andre [Service de Biophysique et Medecine Nucleaire, CHU Hautepierre, UMR 7507, Strasbourg (France); Sandrin, Laurent [Echosens, Research and Development Department, Paris (France)], E-mail:, E-mail:, E-mail:, E-mail:, E-mail:, E-mail:


    Ultrasound-based transient elastography (TE) and magnetic resonance elastography (MRE) are increasingly used methods for the clinical evaluation of soft tissue mechanical properties and their alteration under diseased conditions. This study proposes a comparison between magnetic resonance elastography (MRE) and ultrasound-based transient elastography (TE). Both methods were tested on the same soft tissue-mimicking gels in a common frequency range in order to allow for direct quantitative comparison. For the four gels tested, relatively good agreement was found between the shear moduli measured by both methods, with an averaged relative difference of 23%. This study demonstrates that under the assumption of homogeneous media that are significantly more elastic than viscous, quantitative results obtained by both methods are comparable.

  17. What is the value of ultrasound soft tissue measurements in the prediction of abnormal fetal growth?

    LENUS (Irish Health Repository)

    Farah, N


    Abnormal fetal growth increases the complications of pregnancy not only for the baby but also for the mother. Growth abnormalities also have lifelong consequences. These babies are at increased risk of insulin resistance, diabetes and hypertension later in life. It is important to identify these babies antenatally to optimise their clinical care. Although used extensively antenatally to monitor fetal growth, ultrasound has its limitations. Despite the use of more than 50 different formulae to estimate fetal weight, their performance has been poor at the extremes of fetal weight. Over the past 20 years there has been emerging interest in studying fetal soft tissue measurements to improve detection of growth abnormalities. This review paper outlines the value of soft tissue measurements in identifying fetal growth abnormalities, in estimating fetal weight and in managing diabetes mellitus in pregnancy.

  18. Severe monobacterial necrotizing soft tissue infection by group A Streptococcus:A surgical emergency

    Institute of Scientific and Technical Information of China (English)

    Lanitis S; Khan MAA; Sgourakis G; Kontovounisios C; Papaconstandinou T; Karaliotas C


    Eight percent of necrotizing soft tissue infections (NSTI) are attributable to group A Streptococci (GAS), and among these, 50% develop streptococcal toxic shock syndrome. The reported mortality associated with NSTI reaches 32%. We present cases of two healthy individuals with minor GAS skin infection which developed to a rapidly progressed NSTI and sepsis despite of the antibiotic treatment, aiming to discuss the lessons learned from the course and management of these patients.

  19. Damage of Facial Soft Tissues as a Result of Being Bitten by a Dog

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    Zielińska-Kaźmierska Bogna


    Full Text Available Being bitten by a dog can have serious health effects. That is why, never underestimate even the smallest soft tissue injuries inflicted by aggressive animals. This incident may have an impact on the further condition of a patient. From our first aid will also depend the aesthetic and functional effect of the scar on the face. We should pay attention to the use of antibiotic prophylaxis.

  20. Mean values of Arnett's soft tissue analysis in Maratha ethnic (Indian) population — A cephalometric study (United States)

    Singh, Shikha; Deshmukh, Sonali; Merani, Varsha; Rejintal, Neeta


    Aim: The aim of this article is to evaluate the mean cephalometric values for Arnett's soft tissue analysis in the Maratha ethnic (Indian) population. Materials and Methods: Lateral cephalograms of 60 patients (30 males and 30 females) aged 18–26 years were obtained with the patients in the Natural Head Position (NHP), with teeth in maximum intercuspation and lips in the rest position. Moreover, hand tracings were also done. The statistical analysis was performed with the help of a statistical software, the Statistical Package for the Social Sciences version 16, and Microsoft word and Excel (Microsoft office 2007) were used to generate the analytical data. Results: Statistical significance was tested atP level (1% and 5% level of significance). Statistical analysis using student's unpaired t-test were performed. Various cephalometric values for the Maratha ethnic (Indian) population differed from Caucasian cephalometric values such as nasolabial inclination, incisor proclination, and exposure, which may affect the outcome of the orthodontic and orthognathic treatment. Conclusion: Marathas have more proclined maxillary incisors, less prominent chin, less facial length, acute nasolabial angle, and all soft tissue thickness are greater in Marathas except lower lip thickness (in Maratha males and females) and upper lip angle (in Maratha males) than those of the Caucasian population. It is a fact that all different ethnic races have different facial characters. The variability of the soft tissue integument in people with different ethnic origin makes it necessary to study the soft tissue standards of a particular community and consider those norms when planning an orthodontic and orthognathic treatment for particular racial and ethnic patients. PMID:27583221


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    Vinod Babu. K


    Full Text Available Background: Instrumental assisted soft tissue mobilization and static stretching found to be effective in plantar fasciitis, however the combined effectiveness of these techniques were unknown. The purpose of this study is to find the effect of Instrumental assisted soft tissue mobilization technique for plantar fascia combined with static stretching of triceps surae for subjects with chronic stage of Plantar Fasciitis on pain intensity, ankle dorsiflexion range of motion and functional disability. Methods: An experimental study design, selected subjects with chronic Plantar Fasciitis randomized subjects into each Study and Control group. Total of 40 subject’s data who completed study, 20 in each group, was used for analysis. Control group received conventional exercise while Study group received conventional exercises with Instrumental assisted soft tissue mobilization combined with static stretching of triceps surae muscle. Outcome measurements such as Intensity of pain using Numerical Pain Rating Scale-101 (NPRS-101, function disability using Foot Function Index Pain Subscale (FFI and ankle dorsiflexion active range of motion using Goniometer was measured before and after 2 weeks of intervention. Results: There is statistically significant improvement in means of NRS-101, ankle dorsiflexion active range of motion and Foot Function Index Pain Subscale after intervention in both groups. When the post-intervention means were compared between Study and Control group after 2 weeks of treatment there is statistically significant difference in means between the groups whereas study group showed greater percentage of improvement than control group. Conclusion: It is concluded that Instrumental assisted soft tissue mobilization technique combined with static stretching of triceps surae muscle is significantly effective than conventional exercises on reducing pain, improving ankle dorsiflexion range of motion and functional disability for subjects

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

    Institute of Scientific and Technical Information of China (English)

    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...

  3. Preliminary experience using dynamic MRI at 3.0 tesla for evaluation of soft tissue tumors

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    Park, Micheal; Jee, Won Hee; Jung, Joon Yong [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Kim, Sun Ki [Dept. of Radiology, Incheon St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Incheon (Korea, Republic of); Lee, So Yeon [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)


    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. Dynamic contrast-enhanced magnetic resonance imaging, at 3.0 T with a 1 second temporal resolution in 13 patients with pathologically confirmed soft tissue tumors, was analyzed. Visual assessment of time-signal curves, subtraction images, maximal relative enhancement at the first (maximal peak enhancement [Emax]/1) and second (Emax/2) minutes, Emax, steepest slope calculated by using various time intervals (5, 30, 60 seconds), and the start of dynamic enhancement were analyzed. The 13 tumors were comprised of seven benign and six malignant soft tissue neoplasms. Washout on time-signal curves was seen on three (50%) malignant tumors and one (14%) benign one. The most discriminating DCE-MRI parameter was the steepest slope calculated, by using at 5-second intervals, followed by Emax/1 and Emax/2. All of the steepest slope values occurred within 2 minutes of the dynamic study. Start of dynamic enhancement did not show a significant difference, but no malignant tumor rendered a value greater than 14 seconds. The steepest slope and early relative enhancement have the potential for differentiating benign from malignant soft tissue tumors. Short-length rather than long-length DCE-MRI protocol may be adequate for our purpose. The steepest slope parameters require a short temporal resolution, while maximal peak enhancement parameter may be more optimal for a longer temporal resolution.

  4. Soft tissue conduction as a possible contributor to the limited attenuation provided by hearing protection devices

    Directory of Open Access Journals (Sweden)

    Shai Chordekar


    Full Text Available Context: Damage to the auditory system by loud sounds can be avoided by hearing protection devices (HPDs such as earmuffs, earplugs, or both for maximum attenuation. However, the attenuation can be limited by air conduction (AC leakage around the earplugs and earmuffs by the occlusion effect (OE and by skull vibrations initiating bone conduction (BC. Aims: To assess maximum attenuation by HPDs and possible flanking pathways to the inner ear. Subjects and Methods: AC attenuation and resulting thresholds were assessed using the real ear attenuation at threshold (REAT procedure on 15 normal-hearing participants in four free-field conditions: (a unprotected ears, (b ears covered with earmuffs, (c ears blocked with deeply inserted customized earplugs, and (d ears blocked with both earplugs and earmuffs. BC thresholds were assessed with and without earplugs to assess the OE. Results: Addition of earmuffs to earplugs did not cause significantly greater attenuation than earplugs alone, confirming minimal AC leakage through the external meatus and the absence of the OE. Maximum REATs ranged between 40 and 46 dB, leading to thresholds of 46–54 dB HL. Furthermore, calculation of the acoustic impedance mismatch between air and bone predicted at least 60 dB attenuation of BC. Conclusion: Results do not support the notion that skull vibrations (BC contributed to the limited attenuation provided by traditional HPDs. An alternative explanation, supported by experimental evidence, suggests transmission of sound to inner ear via non-osseous pathways such as skin, soft tissues, and fluid. Because the acoustic impedance mismatch between air and soft tissues is smaller than that between air and bone, air-borne sounds would be transmitted to soft tissues more effectively than to bone, and therefore less attenuation is expected through soft tissue sound conduction. This can contribute to the limited attenuation provided by traditional HPDs. The present study

  5. CT evaluation of soft tissue and muscle infection and inflammation: A systematic compartmental approach

    Energy Technology Data Exchange (ETDEWEB)

    Beauchamp, N.J. Jr. [Dept. of Radiology, and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, MD (United States); Scott, W.W. Jr. [Dept. of Radiology, and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, MD (United States); Gottlieb, L.M. [Dept. of Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD (United States); Fishman, E.K. [Dept. of Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD (United States)


    This essay presents a systematic approach to the evaluation of soft tissue and muscle infection by defining the various pathologic processes and then illustrating them through a series of CT studies with corresponding schematic diagrams. The specific processes discussed are cellulitis, lymphangitis/lymphedema, necrotizing fascitis, myositis/myonecrosis, and abscess. Key points in the differential diagnosis of these entities are discussed and illustrated. The clinical management of the specific pathologic processes is also discussed. (orig./MG)

  6. Gene expression identifies heterogeneity of metastatic propensity in high-grade soft tissue sarcomas

    DEFF Research Database (Denmark)

    Skubitz, Keith M; Francis, Princy; Skubitz, Amy P N;


    Metastatic propensity of soft tissue sarcoma (STS) is heterogeneous and may be determined by gene expression patterns that do not correlate well with morphology. The authors have reported gene expression patterns that distinguish 2 broad classes of clear cell renal carcinoma (ccRCC-gene set......), and other patterns that can distinguish heterogeneity of serous ovarian carcinoma (OVCA-gene set) and aggressive fibromatosis (AF-gene set); however, clinical follow-up data were not available for these samples....

  7. Development of Photocrosslinkable Urethane-Doped Polyester Elastomers for Soft Tissue Engineering


    Zhang, Yi; Tran, Richard T.; Gyawali, Dipendra; Yang, Jian


    Finding an ideal biomaterial with the proper mechanical properties and biocompatibility has been of intense focus in the field of soft tissue engineering. This paper reports on the synthesis and characterization of a novel crosslinked urethane-doped polyester elastomer (CUPOMC), which was synthesized by reacting a previously developed photocrosslinkable poly (octamethylene maleate citrate) (POMC) prepolymers (pre-POMC) with 1,6-hexamethylene diisocyanate (HDI) followed by thermo- or photo-cro...

  8. Livers, guts and gills: mapping the decay profiles of soft tissues to understand authigenic mineral replacement. (United States)

    Clements, Thomas; Purnell, Mark; Gabbott, Sarah


    The hard mineralised parts of organisms such as shells, teeth and bones dominate the fossil record. There are, however, sites around the world where soft-tissues are preserved often through rapid replacement of original tissue by rapidly-precipitating authigenic minerals. These exceptionally well-preserved soft-bodied fossils are much more informative about the anatomy, physiology, ecology and behaviour of ancient organisms as well as providing a more inclusive picture of ecosystems and evolution throughout geological time. However, despite the wealth of information that soft-bodied fossils can provide they must first be correctly interpreted as the processes of both decay and preservation act to modify the carcass from its in vivo condition. Decay leads to alteration of the appearance and topology of anatomy, and ultimately to loss. Preservation is selective with some anatomical features being more likely to be captured than others. These problems are especially germane to the interpretation of deep-time and/or enigmatic fossils where no modern analogue exist for comparative anatomical analysis. It is therefore of vital importance to understand the processes carcasses undergo during the fossilisation process, , in order to interpret the anatomical remains of fossils and thus extract true evolutionary presence or absence of anatomy from absence due to taphonomic biases. We have designed a series of novel experiments to investigate, in real time, how decay processes affect the fossilisation potential of soft-tissues - especially of internal anatomy. Our data allow us to unravel both the timing and sequence of anatomical decay of different organs. At the same time through measuring Eh and pH in selected organs we can predict when anatomical features will fall in to the window of authigenic mineralization and thus potentially become preserved. We can also place constraints on which minerals will operate to capture tissues. Our findings are applied to the fossil record

  9. 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...

