Sample records for facial soft tissue

  1. 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)?

  2. Facial soft tissue thickness in North Indian adult population

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    Tanushri Saxena


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

  3. 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.

  4. 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.

  5. 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.

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

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    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

  7. Facial paralysis reconstruction with Gore-Tex Soft-Tissue Patch. (United States)

    Konior, R J


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

  8. 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.

  9. 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.

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

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    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.

  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. 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.

  13. 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.

  14. 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...

  15. 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.

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

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    Kanhoba Mahabaleshwar Keluskar; N D Zingade; Madhu P Sivan


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

  17. 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.

  18. Variations of midline facial soft tissue thicknesses among three skeletal classes in Central Anatolian adults. (United States)

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


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

  19. 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.

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

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    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

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

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    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.

  2. [Individualized three-dimensional finite element model of facial soft tissue and preliminary application in orthodontics]. (United States)

    Chen, Si; Xu, Tian-min; Lou, Hang-di; Rong, Qi-guo


    To get individualized facial three-dimensional finite element (FE) model from transformation of a generic one to assist orthodontic analysis and prediction of treatment-related morphological change of facial soft tissue. A generic three-dimensional FE model of craniofacial soft and hard tissue was constructed based on a volunteer's spiral CT data. Seven pairs of main peri-oral muscles were constructed based on a combination of CT image and anatomical method. Individualized model could be obtained through transformation of the generic model based on selection of corresponding anatomical landmarks and radial basis functions (RBF) method. Validation was analyzed through superimposition of the transformed model and cone-beam CT (CBCT) reconstruction data. Pre- and post-treatment CBCT data of two patients were collected, which were superimposed to gain the amount of anterior teeth retraction and anterior alveolar surface remodeling that could be used as boundary condition. Different values of Poisson ratio ν and Young's modulus E were tested during simulation. Average deviation was 0.47 mm and 0.75 mm in the soft and hard tissue respectively. It could be decreased to a range of +0.29 mm and -0.21 mm after a second transformation at the lip-mouth region. The best correspondence between simulation and post-treatment result was found with elastic properties of soft tissues defined as follows. Poisson ratio ν for skin, muscle and fat being set as 0.45 while Young's modulus being set as 90.0 kPa, 6.2 kPa and 2.0 kPa respectively. Individualized three-dimensional facial FE model could be obtained through mathematical model transformation. With boundary condition defined according to treatment plan such FE model could be used to analyze the effect of orthodontic treatment on facial soft tissue.

  3. 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.

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

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    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.

  5. 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.

  6. A cross-sectional study of soft tissue facial morphometry in children of West Bengal

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    Badruddin A Bazmi


    Full Text Available Context: Facial analysis is the first step in the evaluation of patients with orthodontic, cosmetic, or reconstructive procedures of the face, and one of the most important components of orthodontic diagnosis and treatment planning. It is a well-established fact that human faces differ from one another on the basis of race and ethnicity. The study will provide the aesthetic guidelines to assess the facial discrepancy in Bengali children to develop a proper treatment plan. Aims: To find out the mean values for selective linear measurements on the facial soft tissue of Bengali children, to demonstrate gender differences in the measurements. Materials and Methods: A cross-sectional study was done on 250 Bengali children of 6-14 years age, by measuring certain identified facial landmarks using a digital caliper. Statistical Analysis Used: Analytical statistical method with the help of student′s t-test was used to determine mean values, standard deviation, and gender differences in the measurements using SPSS version 11.0. Results: In 6-8 years age group, male′s average inter-endocanthion distance was significantly higher than that of females ( P 0.05, though for 87% of cases, it was significant ( P = 0.13. Total facial height for male subject was significantly high compared to that of females ( P < 0.001 in 12-14 years age group. Conclusions: The study will provide the aesthetic guidelines to assess the facial discrepancy in Bengali children and provide a proper treatment plan through a simple and economically reasonable soft tissue analysis method.

  7. Expanded polytetrafluoroethylene (Gore-Tex soft-tissue patch) in facial augmentation. (United States)

    Maas, C S; Gnepp, D R; Bumpous, J


    Expanded polytetrafluoroethylene (EPTFE) (Gore-Tex soft-tissue patch) has received favorable clinical reports for use in facial augmentation procedures. We evaluated the EPTFE soft-tissue patch in short-term (3-week), intermediate-term (6-month), and long-term (12-month) animal models. Nine pathogen-free male and female New Zealand white rabbits weighing 2 to 4 kg were used. After implantation of the EPTFE soft-tissue patch, the animals were carefully observed on a daily basis for signs of wound infection, seroma, or hematoma formation. The stability of the implant was evaluated and graded after the animals were killed. Tissue specimens, including skin, implant, and underlying bone, were removed en bloc. These blocks were sectioned and stained for histologic evaluation. A portion of these blocks were used for scanning electron microscopy. The material increased in stability over time and showed minimal inflammatory cell response and only a delicate fibrous capsule, even in long-term implants. Ultrastructural analysis demonstrated close apposition of the material to tissue, suggesting good interface bioactivity. The EPTFE soft-tissue patch appears to be safe and reliable material for augmentation, demonstrating high biocompatibility, low tissue reactivity, and increasing stability over time.

  8. 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.

  9. Quantified Facial Soft-tissue Strain in Animation Measured by Real-time Dynamic 3-Dimensional Imaging

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    Vivian M. Hsu, MD


    Conclusions: This pilot study illustrates that the face can be objectively and quantitatively evaluated using dynamic major strain analysis. The technology of 3-dimensional optical imaging can be used to advance our understanding of facial soft-tissue dynamics and the effects of animation on facial strain over time.

  10. Facial soft tissue thickness database of Gujarati population for forensic craniofacial reconstruction

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    Anand Lodha


    Full Text Available The forensic facial reconstruction is a scientific art to construct the ante-mortem face from the human skull. The facial recognition is made by reconstructing the contours of the facial soft tissue thickness (FSTT.These FSTT data are essential for probable face reconstruction but the data of FSTT at particular anthropological landmarks differ in various ethnic groups. Until now several works have been reported on different population but no study exists in which the FSTT of a Gujarati population has been measured. The aim of this study is to compile a set of soft tissue depth data of Gujarati population of India to add to existing literature on FSTT. Computed tomography (CT-scan has been utilized to measure the 25 different FSTT landmarks of 324 male and 165 female. Present study shows significant differences in certain FSTT of Gujarati population from that of other populations. Our compiled data set of FSTT for the Gujarati population is important in understanding craniofacial characteristics of the Gujarati population and potentially be helpful in forensic identification.

  11. Facial soft-tissue morphology of adolescent patients with nonsyndromic bilateral cleft lip and palate. (United States)

    Hasanzadeh, Nadia; Majidi, Mohammad Reza; Kianifar, Hamidreza; Eslami, Neda


    The purpose of this study was to cephalometrically evaluate the facial soft-tissue characteristics of adolescent patients with bilateral cleft lip and palate (BCLP) and to compare them with a noncleft control group. Lateral cephalometric radiographs obtained from 56 adolescents with nonsyndromic BCLP (29 boys and 27 girls) were analyzed and compared with 67 control subjects (29 boys and 38 girls) who were matched for sex, age, and ethnicity. All patients had been operated on before the age of 2 years for the surgical repair of cleft lip and palate. None had received any orthopedic or orthodontic treatment. Independent-samples t test revealed that patients with BCLP significantly differed from the control group by having a flatter facial profile, thinner and more retruded nasal base, flatter nasal tip (in males), and reduced upper-lip length. Furthermore, thicker lower-lip pit, shallower mentolabial sulcus, and increased inclination angles of the upper and lower lips relative to the horizontal plane were observed in female patients compared with the normal group. The findings of the current study suggested that adolescent patients with BCLP showed several facial soft-tissue deformities when compared with normal individuals with the same age, sex, and ethnic origin. This study provides objective measures that could lead to better treatment planning and prediction of the need for corrective surgeries in patients with BCLP.

  12. Radiographic assessment of facial soft tissue thickness in South Indian population--An anthropologic study. (United States)

    Kotrashetti, Vijayalakshmi S; Mallapur, M D


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

  13. Comparison of soft tissue facial morphometry in children with Class I and Class II occlusions. (United States)

    Ferrario, V F; Sforza, C; Serrao, G; Puletto, S; Bignotto, M; Tartaglia, G


    Three-dimensional soft tissue facial morphometry was investigated in a sample of 167 children aged 6 to 9 years by using a new noninvasive computerized method. For each child, 16 cutaneous facial landmarks were automatically collected by a system consisting of two infrared CCD cameras, real-time hardware for the recognition of markers, and software for the three-dimensional reconstruction of the x, y, and z coordinates of landmarks. From these landmarks, 15 linear and 10 angular measurements and five linear distance ratios were computed. For each age class, mean values were computed for all children with a bilateral Angle Class I occlusion (modified according to Katz) and compared with values obtained in children with a bilateral Class II occlusion. Most of the differences involved three-dimensional angular measurements: Class II children had more convex faces in the sagittal plane and a less prominent mandible than did Class I children. No differences were found in the linear measurements. Only the lower facial height ratio was different between the two occlusion groups, but the difference was not consistent among all the age groups.

  14. 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

  15. Effect of Head Position on Facial Soft Tissue Depth Measurements Obtained Using Computed Tomography. (United States)

    Caple, Jodi M; Stephan, Carl N; Gregory, Laura S; MacGregor, Donna M


    Facial soft tissue depth (FSTD) studies employing clinical computed tomography (CT) data frequently rely on depth measurements from raw 2D orthoslices. However, the position of each patient's head was not standardized in this method, potentially decreasing measurement reliability and accuracy. This study measured FSTDs along the original orthoslice plane and compared these measurements to those standardized by the Frankfurt horizontal (FH). Subadult cranial CT scans (n = 115) were used to measure FSTDs at 18 landmarks. Significant differences were observed between the methods at eight of these landmarks (p < 0.05), demonstrating that high-quality data are not generated simply by employing modern imaging modalities such as CT. Proper technique is crucial to useful results, and maintaining control over head position during FSTD data collection is important. This is easily and most readily achieved in CT techniques by rotating the head to the FH plane after constructing a 3D rendering of the data.

  16. Facial soft tissue esthetic predictions: validation in craniomaxillofacial surgery with cone beam computed tomography data. (United States)

    Bianchi, Alberto; Muyldermans, Louis; Di Martino, Mirko; Lancellotti, Lorenzo; Amadori, Sara; Sarti, Alessandro; Marchetti, Claudio


    Facial soft tissue prediction in orthognathic surgery could be a valuable aid to preview the results and determine the best surgical treatment. After many years, considerable difficulties are still present in the prediction of the clinical final aspect. The object of the present study was to validate new soft tissue simulation software (SurgiCase CMF; Materialise, Leuven, Belgium), using data acquired by cone beam computed tomography (CBCT), that makes it possible to foresee the final result. Ten patients with craniomaxillofacial deformations underwent CBCT before surgery. Using the SurgiCase CMF software, the data were reconstructed in 3 dimensions, and various osteotomies were simulated in a 3-dimensional virtual environment by applying different surgical procedures. At 6 months after surgery, the patients underwent repeat CBCT. Thus, it was possible to superimpose the pre- and postoperative CBCT studies to evaluate the reproducibility and reliability of the software. CBCT simulations defined an average absolute error of 0.94 mm, a standard deviation of 0.90 mm, and a percentage of error less than 2 mm of 86.80%. The preliminary results have allowed us to conclude that simulations in orthognathic surgery for skull-maxillofacial deformities using CBCT acquisition are reliable, in addition to the low radiation exposure, and could become the reference standard to plan surgical treatment. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  17. The soft tissue landmarks to avoid injury to the facial artery during filler and neurotoxin injection at the nasolabial region. (United States)

    Phumyoo, Thirawass; Tansatit, Tanvaa; Rachkeaw, Natthida


    The aim of this study was to locate the course of the facial artery and to propose "the danger line" vulnerable to vascular complications following filler injection. The entire facial soft tissues were harvested from 14 Thai soft embalmed cadavers as a facial flap specimen. Measurements of the distance, the depth, and the diameter of the facial artery were done at level of the oral commissure and the nasal ala. The distance between the facial artery and the oral commissure was 15.3 ± 3.7 mm and the depth from the skin was 11.1 ± 3.1 mm. The distance between the facial artery and the nasal ala was 6.7 ± 4.4 mm and the depth was 11.6 ± 3.7 mm. The diameters of the facial artery at level of the oral commissure and the nasal ala were 2.6 ± 0.8 and 1.9 ± 0.5 mm, respectively. Maximum risk of arterial complication from dermal filler injection lateral to the oral commissure is located approximately 15 mm at the depth of 11 mm. High risk of arterial injury at the lateral nasal ala is located at 7 mm with the depth of 12 mm.

  18. Preliminary assessment of facial soft tissue thickness utilizing three-dimensional computed tomography models of living individuals. (United States)

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


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

  19. Journal of Tissue Engineering and Reconstructive Surgery%The Clinical Comparison Study of Two Different Methods for Repairing Facial Soft Tissue Defect in Severe Progressive Facial Hemiatrophy

    Institute of Scientific and Technical Information of China (English)

    陈军宝; 李澍源; 曹谊林; 李秉航; 滕利; 卢建建; 徐家杰; 张超; 解芳; 杨莉亚; 杨璐


    Objective To evaluate clinical effect of free anterolateral thigh adipofascial flap transplantation and autologous fat graft to repair facial soft tissue defection in severe progressive facial hemiatrophy. Methods From September 2013 to December 2015, 16 patients with progressive facial hemiatrophy were selected according to enter criterion. The patients were divided into two groups according to different surgical methods, autologous fat graft group (Group A, n=8) and free anterolateral thigh adipofascial flap group (Group B, n=8). The facial three-dimensional data were acquired via 3-D scanner preoperatively. Using Mimics 17.0 and Geomagic studio 12.0 software, facial 3-D model of patient was reconstructed, facial symmetry was analyzed, the volume of facial tissue defect was calculated and the reconstruction scope of facial soft tissue was designed. All the patients were operated and clinical indexes were analysed after 6 months. Results The facial symmetry and soft tissue defect in Group A and Group B 6 months post-operation were both significantly improved compared with pre-operation (P0.05). The patients′clinical indexes: total operation time, postoperative hospital stay in Group B were greater than in Group A, times of hospitalization of Group B surpassed Group A with statistical significance (P0.05). Satisfaction score: patients postoperative satisfaction in Group A was better than in Group B (P0.05). Conclusion The clinical effect of autologous fat graft in repairing facial soft tissue defect of severe PFHA patients is non-inferior to free anterolateral thigh adipofascial flap transplantation with good clinical effects and high satisfactory, and is worthy of clinical application.%目的:比较吻合血管的股前外侧筋膜脂肪瓣移植与自体脂肪移植两种方法,修复重度半侧颜面萎缩(PFHA)患者面部软组织缺损的临床效果。方法自2013年09月至2015年12月,根据入组标准选取PFHA患者16例,分为自

  20. Reproducibility of Facial Soft Tissue Thickness Measurements Using Cone-Beam CT Images According to the Measurement Methods. (United States)

    Hwang, Hyeon-Shik; Choe, Seon-Yeong; Hwang, Ji-Sup; Moon, Da-Nal; Hou, Yanan; Lee, Won-Joon; Wilkinson, Caroline


    The purpose of this study was to establish the reproducibility of facial soft tissue (ST) thickness measurements by comparing three different measurement methods applied at 32 landmarks on three-dimensional cone-beam computed tomography (CBCT) images. Two observers carried out the measurements of facial ST thickness of 20 adult subjects using CBCT scan data, and inter- and intra-observer reproducibilities were evaluated. The measurement method of "perpendicular to bone" resulted in high inter- and intra-observer reproducibility at all 32 landmarks. In contrast, the "perpendicular to skin" method and "direct" method, which measures a distance between one point on bone and the other point on skin, presented low reproducibility. The results indicate that reproducibility could be increased by identifying the landmarks on hard tissue images, rather than on ST images, and the landmark description used in this study can be used in the establishment of reliable tissue depth data using CBCT images.