  10. Posttraumatic Skin and Soft-Tissue Infection due to Pseudomonas fulva

    Directory of Open Access Journals (Sweden)

    Fernando Cobo


    Full Text Available We report a case of posttraumatic skin and soft-tissue infection in a patient with a left thigh wound after a traffic accident. Pseudomonas fulva was isolated from a wound aspirate and was identified to the species level by Maldi-tof. The patient responded to drainage, debridement of wound, and two weeks of intravenous antibiotic therapy. Follow-up after 3 weeks was satisfactory with healthy cover of the injured area.

  11. Biopsies in the Community Lead to Postoperative Complications in Soft Tissue Sarcomas. (United States)

    Bedi, Meena; King, David M; Hackbarth, Donald A; Charlson, John A; Baynes, Keith; Neilson, John C


    Percutaneous biopsies allow for precise diagnosis in soft tissue sarcomas and have a low rate of complications. However, it is unknown whether biopsies performed in a community setting lead to higher rates of wound complications at the time of resection. The goal of this study was to determine whether percutaneous biopsies performed at a sarcoma center have lower rates of wound complications compared with those performed in the community setting. A total of 125 patients with soft tissue sarcomas were treated with neoadjuvant radiation followed by limb-sparing resection. Of these, 92 underwent percutaneous biopsy. Patient, demographic, and treatment variables and postoperative wound complications were reviewed. Predictors of wound complications were evaluated with Fisher's exact test for univariate analysis and with logistic regression for multivariate analysis. The wound complication rate was 27% for open or percutaneous biopsies. When only percutaneous biopsies were assessed, the wound complication rate was 25%. The wound complication rate for percutaneous biopsies was 18% when the biopsy was performed at the authors' sarcoma center and 46% when the biopsy was performed in the community setting (P=.01). The Common Terminology Criteria for Adverse Events grade 4 wound complication rate was 73% in patients who underwent percutaneous biopsy at a community hospital vs 14% in those who underwent percutaneous biopsy at the authors' sarcoma center (P=.005). Multivariate analysis showed that lower-extremity soft tissue sarcomas (P=.03) and biopsies performed in the community setting (P=.01) had an increased rate of postoperative wound complications. Percutaneous biopsies performed at community hospitals had an increased incidence of grade 4 postoperative wound toxicity compared with biopsies done at tertiary centers. These wound results confirmed previous recommendations that biopsy of soft tissue sarcomas should be performed at an experienced sarcoma center.

  12. HMGB1 in severe soft tissue infections caused by Streptococcus pyogenes

    Directory of Open Access Journals (Sweden)

    Linda eJohansson


    Full Text Available Extracellular High Mobility Group Box 1 (HMGB1 has been associated with acute and chronic inflammatory conditions. However, little is known about HMGB1 in necrotizing bacterial infections. We hypothesized that the local HMGB1 response is excessive in severe soft tissue infections, which are characterized by necrosis and hyperinflammation. To explore this, tissue biopsies were collected from patients with varying severity of Streptococcus pyogenes skin and soft tissue infections, including erysipelas, cellulitis, and necrotizing fasciitis. Tissue sections were immunostained for HMGB1, S. pyogenes, and inflammatory cell infiltrates and results quantified by acquired computerized image analysis. HMGB1 expression increased in parallel to disease severity and was significantly higher in necrotizing fasciitis than in erysipelas (p=0.0023. Confocal microscopy of sections co-stained for HMGB1 and cell markers revealed both extracellular and cytoplasmic HMGB1, the latter of which was found predominantly in macrophages. To further verify macrophages as main source of activation triggered HMGB1 release, human macrophages were infected with clinical S. pyogenes isolates. The results demonstrated infection triggered release of HMGB1. Dual staining’s visualized HMGB1 in areas close to, but not overlapping, with neutrophils, indicating a potential chemotactic role. In vitro transmigration experiments showed a chemotactic effect of HMGB1 on neutrophils. The data furthermore provided in vivo support that HGMB1 may form immunostimulatory complexes with IL-1β. Taken together, the findings provide the first in vivo evidence that HMGB1 is abundant at the local site of severe bacterial soft tissue infections and its levels correlated to severity of infections; hence, indicating its potential value as a biomarker for tissue pathology.

  13. Investigation of formalin influence over hard and soft biological tissues fluorescent spectra in vitro (United States)

    Borisova, E.; Uzunov, Tz.; Vladimirov, B.; Avramov, L.


    In order to investigate the formalin influence over fluorescence properties of hard and soft biological tissues during conservation, emission spectra have been registered. Nitrogen laser at 337 nm and light-emitting diode with maximum at 405 nm have been used as excitation sources. For investigation of formalin influence over hard tissues, an experiment was made on teeth samples. Sound teeth were demineralized with a phosphoric acid for 10 seconds to obtain enamel structure near to the tooth lesion, and were fixed in formalin. Before and after teeth treatment spectra from the areas of interest were detected. There were not observed changes in the shape of the teeth spectra, related to the introduction of formalin fluorescence. Samples from mucosa of esophagus and stomach, where initially an ALA/Protoporphyrin IX diagnosis was applied, were used as soft tissue specimens. After fluorescent diagnosis in vivo biopsy samples were obtained from normal and cancerous areas and were conserved in formalin. Initially, spectrum observed has one autofluorescence maximum from the mucous tissue at 500-600 nm and secondary maxima from the protoporphyrin fluorescence at 635 nm and 720 nm, as well as pronounced minima at 540 and 575 nm related to hemoglobin absorption. After formalin conservation hemoglobin absorption was strongly reduced that increases mucous emission signal in green-yellow spectral region. Simultaneously the maxima at 635 nm and 720 nm were reduced. As conclusion we could say that formalin has negligible influence over fluorescence spectra of conserved hard tissues and has more pronounced influence over fluorescence spectra obtained in the case of soft tissue conservation, which has to be taking into account in measurements in vitro.

  14. Evaluation of reports of dioxin exposure and soft tissue sarcoma pathology among chemical workers in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Fingerhut, M.A.; Halperin, W.E.; Honchar, P.A.; Smith, A.B.; Groth, D.H.; Russell, W.O.


    A review of employment records and tissue specimens of seven workers, reported previously as having occupational dioxin exposure and soft tissue sarcomas, confirms that four workers had employment of 2 to 19 years in the production of 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) or trichlorophenol, products contaminated with 2,3,7,8-tetrachlorodibenzodioxin, the most toxic dioxin isomer. Of these individuals, two have confirmed soft tissue sarcomas. In addition three individuals who worked for companies which made 2,4,5-T also have confirmed soft tissue sarcomas. Their employment records do not show specific assignment to 2,4,5-T or trichlorophenol departments; however, one individual worked for 10 d in the production of pentachlorophenol, which is contaminated with different isomers of dioxin. Methodological problems are discussed which must be addressed in the epidemiologic evaluation of the outcome of soft tissue sarcoma.

  15. Clinical assessments of the erbium:YAG laser for soft tissue surgery and scaling. (United States)

    Watanabe, H; Ishikawa, I; Suzuki, M; Hasegawa, K


    We evaluated the clinical usefulness of an erbium:YAG laser for soft tissue surgery, and scaling. Thirty-one patients with soft tissue lesions (13 males and 18 females from 24 to 71 years old), and 60 patients with calculus deposits (21 males and 39 females from 19 to 72 years old) were treated with the laser. The clinical parameters evaluated were pain, redness, swelling of the gingiva, and the subjective patient comfort parameters including uneasiness with the sound and vibration associated with laser treatment. Additionally, hemorrhage and wound healing during and after the surgery, the roughness of the root surface after scaling, and the effectiveness of scaling using the laser were examined. Laser surgery caused less hemorrhage and resulted in better wound healing when compared with conventional methods. It was easy to remove calculi from the root surface with the laser in 95% of the cases. Although the scaled site showed some irregularity, it was not clinically significant in 98% of the cases. Only a few patients complained about the unpleasant sound and vibration. There were no complications or side effects during this clinical trial. Thus, this study suggests that an Er:YAG laser is useful for soft tissue surgery and scaling.

  16. Soft-tissue applications of the holmium:YAG laser in urology (United States)

    Denstedt, John D.; Razvi, Hassan A.; Chun, Samuel S.; Sales, Jack L.


    The ideal surgical laser for the treatment of soft tissue pathology should possess both ablative and hemostatic abilities. As well, for use in urologic conditions the laser must also be suitable for endoscopic use. The Holmium:YAG laser possesses these qualities and in preliminary clinical use has demonstrated a variety of potential urologic applications. In this study we review our initial experience with the Holmium:YAG laser over a 18 month period. A total of 51 patients underwent 53 procedures for a variety of soft tissue conditions including: bladder tumor ablation (25), incision of ureteral stricture (15), incision of urethral stricture (6), treatment of ureteropelvic junction obstruction (3), incision of bladder neck contracture (2), and ablation of a ureteral tumor (2). Satisfactory hemostasis was achieved in all cases. Procedures were considered successful (no further intervention being required to treat the condition) in 81% of the cases. Two patients with dense bladder neck contractures required electroincision under the same anesthetic for completion of the procedure. A single complication, that of urinary extravasation following incision of a urethral stricture resolved with conservative management. In summary, the Holmium:YAG laser has demonstrated safety and proficiency in the treatment of a variety of urologic soft tissue conditions.

  17. Growth changes in the soft tissue profile of Yemenis females: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Fatma A Elsayed


    Full Text Available Aim: To investigate the changes in soft tissue parameters of three age groups of untreated Yemenis females. Materials and Methods: The sample comprised 300 Yemeni females which were randomly selected and divided according to age into three equal groups (Group I: 7.34 ± 0.65 years [prepubertal], Group II: 11.11 ± 1.07 years [pubertal], and Group III: 22.17 ± 3.04 years [postpubertal]. Lateral cephalometric radiographs were taken for each subject, and soft tissue measurements were performed. Comparison between the three groups was done. One cephalogram representing the mean of its group was selected from the three groups; the selected three cephalograms (one from each group were superimposed for growth changes evaluation. Results: Linear, as well as angular soft tissue measurements were significant for all measurements between the different age groups except Ls-Sn Pog', Li-Sn Pog', GSn Pog' and nasolabial angle, respectively. Conclusion: The identified changes with growth in Yemeni females having Class I skeletal and dental relationship should be considered during planning for orthodontic and/or orthognathic treatments.

  18. Integration of soft tissue model and open haptic device for medical training simulator (United States)

    Akasum, G. F.; Ramdhania, L. N.; Suprijanto; Widyotriatmo, A.


    Minimally Invasive Surgery (MIS) has been widely used to perform any surgical procedures nowadays. Currently, MIS has been applied in some cases in Indonesia. Needle insertion is one of simple MIS procedure that can be used for some purposes. Before the needle insertion technique used in the real situation, it essential to train this type of medical student skills. The research has developed an open platform of needle insertion simulator with haptic feedback that providing the medical student a realistic feel encountered during the actual procedures. There are three main steps in build the training simulator, which are configure hardware system, develop a program to create soft tissue model and the integration of hardware and software. For evaluating its performance, haptic simulator was tested by 24 volunteers on a scenario of soft tissue model. Each volunteer must insert the needle on simulator until rearch the target point with visual feedback that visualized on the monitor. From the result it can concluded that the soft tissue model can bring the sensation of touch through the perceived force feedback on haptic actuator by looking at the different force in accordance with different stiffness in each layer.

  19. Incision properties and thermal effects of CO2 lasers in soft tissue (United States)

    Wilder-Smith, Petra B. B.; Arrastia-Jitosho, Anna-Marie A.; Liaw, Lih-Huei L.; Berns, Michael W.


    Thermal and histological events resulting from soft tissue incision using CO2 lasers at 9.3 (mu) or 10.6 (mu) , fitted with a hollow wave guide or an articulated arm delivery system respectively, were investigated. In 9 fresh pigs' mandibles, standardized incisions 3 cm in length were made in the oral mucosa. Incisions were performed in the cw mode at 1 W, 4 W, and 12 W. Thermal events were measured in adjacent soft tissues using thermocouples. Incisions were dissected out, fixed, embedded in paraffin wax, sectioned and stained with Serius Red. The Students' t-test for paired data was used to compare zones of necrosis, zones of collagen damage and thermal events. No significant temperature rise was measured during irradiation at any timepoints or power settings (p < 0.05). Results were very similar for the two lasers with significantly different results obtained only at the 12 W setting (p < 0.05). Vertical incision depths and horizontal incision widths did not differ significantly (p < 0.0001) at 12 W and 4 W. Horizontal and vertical zones of necrosis did not differ significantly (p < 0.0001) either between the two lasers at 12 W and 4 W. Thus the thermal and histological events occurring during soft tissue incision were similar using these two lasers, despite the difference in wavelength and delivery system.