  1. Repair of facial soft tissues for improvement of facial contour%软组织修复法改善面部轮廓

    Institute of Scientific and Technical Information of China (English)

    丁祥生; 王长会; 魏翠娥; 郭妤; 祁佐良


    目的 探讨用中面部软组织修复法改善面部轮廓的效果.方法 应用A型肉毒毒素咬肌内注射,使咬肌萎缩、变薄,同时经口内入路摘除部分颊脂垫,及必要时行面颊部皮下脂肪抽吸.结果 临床治疗36例均获得良好的瘦脸效果,面部轮廓改善显著,经6~12个月随访,效果稳定.结论 面部软组织修复法改善面部轮廓具有操作简便、创伤轻、康复快、安全有效的特点.%Objective To investigate the plastic surgery of facial soft tissue for improvement of facial contour. Methods Botulinum toxin type A was injected into hypertrophied masseter to make it atrophy and attenuation; meanwhile, buccal fat lining was partly resected by intra-oral approach. Buc-cal liposuction was performed if necessary. Results 36 cases got satisfactory face thinning results af-ter treatment. The facial contour of all patients was markedly improved. Following up for 6 - 12 months showed that the effect was stable. Conclusion Plastic repair of facial soft tissue for improve-ment of facial contour is a simple approach, with mild injury, quick recovery, safe and effective.

  2. The frontal soft tissue changes in the lower facial portion after orthodontic treatment combined with anterior segmental osteotomy. (United States)

    Cha, Young Min; Park, Na Seon; Bayome, Mohamed; Han, Seong-Ho; Kim, Yoonji; Kook, Yoon-Ah


    To evaluate changes of the lower facial portion on the frontal view before and after orthodontic treatment combined with anterior segmental osteotomy (ASO) in patients with bimaxillary protrusion. The sample consisted of 16 women in the experimental group who had received ASO and 24 women in the untreated control group. Twelve linear measurements, 5 angular measurements, and the lip perimeter and area were measured and analyzed using unpaired and paired t tests. The upper lip height and lower lip to chin length were significantly greater after treatment. The upper and lower vermilion heights and all vermilion areas decreased significantly, while lip width did not change. Upper lip height was significantly greater in the posttreatment group than in the control group, but there was no difference in upper and total lip areas. Treatment combined with ASO significantly improved the frontal soft tissue proportions. Anticipated frontal soft tissue changes of the lower face should be considered by clinicians for accurate diagnosis and treatment planning.

  3. A new form of spondyloperipheral dysplasia with facial dysmorphism, flattened vertebrae, hypoplastic pelvis, brachydactyly and soft tissue syndactyly

    Energy Technology Data Exchange (ETDEWEB)

    Kitoh, Hiroshi [Aichi Prefectural Colony, Kasugai (Japan). Inst. for Developmental Research; Lachman, R.S. [Cedars-Sinai Medical Research Inst., Los Angeles, CA (United States)


    We report the case of a 9-year-old Japanese boy with spondyloperipheral skeletal dysplasia associated with facial dysmorphism, pelvic abnormalities, and distinctive hands and feet. Radiographic manifestations included mild platyspondyly with posterior scalloping, small flared ilia with shallow acetabulae, mesomelic shortening of long bones, marked delay of carpal bone maturation, and brachydactyly with hypoplastic middle and terminal phalanges bilaterally in both hands and feet. There was bilateral soft tissue syndactyly of the 2nd and 3rd interdigital spaces of the hands, the 2nd interdigital space of the feet, with hypoplastic nails. The clinical and radiographic manifestations in this case appear to represent a unique type of skeletal dysplasia. (orig.)

  4. Quantified Facial Soft-tissue Strain in Animation Measured by Real-time Dynamic 3-Dimensional Imaging (United States)

    Hsu, Vivian M.; Wes, Ari M.; Tahiri, Youssef; Cornman-Homonoff, Joshua


    Background: The aim of this study is to evaluate and quantify dynamic soft-tissue strain in the human face using real-time 3-dimensional imaging technology. Methods: Thirteen subjects (8 women, 5 men) between the ages of 18 and 70 were imaged using a dual-camera system and 3-dimensional optical analysis (ARAMIS, Trilion Quality Systems, Pa.). Each subject was imaged at rest and with the following facial expressions: (1) smile, (2) laughter, (3) surprise, (4) anger, (5) grimace, and (6) pursed lips. The facial strains defining stretch and compression were computed for each subject and compared. Results: The areas of greatest strain were localized to the midface and lower face for all expressions. Subjects over the age of 40 had a statistically significant increase in stretch in the perioral region while lip pursing compared with subjects under the age of 40 (58.4% vs 33.8%, P = 0.015). When specific components of lip pursing were analyzed, there was a significantly greater degree of stretch in the nasolabial fold region in subjects over 40 compared with those under 40 (61.6% vs 32.9%, P = 0.007). Furthermore, we observed a greater degree of asymmetry of strain in the nasolabial fold region in the older age group (18.4% vs 5.4%, P = 0.03). Conclusions: This pilot study illustrates that the face can be objectively and quantitatively evaluated using dynamic major strain analysis. The technology of 3-dimensional optical imaging can be used to advance our understanding of facial soft-tissue dynamics and the effects of animation on facial strain over time. PMID:25426394

  5. Quantified Facial Soft-tissue Strain in Animation Measured by Real-time Dynamic 3-Dimensional Imaging. (United States)

    Hsu, Vivian M; Wes, Ari M; Tahiri, Youssef; Cornman-Homonoff, Joshua; Percec, Ivona


    The aim of this study is to evaluate and quantify dynamic soft-tissue strain in the human face using real-time 3-dimensional imaging technology. Thirteen subjects (8 women, 5 men) between the ages of 18 and 70 were imaged using a dual-camera system and 3-dimensional optical analysis (ARAMIS, Trilion Quality Systems, Pa.). Each subject was imaged at rest and with the following facial expressions: (1) smile, (2) laughter, (3) surprise, (4) anger, (5) grimace, and (6) pursed lips. The facial strains defining stretch and compression were computed for each subject and compared. The areas of greatest strain were localized to the midface and lower face for all expressions. Subjects over the age of 40 had a statistically significant increase in stretch in the perioral region while lip pursing compared with subjects under the age of 40 (58.4% vs 33.8%, P = 0.015). When specific components of lip pursing were analyzed, there was a significantly greater degree of stretch in the nasolabial fold region in subjects over 40 compared with those under 40 (61.6% vs 32.9%, P = 0.007). Furthermore, we observed a greater degree of asymmetry of strain in the nasolabial fold region in the older age group (18.4% vs 5.4%, P = 0.03). This pilot study illustrates that the face can be objectively and quantitatively evaluated using dynamic major strain analysis. The technology of 3-dimensional optical imaging can be used to advance our understanding of facial soft-tissue dynamics and the effects of animation on facial strain over time.

  6. Three-dimensional analyses of facial soft tissue configuration of Japanese females with jaw deformity--a trial of polygonal view of facial soft tissue deformity in orthognathic patients. (United States)

    Shimomatsu, Kouta; Nozoe, Etsuro; Ishihata, Kiyohide; Okawachi, Takako; Nakamura, Norifumi


    In this study, we evaluated the three-dimensional (3D) soft tissue configuration of Japanese females with/without jaw deformity in order to establish the polygonal view of facial soft tissue deformity three-dimensionally. A polygonal chart was applied to assess the outcomes of orthognathic surgery for patients with mandibular hyperplasia with/without deviation. The study included 20 Japanese females with mandibular hyperplasia with/without deviation. All patients received mandibular setback surgery, and 3D measurements were carried out pre-operation, and at 1, 3 and 6 months postoperatively using a non-contact laser scanning system. Eighteen soft tissue landmarks were set on each 3D image and used to calculate a set of selected parameters. As controls, 20 Japanese females with class I occlusion were included. A polygonal chart was constructed based on the mean and S.D. of the control group. Patients with mandibular protrusion characteristically demonstrated significant variances in the items around the lower face. In asymmetric patients, deviation in the mental area disappeared postoperatively, but a small deviation remained when compared to the controls. The method used in this study seems to be a useful index for diagnosis and as a treatment plan for patients with mandibular hyperplasia with/without deviation.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Frequency of Minor Skin and Soft Tissue Complications in Facial and Periorbital Area after Septorhinoplasty

    Directory of Open Access Journals (Sweden)

    Shadman Nemati


    Full Text Available Introduction: High prevalence of rhinoplasty in the community and lack of structured studies about its minor skin and soft tissue complications, point out the necessity of performing precise and comprehensive studies. The aim of this study was to determine the frequency of minor cutaneous and soft tissue complications of rhinoplasty.  Materials and Methods: 110 patients (30 Male and 80 Female, Mean age: 26.3± 6.8 participated in this study. Before surgery all of them were checked for having each of intended complications, and 1 and 3 months after the surgery, they underwent serial visits for monitoring skin & soft tissue complications. The software used for data analysis was SPSS ver.16.  Results: Acne exacerbation was seen in 27% of cases in first post-surgical visit. Nasal tip paresthesia was the most frequent complication in both postsurgical visits (49.6% in first and 36.3% in second visit, followed by eyebrow loss (31.8%, complaint of increased yawning (31.8%, periorbital hyperpigmentation (21.8% in first visit, and, hyperpigmentation (19.1%, complaint of increased yawning (10% and surgical site scar (7.2% in second visit respectively. The frequency of complications was highest in younger than 25 year old age group.  Conclusion: Having knowledge about these complications helps us to know which of them needs prompt medical intervention and which of them will resolve with time and just needs giving reassurance to the patient.

  9. Facial Soft Tissue Augmentation using Autologous Fat Mixed with Stromal Vascular Fraction

    Directory of Open Access Journals (Sweden)

    Sang Kyun Lee


    Full Text Available Background Autologous fat grafting evolved over the twentieth century to become a quick,safe, and reliable method for restoring volume. However, autologous fat grafts have someproblems including uncertain viability of the grafted fat and a low rate of graft survival. Toovercome the problems associated with autologous fat grafts, we used uncultured adiposetissue-derived stromal cell (stromal vascular fraction, SVF assisted autologous fat grafting.Thus, the purpose of this study was to evaluate the effect of SVF in a clinical trial.Methods SVF cells were freshly isolated from half of the aspirated fat and were used incombination with the other half of the aspirated fat during the procedure. Between March2007 and February 2008, a total of 9 SVF-assisted fat grafts were performed in 9 patients.The patients were followed for 12 weeks after treatment. Data collected at each follow-upvisit included clinical examination of the graft site(s, photographs for historical comparison,and information from a patient questionnaire that measured the outcomes from the patientperspective. The photographs were evaluated by medical professionals.Results Scores of the left facial area grafted with adipose tissue mixed with SVF cells weresignificantly higher compared with those of the right facial area grafted with adipose tissuewithout SVF cells. There was no significant adverse effect.Conclusions The subjective patient satisfaction survey and surgeon survey showed that SVFassistedfat grafting was a surgical procedure with superior results.

  10. Nonsurgical Facial Rejuvenation: Outcomes and Safety of Neuromodulator and Soft-Tissue Filler Procedures Performed in a Resident Cosmetic Clinic. (United States)

    Qureshi, Ali A; Parikh, Rajiv P; Sharma, Ketan; Myckatyn, Terence M; Tenenbaum, Marissa M


    The ability to perform nonsurgical facial rejuvenation procedures is a core competency requirement for plastic surgery residents. However, limited data exist on training models to achieve competency in nonsurgical facial rejuvenation and on outcomes of these procedures performed by residents. The purpose here is to evaluate patient-reported outcomes and safety of nonsurgical facial rejuvenation procedures performed by plastic surgery residents. We prospectively enrolled 50 patients undergoing neuromodulator and/or soft-tissue filler injections in a resident cosmetic clinic between April and August 2016. Patients completed FACE-Q modules pre-procedure, and at 1 week and 1 month post-procedure. Paired t-tests were used to calculate statistical significance of changes between pre- and post-procedure scores. Effect sizes were calculated to assess clinical improvement from pre- to post-procedure. The magnitude of change was interpreted using Cohen's arbitrary criteria (small 0.20, moderate 0.50, large 0.80). Forty-five patients completed the study. Patients experienced significant improvements (p Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors .




    BACKGROUND: Indifferent to the origin (congenital or acquired) the facial deformities are difficult to be accepted by the patients. The ideal technique is a simple procedure, with minimal trauma for the patient and with predictable results. The lipostructure can be considered one of these types of reconstruction method and we present our experience with. METHODS: We had used lipostructure at 8 patients for the plasty of postoperative defects (5 after resection of parotidian or cutaneous malig...

  12. Photogrammetric Comparison of Facial Soft Tissue Profile before and after Protraction Facemask Therapy in Class III Children (6-11 Years Old) (United States)

    Moshkelgosha, Vahid; Raoof, Arghavan; Sardarian, Ahmadreza; Salehi, Parisa


    Statement of the Problem: Achieving a normal soft tissue facial profile is considered to be the main concern of class III patients and the goal of most class III treatments. Purpose: The purpose of this study was to investigate the effects of facemask treatment on profile with photogrammetric method. Materials and Method: Before (T0) and after (T1) treatment photograms of 40 class III patients profiles (20 male and 20 female individuals) treated with protraction face mask that met the inclusion criteria were digitized and analyzed using Aesthetic Analyzer software. Selected linear and angular measurements were performed for each patient and the changes were noted. Results: An increase in inferior facial height (pface and consequent fullness in the soft-tissue profile can be achieved by using protraction face mask. The response to treatment is not different between males and females.

  13. The Facial Adipose Tissue: A Revision. (United States)

    Kruglikov, Ilja; Trujillo, Oscar; Kristen, Quick; Isac, Kerelos; Zorko, Julia; Fam, Maria; Okonkwo, Kasie; Mian, Asima; Thanh, Hyunh; Koban, Konstantin; Sclafani, Anthony P; Steinke, Hanno; Cotofana, Sebastian


    Recent advantages in the anatomical understanding of the face have turned the focus toward the subcutaneous and deep facial fat compartments. During facial aging, these fat-filled compartments undergo substantial changes along with other structures in the face. Soft tissue filler and fat grafting are valid methods to fight the signs of facial aging, but little is known about their precise effect on the facial fat. This narrative review summarizes the current knowledge about the facial fat compartments in terms of anatomical location, histologic appearance, immune-histochemical characteristics, cellular interactions, and therapeutic options. Three different types of facial adipose tissue can be identified, which are located either superficially (dermal white adipose tissue) or deep (subcutaneous white adipose tissue): fibrous (perioral locations), structural (major parts of the midface), and deposit (buccal fat pad and deep temporal fat pad). These various fat types differ in the size of the adipocytes and the collagenous composition of their extracellular matrix and thus in their mechanical properties. Minimal invasive (e.g., soft tissue fillers or fat grafting) and surgical interventions aiming to restore the youthful face have to account for the different fat properties in various facial areas. However, little is known about the macro- and microscopic characteristics of the facial fat tissue in different compartments and future studies are needed to reveal new insights to better understand the process of aging and how to fight its signs best.