  20. Cerebellar, Pancreatic, and Paraspinal Metastases in Soft Tissue Sarcomas: Unusual Sites or Changing Patterns?

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    Girish Bedre


    Full Text Available Context Soft tissue sarcomas generally first metastasize to the lungs followed by the involvement of other sites such as lymph nodes and bones as part of the disseminated disease. Cerebellar and pancreatic metastases from tumors of mesenchymal origin such as soft tissue sarcomas are exceptional, more so in the absence of pulmonary metastases. Case report A previously treated case of chest wall sarcoma presented with the sudden onset of neurological symptoms. An MRI brain scan was suggestive of a solitary cerebellar metastasis. A CT scan of the thorax and abdomen showed no evidence of disease. A metastasectomy of the solitary brain lesion confirmed a deposit from a previously treated sarcoma. Within two months he presented with central abdominal pain and low backache radiating down both lower limbs. FDG-PET and CT scans revealed a large pancreatic and left paraspinal mass with intense tracer uptake suggestive of metastatic involvement. There was no evidence of pulmonary metastases. A CT-guided biopsy was suggestive of high-grade sarcoma. He was treated with palliative radiotherapy with good symptomatic relief. Conclusion Cerebellar, pancreatic, and paraspinal metastases from soft tissue sarcomas are rare, especially in the absence of pulmonary metastases. A high index of suspicion is necessary, and appropriate imaging should be considered for symptomatic patients.


    Directory of Open Access Journals (Sweden)

    Olesya Mokhova


    Full Text Available In the context of the above properties of titaniumaquacompleхglycerosolvate and oxytocin we have studied their joint application in order to increase the efficiency of treatment of soft tissue wounds. In the investigation performed, 144 experimental animals (white rats with simulated aseptic wounds were studied. This study will contribute to develop a new treatment for soft tissue wounds, based on the application of aquaglitserosolvatetitanium and oxytocin, examine and assess the effectiveness of aquaglitserosolvatetitanium and oxytocin in the treatment of experimental soft tissue wounds. To assess the process of wound healing in the experiment, methods of clinical, planimetric progressive examinations of wounds, as well as strength characteristics of the scar formed were used. One of the objective measures of wound healing is the study of changes in the area in the healing process. The wound area was calculated by the method of L. N. Popovoy (1942. On the basis of clinical and planimetric methods of investigation, it was found that the decrease in the wound area is significantly faster under the influence of oxytocin and titanium aquacomplexglycerosolvate. 

  2. Reconstruction of soft tissue defect of the extremity with the perforator flap from inguinal region

    Institute of Scientific and Technical Information of China (English)

    HUANG Dong; WANG Hai-wen; WANG Hong-gang; WU Wei-zhi; ZHAO Cheng-yi


    Background The perforator flap has become a very useful reconstructive means of soft tissue defect of extremities.The perforator flap from the inguinal region has advantages that include the ability to cover a large area with little donor site morbidity and provision of suitable thickness for reconstruction.Methods From July 1, 2005 to June 30, 2007, 10 patients with various types of soft tissue defect underwent reconstruction with 10 perforator flaps from the inguinal region. Six flaps were applied to the upper extremities and four flaps to the lower extremities. The dimensions of the transferred flaps ranged from 7-30 cm in length and 4-10 cm in width.Results The postoperative course of all 10 flaps was uneventful and all flaps survived. Distal small partial necrosis was observed in one case due to arterial insufficiency of the distal part of the flap. All patients were satisfied with the functional and esthetic resurfacing outcome.Conclusion Use of perforator flap from the inguinal region could overcome the disadvantages of the traditional free groin flap, and represents a safe and useful tool for coverage of soft tissue defects.

  3. Study on the Clinical Significance of Mathematical Relations between the Thickness of Facial Soft Tissues in Male

    Institute of Scientific and Technical Information of China (English)

    WANG Zixuan; WANG Qinghua


    Objective To discuss the mathematical relations between the thickness of facial soft tissues. Mehtods Measured the thickness of facial soft tissue on X- ray film (51 men). Record seven data every man, computed their related ratio and analysis all the data with SPSS software. Result All of the items were positive correlation and their correlations were significant expect the correlation between the thickness of hair line point and the Sn point. All the results were normal distribution. Conclusion The results can be used to calculate the thickness of injured facial soft tissue in male.

  4. PET/MRI for Preoperative Planning in Patients with Soft Tissue Sarcoma

    DEFF Research Database (Denmark)

    Loft Jakobsen, Annika; Jensen, Karl Erik; L�fgren, Johan;


    Clinical positron emission tomography (PET)/magnetic resonance imaging (MRI) acquisition protocols may improve the evaluation of soft tissue sarcomas (STS) prior to surgical planning. We examined two patients with lower extremity STS using a Siemens Biograph mMR PET/MRI scanner and the glucose...... analogue 18F-fluoro-deoxyglucose (FDG). We investigated clinically relevant tumor volumes and evaluated the relations to skeletal periosteum and nerve bundles. The patient scans suggest that FDG PET/MRI improved the edge detection, and invasion of tumor tissue into important adjacent anatomical structures...... planning, including radiation therapy planning in patients with STS....

  5. 皮下埋线治疗慢性软组织损伤53例%53 cases of chronic soft tissue injury using subcutaneous line embedding therapy

    Institute of Scientific and Technical Information of China (English)

    叶立汉; 胡亚明


    @@ INTRODUCTION Acupuncture and ventouse can dredge meridian, activate blood circulation and relieve pain thus is effective to chronic soft tissue injury.We investigated a kind of method using subcutaneous line-embedding therapy to cure chronic soft tissue injury and explore a high performance and effective method in curing chronic soft tissue injury.

  6. Quantitative Imaging of Young’s Modulus of Soft Tissues from Ultrasound Water Jet Indentation: A Finite Element Study

    Directory of Open Access Journals (Sweden)

    Min-Hua Lu


    Full Text Available Indentation testing is a widely used approach to evaluate mechanical characteristics of soft tissues quantitatively. Young’s modulus of soft tissue can be calculated from the force-deformation data with known tissue thickness and Poisson’s ratio using Hayes’ equation. Our group previously developed a noncontact indentation system using a water jet as a soft indenter as well as the coupling medium for the propagation of high-frequency ultrasound. The novel system has shown its ability to detect the early degeneration of articular cartilage. However, there is still lack of a quantitative method to extract the intrinsic mechanical properties of soft tissue from water jet indentation. The purpose of this study is to investigate the relationship between the loading-unloading curves and the mechanical properties of soft tissues to provide an imaging technique of tissue mechanical properties. A 3D finite element model of water jet indentation was developed with consideration of finite deformation effect. An improved Hayes’ equation has been derived by introducing a new scaling factor which is dependent on Poisson’s ratios v, aspect ratio a/h (the radius of the indenter/the thickness of the test tissue, and deformation ratio d/h. With this model, the Young’s modulus of soft tissue can be quantitatively evaluated and imaged with the error no more than 2%.

  7. Linear elastic properties of the facial soft tissues using an aspiration device: towards patient specific characterization. (United States)

    Luboz, V; Promayon, E; Payan, Y


    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 specifically designed aspiration device, the facial soft tissues deformation is measured at four different locations (cheek, cheekbone, forehead, and lower lip) on 16 young subjects. The stiffness is estimated from the deformations generated by a set of negative pressures using an inverse analysis based on a Neo Hookean model. The initial Young's modulus of the cheek, cheekbone, forehead, and lower lip are respectively estimated to be 31.0 kPa±4.6, 34.9 kPa±6.6, 17.3 kPa±4.1, and 33.7 kPa±7.3. Significant intra-subject differences in tissue stiffness are highlighted by these estimations. They also show important inter-subject variability for some locations even when mean stiffness values show no statistical difference. This study stresses the importance of using a measurement device capable of evaluating the patient specific tissue stiffness during an intervention.

  8. An experimental model of tool mark striations in soft tissues produced by serrated blades. (United States)

    Pounder, Derrick J; Cormack, Lesley


    Stab wounds produced by serrated blades are generally indistinguishable from stab wounds produced by non-serrated blades, except when visible tool mark striations are left on severed cartilage. We explored the possibility that similar striations may be produced on the soft tissues of internal organs. Loin of beef, bovine kidney, and pig heart, liver, and aorta were each stabbed 20 times with a coarsely serrated blade. The walls of the stab tracks were exposed and documented by photography, cast with dental impression material, and the casts photographed. Striations were identified in all of the tissues in every stabbing, but their consistency and quality varied between tissues. Striations were most easily seen in liver, heart, and aorta. Tool mark striations in soft tissues other than cartilage have not been described in homicidal stabbings, likely because they have not been sought. We suggest that the walls of stab wound tracks should be exposed, and tissue striations should be sought as a means of identifying the weapon as having a serrated blade.

  9. Advanced magnetic resonance strategies for the elucidation of nanostructured soft matter. (United States)

    Graf, R; Hansen, M R; Hinderberger, D; Muennemann, K; Spiess, H W


    An overview is given on advanced magnetic resonance strategies and techniques, both nuclear magnetic resonance (NMR) and electron paramagnetic resonance (EPR), as applied to nanostructured soft matter. In addition, the combination of the two forms of spectroscopy to enhance signal intensity in NMR by means of dynamic nuclear polarization (DNP) is described. It is shown how these techniques can provide unique information on the structure of soft matter as well as the local dynamics of the constituents. Examples of recent applications are described, including dendronized and thermoresponsive polymers, hydrogels, synthetic and bio-inspired polymers, as well as polypeptides and biopolymers.

  10. Stem and progenitor cells: advancing bone tissue engineering. (United States)

    Tevlin, R; Walmsley, G G; Marecic, O; Hu, Michael S; Wan, D C; Longaker, M T


    Unlike many other postnatal tissues, bone can regenerate and repair itself; nevertheless, this capacity can be overcome. Traditionally, surgical reconstructive strategies have implemented autologous, allogeneic, and prosthetic materials. Autologous bone--the best option--is limited in supply and also mandates an additional surgical procedure. In regenerative tissue engineering, there are myriad issues to consider in the creation of a functional, implantable replacement tissue. Importantly, there must exist an easily accessible, abundant cell source with the capacity to express the phenotype of the desired tissue, and a biocompatible scaffold to deliver the cells to the damaged region. A literature review was performed using PubMed; peer-reviewed publications were screened for relevance in order to identify key advances in stem and progenitor cell contribution to the field of bone tissue engineering. In this review, we briefly introduce various adult stem cells implemented in bone tissue engineering such as mesenchymal stem cells (including bone marrow- and adipose-derived stem cells), endothelial progenitor cells, and induced pluripotent stem cells. We then discuss numerous advances associated with their application and subsequently focus on technological advances in the field, before addressing key regenerative strategies currently used in clinical practice. Stem and progenitor cell implementation in bone tissue engineering strategies have the ability to make a major impact on regenerative medicine and reduce patient morbidity. As the field of regenerative medicine endeavors to harness the body's own cells for treatment, scientific innovation has led to great advances in stem cell-based therapies in the past decade.

  11. A computer model of soft tissue interaction with a surgical aspirator. (United States)

    Mora, Vincent; Jiang, Di; Brooks, Rupert; Delorme, Sébastien


    Surgical aspirators are one of the most frequently used neurosurgical tools. Effective training on a neurosurgery simulator requires a visually and haptically realistic rendering of surgical aspiration. However, there is little published data on mechanical interaction between soft biological tissues and surgical aspirators. In this study an experimental setup for measuring tissue response is described and results on calf brain and a range of phantom materials are presented. Local graphical and haptic models are proposed. They are simple enough for real-time application, and closely match the observed tissue response. Tissue resection (cutting) with suction is simulated using a volume sculpting approach. A simulation of suction is presented as a demonstration of the effectiveness of the approach.

  12. Formation of spatially and geometrically controlled three-dimensional tissues in soft gels by sacrificial micromolding. (United States)

    Cerchiari, Alec; Garbe, James C; Todhunter, Michael E; Jee, Noel Y; Pinney, James R; LaBarge, Mark A; Desai, Tejal A; Gartner, Zev J


    Patterned three-dimensional (3D) cell culture models aim to more accurately represent the in vivo architecture of a tissue for the purposes of testing drugs, studying multicellular biology, or engineering functional tissues. However, patterning 3D multicellular structures within very soft hydrogels (<500 Pa) that mimic the physicochemical environment of many tissues remains a challenge for existing methods. To overcome this challenge, we use a Sacrificial Micromolding technique to temporarily form spatially and geometrically defined 3D cell aggregates in degradable scaffolds before transferring and culturing them in a reconstituted extracellular matrix. Herein, we demonstrate that Sacrificial Micromolding (1) promotes cyst formation and proper polarization of established epithelial cell lines, (2) allows reconstitution of heterotypic cell-cell interactions in multicomponent epithelia, and (3) can be used to control the lumenization-state of epithelial cysts as a function of tissue size. In addition, we discuss the potential of Sacrificial Micromolding as a cell-patterning tool for future studies.

  13. Extrarenal rhabdoid tumors of soft tissue: a clinicopathologic and immunohistochemical study of 18 cases. (United States)

    Fanburg-Smith, J C; Hengge, M; Hengge, U R; Smith, J S; Miettinen, M


    Rhabdoid tumor is a well-accepted clincopathologic entity among childhood renal neoplasms; similar tumors have been described in extrarenal locations. We present the clinicopathologic profile and the immunohistochemical features of a series of soft tissue rhabdoid tumors. Twenty-eight cases coded as extrarenal rhabdoid tumor (ERRT), RT, possible ERRT, and "large cell sarcoma" were retrieved from the Armed Forces Institute of Pathology soft tissue registry. The tumors were reclassified according to strict criteria by light microscopy, clinical information, immunohistochemistry, and, in some cases, electron microscopy. Soft tissue rhabdoid tumor (STRT) was defined as (1) a tumor composed of noncohesive single cells, clusters, or sheets of large tumor cells with abundant glassy eosinophilic cytoplasm, an eccentric vesicular nucleus, and an extremely large nucleolus; (2) positivity for vimentin and/or cytokeratin or other epithelial markers by immunostaining; and (3) exclusion of other tumor types with rhabdoid inclusions (melanoma, other sarcomas, carcinoma). Eighteen cases met our criteria for soft tissue rhabdoid tumors. The median patient age was 13 years (range, 6 months to 56 years). Ninety-four percent of STRT cases were positive for vimentin and 59% for pan-cytokeratin. Sixty-three percent and 60% were positive for CAM 5.2 and EMA, respectively. Seventy-nine percent stained for at least one epithelial marker; 76% stained for both vimentin and epithelial markers simultaneously. Forty-two percent stained for MSA, and 14% for CEA and SMA. CD99, synaptophysin, CD57 (Leu-7), NSE, and focal S100 protein were identified in 75%, 66%, 56%, 54%, and 31% of the STRT cases, respectively. All STRT cases examined were negative for HMB-45, chromogranin, BER-EP4, desmin, myoglobin, CD34, and GFAP. Follow-up examination in 61% of the STRT patients revealed that 64% of patients died of disease within a median follow-up interval of 19 months (range, 4 months to 5 years); 82% had


    Directory of Open Access Journals (Sweden)

    Rajesh Kumar


    Full Text Available INTRODUCTION: Necrotizing soft tissue infection (NSTI is a broad term applied to infections of "flesh eating bacteria" that may cause cellulitis, fascitis, or myositis. NSTI's can rapidly progress to systemic toxicity, resulting in major morbidity and mortality without prompt recognition and treatment. MATERIAL & METHODS: In the present study, all the cases of necrotizing soft tissue infection attending OPD, emergency & a dmitted in ward of L. L. R. And associated hospitals from Dec. 2012 to June 2014 were selected for the study. The general condition of the patient was noted with special reference to temperature, respiratory rate, pulse rate, blood pressure and signs of to xemia. All routine hematological and biochemical tests were done. Pus and excised tissue sent in sterile container for Gram staining and culture & Histopatholigical examination. RESULTS: In our study we have found that with increasing age the incidence of necrotizing soft tissue infection rises and 9 out of 44 patients expired which is 20.45% of total patient studied. Most common bacteria identified in this study was Group - A  hemolytic streptococcus (52.27%. In most of the case (72.72% infection was found to be poly - microbial (32 out of 42 and only ten out 42(22.72% were mono microbial. Increased mortality was seen in patient associated with diabetes mellitus shock renal dis - function anemia and coagulopathy. CONCLUSION: Earliest possible patient sho uld be treated by extensive debridement broad spectrum antibiotics. Wound closure or grafting should only be performed when there is no longer evidence of necrotic tissue and the patient has been adequately resuscitated.

  15. Immunostaining for SYT protein discriminates synovial sarcoma from other soft tissue tumors: analysis of 146 cases. (United States)

    He, Rui; Patel, Rajiv M; Alkan, Serhan; Hammadeh, Rasheed; Weiss, Sharon W; Goldblum, John R; Venkataraman, Girish; Baila, Horea


    Synovial sarcoma in its classic biphasic form can be distinguished readily from other soft tissue lesions; however, monophasic and poorly differentiated forms are diagnostically more problematic. For this reason, we assessed the efficacy of immunostaining for SYT and SSX1 proteins, the gene products resulting from unique synovial sarcoma translocation, to distinguish synovial sarcoma from other soft tissue lesions. A total number of 146 cases were analyzed, including 47 synovial sarcoma cases (all of which were verified by FISH to have t(X; 18) translocation and SYT-SSX fusion gene) and 99 soft tissue tumors of various types. A polyclonal IgG antibody against SYT was used to stain formalin-fixed paraffin embedded tissues. Forty-one out of 47 (87%) synovial sarcoma displayed strong positive nuclear staining (ranging from 80 to 90% of the tumor cells) for SYT antibody. Nineteen of 99 (19%) non-synovial sarcoma cases showed variable nuclear and cytoplasmic staining with SYT, which ranged from 20 to 60% of tumor nuclei, and included malignant peripheral nerve sheath tumor (5/25), solitary fibrous tumor (2/14), Ewing sarcoma (2/6), low grade fibromyxoid tumor (2/4), extraskeletal mesenchymal chondrosarcoma (2/6), gastrointestinal tumor (4/17), epithelioid sarcoma (2/2). The remaining non-synovial sarcomas were negative. This is the first study demonstrating SYT protein expression in tissue sections of synovial sarcoma. This method could provide an easy, rapid and widely applicable means of assisting in the diagnosis of synovial sarcoma, particularly when material and/or resources are unavailable for PCR or FISH-based testing. However, as variable weak staining for SYT may be encountered in a small percentage of non-synovial sarcoma sarcomas, a positive interpretation should be made only when the staining is strong, nuclear and present in the majority of cells.

  16. Online Image-based Monitoring of Soft-tissue Displacements for Radiation Therapy of the Prostate

    Energy Technology Data Exchange (ETDEWEB)

    Schlosser, Jeffrey [Department of Mechanical Engineering, Stanford University, Stanford, CA (United States); Department of Bioengineering, Stanford University, Stanford, CA (United States); Salisbury, Kenneth [Department of Computer Science, Stanford University, Stanford, CA (United States); Department of Surgery, Stanford University, Stanford, CA (United States); Hristov, Dimitre, E-mail: [Department of Radiation Oncology, Stanford University, Stanford, CA (United States)


    Purpose: Emerging prolonged, hypofractionated radiotherapy regimens rely on high-dose conformality to minimize toxicity and thus can benefit from image guidance systems that continuously monitor target position during beam delivery. To address this need we previously developed, as a potential add-on device for existing linear accelerators, a novel telerobotic ultrasound system capable of real-time, soft-tissue imaging. Expanding on this capability, the aim of this work was to develop and characterize an image-based technique for real-time detection of prostate displacements. Methods and Materials: Image processing techniques were implemented on spatially localized ultrasound images to generate two parameters representing prostate displacements in real time. In a phantom and five volunteers, soft-tissue targets were continuously imaged with a customized robotic manipulator while recording the two tissue displacement parameters (TDPs). Variations of the TDPs in the absence of tissue displacements were evaluated, as was the sensitivity of the TDPs to prostate translations and rotations. Robustness of the approach to probe force was also investigated. Results: With 95% confidence, the proposed method detected in vivo prostate displacements before they exceeded 2.3, 2.5, and 2.8 mm in anteroposterior, superoinferior, and mediolateral directions. Prostate pitch was detected before exceeding 4.7 Degree-Sign at 95% confidence. Total system time lag averaged 173 ms, mostly limited by ultrasound acquisition rate. False positives (FPs) (FP) in the absence of displacements did not exceed 1.5 FP events per 10 min of continuous in vivo imaging time. Conclusions: The feasibility of using telerobotic ultrasound for real-time, soft-tissue-based monitoring of target displacements was confirmed in vivo. Such monitoring has the potential to detect small clinically relevant intrafractional variations of the prostate position during beam delivery.

  17. High dose rate interstitial brachytherapy in soft tissue sarcomas: technical aspect

    Energy Technology Data Exchange (ETDEWEB)

    Chun, Mi Son; Kang, Seung Hee; Kim, Byoung Suck; Oh, Young Taek [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)


    To discuss the technical aspect of interstitial brachytherapy including method of implant, insertion time of radioactive source, total radiation dose, and complication, we reviewed patients who had diagnoses of soft tissue sarcoma and were treated by conservative surgery, interstitial implant and external beam radiation therapy. Between May 1995 and Dec. 1997, the patients with primary or recurrent soft tissue sarcoma underwent surgical resection (wide margin excision) and received radiotherapy including interstitial brachytherapy. Catheters were placed with regular intervals of 1-1.5 cm immediately after tumor removal and covering the critical structures, such as neurovascular bundle or bone, with gelform, muscle, or tissue expander in the cases where the tumors were close to those structures. Brachytherapy consisted of source axis with 2-2.5 Gy/fraction, twice a day, starting on 6th day after the surgery. Within one month after the surgery, total dose of 50-55 Gy was delivered to the tumor bed with wide margin by the external beam radiotherapy. All patients completed planned interstitial brachytherapy without acute side effects directly related with catheter implantation such as infection or bleeding. With median follow up duration of 25 months (range 12-41 months), no local recurrences were observed. And there was no severe form of chromic complication (RTOG/EORTC grade 3 or 4). The high dose rate interstitial brachytherapy is easy and safe way to minimize the radiation dose delivered to the adjacent normal tissue and to decrease radiation induced chronic morbidity such as fibrosis by reducing the total dose of external radiotherapy in the management of soft tissue sarcoma with conservative surgery.

  18. 肢体创伤性软组织缺损修复面面观%General view on the repair of traumatic soft tissue defects of extremities

    Institute of Scientific and Technical Information of China (English)

    柴益民; 陆晟迪; 曾炳芳


    Repir of soft tissue defects takes an important role in the ifeld of traumatic repairative surgery, including repair of the injuries and accidents resulted acute wounds, reconstruction for chronic wounds caused by diabetes and vascular diseases, salvage and functional reconstruction of the injured limbs. The repair of traumatic soft tissue defects of the extremities needs overall considerations on the evaluation, methods, principle, decision making and timing. The evaluation consists of the local condition of the injured limb, as well as the general condition, expectation value to the treatment, and the economic and psychological endurance capacity to the multiple reconstructive operations of the patients. Clinically available methods include VAC ( vacuum assisted closure ) technique, skin substitutes, skin graft, plasty of local skin lfap, skin expender, pedicled transposition or transplantation of axial tissue lfaps, neurofasciocutaneous or perforator lfaps. The principles of repair of soft tissue defects are to use the like tissues to repair the defects, to reduce the damage to the donor sites, to reach the goals in both the functional and cosmetic outcome, to plan the operation carefully and comprehensively. The decision making can be done following the concept of “reconstruction ladder”, by which the surgical procedures are selected gradually from “the simple” to “the complex”. However, with the advanced technique in hands, the surgeons may start with “the best” rather than “the simplest” to repair the soft tissue defects, as long as it is indicated no matter how dififcult it might be. As to the timing, the soft tissue defect is repaired the earlier the better, of cause safety and effectiveness are the prerequisite to do this. A successful microsurgical repair can make full use of the tissues spared from the injury to save the injured limb and to reconstruct its function thus to shorten the treatment process, to relieve the pain of the


    Institute of Scientific and Technical Information of China (English)

    WANG Jian-ping; WANG Ke-hong; WANG Xiu-juan


    @@ In recent several years, the authors of the present paper employed floating needle to treat 120 cases of soft tissue injury of the shoulder-back region and achieved a good therapeutic effect. Following is the report.

  20. Letter to Editor: Carpal tunnel syndrome due to an atypical deep soft tissue leiomyoma: The risk of misdiagnosis and mismanagement

    Directory of Open Access Journals (Sweden)

    Caliandro Pietro


    Full Text Available Abstract A response to Chalidis et al: Carpal tunnel syndrome due to an atypical deep soft tissue leiomyoma: The risk of misdiagnosis and mismanagement. World J Surg Oncol 2007, 5:92.

  1. Computer-assisted three-dimensional surgical planing and simulation. 3D soft tissue planning and prediction. (United States)

    Xia, J; Samman, N; Yeung, R W; Wang, D; Shen, S G; Ip, H H; Tideman, H


    The purpose of this paper is to report a new technique for three-dimensional facial soft-tissue-change prediction after simulated orthognathic surgical planning. A scheme for soft tissue deformation, "Computer-assisted three-dimensional virtual reality soft tissue planning and prediction for orthognathic surgery (CASP)", is presented. The surgical planning was based on three-dimensional reconstructed CT visualization. Soft tissue changes were predicted by two newly devised algorithms: Surface Normal-based Model Deformation Algorithm and Ray Projection-based Model Deformation Algorithm. A three-dimensional color facial texture-mapping technique was also used for generating the color photo-realistic facial model. As a final result, a predicted and simulated patient's color facial model can be visualized from arbitrary viewing points.

  2. Brain Metastasis in Bone and Soft Tissue Cancers: A Review of Incidence, Interventions, and Outcomes

    Directory of Open Access Journals (Sweden)

    Faris Shweikeh


    Full Text Available Bone and soft tissue malignancies account for a small portion of brain metastases. In this review, we characterize their incidence, treatments, and prognosis. Most of the data in the literature is based on case reports and small case series. Less than 5% of brain metastases are from bone and soft tissue sarcomas, occurring most commonly in Ewing’s sarcoma, malignant fibrous tumors, and osteosarcoma. Mean interval from initial cancer diagnosis to brain metastasis is in the range of 20–30 months, with most being detected before 24 months (osteosarcoma, Ewing sarcoma, chordoma, angiosarcoma, and rhabdomyosarcoma, some at 24–36 months (malignant fibrous tumors, malignant peripheral nerve sheath tumors, and alveolar soft part sarcoma, and a few after 36 months (chondrosarcoma and liposarcoma. Overall mean survival ranges between 7 and 16 months, with the majority surviving < 12 months (Ewing’s sarcoma, liposarcoma, malignant fibrous tumors, malignant peripheral nerve sheath tumors, angiosarcoma and chordomas. Management is heterogeneous involving surgery, radiosurgery, radiotherapy, and chemotherapy. While a survival advantage may exist for those given aggressive treatment involving surgical resection, such patients tended to have a favorable preoperative performance status and minimal systemic disease.