  14. Plastic Surgery for Repairing Facial Soft Tissue Injury%面部软组织损伤的整形美容修复

    Institute of Scientific and Technical Information of China (English)



    Objective:To investigate the effects and the application of cosmetic repair of patients with injury of facial soft tissue. Method:130 patients for surgery from February,2012 to December,2013 were selected,high-tech means and minimally invasive techniques was used,and plastic repair of facial soft tissue injury was adopted. Result:The repair effect is ideal with good functional recovery,without infection, hematoma and skin flap necrosis. After 1~12 months follow-up,rehabilitation effect was significant. Conclusion:The facial soft tissue injury of the situation is more complicated,and recovery effect is not ideal by using the traditional plastic method. The new technology and minimally invasive technique for facial repair is used with significant effect.%目的:探讨面部软组织损伤患者整形美容修复效果以及应用方法。方法:我所选取2012年2月至2013年12月间进行整容的130例患者,采用高科技手段与微创技术,进行面部软组织损伤的整形美容修复。结果:修复效果理想,功能恢复良好,且未出现感染、皮瓣坏死以及血肿等情况。随访1~12月后,康复效果显著。结论:面部软组织损伤的情况较为复杂,利用传统整形美容方法恢复效果不理想,我们采用新型科技手段与微创技术进行面部修复,效果显著。

  15. Patient-specific modeling of facial soft tissue based on radial basis functions transformations of a standard three-dimensional finite element model

    Institute of Scientific and Technical Information of China (English)

    LOU Hang-di; CHEN Si; CHEN Gui; XU Tian-min; RONG Qi-guo


    Background An important purpose of orthodontic treatment is to gain the harmonic soft tissue profile.This article describes a novel way to build patient-specific models of facial soft tissues by transforming a standard finite element(FE)model into one that has two stages:a first transformation and a second transformation,so as to evaluate the facial soft tissue changes after orthodontic treatment for individual patients.Methods The radial basis functions(RBFs)interpolation method was used to transform the standard FE model into a patient-specific one based on landmark points.A combined strategy for selecting landmark points was developed in this study:manually for the first transformation and automatically for the second transformation.Four typical patients were chosen to validate the effectiveness of this transformation method.Results The results showed good similarity between the transformed FE models and the computed tomography(CT)models.The absolute values of average deviations were in the range of 0.375-0.700 mm at the lip-mouth region after the first transformation,and they decreased to a range of 0.116-0.286 mm after the second transformation.Conclusions The modeling results show that the second transformation resulted in enhanced accuracy compared to the first transformation.Because of these results,a third transformation is usually not necessary.

  16. Photogrammetric Comparison of Facial Soft Tissue Profile before and after Protraction Facemask Therapy in Class III Children (6-11 Years Old

    Directory of Open Access Journals (Sweden)

    Vahid Moshkelgosha


    Full Text Available Statement of the Problem: Achieving a normal soft tissue facial profile is considered to be the main concern of class III patients and the goal of most class III treatments. Purpose: The purpose of this study was to investigate the effects of facemask treatment on profile with photogrammetric method. Materials and Method: Before (T0 and after (T1 treatment photograms of 40 class III patients profiles (20 male and 20 female individuals treated with protraction face mask that met the inclusion criteria were digitized and analyzed using Aesthetic Analyzer software. Selected linear and angular measurements were performed for each patient and the changes were noted. Results: An increase in inferior facial height (p< 0.001 and inferior facial angle (p< 0.001 was observed. Nasal prominence and upper lip prominence also increased significantly (p< 0.001. Advancement of sub nasal area was observed to be significant in females (p< 0.05 in contrast to males. Conclusion: Remarkable advancement in the middle face and consequent fullness in the soft-tissue profile can be achieved by using protraction face mask. The response to treatment is not different between males and females.

  17. 面部软组织损伤的整形美容修复分析%Analysis of Plastic Surgery for Repairing Facial Soft Tissue Injury

    Institute of Scientific and Technical Information of China (English)



    目的:探讨整形美容修复面部软组织损伤的效果。方法:选取本院整形科门诊与住院部在2012年3月~2013年1月间收治的100例面部软组织创伤患者,进行整形美容修复,观察治疗后效果。结果:经过修复治疗后,伤口在Ⅰ期的愈合率为90%。结论:整形美容修复对面部创面进行修复,能够有效的达到较佳的修复效果。%Objective:To study the effect of cosmetic surgery to repair facial soft tissue injuries. Methods:Selecting 100 patients with facial soft tissue trauma in plastic outpatient and inpatient deparments from March,2012 to January,doing cosmetic surgery repair,and observing the therapeutic effect after treatment. Results:After repair therapy,the wound in Ⅰ healing rate was 90%. Conclusion:Cosmetic surgery on facial wounds repair can effectively achieve the best effect.

  18. Changing the facial features of patients with Treacher Collins syndrome: protocol for 3-stage treatment of hard and soft tissue hypoplasia in the upper half of the face. (United States)

    Mitsukawa, Nobuyuki; Saiga, Atsuomi; Satoh, Kaneshige


    Treacher Collins syndrome is a disorder characterized by various congenital soft tissue anomalies involving hypoplasia of the zygoma, maxilla, and mandible. A variety of treatments have been reported to date. These treatments can be classified into 2 major types. The first type involves osteotomy for hard tissue such as the zygoma and mandible. The second type involves plastic surgery using bone grafting in the malar region and soft tissue repair of eyelid deformities. We devised a new treatment to comprehensively correct hard and soft tissue deformities in the upper half of the face of Treacher Collins patients. The aim was to "change facial features and make it difficult to tell that the patients have this disorder." This innovative treatment strategy consists of 3 stages: (1) placement of dermal fat graft from the lower eyelid to the malar subcutaneous area, (2) custom-made synthetic zygomatic bone grafting, and (3) Z-plasty flap transposition from the upper to the lower eyelid and superior repositioning and fixation of the lateral canthal tendon using a Mitek anchor system. This method was used on 4 patients with Treacher Collins syndrome who had moderate to severe hypoplasia of the zygomas and the lower eyelids. Facial features of these patients were markedly improved and very good results were obtained. There were no major complications intraoperatively or postoperatively in any of the patients during the series of treatments. In synthetic bone grafting in the second stage, the implant in some patients was in the way of the infraorbital nerve. Thus, the nerve was detached and then sutured under the microscope. Postoperatively, patients had almost full restoration of sensory nerve torpor within 5 to 6 months. We devised a 3-stage treatment to "change facial features" of patients with hypoplasia of the upper half of the face due to Treacher Collins syndrome. The treatment protocol provided a very effective way to treat deformities of the upper half of the face

  19. Intervention of plastic surgery for emergency facial soft tissue injury%急诊面部软组织创伤的整形外科干预

    Institute of Scientific and Technical Information of China (English)

    孙秀锋; 郑妍丽; 姜涛; 王洪燕


    [目的]探讨应用整形外科原则和技术,处理急诊面部软组织创伤的方法和经验.[方法]选择急诊面部软组织创伤病例320例,采用整形外科原则和技术行清创及Ⅰ期缝合,观察治疗效果.[结果]伤口Ⅰ期愈合,无明显瘢痕增生,无功能障碍,不需要Ⅱ期修复,美容效果良好.[结论]应用整形外科基本原则和技术处理面部急性软组织创伤,可获得满意的美容效果,值得推广应用.%[Objective] To explore the clinical method of treating emergency facial soft tissue trauma with plastic surgical principles and techniques. [ Methods] The emergency facial soft tissue injuries of 320 patients were selected. They had been debrided and repaired primarily with plastic surgical principles and techniques. Healing effects were observed. [ Results] All cases were primary healing. There were no obvious hyperplasy scars and functional disturbance. Second stage reparation was not required. The cosmetic effect was perfect. [ Conclusion] It is a satisfactory and effective method to treat emergency facial soft tissue trauma with plastic surgical principles and techniques,which can be recommended to all the surgeons.

  20. [Clinical-morphological and histometric characteristics of soft tissue wounds in maxilla-facial region of patients in different terms after trauma]. (United States)

    Fedorina, T A; Braĭlovskaia, T V


    504 patients with open traumas of face soft tissues which were given primary surgical wounds treatment with reconstructive operations in maxilla-facial surgical clinics of Samara State Medical University in 2005-2008 also received detailed description. The results of statistical analysis of patients' surgical treatment for the previous 5 year period were listed. It was noted that in the majority of cases (75,5%) patients turned to stomatological aid in first hours or first day and night after receiving the injury, more often there were isolated soft tissue injuries (73,3%), tear-contused and cut wounds put together 80,5%. Morphological and histometric studies of operational-biopsy material let determine the character of changes of leucocyte infiltration and of epithelium - stromal interrelation in different zones of wound edges in patients incoming in different terms after trauma. Objective criteria of tissue excision volumes were received in the process of surgical wound treatment. During last 3 years esthetic results of patient treatment with maxilla-facial traumas improved, the postoperative complications frequency was reduced by 8,1% if compared with the previous 5-year period.

  1. Three-dimensional imaging methods for quantitative analysis of facial soft tissues and skeletal morphology in patients with orofacial clefts: a systematic review.

    Directory of Open Access Journals (Sweden)

    Mette A R Kuijpers

    Full Text Available BACKGROUND: Current guidelines for evaluating cleft palate treatments are mostly based on two-dimensional (2D evaluation, but three-dimensional (3D imaging methods to assess treatment outcome are steadily rising. OBJECTIVE: To identify 3D imaging methods for quantitative assessment of soft tissue and skeletal morphology in patients with cleft lip and palate. DATA SOURCES: Literature was searched using PubMed (1948-2012, EMBASE (1980-2012, Scopus (2004-2012, Web of Science (1945-2012, and the Cochrane Library. The last search was performed September 30, 2012. Reference lists were hand searched for potentially eligible studies. There was no language restriction. STUDY SELECTION: We included publications using 3D imaging techniques to assess facial soft tissue or skeletal morphology in patients older than 5 years with a cleft lip with/or without cleft palate. We reviewed studies involving the facial region when at least 10 subjects in the sample size had at least one cleft type. Only primary publications were included. DATA EXTRACTION: Independent extraction of data and quality assessments were performed by two observers. RESULTS: Five hundred full text publications were retrieved, 144 met the inclusion criteria, with 63 high quality studies. There were differences in study designs, topics studied, patient characteristics, and success measurements; therefore, only a systematic review could be conducted. Main 3D-techniques that are used in cleft lip and palate patients are CT, CBCT, MRI, stereophotogrammetry, and laser surface scanning. These techniques are mainly used for soft tissue analysis, evaluation of bone grafting, and changes in the craniofacial skeleton. Digital dental casts are used to evaluate treatment and changes over time. CONCLUSION: Available evidence implies that 3D imaging methods can be used for documentation of CLP patients. No data are available yet showing that 3D methods are more informative than conventional 2D methods

  2. Three-dimensional Imaging Methods for Quantitative Analysis of Facial Soft Tissues and Skeletal Morphology in Patients with Orofacial Clefts: A Systematic Review (United States)

    Kuijpers, Mette A. R.; Chiu, Yu-Ting; Nada, Rania M.; Carels, Carine E. L.; Fudalej, Piotr S.


    Background Current guidelines for evaluating cleft palate treatments are mostly based on two-dimensional (2D) evaluation, but three-dimensional (3D) imaging methods to assess treatment outcome are steadily rising. Objective To identify 3D imaging methods for quantitative assessment of soft tissue and skeletal morphology in patients with cleft lip and palate. Data sources Literature was searched using PubMed (1948–2012), EMBASE (1980–2012), Scopus (2004–2012), Web of Science (1945–2012), and the Cochrane Library. The last search was performed September 30, 2012. Reference lists were hand searched for potentially eligible studies. There was no language restriction. Study selection We included publications using 3D imaging techniques to assess facial soft tissue or skeletal morphology in patients older than 5 years with a cleft lip with/or without cleft palate. We reviewed studies involving the facial region when at least 10 subjects in the sample size had at least one cleft type. Only primary publications were included. Data extraction Independent extraction of data and quality assessments were performed by two observers. Results Five hundred full text publications were retrieved, 144 met the inclusion criteria, with 63 high quality studies. There were differences in study designs, topics studied, patient characteristics, and success measurements; therefore, only a systematic review could be conducted. Main 3D-techniques that are used in cleft lip and palate patients are CT, CBCT, MRI, stereophotogrammetry, and laser surface scanning. These techniques are mainly used for soft tissue analysis, evaluation of bone grafting, and changes in the craniofacial skeleton. Digital dental casts are used to evaluate treatment and changes over time. Conclusion Available evidence implies that 3D imaging methods can be used for documentation of CLP patients. No data are available yet showing that 3D methods are more informative than conventional 2D methods. Further research

  3. Current methods of assessing the accuracy of three-dimensional soft tissue facial predictions: technical and clinical considerations. (United States)

    Khambay, B; Ullah, R


    Since the introduction of three-dimensional (3D) orthognathic planning software, studies have reported on their predictive ability. The aim of this study was to highlight the limitations of the current methods of analysis. The predicted 3D soft tissue image was compared to the postoperative soft tissue. For the full face, the maximum and 95th and 90th percentiles, the percentage of 3D mesh points ≤ 2 mm, and the root mean square (RMS) error, were calculated. For specific anatomical regions, the percentage of 3D mesh points ≤ 2 mm and the distance between the two meshes at 10 landmarks were determined. For the 95th and 90th percentiles, the maximum difference ranged from 7.7 mm to 2.2 mm and from 3.7 mm to 1.5 mm, respectively. The absolute mean distance ranged from 0.98 mm to 0.56 mm and from 0.91 mm to 0.50 mm, respectively. The percentage of mesh with ≤ 2 mm for the full face was 94.4-85.2% and 100-31.3% for anatomical regions. The RMS error ranged from 2.49 mm to 0.94 mm. The majority of mean linear distances between the surfaces were ≤ 0.8 mm, but increased for the mean absolute distance. At present the use of specific anatomical regions is more clinically meaningful than the full face. It is crucial to understand these and adopt a protocol for conducting such studies.

  4. 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 ...