  3. Experiences and lessons about soft-tissue flaps covering of severe open tibial fracture

    Institute of Scientific and Technical Information of China (English)


    Objective: To sum up experiences and lessons about management of soft-tissue reconstruction in open tibial fracture over a 6-year period.Methods: Twenty-two flap reconstructions were performed to treat soft-tissue defect of 22 patients with open tibial fracture Type IIIB (Gustilo) from 1993 to 1998. The cases were analyzed and discussed retrospectively after follow up of 12-61 months.Results: The size of the flap ranged from 6.6 cm2 to 28.18 cm2 and the rate of flap failure was 13.6%. Besides, 3 partial necrosis and 2 postoperative infections occurred in this series.Conclusions: For soft tissuedefect of delayed open tibial fracture Type HIB, flap reconstruction is still an optimal option. The experiences we obtained are ① to design a triangular skin extension or a small Z-plasty over the pedicle to reduce the flap tension; ② to select a unilateral external fixation to provide convenience for anysecondary manipulation; and ③ to use serial debridementto diminish flap failure. de

  4. Increased Risk of Revision after ACL Reconstruction with Soft Tissue Allograft Compared to Autograft (United States)

    Maletis, Gregory; Chen, Jason; Inacio, Maria Carolina Secorun; Love, Rebecca; Funahashi, Tadashi Ted


    Objectives: The use of allograft tissue for anterior cruciate ligament reconstruction (ACLR) remains controversial. Numerous meta-analysis and systematic reviews of small clinical studies have not found differences between autograft and allograft outcomes but large registry studies have shown an increased risk of revision with allografts. The purpose of this study was to compare the risk of aseptic revision between bone-patellar tendon-bone (BPTB) autografts, hamstring tendon autografts and soft tissue allografts. Methods: A retrospective cohort study of prospectively collected data was conducted using an US ACLR Registry. A cohort of primary unilateral ACLR cases reconstructed with BPTB autografts, hamstring autografts and soft tissue allografts (from any site) was identified. Aseptic revision was the end point of the study. Type of graft and allograft processing methods (non-processed, 1.8 Mrads irradiation with and without chemical processing, and chemical processing alone (BioCleanse)) were the exposures of interest evaluated. Time from surgery was evaluated as an effect modifier. All analyses were adjusted for age, gender, and race. Kaplan-Meier curves and Cox proportional hazard models were employed. Hazard ratios (HR), 95% confidence intervals (CI) are provided. Results: The cohort had 14015 cases, 8924 (63.7%) were male, 6397 (45.6%) were White, 4557 (32.5%) cases used BPTB autograft, 3751 (26.8%) cases used soft tissue allograft and 5707 (40.7%) cases used hamstring autograft. The median age was 34.6 years-old (IQR 24.1-43.2) for allograft cases and 24.3 years-old (IQR 17.7-33.8) for hamstring autograft cases, and 22.0 years-old (IQR 17.6-30.0) for BPTB autograft cases. Compared to hamstring tendon autografts, an increased risk of revision was found in allografts processed with >1.8Mrads without chemical processing after 2.5 years (HR: 3.88 95%CI 1.48-10.12), and >1.8Mrads with chemical processing after only 1 year (HR: 3.43 95%CI 1.58-7.47) and with Bio

  5. Factors influencing soft tissue profile changes following orthodontic treatment in patients with Class II Division 1 malocclusion

    Directory of Open Access Journals (Sweden)

    Suhatcha Maetevorakul


    Full Text Available Abstract Background Several studies have shown soft tissue profile changes after orthodontic treatment in Class II Division 1 patients. However, a few studies have described factors influencing the soft tissue changes. The purpose of this study was to investigate the factors influencing the soft tissue profile changes following orthodontic treatment in Class II Division 1 patients. Methods The subjects comprised 104 Thai patients age 8–16 years who presented Class II Division 1 malocclusions and were treated with different orthodontic modalities comprising cervical headgear, Class II traction and extraction of the four first premolars. The profile changes were evaluated from the lateral cephalograms before and after treatment by means of the X-Y coordinate system. Significant soft tissue profile changes were evaluated by paired t test at a 0.05 significance level. The correlations among significant soft tissue changes and independent variables comprising treatment modality, age, sex, pretreatment skeletal, dental and soft tissue morphology were evaluated by stepwise multiple regression analysis at a 0.05 significance level. Results The multiple regression analysis indicated that different treatment modalities, age, sex, pretreatment skeletal, dental and soft tissue morphology were related to the profile changes. The predictive power of these variables on the soft tissue profile changes ranged from 9.9 to 40.3 %. Conclusions Prediction of the soft tissue profile changes following treatment of Class II Division 1 malocclusion from initial patient morphology, age, sex and types of treatment was complicated and required several variables to explain their variations. Upper lip change in horizontal direction could be found only at the stomion superius and was less predictable than those of the lower lip. Variations in upper lip retraction at the stomion superius were explained by types of treatment (R 2 = 0.099, whereas protrusion of the lower

  6. Fabrication of polyurethane and polyurethane based composite fibres by the electrospinning technique for soft tissue engineering of cardiovascular system. (United States)

    Kucinska-Lipka, J; Gubanska, I; Janik, H; Sienkiewicz, M


    Electrospinning is a unique technique, which provides forming of polymeric scaffolds for soft tissue engineering, which include tissue scaffolds for soft tissues of the cardiovascular system. Such artificial soft tissues of the cardiovascular system may possess mechanical properties comparable to native vascular tissues. Electrospinning technique gives the opportunity to form fibres with nm- to μm-scale in diameter. The arrangement of obtained fibres and their surface determine the biocompatibility of the scaffolds. Polyurethanes (PUs) are being commonly used as a prosthesis of cardiovascular soft tissues due to their excellent biocompatibility, non-toxicity, elasticity and mechanical properties. PUs also possess fine spinning properties. The combination of a variety of PU properties with an electrospinning technique, conducted at the well tailored conditions, gives unlimited possibilities of forming novel polyurethane materials suitable for soft tissue scaffolds applied in cardiovascular tissue engineering. This paper can help researches to gain more widespread and deeper understanding of designing electrospinable PU materials, which may be used as cardiovascular soft tissue scaffolds. In this paper we focus on reagents used in PU synthesis designed to increase PU biocompatibility (polyols) and biodegradability (isocyanates). We also describe suggested surface modifications of electrospun PUs, and the direct influence of surface wettability on providing enhanced biocompatibility of scaffolds. We indicate a great influence of electrospinning parameters (voltage, flow rate, working distance) and used solvents (mostly DMF, THF and HFIP) on fibre alignment and diameter - what impacts the biocompatibility and hemocompatibility of such electrospun PU scaffolds. Moreover, we present PU modifications with natural polymers with novel approach applied in electrospinning of PU scaffolds. This work may contribute with further developing of novel electrospun PUs, which may be

  7. Autologous Skin Cell Spray for Massive Soft Tissue War Injuries: A Prospective, Case-Control, Multicenter Trial (United States)


    AD______________ AWARD NUMBER: W81XWH-13-2-0031 TITLE: Autologous Skin Cell Spray for Massive Soft Tissue War Injuries: A Prospective, Case...DATES COVERED 15Mar2013-31Oct2014 4. TITLE AND SUBTITLE Autologous Skin Cell Spray for Massive Soft Tissue War Injuries: A Prospective, Case-Control...assess the success of skin cell spray combined with a biocomposite subcutaneous (INTEGRA) layer for repair of large open wounds. The objective is the

  8. Soft Tissue Augmentation with Autologous Platelet Gel and β-TCP: A Histologic and Histometric Study in Mice



    Background. Facial aging is a dynamic process involving both soft tissue and bony structures. Skin atrophy, with loss of tone, elasticity, and distribution of facial fat, coupled with gravity and muscle activity, leads to wrinkling and folds. Purpose. The aim of the study was to evaluate microporous tricalcium phosphate (β-TCP) and autologous platelet gel (APG) mix in mice for oral and maxillofacial soft tissue augmentation. The hypothesis was that β-TCP added with APG was able to increase th...

  9. The role of MRI in image-guided needle biopsy of focal bone and soft tissue neoplasms. (United States)

    Khoo, M M Y; Saifuddin, A


    Magnetic resonance imaging (MRI) plays a critical role in the management pathway of both soft tissue and bone neoplasms, from diagnosis through to post-treatment follow-up. There are a wide range of surgical, oncological, and combined treatment regimes but these rely on accurate histopathological diagnosis. This article reviews the role of MRI in the planning of image-guided needle biopsy for suspected soft tissue and bone tumors.

  10. Evaluation of mortality and length of therapy in patients with soft tissue infections 1989-99

    Directory of Open Access Journals (Sweden)

    Geranmayeh L


    Full Text Available Background: Necrotizing soft tissue infections are one of the most dreaded infections in human and result in a very high rate of mortality. The treatment of these infections must be very aggressive and consists of radical debridement of all necrotic tissue accompanied by appropriate antibiotics. Materials and Methods: This study was undertaken to assess the mortality rate, the time from diagnosis to cure, and some of the parameters which may affect mortality in our patients. In this descriptive, retrospective study first files from patients attended by necrotizing soft tissue infections including Fournier's gangrene or disease, gas gangrene, hemolytic streptococcal infections, myonecrosis, necrotizing fascitis and related subjects in Sina and Amir-Alam hospitals from 1989 to 1999 were studied. Data were extracted and analyzed by SPSS. Results: The total number of cases was 36. The median age was 47.69 years. Seven of the patients were female. The median time from onset to cure was 10 days. The most common site affected was the perineum and the most common etiology was perianal abscess. Diabetes mellitus was the underlying disease mostly observed. Half of the patients had received inappropriate treatments. In this group mortality was higher. Conclusion: It is crucial that general practitioners be acquainted with the diagnosis of necrotizing soft tissue infections so that patients are referred immediately to surgical centers. In our referral center the mortality was acceptable but it can be lowered further. The sex, sites of infection, underlying disease and etiologies in our patients were similar to patient in other countries except for alcoholism. It appears that data in foreign texts can be attributed to Iranian patients.

  11. Phase II Study of Neoadjuvant Bevacizumab and Radiotherapy for Resectable Soft Tissue Sarcomas

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sam S., E-mail: [Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Department of Cancer Biology, University of Pennsylvania School of Medicine, Philadelphia, PA (United States); Duda, Dan G. [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Karl, Daniel L. [Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Kim, Tae-Min [Center for Biomedical Informatics, Harvard Medical School and Partners Center for Personalized Genetic Medicine, Boston, MA (United States); Kambadakone, Avinash R. [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Chen, Yen-Lin [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Rothrock, Courtney [Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Rosenberg, Andrew E.; Nielsen, G. Petur [Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Kirsch, David G. [Departments of Radiation Oncology and Cancer Biology, Duke University Medical Center, Durham, NC (United States); Choy, Edwin; Harmon, David C. [Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Hornicek, Francis J. [Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Dreyfuss, Jonathan [Center for Biomedical Informatics, Harvard Medical School and Partners Center for Personalized Genetic Medicine, Boston, MA (United States); Ancukiewicz, Marek [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); and others


    Purpose: Numerous preclinical studies have demonstrated that angiogenesis inhibitors can increase the efficacy of radiotherapy (RT). We sought to examine the safety and efficacy of bevacizumab (BV) and RT in soft tissue sarcomas and explore biomarkers to help determine the treatment response. Methods and Materials: Patients with {>=}5 cm, intermediate- or high-grade soft tissue sarcomas at significant risk of local recurrence received neoadjuvant BV alone followed by BV plus RT before surgical resection. Correlative science studies included analysis of the serial blood and tumor samples and serial perfusion computed tomography scans. Results: The 20 patients had a median tumor size of 8.25 cm, with 13 extremity, 1 trunk, and 6 retroperitoneal/pelvis tumors. The neoadjuvant treatment was well tolerated, with only 4 patients having Grade 3 toxicities (hypertension, liver function test elevation). BV plus RT resulted in {>=}80% pathologic necrosis in 9 (45%) of 20 tumors, more than double the historical rate seen with RT alone. Three patients had a complete pathologic response. The median microvessel density decreased 53% after BV alone (p <.05). After combination therapy, the median tumor cell proliferation decreased by 73%, apoptosis increased 10.4-fold, and the blood flow, blood volume, and permeability surface area decreased by 62-72% (p <.05). Analysis of gene expression microarrays of untreated tumors identified a 24-gene signature for treatment response. The microvessel density and circulating progenitor cells at baseline and the reduction in microvessel density and plasma soluble c-KIT with BV therapy also correlated with a good pathologic response (p <.05). After a median follow-up of 20 months, only 1 patient had developed local recurrence. Conclusions: The results from the present exploratory study indicated that BV increases the efficacy of RT against soft tissue sarcomas and might reduce the incidence of local recurrence. Thus, this regimen warrants

  12. Soft tissue distraction using pentagonal frame for long-standing traumatic flexion deformity of interphalangeal

    Directory of Open Access Journals (Sweden)

    Nazerani Shahram


    Full Text Available 【Abstract】Objective: Interphalangeal joint con-tracture is a challenging complication of hand trauma, which reduces the functional capacity of the entire hand. In this study we evaluated the results of soft tissue distraction with no collateral ligament transection or volar plate removal in comparison with traditional operation of contracture re-lease and partial ligament transection and volar plate removal. Methods: In this prospective study, a total of 40 pa-tients in two equal groups (A and B were studied. Patients suffering from chronic flexion contracture of abrasive trau-matic nature were included. Group A were treated by soft tissue distraction using pentagonal frame technique and in Group B the contracture release was followed by finger splinting. Results: Analyzed data revealed a significant differ-ence between the two groups for range of motion in the proximal interphalangeal joints (P<0.05, while it was not meaningful in the distal interphalangeal joints (P>0.05. There was not a significant difference in the degrees of flexion contracture between groups (P>0.05. Regression analysis showed that using pentagonal frame technique significantly increased the mean improvement in range of motion of proxi-mal interphalangeal joints (P<0.001, while the higher the preoperative flexion contracture was observed in proximal interphalangeal joints, the lower improvement was achieved in range of motion of proximal interphalangeal joints after intervention (P<0.001. Conclusion: Soft tissue distraction using pentagonal frame technique with gradual and continuous collateral liga-ment and surrounding joint tissues distraction combined with skin Z-plasty significantly improves the range of mo-tion in patients with chronic traumatic flexion deformity of proximal and/or distal interphalangeal joints. Key words: Osteogenesis, distraction; Finger joint; Hand deformities

  13. Effect of head position on cephalometric evaluation of the soft-tissue facial profile (United States)

    Hoogeveen, RC; Sanderink, GCH; Berkhout, WER


    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, comparing the recordings in natural head position (NHP) and supine head position (SHP) and (2) to investigate if age, gender and body mass index (BMI) are contributing factors to the effect of the head position. Methods: 90 subjects were photographed in profile both in NHP and in SHP. 12 soft-tissue angular and linear cephalometric values were calculated. Two-way random intraclass correlation coefficients were calculated to determine observer reliability. Paired t-tests and linear regression analyses were performed to investigate the differences between the head positions and the influence of age, gender and BMI. Results: Intraobserver reliability was generally high. Paired t-tests showed significant changes as a result of head positioning (p < 0.0001) in 9 of the 12 measurements. These differences were small and clinically not relevant, except for the “lower face—throat angle”. Regression analysis revealed no relevant influence of age, gender and BMI. Conclusions: Cephalometric soft-tissue evaluation from a recording in SHP is generally reliable, except for the throat–chin area where a clinically relevant difference was found. The contour of the submandibular tissues in SHP causes the chin to appear more prominently. This can cause incorrect orthodontic diagnosis and treatment planning. PMID:23412462

  14. The pediculated gastrocnemius muscle flap as a treatment for soft tissue problems of the knee – indication, placement and results

    Directory of Open Access Journals (Sweden)

    Moebius, Boris


    Full Text Available With the increase of endoprosthetic knee replacements, there is also an increase of critical wounds to the knee due to a high incidence of soft tissue problems (ranging from wound healing defects to severe wound infections. The literature describes a general rate of soft tissue complications of up to 20% [1], [2], with 5% [3] involving exposed bone. These complications are an increasingly important problem for surgeons. Since sufficient coverage of bones, tendons and prosthetic material with soft tissue is a necessity, the use of a pediculated muscle flap is the only solution in some cases. The gastrocnemius muscle is very useful for this purpose. It is an elaborate procedure which is associated with a high rate of complications. However, this procedure can establish a secure coverage with soft tissue, and the function of the prosthesis and the patient’s extremity can be saved. We have treated 23 patients with a gastrocnemius rotation flap after knee prosthesis or knee arthrodesis infection with consecutive soft tissue damage at our hospital from 8/2004 through 3/2011. The overall rate of healing of the knee infections with stable soft tissue status is almost 87%. The revision rate with lifting of the flap and revision of the sutures at the point of insertion as well as the point of extraction was about 35% with long-term conservative or additional surgical treatments.

  15. Shear wave dispersion behaviors of soft, vascularized tissues from the microchannel flow model. (United States)

    Parker, K J; Ormachea, J; McAleavey, S A; Wood, R W; Carroll-Nellenback, J J; Miller, R K


    The frequency dependent behavior of tissue stiffness and the dispersion of shear waves in tissue can be measured in a number of ways, using integrated imaging systems. The microchannel flow model, which considers the effects of fluid flow in the branching vasculature and microchannels of soft tissues, makes specific predictions about the nature of dispersion. In this paper we introduce a more general form of the 4 parameter equation for stress relaxation based on the microchannel flow model, and then derive the general frequency domain equation for the complex modulus. Dispersion measurements in liver (ex vivo) and whole perfused placenta (post-delivery) correspond to the predictions from theory, guided by independent stress relaxation measurements and consideration of the vascular tree structure.

  16. Non-linear mass-spring system for large soft tissue deformations modeling

    CERN Document Server

    Nikolaev, Sergei


    Implant placement under soft tissues operation is described. In this operation tissues can reach such deformations that nonlinear properties are appeared. A mass-spring model modification for modeling nonlinear tissue operation is developed. A method for creating elasticity module using splines is described. For Poisson ratio different stiffness for different types of springs in cubic grid is used. For stiffness finding an equation system that described material tension is solved. The model is verified with quadratic sample tension experiment. These tests show that sample tension under external forces is equal to defined nonlinear elasticity module. The accuracy of Poisson ratio modeling is thirty five percent that is better the results of available ratio modeling method.

  17. Effects of activator and high-pull headgear combination therapy: skeletal, dentoalveolar, and soft tissue profile changes. (United States)

    Marşan, Gülnaz


    The aim of this study was to evaluate skeletal, dentoalveolar, and soft tissue profile changes with activator and high-pull headgear combination therapy in patients with Class II malocclusions caused by maxillary prognathism and mandibular retrognathism. The subjects, all in the mixed dentition, were selected from a single centre and were divided into two groups: 28 patients were treated with an incisor double capping activator and a high-pull headgear combination appliance (13 girls, 15 boys mean chronological age 11.7 +/- 1.2 years, skeletal age 12.1 +/- 1.4 years) and an untreated group of 28 subjects (14 girls, 14 boys mean chronological mean age 11.9 +/- 1.1 years, skeletal age 12.3 +/- 1.3 years). The skeletal, dentoalveolar, and soft tissue profile changes that occurred were compared on lateral cephalograms taken before treatment (T0) and after 1.1 +/- 0.3 years when the combination appliance was removed (T1). In the control group, the radiographs were obtained at the start (T0) and after an observation period 1.2 +/- 0.4 years (T1). Statistical analysis was undertaken with Wilcoxon's ranked-sum test for intra-group comparisons and differences between groups with t-test and Bonferroni's test at a level of significance of P high-pull headgear combination treatment in these growing patients resulted in a correction of the skeletal Class II relationship (ANB -3.4 degrees), a restriction of maxillary growth (SNA -2.0 degrees, OLp-A -2.3 mm), an advancement of the mandibular structures (SNB +2.6 degrees, FH-NPg +2.3 degrees, OLp-B +2.7 mm, OLp-Pg +2.2 mm), an increase in lower face height (ANS-Me +3.9 mm), a correction of the overjet (-5.4 mm), an improvement in overbite (-2.2 mm), uprighting of the maxillary incisors (U1-FH -5.3 degrees, OLp-U1 -2.5 mm), protrusion of the mandibular incisors (IMPA +2.0 degrees, OLp-L1 +2.7 mm), and a correction of the dental Class II malocclusion (OLp-L6 +3.5 mm). The soft tissue profile changes were a correction of facial

  18. Bioreactors Drive Advances in Tissue Engineering (United States)


    problems. It dawned on me that rotating the wall of the reactor would solve one of our fundamental fluid mechanical problems, specifically by removing the velocity gradient of the tissue culture fluid media near the reactor s walls, says Wolf. It looked as though it would allow us to suspend the growing cells within the reactor without introducing turbulent fluid mechanical conditions.

  19. Adaptive radiotherapy for soft tissue changes during helical tomotherapy for head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Duma, M.N.; Kampfer, S.; Winkler, C.; Geinitz, H. [Universitaetsklinikum rechts der Isar, Muenchen (Germany). Dept. of Radiation Oncology; Schuster, T. [Universitaetsklinikum rechts der Isar, Muenchen (Germany). Inst. of Medical Statistics and Epidemiology


    The goal of the present study was to assess the frequency and impact of replanning triggered solely by soft tissue changes observed on the daily setup mega-voltage CT (MVCT) in head and neck cancer (H and N) helical tomotherapy (HT). A total of 11 patients underwent adaptive radiotherapy (ART) using MVCT. Preconditions were a soft tissue change > 0.5 cm and a tight mask. The dose-volume histograms (DVHs) derived from the initial planning kVCT (inPlan), the recalculated DVHs of the fraction (fx) when replanning was decided (actSit) and the DVHs of the new plan (adaptPlan) were compared. Assessed were the following: maximum dose (D{sub max}), minimum dose (D{sub min}), and mean dose (D{sub mean}) to the planning target volume (PTV) normalized to the prescribed dose; the D{sub mean}/fx to the parotid glands (PG), oral cavity (OC), and larynx (Lx); and the D{sub max}/fx to the spinal cord (SC) in Gy/fx. No patient had palpable soft tissue changes. The median weight loss at the moment of replanning was 2.3 kg. The median PTV D{sub mean} was 100% for inPlan, 103% for actSit, and 100% for adaptPlan. The PTV was always covered by the prescribed dose. A statistically significant increase was noted for all organs at risk (OAR) in the actSit. The D{sub mean} to the Lx, the D{sub mean} to the OC and the D{sub max} to the SC were statistically better in the adaptPlan. No statistically significant improvement was achieved by ART for the PGs. No significant correlations between weight and volume loss or between the volume changes of the organs to each other were observed, except a strong positive correlation of the shrinkage of the PGs ({rho} = + 0.77, p = 0.005). Soft tissue shrinkage without clinical palpable changes will not affect the coverage of the PTV, but translates into a higher delivered dose to the PTV itself and the normal tissue outside the PTV. The gain by ART in individual patients - especially in patients who receive doses close to the tolerance doses of the OAR

  20. A feasibility study of soft embalmed human breast tissue for preclinical trials of HIFU- preliminary results (United States)

    Joy, Joyce; Yang, Yang; Purdie, Colin; Eisma, Roos; Melzer, Andreas; Cochran, Sandy; Vinnicombe, Sarah


    Breast cancer is the commonest cancer in women in the UK, accounting for 30% of all new cancers in women, with an estimated 49,500 new cases in 20101. With the widespread negative publicity around over-diagnosis and over-treatment of low risk breast cancers, interest in the application of non-invasive treatments such as magnetic resonance imaging (MRI) guided high intensity focused ultrasound (HIFU) has increased. Development has begun of novel US transducers and platforms specifically designed for use with breast lesions, so as to improve the range of breast lesions that can be safely treated. However, before such transducers can be evaluated in patients in clinical trials, there is a need to establish their efficacy. A particular issue is the accuracy of temperature monitoring of FUS with MRI in the breast, since the presence of large amounts of surrounding fat can hinder temperature measurement. An appropriate anatomical model that imposes similar physical constraints to the breast and that responds to FUS in the same way would be extremely advantageous. The aim of this feasibility study is to explore the use of Thiel embalmed cadaveric tissue for these purposes. We report here the early results of laboratory-based experiments sonicating dissected breast samples from a Thiel embalmed soft human cadaver with high body mass index (BMI). A specially developed MRI compatible chamber and sample holder was developed to secure the sample and ensure reproducible sonications at the transducer focus. The efficacy of sonication was first studied with chicken breast and porcine tissue. The experiments were then repeated with the dissected fatty breast tissue samples from the soft-embalmed human cadavers. The sonicated Thiel breast tissue was examined histopathologically, which confirmed the absence of any discrete lesion. To investigate further, fresh chicken breast tissue was embalmed and the embalmed tissue was sonicated with the same parameters. The results confirmed the

  1. Recent advances in cryo-TEM imaging of soft lipid nanoparticles

    DEFF Research Database (Denmark)

    Helvig, Shen Yu; Mat Azmi, Intan Diana Binti; Moghimi, Seyed Moien;


    Cryo-transmission electron microscopy (Cryo-TEM), and its technological variations thereof, have become a powerful tool for detailed morphological characterization and 3D tomography of soft lipid and polymeric nanoparticles as well as biological materials such as viruses and DNA without chemical...... fixation. Here, we review and discuss recent advances in Cryo-TEM analysis of lipid-based drug nanocarriers with particular emphasis on morphological and internal nanostructure characterization of lyotropic liquid crystalline nanoparticles such as cubosomes and hexosomes....