  5. Comparação das dimensões de tecido mole entre padrões faciais distintos Comparison of soft tissue size between different facial patterns

    Directory of Open Access Journals (Sweden)

    Murilo Fernando Neuppmann Feres


    Full Text Available OBJETIVO: o presente estudo destinou-se a comparar a morfologia tegumentar de indivíduos segundo a tipologia facial. MÉTODOS: foram utilizadas 90 telerradiografias de pacientes de ambos os sexos, de 12 a 16 anos de idade, divididas em três grupos distintos, referentes a cada padrão morfológico: mesofacial, dolicofacial e braquifacial. Os grupos foram comparados no que se refere às medidas de espessura e altura do lábio superior e inferior, além da espessura do mento mole. Ainda, foi apurada a presença de correlações entre as variáveis de tecido mole avaliadas e medidas cefalométricas de natureza dentária e esquelética. RESULTADOS E CONCLUSÕES: os lábios superiores e inferiores, assim como o mento mole, não apresentaram diferenças em relação às suas espessuras em todos os grupos morfológicos. Porém, as alturas do lábio superior e inferior foram significativamente maiores para os dolicofaciais quando esses foram comparados aos demais grupos. Braquifaciais apresentaram menor altura do lábio superior quando comparados aos mesofaciais, embora ambos não tenham se diferenciado significativamente no que se refere à altura do lábio inferior. A análise das correlações estabelecidas entre as variáveis dos tecidos moles e duros indicou evidências de um desenvolvimento vertical dos lábios superior e inferior em acompanhamento ao desenvolvimento vertical do esqueleto. O posicionamento vertical do incisivo superior se correlacionou significativamente aos mesmos parâmetros labiais, o que garantiu um nível de exposição semelhante desse elemento dentário em todos os grupos.OBJECTIVE: This study was designed to compare the soft tissue morphology of individuals according to their facial patterns. METHODS: Were used cephalograms of 90 patients of both genders, aged 12 to 16 years, which were divided into three distinct groups, according to their morphological patterns, i.e., mesofacials, dolichofacials and brachyfacials. The

  6. Establishment of a Reliable Horizontal Reference Plane for 3-Dimensional Facial Soft Tissue Evaluation Before and After Orthognathic Surgery. (United States)

    Chortrakarnkij, Peerasak; Lonic, Daniel; Lin, Hsiu-Hsia; Lo, Lun-Jou


    This study aims to demonstrate the reliability of our proposed facial reference system in the horizontal axis using 3-dimensional photogrammetry and to find a correlation between this plane and the Frankfurt horizontal (FH) plane. Forty-one patients were enrolled. Three-dimensional facial images were taken before and 6 months after orthognathic surgery. Superimposition was carried out, and differences in landmark position were evaluated. Two constant landmarks were selected to construct a reference system within a standardized reference frame. Cone-beam computed tomography and 3-dimensional facial images were superimposed. Two reference lines were identified, and the angle between these lines was calculated. For landmark reliability, 5 landmarks [gnathion, nasion, exocanthion (Ex), endocanthion, and tragion (T)] were constant. Two landmarks (Ex and T) were selected to construct a reference system within a standardized reference frame. For angular measurement, the mean angle between this reference plane and the skeletal FH plane was 17.6 ± 2.0 degrees. There was no statistical difference between sex, side, and preoperative/postoperative timing of photography. Our proposed reference plane is constructed from reliable facial Ex and T landmarks. This plane is consistent and crosses the FH plane at 17.6 degrees.

  7. 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.

  8. 颜面部筋膜蒂皮瓣修复颜面部皮肤软组织缺损的探讨%Discussion on facial soft tissue defects reparation with facial fascio-cutaneous flaps

    Institute of Scientific and Technical Information of China (English)

    王华; 关志广; 方建勇; 胡发明; 陈国威


    Objective To discuss clinical effect of facial skin soft tissue defects reparation with facial fascio-cutaneous flaps. Methods Out of 48 patients in our hospital, 20 cases of facial skin tumors, 8 cases of traumatic defects, 9 cases of pigmented nevus, 6 cases of anabrosis, 3 cases of scars, 2 cases of scars together with tissue depression. The minimum area of defect was 1.0 cmx1.0 cm and the maximum area was 4.0 cm x 3.0 cm. All of these cases were treated with facial fascio-cutaneous flaps for reparation. Results In these 48 cases, the maximum area of fascio-cutaneous flaps was 5.0×3.5cm, and the minimum area was 1.5 cm×1.2 cm. The width of the pedicle was 1.0~3.0 cm. All of the fascio-cutaneous flaps survived. 6~12 months of follow-up, the appearance of the faces were satisfied. Conclusion The advantages of this method are obvious, including the good aesthetic effects and the aesthetic facial appearance with hidden incision and small scar. The survival rate of fascio-cutaneous flaps is high. The material supply area can be more easily achieved from the operated patient nearby.%目的探讨颜面部筋膜蒂皮瓣修复颜面部皮肤软组织缺损的临床效果。方法48例患者,其中颜面部皮肤肿瘤20例,外伤缺损伤8例,色素痣9例,溃疡6例,瘢痕3例,瘢痕合并组织凹陷2例,缺损面积最小1.0 cm×1.0 cm,最大4.0 cm×3.0 cm,所有病例均应用颜面部筋膜蒂皮瓣进行修复。结果本组48例,皮瓣面积最大为5.0 cm×3.5 cm,最小为1.5 cm×1.2 cm,蒂宽1.0~3.0 cm,皮瓣全部成活。随访6~12个月,颜面部外观满意。结论本方法具有良好的美学效果,颜面部外形美观、皮瓣成活率高、供区就近取材、切口隐蔽且瘢痕小等优点。

  9. 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

  10. 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.

  11. 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.

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

    Institute of Scientific and Technical Information of China (English)

    李娟; 丁寅; 叶艳艳; 惠雯婷; 黄曼


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

  13. 整形外科技术在面部软组织损伤急诊处理中的应用%Clinical application of plastic surgery techniques in emergency treatment of facial soft tissue injuries

    Institute of Scientific and Technical Information of China (English)

    师军涛; 秦宏伟; 王新征


    目的 探讨整形外科技术在面部软组织损伤急诊处理中应用的临床效果,以及最大限度地恢复患者面部形态及功能的整形外科方法.方法 回顾性分析2009年6月至2011年6月收治的798例面部软组织创伤患者,采用整形外科技术,根据具体伤情设计不同修复方法,严格遵守无菌无创原则,进行清创、创面修复、皮瓣修复等治疗.结果 790例患者术后Ⅰ期愈合,8例伴有轻微瘢痕,随访6个月至1年,无感染、坏死、明显瘢痕等并发症发生,面部形态及功能恢复良好.结论 在面部软组织损伤急诊处理时,尽早应用整形外科技术进行Ⅰ期修复,避免创面自然愈合后发生畸形及功能障碍,无需Ⅱ期手术整形.%Objective To evaluate the clinical application and effect of plastic surgery in emergency treatment of facial soft tissue injuries,and to explore the better plastic surgery method for facial soft tissue injuries in order to regain the patient facial morphology and function maximally.Methods The clinical data of 798 patients with facial soft tissue injuries from June 2009 to June 2011 were analyzed retrospectively.And plastic surgical techniques were applied to the early treatment of facial soft tissue injuries in this group cases,according to the size of defect and the degree of deformity of the patient,different plastic surgery treatment was chosen,such as skin flap or skin graft to repair wound surfaces.In this process,one must follow sterile noninvasive principle strictly with emphasis on the technique of plastic surgery such as entire debridement,wound healing application of skin flap and so on.Results 790 cases of facial soft tissue injuries were healed by first intention without significant complications,while 8 cases of them had mild scars.During 6 to 12 months of follow-up,neither scar,nor infections and necrosis of the wound region occurred,and the morphology and function of patients' face recovered well without the

  14. Reconstruction of facial soft tissue defects with pedicled expanded flaps%固定血管分支蒂扩张皮瓣修复面部软组织缺损

    Institute of Scientific and Technical Information of China (English)

    李养群; 唐勇; 陈文; 杨喆; 赵穆欣; 许砾思; 胡春梅; 刘媛媛; 马宁


    Objective To investigate the application of pedicled expanded flaps for the reconstruction of facial soft tissue defects.Methods The expanded skin flaps,pedicled with orbicularis oculi muscle,submental artery,the branch of facial artery,superficial temporal artery,interior upper arm artery,had similar texture and color as facial soft tissue.The pedicled expanded flaps have repaired the facial soft tissue defects.Results Between Jan.2003 to Dec.2013,157 cases with facial soft tissue defects were reconstructed by pedicled expanded flaps.Epidermal necrosis happened at the distal end of 8 expanded flaps,pedicled with interior upper arm artery(4 cases),orbicularis oculi muscle (3 cases) and submental artery(1 case),which healed spontaneously after dressing.All the other flaps survived completely with similar color and inconspicuous scar.112 cases were followed up for 8 months to 8 years.Satisfactory results were achieved in 75 cases.37 cases with hypertrophic scar at incisions need secondary operation.Conclusions Island pedicled expanded flap with similar texture and color as facial soft tissue is suitable for facial soft tissue defects.The facial extra-incision and large dog-ear deformity could be avoided.%目的 探讨面部软组织缺损的修复方法和固定血管分支扩张皮瓣的临床应用.方法 选择与面部组织质地、色泽相近部位进行扩张,以眼轮匝肌、颏动脉分支、面动脉分支、颞浅血管、上臂内侧血管等固定血管分支为蒂,形成带蒂扩张皮瓣,转移修复面部软组织缺损.结果 2003年1月至2013年12月,于临床应用157例,其中有4例上臂内侧扩张皮瓣发生远端血运障碍,表皮坏死,换药2~4周后愈合;3例眼轮匝肌蒂扩张皮瓣及1例颏部扩张皮瓣远端出现表皮坏死,均换药后自愈;其余皮瓣均成活良好,皮肤色泽接近,继发切口瘢痕隐蔽.电子邮箱及电话随访112例,时间为8个月至8年,外形满意者75例,有37例切口瘢痕增生明

  15. Tissue Engineering and the Future of Facial Volumization. (United States)

    Reuther, Marsha; Watson, Deborah


    Volume loss due to facial aging can be restored by facial volumization using a variety of materials. Volumization can be performed in isolation or concurrent with other facial rejuvenation procedures to obtain an optimal aesthetic result. There is a myriad of manufactured products available for volumization. The use of autologous fat as facial filler has been adopted more recently and possesses certain advantages; however, the ideal filler is still lacking. Tissue engineering may offer a solution. This technology would provide autologous soft-tissue components for use in facial volumization. The use of stem cells may enable customization of the engineered product for the specific needs of each patient. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

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

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

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

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

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

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

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

  20. 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.

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

    Institute of Scientific and Technical Information of China (English)

    张兰成; 侯敏; 张锡忠; 宋大立; 杜清香


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

  2. 超12小时面部软组织创伤Ⅰ期修复临床观察%clinical observation of repairing primarily for over 12-houred facial soft tissue injury

    Institute of Scientific and Technical Information of China (English)

    孙秀锋; 王洪燕; 郑妍丽; 姜涛


    目的:探讨Ⅰ期整形修复超12小时面部软组织创伤的方法和经验.方法:选择我院急诊面部软组织创伤超过12h病例17例,采用积极扩创和整形外科技术Ⅰ期修复,观察治疗效果.结果:伤口均甲级愈合,无明显瘢痕增生,无功能障碍,不需要Ⅱ期修复,美容效果良好.结论:超12h面部软组织创伤,采用积极扩创和整形缝合,可获Ⅰ期修复和满意的美容效果,值得临床应用和深入研究.%Objective To explore the clinical method and experience of repairing over 12-houred emergency facial soft tissue trauma primarily with plastic surgical techniques. Methods The over 12-houred emergency facial soft tissue injuries of 17 patients were selected. They had been expanded debrided and repaired primarily with plastic surgical techniques. Healing effects were observed and compared. Results All cases were primary healing.There were no obvious scar formative or function problems.Second stage reconstruction was not needed, the cosmetic effect was perfect. Conclusion The facial soft tissue injury of over 12-hours can require primary healing and- satisfactory cosmetic result with active expanded debride and plastic surgical techniques. It is worth clinical applying and deeply researching.

  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. Three-dimensional Imaging Methods for Quantitative Analysis of Facial Soft Tissues and Skeletal Morphology in Patients with Orofacial Clefts: A Systematic Review

    NARCIS (Netherlands)

    Kuijpers, M.A.R.; Chiu, Y.T.; Nada, R.M.; Carels, C.E.L.; Fudalej, P.S.


    BACKGROUND: Current guidelines for evaluating cleft palate treatments are mostly based on two-dimensional (2D) evaluation, but three-dimensional (3D) imaging methods to assess treatment outcome are steadily rising. OBJECTIVE: To identify 3D imaging methods for quantitative assessment of soft tissue

  5. 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.

  6. Angular Photogrammetric Analysis of the Soft tissue Facial Profile of Attractive Uygur Females in Xinjiang%新疆维吾尔族美貌女性侧貌软组织形态角度测量分析

    Institute of Scientific and Technical Information of China (English)

    姬晓炜; 梁学萍; 葛菲


    Objective; To obtain objective angular measurements of the soft tissue facial profile of the attractive Uygur female in Xinjiang to use them as a guide for aesthetic clinicians and explore the relationship between angular analysis and facial profile. Methods: Thirty one attractive Uygur women were selected. Standardized facial photographic records were taken in the natural head position(NHP) and 13 standard anthropometric marks were determined, then 15 measurements were performed by photoshopCS software. The reliability of the method was analysed using Dahlberg's formula. Result: The objective average measurements of the soft tissue facial profile of the attractive Uygur female in Xinjiang were obtained. Wide individual variations existed in nasolabial. mentolabial and ethnic pyramid angles. Conclusion: Angular analysis plays a significant role in the measurement of the soft tissue facial profile. Aesthetic triangles could be used as standard screening values for profile analysis and that ethnic pyramid could be used to consider ethnicity.%目的:建立新疆维吾尔族美貌女性侧貌软组织角度参考值并分析角度与侧貌特征的关系,为口腔颌面相关学科医生提供临床参考数据.方法:按标准选取31名新疆维吾尔族美貌女性,在自然头位摄取其侧面数码照片,在计算机上用photoshopCS软件选择13个软组织标志点,测量15个角度值,应用SPSS13.0统计软件包对数据进行处理,使用Dahlberg's公式计算测量方法误差.结果:新疆维吾尔族美貌女性侧貌软组织角度测量值范围.方法误差显示了测量方法的可靠性和可重复性.结论:所测角度在侧貌软组织特征分析中具有重要作用,“美学三角”可以作为侧貌美学分析的参考平面,“种族金字塔”中的3个角度可用于分析种族的差异性.

  7. 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.

  8. 面部软组织外伤中西医结合美容修复%Emergency Cosmetic Repair of Facial Soft Tissue Trauma with the Combination of Traditional Chinese Medicine and Western Medicine

    Institute of Scientific and Technical Information of China (English)

    张威; 王雪山; 刘明珠; 马艳


    目的:研究面部软组织外伤中西医结合修复效果,总结治疗经验。方法:选取86例面部软组织外伤患者作为研究对象,行急诊手术治疗后,给予对照组患者术后西医护理,给予观察组患者术后中西医结合护理,对比两组患者对治疗效果满意程度。结果:对照组患者总满意率79.69%,观察组患者总满意率94.59%,差异具有统计学意义(P<0.05)。结论:采用中西医结合护理方式对面部软组织创伤修复具有良好的促进作用,值得临床推广。%Objective:To study the facial soft tissue trauma Integrative repair effect,and summarize the treatment experience. Methods:86 cases with facial soft tissue trauma were research subjects. After emergency surgery,the control group were given Western postoperative care,and the observation group were given integrative care. Then ttreatment satisfaction in two groups was compared. Results:The overall satisfaction rate of the control group was 79.69%,and that of the observation group was 94.59%,with statistically significant difference(P<0.05). Conclusion:Integrative care for facial soft way is to promote wound healing with good effect,and is worthy of promotion.