  2. Magnetic resonance imaging of intraoral hard and soft tissues using an intraoral coil and FLASH sequences

    Energy Technology Data Exchange (ETDEWEB)

    Fluegge, Tabea; Eisenbeiss, Anne-Kathrin; Schmelzeisen, Rainer; Nelson, Katja [University Medical Center Freiburg, Department of Oral and Maxillofacial Surgery, Freiburg (Germany); Hoevener, Jan-Bernd; Ludwig, Ute; Hennig, Juergen [University Medical Center Freiburg, Medical Physics, Department of Radiology, Freiburg (Germany); Spittau, Bjoern [Albert Ludwig University of Freiburg, Institute of Anatomy and Cell Biology, Freiburg (Germany)


    To ascertain the feasibility of MRI as a non-ionizing protocol for routine dentomaxillofacial diagnostic imaging. Wireless coils were used for MRI of intraoral hard and soft tissues. FLASH MRI was applied in vivo with a mandible voxel size of 250 x 250 x 500 μm{sup 3}, FOV of 64 x 64 x 28 mm{sup 3} and acquisition time of 3:57 min and with a maxilla voxel size of 350 μm{sup 3} and FOV of 34 cm{sup 3} in 6:40 min. Ex vivo imaging was performed in 4:38 min, with a resolution of 200 μm{sup 3} and FOV of 36.5 cm{sup 3}. Cone beam (CB) CT of the mandible and subjects were acquired. MRI was compared to CBCT and histological sections. Deviations were calculated with intraclass correlation coefficient (ICC) and coefficient of variation (c{sub v}). A high congruence between CBCT, MRI and specimens was demonstrated. Hard and soft tissues including dental pulp, periodontium, gingiva, cancellous bone and mandibular canal contents were adequately displayed with MRI. Imaging of select intraoral tissues was achieved using custom MRI protocols with an easily applicable intraoral coil in a clinically acceptable acquisition time. Comparison with CBCT and histological sections helped demonstrate dimensional accuracy of the MR images. The course of the mandibular canal was accurately displayed with CBCT and MRI. (orig.)

  3. A comparison of numerical methods used for finite element modelling of soft tissue deformation

    KAUST Repository

    Pathmanathan, P


    Soft tissue deformation is often modelled using incompressible non-linear elasticity, with solutions computed using the finite element method. There are a range of options available when using the finite element method, in particular the polynomial degree of the basis functions used for interpolating position and pressure, and the type of element making up the mesh. The effect of these choices on the accuracy of the computed solution is investigated, using a selection of model problems motivated by typical deformations seen in soft tissue modelling. Model problems are set up with discontinuous material properties (as is the case for the breast), steeply changing gradients in the body force (as found in contracting cardiac tissue), and discontinuous first derivatives in the solution at the boundary, caused by a discontinuous applied force (as in the breast during mammography). It was found that the choice of pressure basis functions is vital in the presence of a material interface, higher-order schemes do not perform as well as may be expected when there are sharp gradients, and in general it is important to take the expected regularity of the solution into account when choosing a numerical scheme. © IMechE 2009.

  4. Adhesion-governed buckling of thin-film electronics on soft tissues

    Directory of Open Access Journals (Sweden)

    Bo Wang


    Full Text Available Stretchable/flexible electronics has attracted great interest and attention due to its potentially broad applications in bio-compatible systems. One class of these ultra-thin electronic systems has found promising and important utilities in bio-integrated monitoring and therapeutic devices. These devices can conform to the surfaces of soft bio-tissues such as the epidermis, the epicardium, and the brain to provide portable healthcare functionalities. Upon contractions of the soft tissues, the electronics undergoes compression and buckles into various modes, depending on the stiffness of the tissue and the strength of the interfacial adhesion. These buckling modes result in different kinds of interfacial delamination and shapes of the deformed electronics, which are very important to the proper functioning of the bio-electronic devices. In this paper, detailed buckling mechanics of these thin-film electronics on elastomeric substrates is studied. The analytical results, validated by experiments, provide a very convenient tool for predicting peak strain in the electronics and the intactness of the interface under various conditions.

  5. Soft tissue augmentation for restoration of facial contour deformities using the free SCIA/SIEA flap. (United States)

    Nasir, Serdar; Aydin, Mustafa Asim; Altuntaş, Selman; Sönmez, Erhan; Safak, Tunç


    Reconstruction for facial contour deformities is still a challenging process and treatment for most cases is achieved only by soft tissue augmentation. The use of free tissue transfer offers the advantage of one step vascularized soft tissue augmentation. This article summarized the authors' use of de-epithelialized free superficial circumflex iliac artery/superficial inferior epigastric artery flap for facial contour deformities. Of these patients, two had hemifacial microsomia, one depressed scar, and one had hemifacial progressive atrophy. Stable restoration of the facial contour was achieved in all patients. The advantages of this flap are numerous. Two surgical teams may work at the same time for flap harvesting and recipient area preparation. A wide flap may be planned for large contour deformity to achieve one single stage augmentation. Pedicle course of this flap allows primary de-fating without disturbing distal flap circulation when in need of a thin flap for mild contour deformity. Donor site may be closed with bikini (abdominoplasty) incision, which has excellent esthetic outcome compared to other flaps.

  6. Influence of exercise loading on magnetic resonance image texture of thigh soft tissues. (United States)

    Sikiö, Minna; Harrison, Lara C V; Nikander, Riku; Ryymin, Pertti; Dastidar, Prasun; Eskola, Hannu J; Sievänen, Harri


    Adaptation to exercise training can affect bone marrow adiposity; muscle-fat distribution; and muscle volume, strength and architecture. The objective of this study was to identify exercise-load-associated differences in magnetic resonance image textures of thigh soft tissues between various athlete groups and non-athletes. Ninety female athletes representing five differently loading sport types (high impact, odd impact, high magnitude, repetitive low impact and repetitive non-impact), and 20 non-athletic clinically healthy female controls underwent magnetic resonance imaging. Five thigh muscles, subcutaneous fat and femoral bone marrow were analysed with co-occurrence matrix-based quantitative texture analysis at two anatomical levels of the dominant leg. Compared with the controls thigh muscle textures differed especially in high-impact and odd-impact exercise-loading groups. However, all sports appeared to modulate muscle textures to some extent. Fat tissue was found different among the low-impact group, and bone marrow was different in the high-impact group when compared to the controls. Exercise loading was associated with textural variation in magnetic resonance images of thigh soft tissues. Texture analysis proved a potential method for detecting apparent structural differences in the muscle, fat and bone marrow.

  7. A model for the anisotropic response of fibrous soft tissues using six discrete fibre bundles

    KAUST Repository

    Flynn, Cormac


    The development of constitutive models of fibrous soft-tissues is a challenging problem. Many consider the tissue to be a collection of fibres with a continuous distribution function representing their orientations. A discrete fibre model is presented consisting of six weighted fibre-bundles. Each bundle is oriented such that it passes through opposing vertices of a regular icosahedron. A novel aspect is the use of simple analytical distribution functions to simulate undulated collagen fibres. This approach yields closed-form analytical expressions for the strain energy of the collagen fibre-bundle that avoids the sometimes costly numerical integration of some statistical distribution functions. The elastin fibres are characterized by a modified neo-Hookean type strain energy function which does not allow for fibre compression. The model accurately simulates biaxial stretching of rabbit-skin (error-of-fit 8.7), uniaxial stretching of pig-skin (error-of-fit 7.6), equibiaxial loading of aortic valve cusp (error-of-fit 0.8), and simple shear of rat septal myocardium (error-of-fit 8.9). It compares favourably with previous soft-tissue models and alternative methods of representing undulated collagen fibres. Predicted collagen fibre stiffnesses range from 8.0thinspaceMPa to 930MPa. Elastin fibre stiffnesses range from 2.0 kPa to 154.4 kPa. © 2011 John Wiley & Sons, Ltd.

  8. [Microsurgical elimination of foot soft tissue defects with free vascularized flaps]. (United States)

    Moroz, V I; Iudenich, A A; Mikhaílov, I A; Kafarov, T G; Kuntsevich, G I


    The results of 40 microsurgical transplantations of complex flaps in 37 patients with cicatricial-ulcerous foot deformations are analysed. The surgery was indicated in cicatricial soft tissues defects, unhealing trophic ulcers, inability to use local tissues for plastic surgery. The scapular flap was used in 34 cases, thoraco-dorsal flap in 5 cases, deltoid flap in 1 case. It was necessary to increase the square of the scapular flap in case of a vast cicatricial soft tissue defect of the talocrural joint and dorsal surface of the foot and the sole. A special expander was used for this purpose. The importance of ultrasound methods for evaluation of the vessels supplying the sole, as well as the state of the microvascular anastomoses in postoperative period is stressed. The long-term results were followed up for 1.5 to 5 years in 29 of 37 patients. The good results was noted in 18 patients, satisfactory in 7 patients, complications (unhealed trophic ulcers) in 4 patients. The complications were caused by calcanel tuber deformation with osteophyte, osteomyelitis, inradically removed scars.

  9. Preclinical evaluation of oncolytic vaccinia virus for therapy of canine soft tissue sarcoma.

    Directory of Open Access Journals (Sweden)

    Ivaylo Gentschev

    Full Text Available Virotherapy using oncolytic vaccinia virus (VACV strains is one promising new strategy for canine cancer therapy. In this study we describe the establishment of an in vivo model of canine soft tissue sarcoma (CSTS using the new isolated cell line STSA-1 and the analysis of the virus-mediated oncolytic and immunological effects of two different Lister VACV LIVP1.1.1 and GLV-1h68 strains against CSTS. Cell culture data demonstrated that both tested VACV strains efficiently infected and destroyed cells of the canine soft tissue sarcoma line STSA-1. In addition, in our new canine sarcoma tumor xenograft mouse model, systemic administration of LIVP1.1.1 or GLV-1h68 viruses led to significant inhibition of tumor growth compared to control mice. Furthermore, LIVP1.1.1 mediated therapy resulted in almost complete tumor regression and resulted in long-term survival of sarcoma-bearing mice. The replication of the tested VACV strains in tumor tissues led to strong oncolytic effects accompanied by an intense intratumoral infiltration of host immune cells, mainly neutrophils. These findings suggest that the direct viral oncolysis of tumor cells and the virus-dependent activation of tumor-associated host immune cells could be crucial parts of anti-tumor mechanism in STSA-1 xenografts. In summary, the data showed that both tested vaccinia virus strains and especially LIVP1.1.1 have great potential for effective treatment of CSTS.

  10. Multidrug-resistant Escherichia coli soft tissue infection investigated with bacterial whole genome sequencing (United States)

    Buchanan, Ruaridh; Stoesser, Nicole; Crook, Derrick; Bowler, Ian C J W


    A 45-year-old man with dilated cardiomyopathy presented with acute leg pain and erythema suggestive of necrotising fasciitis. Initial surgical exploration revealed no necrosis and treatment for a soft tissue infection was started. Blood and tissue cultures unexpectedly grew a Gram-negative bacillus, subsequently identified by an automated broth microdilution phenotyping system as an extended-spectrum β-lactamase producing Escherichia coli. The patient was treated with a 3-week course of antibiotics (ertapenem followed by ciprofloxacin) and debridement for small areas of necrosis, followed by skin grafting. The presence of E. coli triggered investigation of both host and pathogen. The patient was found to have previously undiagnosed liver disease, a risk factor for E. coli soft tissue infection. Whole genome sequencing of isolates from all specimens confirmed they were clonal, of sequence type ST131 and associated with a likely plasmid-associated AmpC (CMY-2), several other resistance genes and a number of virulence factors. PMID:25331151

  11. Combining mechanical foaming and thermally induced phase separation to generate chitosan scaffolds for soft tissue engineering. (United States)

    Biswas, D P; Tran, P A; Tallon, C; O'Connor, A J


    In this paper, a novel foaming methodology consisting of turbulent mixing and thermally induced phase separation (TIPS) was used to generate scaffolds for tissue engineering. Air bubbles were mechanically introduced into a chitosan solution which forms the continuous polymer/liquid phase in the foam created. The air bubbles entrained in the foam act as a template for the macroporous architecture of the final scaffolds. Wet foams were crosslinked via glutaraldehyde and frozen at -20 °C to induce TIPS in order to limit film drainage, bubble coalescence and Ostwald ripening. The effects of production parameters, including mixing speed, surfactant concentration and chitosan concentration, on foaming are explored. Using this method, hydrogel scaffolds were successfully produced with up to 80% porosity, average pore sizes of 120 μm and readily tuneable compressive modulus in the range of 2.6 to 25 kPa relevant to soft tissue engineering applications. These scaffolds supported 3T3 fibroblast cell proliferation and penetration and therefore show significant potential for application in soft tissue engineering.

  12. Standardized 3D Bioprinting of Soft Tissue Models with Human Primary Cells. (United States)

    Rimann, Markus; Bono, Epifania; Annaheim, Helene; Bleisch, Matthias; Graf-Hausner, Ursula


    Cells grown in 3D are more physiologically relevant than cells cultured in 2D. To use 3D models in substance testing and regenerative medicine, reproducibility and standardization are important. Bioprinting offers not only automated standardizable processes but also the production of complex tissue-like structures in an additive manner. We developed an all-in-one bioprinting solution to produce soft tissue models. The holistic approach included (1) a bioprinter in a sterile environment, (2) a light-induced bioink polymerization unit, (3) a user-friendly software, (4) the capability to print in standard labware for high-throughput screening, (5) cell-compatible inkjet-based printheads, (6) a cell-compatible ready-to-use BioInk, and (7) standard operating procedures. In a proof-of-concept study, skin as a reference soft tissue model was printed. To produce dermal equivalents, primary human dermal fibroblasts were printed in alternating layers with BioInk and cultured for up to 7 weeks. During long-term cultures, the models were remodeled and fully populated with viable and spreaded fibroblasts. Primary human dermal keratinocytes were seeded on top of dermal equivalents, and epidermis-like structures were formed as verified with hematoxylin and eosin staining and immunostaining. However, a fully stratified epidermis was not achieved. Nevertheless, this is one of the first reports of an integrative bioprinting strategy for industrial routine application.

  13. Preferential soft-tissue preservation in the Hot Creek carbonate spring deposit, British Columbia, Canada (United States)

    Rainey, Dustin K.; Jones, Brian


    The relict Holocene Hot Creek carbonate spring deposit in southeast British Columbia is characterized by excellent preservation of soft-tissue organisms (e.g. cyanobacteria), but poor preservation of organisms with hard-tissue (e.g. wood, diatoms). The deposit is formed mainly of calcified cyanobacteria, with fewer mineralized macrophytes (plants), bryophytes (mosses), wood, and diatoms. Cyanobacteria grew as solitary filaments ( Lyngbya) and as radiating hemispherical colonies ( Rivularia). Both were preserved by encrustation and encapsulation while alive, and as casts after filament death and decay. Sheath impregnation was rare to absent. Filament encrustation, whereby calcite crystals nucleated on, and grew away from the sheath exterior, produced moulds that replicated external filament morphology, but hastened filament decay. Filament encapsulation, whereby calcite nucleated in the vicinity of, and grew towards the encapsulated filament, promoted sheath preservation even after trichome decay. Subsequent calcite precipitation inside the hollow sheath generated sheath casts. The inability of mineralizing spring water to penetrate durable cell walls meant that bryophytes, macrophytes, and most wood was preserved by encrustation. Some wood resisted complete decay for several thousand years, and its lignified cell walls allowed rare permineralizations. Diatoms were not preserved in the relict deposit because the frustules were dissolved by the basic spring water. Amorphous calcium carbonate produced by photosynthetic CO 2 removal may have acted as nucleation sites for physicochemically precipitated calcite. Thus, metabolic activities of floral organisms probably initiated biotic mineralization, but continuous inorganic calcite precipitation on and in flora ensured that soft tissues were preserved.

  14. Advances and Perspectives on Tissue Repair and Healing (United States)

    Pinheiro, Antonio L. B.; Marques, Aparecida M. C.; de Sousa, Ana Paula C.; Aciole, Jouber M. S.; Soares, Luiz G. P.


    Wound healing involves local and systemic responses that reflect the etiology of the lesion, type of tissue, systemic condition and others. Despite being essentially the same for different wounds, the pattern of healing may change due to intrinsic and/or extrinsic factors. The type of tissue has also to be considered. Several therapeutic approaches have been used to improve healing including phototherapies such as Laser, LEDs and Lamps. Their effects on soft and mineralized tissues are well reported. The choice of appropriated parameters is essential for the results of the treatment and includes wavelength, power density, energy, duration and frequency of application and others. We studied the effects of different types of light on the healing of both soft and mineralized tissues using different models. We found that the use of Laser and polarized light are effective on improving the healing of diabetic and undernourished animals. We also found that Laser light is capable of improving the healing of drug-induced impairment and on increasing the survival rate of flaps on both diabetic and non-diabetic animals. We have also studied and shown the influence of the laser parameters on the healing of surgical and laser wounds. Lately we verified the positive effect of LEDs on healing. We used Laser/LED light for improving bone healing in conditions such as in dental implants, autologous grafts, biomaterials and fractures. From these reports and our own experience we have no doubt whatsoever that the use of phototherapies, carried out with appropriate parameters, promotes quicker tissue repair.

  15. Cutaneous and Subcutaneous Soft Tissue Tumours in Snakes: A Retrospective Study of 33 Cases. (United States)

    Dietz, J; Heckers, K O; Aupperle, H; Pees, M


    Cutaneous and subcutaneous soft tissue tumours have been rarely described in detail in snakes. Several malignant entities show strikingly similar histological patterns and therefore the term soft tissue sarcoma (STS) has become a standard histopathological diagnosis. The present study characterizes soft tissue tumours in 33 snakes. Samples included 29 surgically excised masses and four carcasses. Additionally, six animals were humanely destroyed and submitted for necropsy examination following tumour recurrence. Benign neoplasms (n = 8) were described as lipomas of varying differentiation. Recurrence was observed in two of five snakes in which the clinical course was recorded. Malignant neoplasms (n = 25) were diagnosed as STS and graded according to a three-point system previously applied to canine STS. Five (20%) of the primary tumours were classified as grade 1, eleven (44%) as grade 2 and nine (36%) as grade 3 sarcomas. Clinically, recurrence of STS was observed in 11 of 17 cases with available follow-up information. Pathologically, multiple cutaneous metastases were found in one grass snake (Natrix natrix), while visceral metastases were observed in one carpet python (Morelia spilota) and two corn snakes (Pantherophis guttatus). Metastatic risk appears to increase with histological grade. Surgical excision generally represents the current therapy of choice for STS. This study includes the first reports of conventional lipomas in a ribbon snake (Thamnophis radix), angiolipomas in a black-headed python (Aspidites melanocephalus) and a corn snake as well as of STS in a Jamaican boa (Epicrates subflavus), emerald tree boa (Corallus caninus), grass snake (N. natrix), African house snake (Lamprophis fuliginosus), California kingsnake (Lampropeltis getula californiae) and common garter snake (Thamnophis sirtalis).

  16. The HVL in soft tissue and the AAPM and IEC exposure indices. (United States)

    Poletti, John


    Manual exposure settings for radiographic projections were once based on a points system which assumed that the HVL in soft tissue is 3.0 cm and that each change of 1.0 cm of soft tissue corresponded to a change of 25% in image receptor dose. A set of mAs steps and equivalent kVp steps was estimated that would give appropriate technique factors for changes in patient thickness. With the advent of rare-earth screen-film systems and AEC systems the points system fell into disuse. Screen-film imaging systems have almost entirely been replaced by CR or DR systems and recently, standardised exposure indices have been recommended by the AAPM and IEC to provide exposure guidance for these systems. If the fundamental assumptions on which the points system was based are still valid for modern high-frequency generators and digital imaging systems, then there would be an elegant correspondence between the predictions of the points system and the requirements for correction of exposure errors indicated by the AAPM and IEC indices. This study estimated the HVL and attenuation per cm in soft tissue using computer simulation, finding that practically, the HVL is between 2.0 and 5.0 cm and attenuation per cm ranges from 15 to 25%. The study concluded that agreement between the points system predictions and the true effects of technique factors changes on dose to the image receptor was moderately good, that use of the points system and technique charts based on this system should be encouraged and that use of the IEC or AAPM digital exposure indices should be standardised.

  17. Surgical Management of Levamisole-Adulterated Cocaine Induced Soft Tissue Necrosis: Case Study and Treatment Algorithm. (United States)

    Mcevenue, Giancarlo; Brichacek, Michael; Logsetty, Sarvesh; Shahrokhi, Shar


    Levamisole is an increasingly common cocaine adulterant that can cause severe and rapid onset cutaneous vasculitis in humans. While most cases may be managed conservatively, we describe a series of patients in whom the extent of skin and soft tissue necrosis mandated surgical intervention. A retrospective review of all patients admitted to one of two regional burn centers between 2006 and 2016 for soft tissue necrosis after exposure to levamisole-adulterated cocaine was included in our study. Ten patients, majority female (9/10) with an average age of 43.4 years (range 31-57), were included. Cocaine usage before presentation averaged 6 days (range 1-14). Presenting complaints consisted of arthralgia (5/10), fever (7/10), and purpuric lesions (10/10). Average TBSA involvement was 23.5% (range 4-70). Immunological testing revealed pANCA+ in 8 of 10 and cANCA+ in 4 of 8 patients. Operative intervention occurred by postadmission day 11.6 (range 3-30). The mean number of operations required was 3 (range 2-6); length of stay averaged 46.8 days (range 14-120); and survival to discharge was 100% (10/10). To our knowledge, this is the largest case study detailing the surgical management of levamisole-associated skin necrosis. Additionally, we describe the most extensive case of this disease process at 70% TBSA involvement. Based on our experience, we recommend waiting for purpuric rash resolution and soft tissue necrosis to be fully demarcated before fascial debridement and then staged skin grafting with allograft followed by autograft.

  18. An experimental model of tool mark striations by a serrated blade in human soft tissues. (United States)

    Jacques, Rebekah; Kogon, Stanley; Shkrum, Michael


    Tool mark analysis is a method of matching a weapon with the injury it caused. In a homicidal stabbing using a serrated knife, a stab wound that involves a cartilage may leave striations from the serration points on the blade edge. Assessing tissue striations is a means of identifying the weapon as having a serrated blade. This prospective study examines the possibility that similar striations may be produced in human soft tissues. Using tissues taken at the time of hospital-consented autopsies, stab wound tracks were assessed in a variety of human tissues (aorta, skin, liver, kidney, and cardiac and skeletal muscle). Stab wounds were produced postmortem with similar serrated and smooth-edged blades. The walls of the stab wounds were exposed, documented by photography and cast with dental impression material. Striations were identified by naked-eye examination in the skin and aorta. Photodocumentation of fresh tissue was best achieved in the aorta. Striations were not identified in wound tracks produced by the smooth-edged blade. Three blinded forensic pathologists were assessed for their ability to detect striations in photographs of wound tracks and had substantial interobserver agreement (κ = 0.76) identifying striations. This study demonstrates that tool mark striations can be present in some noncartilaginous human tissues.

  19. Distribution and relationships of trace metals in soft tissue, byssus and shells of Mytilus edulis trossulus from the southern Baltic

    Energy Technology Data Exchange (ETDEWEB)

    Szefer, P.; Frelek, K.; Szefer, K.; Lee, C.-B.; Kim, B.-S.; Warzocha, J.; Zdrojewska, I.; Ciesielski, T


    Soft tissues and byssus of the blue mussel (Mytilus edulis) were better metal bioindicators than shells. - Concentrations of Hg, Cd, Pb, Ag, Cu, Zn, Cr, Ni, Co, Mn, and Fe in soft tissues, shells and byssus of blue mussel (Mytilus edulis trossulus) from 23 sites along the Polish coast of the Baltic Sea were determined by AAS method. Byssus, as compared with the soft tissue, concentrated more effectively Pb, Cu, Cr, and especially Ag, Ni, Mn and Fe, moderately Hg and Zn and less effectively Cd. Significant inter-regional and inter-size differences in metal concentrations in both soft tissues and byssus were recorded. Highly significant correlations (P<0.01, P<0.05) were observed between tissue and byssal concentrations of Cd, Pb, Ni and Ag. Factor analysis showed clear separation of both the tissue and byssi samples based on their geographic distribution, possibly reflecting a different rate of deposition of clay minerals at the head of the Pomeranian Bay and the Gulf of Gdansk. The Pomeranian Bay differs from the Gulf of Gdansk in respect to geological structure of bottom sediments as a substrata for the M. edulis trossulus as well as in relation to various sources of metallic pollutants. From the data obtained in the present study and those reported previously the soft tissue and especially byssus of M. edulis, in contrast to shells, appear to be a significantly better bioindicator for identification of coastal areas exposed to metallic contaminants.

  20. RFA of osseous and soft tissue tumors; RFA von Tumoren des Knochens und der Weichteile

    Energy Technology Data Exchange (ETDEWEB)

    Jakobs, T.F.; Hoffmann, R.T.; Vick, C.; Wallnoefer, A.; Reiser, M.F.; Helmberger, T.K. [Inst. fuer Klinische Radiologie, Klinikum Grosshadern der Univ. Muenchen (Germany)


    Radiofrequency ablation (RFA) of primary and secondary liver malignancies is a promising and rapidly evolving technique, which increasingly gains importance. A new field of RFA is the minimal invasive therapy of osseous and soft tissue tumors. In the management of osteoid-osteoma, RFA is a well established treatment option. Basic principles, indications, complications and results of RFA will be presented. A careful evaluation of indications for RFA in osseous of soft tissue neoplasms is mandatory. In patients who are neither candidates for surgical tumor resection nor respond to chemotherapy, there is a need for alternative treatment options. In these preselected patients a substantial improvement in quality of life with low associated morbidity can be provided by RFA. In malignancies of bone and soft-tissue tumors, RFA is a palliative treatment option. Therefore, the results can not be compared to those of surgical resection or chemotherapy which essentially are employed with curative intention. Our own experiences as well as data published in the literature indicate that RFA is a helpful tool in preserving patient's quality of life. The high technical and clinical success together with a low complication rate makes RFA of osseous and soft tissue neoplasms a valuable supportive tool for patients not referable for surgery or systemic therapy. (orig.) [German] Die Radiofrequenzablation (RFA) von primaeren oder sekundaeren Lebertumoren ist eine vielversprechende und sich schnell weiterentwickelnde Technik, die sich in den letzten Jahren bei der Behandlung von Lebermalignomen zunehmend etabliert hat. Waehrend die RFA schon seit laengerem erfolgreich fuer die Behandlung von Osteoidosteomen eingesetzt wird, findet sie ein neues Einsatzgebiet in der minimal-invasiven Therapie fokal begrenzter, maligner Tumoren des Knochens und der Weichteile. Technik, Indikationen, Komplikationen und erste Ergebnisse der RFA von Knochen- und Weichteiltumorn werden vorgestellt. Die