  9. Clinical application of expanded submental island flap in facial soft tissue defect%颏下动脉颈部岛状扩张皮瓣修复面部软组织缺损

    Institute of Scientific and Technical Information of China (English)

    李峰永; 李养群; 陈文; 李强; 周传德; 唐勇; 杨喆; 赵穆欣


    目的 探讨以颏下动脉为蒂的颈部扩张皮瓣在面部软组织缺损修复中的临床应用效果.方法 2004年9月至2008年9月,应用以颏下血管为蒂的颈部岛状扩张皮瓣修复面部软组织缺损12例.手术分两期进行,一期行颈部扩张器植入术,二期以一侧颏下动脉为蒂,设计岛状皮瓣转移修复面部软组织缺损.皮瓣的最大面积16 cm×9 cm.结果 12例皮瓣全部成活,其中1例因静脉回流不畅而出现皮瓣远端表皮坏死,经换药等治疗后愈合.4例获得远期随访,随访时间为6个月至2年,皮瓣质地及色泽均接近面部正常组织,外形满意,颈部供区瘢痕隐蔽、活动无明显受限.结论 颏下动脉走行恒定,颈部扩张后可以提供较大面积高质量的皮肤组织,以颏下动脉为蒂的颈部岛状扩张皮瓣是修复面部损伤后瘢痕挛缩及面部浅表肿瘤切除后组织缺损的较好的方法.%Objective To investigate the application of the expanded submental island flap in facial soft tissue defect. Method 12 patients with facial soft tissue defects were treated with the expanded submental island flaps during September 2004 to September 2008. At the first stage, soft tissue expander was implanted in the neck. At the second stage, the submental island flap was designed to repair the facial soft tissue defect. The largest size of the flap was about 16 cm×9 cm. Result All flaps survived well except for one case of partial epidermal necrosis at the distal part of the flap. The wound healed with dressing. 4 patients were followed up for 6~24 months with satisfactory results. Conclusion The submental artery was a constant branch of facial artery.Large cervical flap with high quality tissue can be provided after expansion. The expanded submental island flap is a good choice for repairing the facial soft tissue defect.

  10. Application of Nasolabial sulcus flap in facial soft tissue defect’s repair%鼻唇沟皮瓣在面部软组织缺损修复中的应用

    Institute of Scientific and Technical Information of China (English)

    孙明亮; 潘实; 董贤平; 殷佳鹏; 樊树强; 廖立新


    目的:探讨鼻唇沟皮瓣在颜面部软组织缺损修复中的应用。方法:应用鼻唇沟瓣修复因肿瘤、外伤等原因所致颜面部软组织缺损25例,缺损部位包括鼻部、唇部、颊部等。结果:25例患者手术全部成功,皮瓣均成活,效果满意。结论:鼻唇沟皮瓣用于鼻及口腔颌面部缺损或畸形的修复不失为一个实用而有效的方法。%Objective:To investigate the Application of Nasolabial sulcus flap in facial soft tissue defect’s repair. Methods:25 patients with facial soft tissue defects caused by tumor or trauma were repaired by nasolabial sulcus flaps. All defects were located in the nasal,oral or maxillofacial areas. Results:All the nasolabial sulcus flaps of 25 patients had survived. All patients were satisfied with the postoperative appearance and function. Conclusions:These data confirmed that using a nasolabial sulcus flap was a simple, effective method for repair of defects in the nose,Oral and maxillofacial region.

  11. Avoiding Facial Incisions with Midface Free Tissue Transfer (United States)

    Stalder, Mark W.; Sosin, Michael; Urbinelli, Leo J.; Mayo, James L.; Dorafshar, Amir H.; Hilaire, Hugo St.; Borsuk, Daniel E.


    Background: We have adopted an intraoral microsurgical anastomosis to the facial vessels to eliminate the need for any visible facial incisions. Methods: Cadaveric dissection was used to demonstrate accessibility of the facial artery and vein through an intraoral approach. Additionally, 5 patients underwent free tissue transfer for reconstruction of major defects of the midface through an intraoral, transmucosal approach, obviating the need for visible skin incisions. Results: The pathology included palatal defects due to mucoepidermoid carcinoma and ischemic necrosis from cocaine abuse, maxillary defects secondary to fibrous dysplasia and avascular necrosis from traumatic blast injury, and a residual posttraumatic bony deformity of the zygoma. Reconstructions were performed with a free ulnar forearm flap, a free vastus lateralis muscle flap, a deep circumflex iliac artery myoosseous flap, a free fibula flap, and a deep circumflex iliac artery osseous flap, respectively. The facial artery and vein were used as recipient vessels for microvascular anastomosis for all cases. Mean follow-up was 12.2 months. All free tissue transfers were successful, and each patient had a satisfactory aesthetic outcome with no associated facial scars. Conclusion: This technique can be employed during reconstruction of an array of bony or soft-tissue midface deficits with minimal morbidity. This small series effectively demonstrates the varied pathologies and tissue deficiencies that can be successfully reconstructed with free tissue transfer using an entirely intraoral approach to the recipient facial vessels, resulting in no visible scars on the face and an improvement in the overall aesthetic outcome. PMID:28280662

  12. Methods and clinical study of plastic surgery technology treatment for fa-cial ministry skin soft tissue defects%颜面部皮肤软组织缺损整形治疗的方法与探讨

    Institute of Scientific and Technical Information of China (English)



    Objective:To compare the curative effects of different parts of the skin flap transplantation for facial ministry differ-ent types of skin and soft tissue defects. Methods:From January 2012 to December 2012,87 cases had skin soft tissue expansion tech-nique and skin flap transplantation in our hospital to treat facial skin and soft tissue defects. 44 cases with Type I defects had facial skin soft tissue dilatation and skin flap transplantation, while 43 cases with Type II defects had chest skin soft tissue expansion and flap transplantation. General postoperative condition of graft site and the incidence of complications were compared. Results:Two groups of patients had no significant difference in postoperative graft site appearance color, muscle contraction, phase I recovery rate and hair growth (P>0. 05). Two groups of patients with postoperative bleeding,infection,skin necrosis,ecchymos and incision dehiscence com-plications had no significant difference (P>0. 05). Patients with above mentioned complications were treated with emergency debride-ment,drainage,antibiotics and secondary operation. All patients with secondary surgery had no complications again. Conclusion:Based on the different types of facial soft tissue defects,reasonably choosing and taking different operation schemes can effectively improve the prognosis and had no significant difference in clinical curative effect.%目的::比较不同部位皮瓣移植对于颜面部不同类型皮肤软组织缺损的治疗疗效。方法:选取我科2012年1月至2013年12月因颜面部皮肤软组织缺损而进行皮肤软组织扩张术+皮瓣移植的患者共87例。其中I型缺损44例,进行面部皮肤软组织扩张术+皮瓣移植;II型缺损43例,进行胸部皮肤软组织扩张术+皮瓣移植。比较两组患者术后移植部位一般情况和并发症发生率。结果:两组患者在术后移植部位外观色泽、肌肉收缩、I期修复创面率和毛发生长情况方

  13. Emergency repair of the facial soft tissue injuries with plastic surgery%应用整形美容技术修复面部软组织损伤的临床效果

    Institute of Scientific and Technical Information of China (English)

    徐传岗; 陈艳; 赵静


    Objective To investigate the effect of cosmetic surgery on the facial soft tissue injuries.Methods The clinical data of 52 patients with facial soft tissue injuries from June 2013 to June 2014 were analyzed retrospectively.And plastic surgical techniques were applied to the early treatment of facial soft tissue injuries in patients,according to the size of defect and the degree of deformity of the patients,different plastic surgery treatment was chosen,such as skin flap or skin graft to repair wound surfaces.In this process,one must follow sterile noninvasive principle strictly with emphasis on the technique of plastic surgery such as entire debridement,wound healing application of skin flap and so on.Results Total 49 cases of facial soft tissue injuries were healed by first intention without significant complications,while 4 cases of them had mild scars.Absorbable suture exposition appeared in 3 patients after primary healing.Those sutures were romoved after disinfected and no sequelaes were happened.All patients were recovered with good appearances and functions to the most exent.Conclusions The treatment of facial soft tissue injuries,by applying plastic and aesthetic surgery,could reduce scar and postoperative deformity,and secondary corrective procedures can be avoided in most patients.%目的 探讨应用整形美容技术修复面部软组织损伤的方法及临床效果.方法 回顾性分析52例面部软组织创伤患者,采用整形外科技术,根据具体伤情设计不同修复方法,严格遵守无菌、无创原则,进行清创、创面修复、皮瓣修复等治疗.结果 49例患者术后Ⅰ期愈合,4例伴有轻微瘢痕,3例患者Ⅰ期愈合后出现局部皮下可吸收线头外露,予以消毒后拆除,无并发症发生.随访6~12个月,无感染、无坏死、无明显瘢痕等并发症发生.52例患者面部功能及形态均达到了最大限度的修复,患者均较满意.结论 应用整形美容技术修复面部软组织损伤,

  14. Aesthetic applications of random pattern skin flap in repair of facial soft tissue defects%随意型皮瓣在面部软组织缺损美学修复中的应用

    Institute of Scientific and Technical Information of China (English)

    王淑琴; 谭谦; 郑东风; 许澎; 葛华强; 林樾; 燕辛


    Objective To discuss the effects of random pattern skin flap on the repair of facial soft tissue defects as well as its aesthetic applications.Methods In view of the facial soft tissue defects caused by various reasons,36 cases of patients were repaired according to the defect location,size,design such as "the kite" flap,adjacent pedicle flap or V-Y glide flaps.Results After operation,all flaps were survived;Incisions were healed at stage Ⅰ;follow-up for 2 to 12 months,the cosmetic results were satisfactory.Conclusions The random pattern skin flap can be applied to repair facial soft tissue defects with aesthetic effects.The flap's texture and color have no obvious difference from nor mal skin;postoperative incision scar is slightly,and it can retains the facial appearance and function to the maximum limit.%目的 探讨随意型皮瓣在修复面部软组织缺损中的美学效果.方法 针对各种原因所致的面部软组织缺损,根据缺损部位所处的面部美学亚单位、缺损形态及缺损面积等设计随意型皮瓣,如旋转皮瓣、推进皮瓣、易位皮瓣、“风筝”皮瓣等,对36例患者进行修复.切口设计顺皮纹方向,切口无张力缝合.结果 术后36例患者的皮瓣全部成活,切口均Ⅰ期愈合,切口瘢痕轻微,随访2~1 2个月,美学效果满意.结论 应用随意型皮瓣修复面部软组织缺损,皮瓣质地柔软,色泽无明显差异,能最大限度地保留面部美观及功能.

  15. Soft tissue angiosarcomas

    Energy Technology Data Exchange (ETDEWEB)

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


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

  16. 颏下动脉岛状瓣在颜面部软组织缺损修复中的应用%Application of the Submental Artery Island Flap for Repairing Facial Soft Tissue Defect

    Institute of Scientific and Technical Information of China (English)

    王贺红; 汪春兰; 赵宇


    Objective To explore the application of the submental artery island flap in repairing facial soft tissue defect. Methods From July 2007 to 2014, 10 cases with facial soft tissue defect were admitted in this study. Primary lesions in-cluded trauma (2 cases), buccal mucosa squamous cell carcinoma (SCC, 4 cases), buccal basal cell carcinoma (BCC, 1 case), and scar hyperplasia caused by burning or scalding (3 cases). Flaps ranging from 3 cm ×6 cm to 4 cm×10 cm were designed according to the size and location of the facial defects to repair facial soft tissue defects. Results Pale, swell and/or conges-tion were observed in all flaps postoperative, but the situation improved 5 days later. Partial necrosis was observed in 1 case but healed by dressing. All the patients were followed up for 3-12 months, full thickness skin which was used to cover the donor-site in 3 cases shrank inordinately during followed-up. Appearance and functions of the recipient site were satisfacto-ry. The scar of the donor-sites was not conspicuous. Conclusion The submental artery island flap is similar with the facial soft tissue on color and texture, and it offers the advantages of simplicity, reliability and aesthetic result, so it is an excellent choice for repairing facial defects and deformity.%目的:探讨颏下动脉岛状瓣在修复颜面部软组织缺损中的应用。方法2007年7月至2014年3月,收治颜面部软组织缺损患者10例,其中外伤2例,面部鳞癌4例,面部基底细胞癌1例,烫伤或烧伤后瘢痕增生3例。根据缺损位置及大小设计颏下动脉岛状瓣进行修复,最小为3 cm×6 cm,最大为4 cm×10 cm。结果术后皮瓣存在不同程度的肿胀苍白及淤血,5 d后逐渐改善。1例皮瓣远端出现坏死,经换药处理愈合。术后随访3~12个月,3例供皮区采用全厚皮覆盖创面,随访期间发现皮片不同程度收缩。其余受区外观及功能均较满意,供区瘢痕隐蔽。结论颏下

  17. 颜面部软组织创伤的急诊美容修复与护理%Plastic surgery and nursing for repairing of facial soft tissue injury

    Institute of Scientific and Technical Information of China (English)

    朱瑜; 李琳


    目的:探讨颜面部外伤的急诊美容修复与护理。方法:根据伤情,细心清创,对创面的处理方法做出正确的设计,采用肿胀麻醉,解剖对位,分层缝合,深层用0/5可吸收线减张缝合,皮肤用0/6单丝尼龙线缝合,缺损创面用带真皮下毛细血管网的皮肤或邻近皮瓣修复。结果:本组197处受伤部位,除了3例因皮肤挫伤缺损严重,待二期行肉芽创面植皮,其余病例均一期愈合。结论:颜面部软组织伤的急诊处理应遵循整形外科原则,术后精心护理,预防感染,减少颜面部的瘢痕、畸形、外伤性灰尘文身等医源性毁容。%Objective To observe the nursing and technique of plastic surgical repair in facial soft tissue trauma. Methods We repaired the wounds of emergency traumaticcases with aesthetic surgery methods and technique. Results The 197 wounds of emergency traumatic cases healed perfectly except the 3 cases with serious bruise were grafted skin on the granulation burn wounds. Conclusion Injury of facial superficial soft tissue might be repaired with cosmetic surgical operation on emergency and intensive perioperative nursing and we applied aesthetic surgery methods to repair the facial trauma can reduce postoperative scar abnormality and iatrogenic disfigure effectively.

  18. Estudo comparativo entre a Análise Facial Subjetiva e a Análise Cefalométrica de Tecidos Moles no diagnóstico ortodôntico Comparative study between the Subjective Facial Analysis and the Soft Tissue Cephalometric Analysis on the orthodontic diagnosis

    Directory of Open Access Journals (Sweden)

    Renata Feres


    Full Text Available OBJETIVO: avaliar a concordância entre a Análise Facial Subjetiva, proposta por Capelozza Filho, e a Análise Cefalométrica de Tecidos Moles, de Arnett e McLaughlin. MÉTODOS: fotografias de frente e de perfil e telerradiografias em norma lateral padronizadas de 50 indivíduos, com média de idade de 24 anos e 1 mês, foram utilizadas para essa avaliação. Verificou-se, também, nos indivíduos classificados como Padrão I, a correspondência dos valores médios e desvios-padrão das medidas obtidas com os valores normativos da Análise Cefalométrica de Tecidos Moles para os indivíduos com harmonia facial. RESULTADOS: constatou-se, em indivíduos do Padrão I, que os lábios sempre se encontram à frente da Linha Vertical Verdadeira e que, apesar de grandes variações do ponto pogônio, o equilíbrio facial ainda se mantinha. CONCLUSÃO: os resultados demonstraram que a Análise Facial Subjetiva é um método eficiente na classificação do padrão facial.AIM: To evaluate the agreement between the Subjective Facial Analysis, proposed by Capelozza Filho, and the Soft Tissue Cephalometric Analysis, proposed by Arnett and McLaughlin. METHODS: Fifty standardized frontal and lateral photographs and fifty cephalometric x-rays were used, in a sample with a mean age of 24 years and 1 month. After that it was verified, on the Pattern I patients, the correspondence of the values found on this sample with the ones proposed by the Soft Tissue Cephalometric Analysis normative values. RESULTS: It was demonstrated that the lips are always positioned ahead the True Vertical Line, and that, despite the variation of the pogonion point, the facial equilibrium is still maintained. CONCLUSION: The results related to the Subjective Facial Analysis showed that this is a valid and efficient method of Facial Pattern classification.

  19. 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, ...

  20. 自体脂肪颗粒移植在面部凹陷畸形中的应用%Clinical application of fat granule auto-graft in facial soft tissue depression

    Institute of Scientific and Technical Information of China (English)

    张连波; 王冰; 高庆国; 张广; 尹维田


    Objective To evaluate the clinical application of fat granule auto-graft in facial soft tissue depression reconstruction.Methods Autologous subcutaneous fat granules were obtained by syringe aspiration from donating site.then washed with normal saline.Small amounts of fat granules were injected into the facial sites with soft tissue depression by means of multiple passes immediately.Results We performed such fat iniection in a total of 18 cases,all of the procedures were safe and successful.In most cases,single injection were enough,only one underwent two sessions of fat iniection.All members were followed-up for 1.5 months to 24months,the average were 14 months.All facial tissue depression were reconstructed for difierent degrees.The rate of fullness and symmetry.fullness and pretty symmetry and fullness with little asymmetry were 77.8%,16.7%and 5.5%.respectively.No infection,fat necrosis or liquefaction occured.Conclusion Being satisfled in correction of deformity of facial depression.the implantation of autologous fat globules iS safe and effective with less side-effects.%目的 探讨自体脂肪颗粒移植在面部软组织凹陷畸形矫正中的作用.方法 采用注射器法从供区皮下抽吸脂肪颗粒,经过冲洗后少量多层次的注射移植到面部凹陷部位.结果 18例患者均进行了随访,最短者1.5个月,最长者2年,平均14个月,全部患者面部凹陷畸形得到不同程度的矫正,充填后丰满平坦,双侧对称者占77.8%;凹陷术后较丰满,双侧基本对称占16.7%;凹陷较丰满双侧轻度不对称者占5.5%.无1例出现血肿、脂肪液化、感染等并发症,效果比较满意.结论 自体脂肪颗粒注射游离移植对面部凹陷畸形的矫正可取得较好的临床效果,副作用最小,不失为一种安全、有效的方法.

  1. Soft tissue application of lasers. (United States)

    Holt, Timothy L; Mann, Fred A


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

  2. [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.

  3. 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.

  4. Trabectedin in Soft Tissue Sarcomas

    Directory of Open Access Journals (Sweden)

    Bradley J. Petek


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

  5. 面部软组织厚度测量及其在面貌复原中的应用%Facial Soft Tissue Thickness Measurement and Its Application in Craniofacial Reconstruction

    Institute of Scientific and Technical Information of China (English)

    税午阳; 周明全; 纪元; 殷荣超


    软组织厚度作为颅骨面貌复原的基础,具有重要的应用价值.本文借助计算机技术对西安地区132例成年人颅面数据样本开展软组织测量、分析及应用研究,结果表明,1)通过分析特征点处软组织厚度和面部软组织分布图,发现面部软组织分布具有一定的规律,额头区域软组织厚度薄且样本间差异小,脸颊区域软组织厚且样本间差异大;2)通过比较不同年龄段男性软组织厚度的均值,发现20~30岁阶段软组织厚度均值最小,50~60岁阶段软组织厚度均值其次,30~40岁阶段软组织厚度均值最大,但30~40岁和40~50岁两个年龄段的软组织厚度近似;通过比较不同年龄段女性软组织厚度的均值,发现20~30岁阶段软组织厚度均值最小,30~40岁阶段软组织厚度均值其次,40~50岁阶段的软组织厚度均值最大;3)特征点处软组织厚度标准差可以反映面貌体态的差异,因此根据10个脸颊特征点的软组织厚度均值和标准差实现面貌体态分类;4)根据不同性别、年龄、体态对应的软组织平均厚度,应用计算机技术实现给定颅骨的三维面貌复原,复原结果相比于传统手工复原的结果更加科学.%As a fundamental part of craniofacial reconstruction,soft tissue thickness is key.This paper,based on 132 adult craniofacial samples,with the aid of computer technology,explores measurement,analysis and application of soft tissue.The results are as follows:l) By analyzing the soft tissue thickness of landmarks and facial soft tissue distribution,it has been shown that the arrangement of facial soft tissues has some rules:the forehead is thin with small differences between various samples,while the cheek is thick with large differences between various samples.2) By comparing soft tissue thickness averages of males of different ages,it has been shown that these averages between 20 and 30 are the lowest,the next are between 50 and 60

  6. 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.)

  7. Necrotizing soft tissue infection (United States)

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

  8. The application of comprehensive physicotherapeutics in the facial soft tissue injury%综合物理治疗在面部软组织挫伤后的应用

    Institute of Scientific and Technical Information of China (English)

    杨青; 刘剑毅; 曹川; 李世荣


    目的 探讨综合物理治疗在促进面部软组织挫伤恢复、防治并发症等方面的作用.方法 将56例面部软组织挫伤患者分成综合物理治疗组29例和非物理治疗组27例,综合物理治疗组应用微波、等幅中频正弦电(音频)、超声波、手法按摩等物理治疗并配戴低温热塑板材成型的面部支具进行局部压迫.非物理治疗组伤后不进行任何物理治疗,待其自然恢复.结果 综合物理治疗组面部软组织挫伤处局部淤血、肿痛、感觉障碍、皮下组织粘连4周恢复率为97%,非物理治疗组伤后4周恢复率为74%,显著低于综合物理治疗组.结论 面部软组织挫伤后物理治疗联合低温热塑板材加压的综合治疗能迅速消除面部软组织挫伤后的肿痛、促进淤血吸收、减少面部软组织挫伤引起的感觉障碍、皮下组织粘连引起的面部凹陷或动力性凹陷等并发症,是面部软组织挫伤后良好的治疗手段.%Objective To explore the method of treating the facial soft tissue injury with comprehensive physicotherapeutics and preventing the complication. Methods Altogether 56 facial soft tissue injury outpatients were divided into comprehensive physico therapeutics group(29) and non-comprehensive physicotherapeutics group (27). Micrewave therapy, acoustic frequency therapy, ultrasonic therapy,maneuver massage therapy and hypothermia forming board for pression were used in the comprehensive physico therapeutics group. No therapy were used for non-comprehensive physicotherapeutics group. Results The recovery rate of local haemostasis,pain,sensation disorder and subcutaneous tissue conglutination after 30 days was 97% in the comprehensive physicotherapeutics group. However, the recovery rate of those in non-comprehensive physicotherapeutics group was 74%. Conclusion Comprehensive physicotherapeutics combined with hypothermia forming board for pression can quickly eliminate the local haemostasis, pain

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

    Directory of Open Access Journals (Sweden)

    Manish Goyal


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

  10. Facial tissue depths in children with cleft lip and palate. (United States)

    Starbuck, John M; Ghoneima, Ahmed; Kula, Katherine


    Cleft lip and palate (CLP) is a craniofacial malformation affecting more than seven million people worldwide that results in defects of the hard palate, teeth, maxilla, nasal spine and floor, and maxillodental asymmetry. CLP facial soft-tissue depth (FSTD) values have never been published. The purpose of this research is to report CLP FSTD values and compare them to previously published FSTD values for normal children. Thirty-eight FSTDs were measured on cone beam computed tomography images of CLP children (n = 86; 7-17 years). MANOVA and ANOVA tests determined whether cleft type, age, sex, and bone graft surgical status affect tissue depths. Both cleft type (unilateral/bilateral) and age influence FSTDs. CLP FSTDs exhibit patterns of variation that differ from normal children, particularly around the oronasal regions of the face. These differences should be taken into account when facial reconstructions of children with CLP are created.

  11. Avaliação da proporção facial vertical: relação entre as alturas tegumentar e esquelética Evaluation of facial proportions in the vertical plane to investigate the relationship between skeletal and soft tissue dimensions

    Directory of Open Access Journals (Sweden)

    Márcia Cristina Cunha Costa


    Full Text Available OBJETIVO: determinar a relação entre as alturas faciais obtidas na avaliação do tegumento e do esqueleto subjacente, na análise da proporção facial vertical, na região anterior. MÉTODOS: foram utilizadas 24 radiografias cefalométricas de perfil e 48 fotografias da face, sendo 24 de perfil e 24 frontais, pertencentes a 24 indivíduos brasileiros, 7 do sexo masculino e 17 do feminino, na faixa etária de 19 a 38 anos. Foram realizados traçados cefalométricos e, sobre esses, obtidas medidas lineares, segundo as análises preconizadas por Schudy, Wylie e Johnson e Thompson e Brodie. Sobre as fotografias faciais, foram demarcados os pontos glabela, subnasal e mento, o que permitiu a medição das distâncias lineares entre os mesmos. Os dados obtidos foram, então, tratados estatisticamente. RESULTADOS E CONCLUSÕES: encontrou-se correlação positiva entre as avaliações do tegumento e do esqueleto subjacente, com base nas análises de Schudy (r=0,619, pOBJECTIVE: To determine the relationship between facial heights by evaluating the soft tissues and underlying skeleton and by analyzing vertical facial proportions in the anterior region. METHODS: The study used 24 lateral cephalometric x-rays and 48 photographs of the face, 24 in profile view and 24 in front view, belonging to 24 Brazilian individuals, 7 men and 17 women whose ages ranged from 19 to 38 years. Cephalometric tracings were performed and linear measurements obtained according to the analyses suggested by Schudy, Wylie & Johnson, and Thompson & Brodie. The anatomical landmarks glabella, subnasal and menton were identified on the photographs, which allowed the measurement of linear distances between these points. The data were then statistically analyzed. RESULTS AND CONCLUSIONS: A positive correlation was found between evaluations of the soft tissues and underlying skeleton based on the analyses advanced by Schudy (r=0.619, p<0.001, Wylie & Johnson (r=0.595, p<0.002 and

  12. 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.

  13. Effects of facial hard tissue surgery on facial aesthetics: changes in facial content and frames. (United States)

    Choi, Jin-Young; Lee, Sang-Hoon; Baek, Seung-Hak


    Aesthetic units of the face can be divided into facial content (FC; eyes, nose, lips, and mouth), anterior facial frame (AFF; a contour line from the trichion, the temporal line of the frontal bone, the lateral orbital rim, the most lateral line of the anterior part of the zygomatic body, the anterior border of the masseter muscle, to the inferior border of the chin), and posterior facial frame (PFF; a contour line from the hairline, the zygomatic arch, to the ramus and gonial angle area of the mandible). The size and shape of each FC and the balance and proportion between FCs create a unique appearance for each person. The facial form can be determined through the combination of AFF and PFF. In the Asian population, clinicians frequently encounter problems of FC (eg, acute nasolabial angle, protrusive and everted lips, nonconsonant lip line, or lip canting), AFF (eg, midface hypoplasia, protrusive and asymmetric chin, vertical deficiency/excess of the anterior maxilla and symphysis, or prominent zygoma), and PFF (eg, square mandibular angle). These problems can be efficiently and effectively corrected through the combination of hard tissue surgery such as anterior segmental osteotomy, genioplasty, mandibular angle reduction, malarplasty, and orthognathic surgery. Therefore, the purposes of this article were to introduce the concepts of FC, AFF, and PFF, and to explain the effects of facial hard tissue surgery on facial aesthetics.

  14. 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.

  15. 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.

  16. 女性下颌角截骨术后面部软组织变化的回顾性研究%The Change of the Female Facial Soft Tissue after Mandibular Angle Osteotomy

    Institute of Scientific and Technical Information of China (English)

    许祐荣; 柴岗; 张艳; 侯亦康; 曲淼; 沈聪聪


    目的:观察女性下颌角截骨术后面部软组织的变化情况。方法将130例行下颌角截骨术(口内切口)的女性下颌角肥大患者纳入本次研究,通过CT、成像软件测量术前及术后6个月面部软组织①耳垂点至下颌角高度与下面高度的比值②正位双下颌角间距与双颧间距比值③软组织下颌角角度,观察手术前后中下面部软组织的变化。结果术前耳垂至下颌角高度与下面高度比值为1∶(1.5±0.12),术后为1∶(1.92±0.15);术前正位双下颌角间距与双颧间距比值为1∶(1.03±0.11),术后为1∶(1.2±0.21);术前下颌角角度为(109±1.7)°,截骨术后下颌角角度为(121±2.1)°。结论下颌角肥大患者行下颌角截骨术约6个月后,中下面部软组织外形改善明显。%Objective To observe the change of facial soft tissue after mandibular angle osteotomy. Methods Comuterized tomography (CT) examination was performed on 130 patients treated by mandibular angle ostemomy before operation and 6 months after operation, respectively. Intra-oral incision were used for correcting prominent mandibular angle (PMA).①ratio of the height from lobule to mandibular angle&the height of lower face, ②ratio of the distance between the two sides of mandibular angle&the distance between the two sides of zygometic arch and ③the degree of mandibular angle were all calculated pre-and postoperatively to evaluate the change of facial soft tissue. Results The preoperative ratio of the height from lobule to mandibular angle&the height of lower face was 1∶(1.5±0.12), while the postoperative was 1∶(1.92±0.15);The preoperative ratio of the distance between the two sides of mandibular angle & the distance between the two sides of zygometic arch was 1∶(1.03±0.11), while the postoperative was 1∶(1.2±0.21);The preoperative mandibular angle was (109±1.7) °, while the postoperative was (121 ±2.1) ° . Conclusion

  17. 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 ...

  18. 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 ...

  19. Profil jaringan lunak wajah kasus borderline maloklusi klas I pada perawatan ortodonti dengan dan tanpa pencabutan gigi (Facial soft tissue profile on borderline class I malocclusion in orthodontic treatment with or without teeth extraction

    Directory of Open Access Journals (Sweden)

    Pinandi Sri Pudyani


    Full Text Available Background: Determination of orthodontic treatment plan with or without teeth extraction remains controversial, especially in borderline cases, so it requires more data and information to establish appropriate treatment plans in order to obtain optimal treatment results. Purpose: The study was aimed to determine the facial soft tissue changes in the borderline class I cases treated with and without tooth extraction on post-orthodontic treatment. Methods: The study was conducted on 28 lateral cephalograms, divided into two groups; 13 cases with tooth extraction, and 15 cases without tooth extraction. The subject criterias were as follows; class I malocclusion treated with straightwire technique, skeletal class I, in range of age between 18 to 30 years old, normal overjet 2-4 mm, arch length discrepancy between 2.5 to 5 mm, Index of Fossa Canine (IFC between 37% to 44%, did not using extraoral devices, and treated with teeth extraction of 4 second premolars or without tooth extraction. The measurement of nasolabial angle, labiomental angle, and linear position of the upper and lower lip to E-Ricketts line were done on each cephalogram before and after orthodontic treatment. Results: In teeth extraction cases, there was a change on upper and lower lips positions (p<0.05, but there were no changes on nasolabial angle and labiomental angle (p>0.05. In non teeth extraction cases, there were no changes in nasolabial angle, labiomental angle, and lips positions (p>0.05. Both of groups also have indicated that there were no changes on linear position of the upper and lower lip (p>0.05. Post-orthodontic treatment indicated a significant differences between extraction and nonextraction cases on nasolabial and labiomental angle, and lips position (p<0.05. Conclusion: The facial soft tissue profile changes on teeth extraction case was more retruded than non- teeth extraction case.Latar belakang: Penentuan rencana perawatan ortodonti dengan pencabutan atau

  20. 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.)

  1. Soft tissue cephalometric norms in Iranian normal subjects

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    Hossein Aghili


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

  2. Soft tissue aneurysmal bone cyst

    Energy Technology Data Exchange (ETDEWEB)

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


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

  3. A Case of Complex Facial Clefts Treated with Staged-tissue Expansion

    Directory of Open Access Journals (Sweden)

    Koichi Ueda, MD, PhD


    Full Text Available Summary: Craniofacial clefts involve all soft tissue and skeletal elements throughout the cleft. Usefulness of tissue expansion in craniofacial clefts is reported. Surgery for a complex type of facial clefts is more difficult and more extensive than for a simple one. We experienced a primary case of complex facial clefts (Tessier No. 2 and 12 on the right and 3, 11, and 5 on the left. Soft-tissue closure of all clefts could be completed by using 4 tissue expanders and 7 operations. Because multiple tissue deficiencies and abnormalities exist in craniofacial clefts, especially complex type, a planned, staged, sequential approach by tissue expansion is necessary to produce ideal results.

  4. Olaratumab for soft tissue sarcoma. (United States)

    Teyssonneau, Diego; Italiano, Antoine


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

  5. 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.

  6. Nonspecificity of Chronic Soft Tissue Pain Syndromes

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    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.

  7. Impact of Fixed Appliance Combined with Bite Splint Treatment on Facial Soft Tissue Changes in Patients with Anterior Crossbite%固定矫治器联合后牙垫治疗前牙反对颜面软组织侧貌的影响

    Institute of Scientific and Technical Information of China (English)



    目的:探讨固定矫治器联合可摘式后牙�垫治疗前牙反�对颜面软组织侧貌的影响。方法:选取40例前牙反�患者,采用直丝弓矫治技术配合可摘式后牙�垫矫正,均未拔牙。采用X线头颅定位侧位片分析矫正后患者软组织侧貌的改变。结果:矫治后患者面型改善,反�得以矫正,牙齿排列、咬合关系改善;与矫治前相比,下唇突距减小,面突角减小,差异有统计学意义(P<0.05)。结论:固定矫治器联合可摘式后牙牙合垫治疗前牙反�对软组织侧貌有明显的改善作用。%Objective:To study the facial soft tissue changes in patients with anterior crossbite after treatment of fixed appli-ance combined with bite splint treatment .Methods :Forty cases patients with anterior crossbite were selected and treated by straight wire appliance combined with bite splint .The facial soft tissue changes after treatment were analyzed by X-ray cephalo-metric measurements .Results:After treatment ,the facial soft tissue was significantly improved ,the cross bite was relieved , and the teeth arrangement and malocclusion were also improved significantly .Compared with those before treatment ,LL-SnPg’ and G-Sn-Pog’ were decreased significantly after treatment ,the difference was statistically significant (P<0 .05) .Con-clusions:Treatment of fixed appliance combined with bite splint can significantly improve facial soft tissue changes .

  8. 皮肤恶性肿瘤致颜面部大面积软组织缺损修复的临床体会%Clinical experience of a large area of facial soft tissue defect repair after skin malignancies excision

    Institute of Scientific and Technical Information of China (English)

    邓建平; 张治平; 黄雁翔; 黄伟; 邹小梅; 杨成锦


    Objective To discuss the surgical methods and clinical efifcacy of the different types of skin lfap or temporal fascia lfap in repairing of the large facial soft tissue defect that caused by the skin cancer.MethodsIn the group of 21 patients with large facial defect (average 5.0cm×8.5cm) after tumor resection,we repaired the soft tissue defect with the frontal lfap,or the temporal fascia lfap with skin graft,and use the double frontal lfap in the nasal defect.Results All the 21 cases of facial soft tissue defect were repaired in one or two surgery, and all lfaps were alive with satisifed appearance and function.Conclusion It can be effectively treated through different types of skin lfap or temporal fascia lfap in repairing the large and complex facial soft tissue defect in different parts.%目的:探讨采用不同类型皮瓣或颞筯膜瓣修复因皮肤恶性肿瘤所致颜面部大面积软组织缺损的方法及临床疗效。方法:本组共21例患者,肿瘤切除后均造成颜面部大面积缺损,平均缺损面积达5.0cm×8.5cm。除了常用的额部皮瓣修复外,笔者选择颞顶筋膜瓣转移加植皮术修复颞部大面积软组织缺损,双侧额瓣法修复鼻部洞穿性缺损。结果:21例颜面部软组织缺损均经过一期或二期修复手术,所有皮瓣均成活,形态满意,功能恢复良好。结论:修复颜面部不同部位复杂的大面积软组织缺损,选择不同类型皮瓣或颞筯膜瓣进行修复可以获得良好的治疗效果。

  9. 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

  10. 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...

  11. 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.

  12. 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...

  13. Childhood Soft Tissue Sarcoma: Treatment Information (United States)

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

  14. 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 ...

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

    Directory of Open Access Journals (Sweden)

    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.

  16. 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.

  17. 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.

  18. 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. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  19. Soft tissue and esthetic considerations around implants

    Directory of Open Access Journals (Sweden)

    Joann Pauline George


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

  20. Evaluation of the Efficacy and Safety of a Lidocaine and Tetracaine (7%/7%) Cream for Induction of Local Dermal Anesthesia for Facial Soft Tissue Augmentation with Hyaluronic Acid


    Cohen, Joel L.; Gold, Michael H.


    Injection of dermal fillers for soft tissue augmentation is a minimally invasive cosmetic procedure with growing popularity. However, patients often express concern about pain with such procedures. A topical anesthetic cream formulated with lidocaine/tetracaine 7%7% was approved by the United States Food and Drug Administration in 2006 and recently reintroduced to the market for use during superficial dermatological procedures. A Phase 3 study was conducted to assess the efficacy and safety o...

  1. Quantification and validation of soft tissue deformation

    DEFF Research Database (Denmark)

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


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

  2. 除皱术在一期修复面部小面积皮肤及软组织缺损中的应用%Clinical applacation of rhytidectomy in one stage repair of facial small area skin and soft tissue defecet

    Institute of Scientific and Technical Information of China (English)

    翟朝晖; 李兆欣


    目的 初步探讨通过面部除皱术一期修复部分面部小面积皮肤软组织缺损的新方法,讨论其优点和缺点.方法 选择头面部皮肤、软组织缺损且面部皱纹明显的患者6例,实施面部除皱手术,同时修复缺损.结果 所有患者均一期修复面部缺损,术后随访6个月,除皱效果良好,无并发症,患者满意.结论 利用面部除皱术一期修复局部面部小面积皮肤及软组织缺损,是一项安全、有效的手术方式,不仅可以修复部分面部的小面积皮肤、软组织缺损,还可以同时有效的改善面部的皱纹情况.%Objective To investigate a new method of rapairing local facial small area skin and soft tissue defecet by means of rhytidectomy,in order to assess the value of it.Methods Six patients who suffered from facial aging skin with small area skin and soft tissue defecet in their faces were seleted to use this method.Results All the defecets were repaired in one stage with no complications using this new method,the effect of all patients was pleasure after six months follow-up.Conclusion This new method can remove wrinkles of skin,repair the skin and soft tissue defecet.This approach brings more rapid recorery of patients and it is feasible and safe for selected patientsment.

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

    Directory of Open Access Journals (Sweden)

    Siddharth Shashidhar Revankar


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

  4. 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.

  5. Soft-tissue mineralization in Werner syndrome

    Energy Technology Data Exchange (ETDEWEB)

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


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

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. Clinical analysis of repairing soft tissue defects in oromaxillo-facial region with rectus abdominis musculocutaneous flaps in 18 Cases%腹直肌肌皮瓣修复口腔颌面部软组织缺损18例临床分析

    Institute of Scientific and Technical Information of China (English)

    羊书勇; 郑维银; 李晨军; 李浩; 米增媛; 李焰; 张建设; 卢艳鹏


    目的 总结腹直肌肌皮瓣用于口腔颌面部修复的经验,对腹直肌肌皮瓣的用途、应用方法 、成败因素等加以分析和讨论.方法 2007年6月~2010年6月,应用腹直肌肌皮瓣修复口腔颌面部软组织缺损18例,其中男性11例,女性7例,年龄46~71岁,均为肿瘤切除造成的组织缺损,所有病例均为即刻修复.结果 18例游离组织瓣成活17例,修复成功率为94.4%.结论 对于口腔颌面部肿瘤切除后形成的组织缺损,腹直肌肌皮瓣是进行修复的理想选择.%Objective To summarize the experience of repairing soft tissue defects in the oromaxillo - facial region with rectus abdominis musculocutaneous( RAM )flaps, and to discuss the usage, application method of RAM flaps and factors of success or failure. Methods From June 2007 to June 2010,there were 18 cases receiving the reparation of soft tissue defects in the oromaxillo - facial region with RAM flaps,in which 11 cases were male and 7 ones were female with the age ranged from 46 to 71. The tissue defects were all caused by tumor resection, and all cases received the immediate reparation. Results The dissociation tissue flaps in 17 cases survived. The success rate of reparation was 94. 4% . Conclusion RAM flap is a preferable choice for the reparation of tissue defects caused by tumor resection in the oromaxillo - facial region.

  14. Evaluation of the efficacy and safety of a lidocaine and tetracaine (7%/7%) cream for induction of local dermal anesthesia for facial soft tissue augmentation with hyaluronic Acid. (United States)

    Cohen, Joel L; Gold, Michael H


    Injection of dermal fillers for soft tissue augmentation is a minimally invasive cosmetic procedure with growing popularity. However, patients often express concern about pain with such procedures. A topical anesthetic cream formulated with lidocaine/tetracaine 7%7% was approved by the United States Food and Drug Administration in 2006 and recently reintroduced to the market for use during superficial dermatological procedures. A Phase 3 study was conducted to assess the efficacy and safety of lidocaine/tetracaine 7%7% cream versus placebo cream when used to induce local dermal anesthesia during injections with hyaluronic acid. Mean visual analog scale scores significantly favored lidocaine/tetracaine 7%7% cream. A significant percent of subjects also indicated that lidocaine/tetracaine 7%7% cream provided adequate pain relief and that they would use lidocaine/tetracaine 7%7% cream again. Investigators also rated lidocaine/tetracaine 7%7% cream significantly better than placebo cream for providing adequate pain relief and on the assessment of pain scale. Lidocaine/tetracaine 7%7% cream was safe and well tolerated with most subjects reporting no erythema, edema, or blanching. No related adverse events were reported with lidocaine/tetracaine 7%7% cream; one related adverse event of erythema was reported with placebo cream. The results of this study indicate that lidocaine/tetracaine 7%7% cream is efficacious and safe at providing pain relief for soft tissue augmentation with hyaluronic acid.

  15. Head and Neck Soft Tissue Sarcoma


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


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

  16. 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...

  17. 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...

  18. 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.)

  19. Biodegradable elastomeric scaffolds for soft tissue engineering

    NARCIS (Netherlands)

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


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


    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.

  1. 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

  2. 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

  3. Soft tissue sarcoma : why not treated?

    NARCIS (Netherlands)

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


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

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. [Computer-aided analysis of maxillofacial soft tissue simulating with vertical dimensions of 4 different types (United States)

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


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

  9. Staphylococcus aureus soft tissue infection may increase the risk of subsequent staphylococcal soft tissue infections. (United States)

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


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

  10. 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.

  11. 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.

  12. Clinical application research of moist exposed method in the treatment of facial soft tissue defect%湿性医疗技术治疗面部软组织缺损的临床应用

    Institute of Scientific and Technical Information of China (English)

    王俊; 李巧梅; 郝兰清; 王高丽; 吕飞飞; 夏欣; 王金雨; 邹晶; 和王刚; 周小龙


    目的:通过湿性医疗技术治疗面部软组织缺损的临床效果观察,介绍一种治疗面部软组织缺损的新方法。方法:对85例面部软组织缺损患者采用湿性医疗技术进行治疗,临床观察创面愈合时间、愈后疤痕及面形、功能变化,分析其疗效。结果:85例患者创面愈合时间最短12 d,最长72 d,74例患者面形及功能恢复正常,伤区皮肤弹性好,瘢痕较轻;11例失访,2例鼻尖、鼻小柱皮肤及鼻翼软骨缺损愈合时间最长,愈后左侧鼻孔边缘遗留V形缺损,湿性医疗技术可能对软骨无作用。结论:湿性医疗技术可以使面部软组织缺损达到较为理想的愈合,操作方法简单,能明显降低医疗费用,是一种简单有效的方法,特别适用于老年患者、全身情况差,不能耐受复杂手术治疗的患者。%Objective:To summary clinical experience of treatments of maxillofacial soft tissue defects by moist ex-posed method and introduce a new therapeutic strategy of maxillofacial soft tissue defects. Method:85 patients with max-illofacial soft tissue defects were treated by moist exposed method. We analyzed the efficacy by observing the time of wound healing,healing scar,and change of face shape and functions,in these patients. Result:In these 85 patients,the shortest time of wound healing was 12 days and longest one was 72 days. 74 patients recovered their face shapes and functions. The healing skin has relative good elasticity,less scarring. 11cases were lost to follow-up. 2 patients with defect of tip of nose, skin of columella and alar cartilage has longest time of wound healing,as well as V-shaped defect in the margin of left nos-tril, thought to be of cartilage has no effect. Conclusion:Moist exposed method can lead ideal healing in patients with oral and maxillofacial soft tissue defects. This is an easily performed effective technology without requirement of specific medical equipment

  13. Palmar Soft Tissue Infection From Shewanella putrefaciens. (United States)

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


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

  14. 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.

  15. 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.

  16. 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.

  17. Modern Soft Tissue Pathology | Center for Cancer Research (United States)

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

  18. 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.

  19. [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.

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

    Institute of Scientific and Technical Information of China (English)

    杨震; 亓发芝; 顾建英; 曹小曼


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

  1. Case presentation of soft tissue parapharyngeal chondroma in a pediatric patient. (United States)

    Smith, Erin J; Rezeanu, Luminita; Carron, Jeffrey


    Soft tissue chondromas are uncommon benign tumors found mostly in the hands and feet and rarely reported in the pediatric population. In this case presentation we describe a 10 year old boy who had an MRI for facial paralysis due to Ramsey Hunt Syndrome, which incidentally revealed a parapharyngeal mass. He underwent transoral resection of the mass without complication, and histopathology confirmed the diagnosis of soft tissue chondroma. This case is unique due to the unusual location of the tumor and its presentation in a child. © 2013 Elsevier Inc. All rights reserved.

  2. Soft tissue management in endodontic surgery. (United States)

    Velvart, Peter; Peters, Christine I


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

  3. 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

  4. Application of local flap in emergent reconstruction of the skin and soft tissue defects after facial trauma%局部皮瓣在面部创伤性皮肤软组织缺损急诊修复中的应用

    Institute of Scientific and Technical Information of China (English)

    何小川; 胡纯兵; 周滨; 刘震; 高志丹; 吴国平; 郭力


    Objective To explore the procedures of reconstruction emergency for skin and soft tisue defects due to trauma with local flap based on plastic surgical principles and techniques.Methods Thirty-two patients with facial defects caused by tramua were treated.After strict debridement of the wound of the skin and soft tissue,the flaps were designed according to the wound condition with plastic surgical principles.Subcutaneous SMAS pedicle flap,V-Y advancement flap,orbicularis flap,nasolabial groove flaps and others were chosen for wound repair,to suture and close the wound meticu lously.Results All of 32 treated cases,the wounds were primary healing.After 6-18 months follow-up,there was no obvious scar formation or functional problems.Second stage reconstruction was not needed since the cosmetic effect was perfect.Conclusions It is a satisfactory and effective method to emergently treat the skin and soft tissue defects after facial trauma with local flap based on the plastic surgical principles,which is well worth popularizing in clinic.%目的 探索依据整形外科原则应用局部皮瓣急诊修复面部创伤性软组织缺损的效果.方法 对32例面部皮肤软组织即时性创伤性缺损,于严格清创后,根据创面缺损情况,按整形外科原则分别设计皮下浅表肌腱膜系统(SMAS)蒂皮瓣、V-Y推进皮瓣、眼轮匝肌蒂岛状皮瓣、鼻唇沟皮瓣等修复创面,精细缝合关闭伤口.结果 32例伤口均Ⅰ期愈合,随访6~18个月,无明显瘢痕增生,无功能障碍,无需Ⅱ期修复,美容效果良好.结论 遵照整形外科基本原则采用局部皮瓣修复面部创伤性皮肤软组织缺损,可获得满意的效果,值得临床推广应用.

  5. 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...

  6. Soft Tissue Preservation in Terrestrial Mesozoic Vertebrates (United States)

    Schweitzer, Mary Higby


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

  7. 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

  8. 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.

  9. 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.

  10. 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.

  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. Histology and imaging of soft tissue sarcomas

    Energy Technology Data Exchange (ETDEWEB)

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


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


    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. 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.

  17. 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

  18. Necrotizing soft tissue infection in pregnancy

    Directory of Open Access Journals (Sweden)

    Nestorović Milica


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

  19. Soft tissue management of orbitotemporal neurofibromatosis. (United States)

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


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

  20. Electrospun nanofiber scaffolds: engineering soft tissues

    Energy Technology Data Exchange (ETDEWEB)

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


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

  1. 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.

  2. 拔牙矫治对 AngleⅡ1错牙合成年女性面部软组织正貌的影响%Impacts of orthodontic treatment with tooth extraction on the frontal view of facial soft tissue in adult fe-males with class Ⅱ division 1 malocclusion

    Institute of Scientific and Technical Information of China (English)

    谢妹洪; 劳柯杰; 覃昌焘; 马琴琴; 莫水学


    目的:探讨 AngleⅡ1错成年女性拔牙矫治后面部软组织正貌的改变。方法:采用直接活体测量法,测量51例成年女性 AngleⅡ1错患者矫治前后面部软组织正貌美学指标的改变,其中拔牙组30例,非拔牙对照组21例,并对矫治前后的变化量进行统计学分析。结果:拔牙组矫治后 N-Me、Sn-Me、Sn-UL、LL-Sm、Sto-M、Ch-Ch 增大(P <0.05),UL-LL 减小(P<0.05),Zy-Zy、Go-Go 无明显变化(P >0.05)。非拔牙组矫治后各指标均无明显变化(P >0.05)。组间比较中 Sn-UL、LL-Sm、UL-LL 差异有统计学意义(P <0.01),其余各项无统计学意义(P >0.05)。结论:成年女性 AngleⅡ1错患者通过拔牙矫治,主要表现为口周软组织的变化,开唇露齿明显改善,上下唇形态更趋协调;对面高及面宽无明显影响。%Objective:To explore the changes of orthodontic therapy with tooth extraction on frontal view of facial soft tissue in adult females with Class Ⅱ division 1 malocclusion.Methods:Frontal view of facial soft tissue aesthetic charaeteristics of 30 with and 21 without tooth extraction adult females with Class Ⅱ division 1 malocclusion were measured with direct anthropometry before and after orthodontic treatment.Results:After the extraction treatment,the distance of N-Me,Sn-Me,Sn-UL,LL-Sm,Sto-Me,Ch-Ch in-creased(P 0.05).There was no sig-nificant change in each parameter in nonextraction group(P >0.05).Between the 2 groups Sn-UL,LL-Sm and UL-LL showed differ-ence(P 0.05).Conclusion:Orthodontic treatment with tooth for the fe-males with Class Ⅱ division 1 malocclusion can improve the incompetent lips,and recover the coordination between the upper and lower lips.There is little change on facial height and width.

  3. 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 ...

  4. 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.

  5. Facial asymmetry: a case report of localized linear scleroderma patient with muscular strain and spasm


    Kim, Jae-Hyung; Lee, Suck-Chul; Kim, Chul-Hoon; Kim, Bok-Joo


    Facial asymmetry is found in patients with or without cosmetic facial alterations. Some patients have facial asymmetry that manifests underlying skeletal problems, while others have only limited soft-tissue facial asymmetry. Orthognathic surgery brings about a dermatic change, as soft tissue covers underlying bones. Limited soft-tissue asymmetry, meanwhile, is difficult to correct. The treatment modalities for the creation or restoration of an esthetically pleasing appearance were autogenous ...

  6. In vivo facial tissue depth for Canadian aboriginal children: a case study from Nova Scotia, Canada. (United States)

    Peckmann, Tanya R; Manhein, Mary H; Listi, Ginesse A; Fournier, Michel


    This study examines facial tissue depth in Canadian Aboriginal children. Using ultrasound, measurements were taken at 19 points on the faces of 392 individuals aged 3-18 years old. The relationships between tissue thickness, age, and sex were investigated. A positive linear trend may exist between tissue thickness and age for Aboriginal females and males at multiple points. No points show significant differences in facial tissue depth between males and females aged 3-8 years old; seven points show significant differences in facial tissue depth between males and females aged 9-13 years old; and five points show significant differences in facial tissue depth between males and females aged 14-18 years old. Comparisons were made with White Americans and African Nova Scotians. These data can assist in 3-D facial reconstructions and aid in establishing an individual's identity. Previously, no data existed for facial tissue thickness in Canadian Aboriginal populations. © 2013 American Academy of Forensic Sciences.

  7. 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.

  8. 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.

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

    African Journals Online (AJOL)


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

  10. Imaging techniques for the diagnosis of soft tissue tumors

    Directory of Open Access Journals (Sweden)

    Afonso PD


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

  11. A systematic review assessing soft tissue augmentation techniques. (United States)

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


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

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

    Directory of Open Access Journals (Sweden)

    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

  13. 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.

  14. 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.

  15. Alterações no perfil facial tegumentar, avaliadas em jovens com Classe II, 1ª divisão, após o tratamento ortodôntico Soft tissue changes evaluated in Class II, division 1 cases, after orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Júlio César de Oliveira Brant


    .B'.Pog' and the facial profile angle (G'.SN.Pog' in both groups and a significantly decrease in Ls-SNPog' and the interlabial gap (Sts-Sti. The extraction group tends to have an increase of B'-SNPog' and a decrease of Li-SN-Pog'. CONCLUSION: the average soft tissue measurement for both extractions and nonextractions groups were close to the normal standards after the treatment with a significant better position of the lower lip, a decrease of the interlabial gap and an increase of the facial profile angle.

  16. 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

  17. 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 ...

  18. The Adjunctive Soft-Tissue Diode Laser in Orthodontics. (United States)

    Borzabadi-Farahani, Ali


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

  19. 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.

  20. The Science and Theory behind Facial Aging


    Jordan P. Farkas, MD; Joel E. Pessa, MD; Bradley Hubbard, MD; Rod J. Rohrich, MD, FACS


    Summary: The etiology of age-related facial changes has many layers. Multiple theories have been presented over the past 50–100 years with an evolution of understanding regarding facial changes related to skin, soft tissue, muscle, and bone. This special topic will provide an overview of the current literature and evidence and theories of facial changes of the skeleton, soft tissues, and skin over time.

  1. A study on the relationship between maxillary protraction treatment and changes of nasomaxillary complex facial soft tissue of children with skeletal Class m malocclusion%上颌前方牵引矫治骨性Ⅲ类错(牙合)儿童鼻上颌复合体部软组织变化的研究

    Institute of Scientific and Technical Information of China (English)

    朱吉坤; 张桂荣; 郭艳明; 李济强; 刘继辉


    目的 评价上颌前方牵引矫治上颌骨发育不足所致的骨性Ⅲ类错(牙合)儿童鼻上颌复合体部软组织变化,为临床治疗上颌后缩的患者提供理论基础和参考依据.方法 选取上颌发育不足、骨性Ⅲ类错(牙合)患儿30例,男女各15例,年龄9 ~11(平均10.5)岁,均处于生长发育高峰前期或高峰期.采取上颌前方牵引矫形治疗,前方牵引时间6~8个月.试验前后拍摄头颅侧位定位X线片,并测量各项鼻部形态及口颌部软组织侧面形态指标,综合分析矫治前后差异.结果 矫治前后鼻部软组织鼻根点距离(Ns-Y)、鼻尖角的差异无统计学意义(P>0.05);治疗后,鼻中点距离(M-Y)增大(P<0.05),鼻尖点距离(Prn-Y)、鼻额角增大(P<0.01),鼻唇角减小(P<0.05).唇部及颏部软组织上唇凹点至Y轴的距离(As-Y)、上唇突点至Y轴的距离(UL-Y)、上唇凸距(UL-E)、上唇基角(S-Ns-Sn)均增大(P<0.01);下唇凸距(LL-E)、软组织颏前点距离(Pos-Y)均减小(P<0.05);矫治前后下唇凹点至Y轴的距离(Bs-Y)的差异无统计学意义.结论 上颌前方牵引不仅可以早期矫治上颌后缩Ⅲ类错(牙合)、改善上下颌骨不调关系,同时有助于鼻上颌复合体部软组织良好外形的形成.鼻部及上唇前移、颏部后移,使患儿侧貌突度更趋于协调美观.%Objective To investigate nasomaxlllary complex facial soft tissue changes after the treatment with maxillary protraction appliance with skeletal Class Ⅲ malocclusion with a retruded maxilla.Methods Thirty growing subjects with skeletal Class Ⅲ malocclusions with maxillary retrognathism were selected and treated by facial mask(male 15,female 15,with an average age of 10.5).They were given a maxillary protraction treatment with face mask for 6-8 months.Cephalometric measurements about nasomaxillary complex soft tissue changes were analyzed to draw the statistic conclusion.Results After maxillary protraction treatment

  2. Combined soft and skeletal tissue modelling of normal and dysmorphic midface postnatal development. (United States)

    Ibrahim, Amel; Suttie, Michael; Bulstrode, Neil W; Britto, Jonathan A; Dunaway, David; Hammond, Peter; Ferretti, Patrizia


    Midface hypoplasia as exemplified by Treacher Collins Syndrome (TCS) can impair appearance and function. Reconstruction involves multiple invasive surgeries with variable long-term outcomes. This study aims to describe normal and dysmorphic midface postnatal development through combined modelling of skeletal and soft tissues and to develop a surgical evaluation tool. Midface skeletal and soft tissue surfaces were extracted from computed tomography scans of 52 control and 14 TCS children, then analysed using dense surface modelling. The model was used to describe midface growth, morphology, and asymmetry, then evaluate postoperative outcomes. Parameters responsible for the greatest variation in midface size and shape showed differences between TCS and controls with close alignment between skeletal and soft tissue models. TCS children exhibited midface dysmorphology and hypoplasia when compared with controls. Asymmetry was also significantly higher in TCS midfaces. Combined modelling was used to evaluate the impact of surgery in one TCS individual who showed normalisation immediately after surgery but reversion towards TCS dysmorphology after 1 year. This is the first quantitative analysis of postnatal midface development using combined modelling of skeletal and soft tissues. We also provide an approach for evaluation of surgical outcomes, laying the foundations for future development of a preoperative planning tool. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  3. 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.

  4. 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....

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 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.

  7. 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

  8. 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

  9. [Soft tissue infection associated with bacteremia caused by Shewanella putrefaciens]. (United States)

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


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

  10. Injection resorbable polymer shells for soft tissue augmentation

    CSIR Research Space (South Africa)

    Naidoo, Kersch


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


    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.

  12. Operational morbidity analysis of soft tissue injuries during Operation TELIC. (United States)

    Ollerton, J; Hodgetts, T; Russell, R


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


    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.

  14. Facial lipohypertrophy in HIV-infected subjects who underwent autologous fat tissue transplantation. (United States)

    Guaraldi, Giovanni; De Fazio, Domenico; Orlando, Gabriella; Murri, Rita; Wu, Albert; Guaraldi, Pietro; Esposito, Roberto


    Of 41 HIV-infected patients with facial lipoatrophy who underwent autologous fat transplantation, disfiguring facial lipohypertrophy at the graft site occurred at the same time as recurrent fat accumulation at the tissue harvest site in 4 patients who had had fat transferred from the dorsocervical fat pad or from subcutaneous abdominal tissue.

  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. Use of cross-linked carboxymethyl cellulose for soft-tissue augmentation: preliminary clinical studies

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    Mauro Leonardis


    Full Text Available Mauro Leonardis1, Andrea Palange2, Rodrigo FV Dornelles3, Felipe Hund41Department of Plastic Surgery, Salvator Mundi International Hospital, Roma, Italy; 2Department of Aesthetic Medicine, Fisiobios, Roma, Italy; 3Department of Plastic Surgery, Núcleo de Plástica Avançada, São Paulo, SP, Brazil; 4Department of Plastic Surgery, Consultorio de Cirurgia Plastica, Criciuma, SC, BrazilPurpose: The continual search for new products for soft-tissue augmentation has in recent years led to the introduction of long lasting alternatives to hyaluronic acids and collagen that are composed of other polymers able to improve clinical persistence over time. This is the first report in which sodium carboxymethyl cellulose (CMC has been chemically treated by the cross-linking process and thus used as a hydrogel for soft-tissue augmentation through injection with thin needles. The study evaluates, from a clinical point of view, the behavior of cross-linked carboxymethyl cellulose hydrogel used in the aesthetic field and its side effects so as to check the safety and performance of the polymer following intradermal injections.Patients and methods: This work shows the preliminary results of an ongoing clinical study conducted between 2006 and 2009, performed on 84 healthy volunteers (62 females, 22 males aged between 18 and 72 years, for the treatment of 168 nasolabial folds, 45 perioral wrinkles, and 39 lip volume.Results: Study results show an excellent correction of facial defects. Tolerance and aesthetic quality of the correction obtained indicate considerable safety features and absence of side effects. From a clinical point of view, hydrogel is gradually absorbed into the injection site without migration issues.Conclusion: Cross-linked CMC hydrogel proves to be an ideal agent for soft tissue augmentation with regard to safety and ease of application. It did not cause infection, extrusion, migration, or adverse reactions in the patients who have been

  17. [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.

  18. 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.

  19. Soft tissue sealing around dental implants based on histological interpretation. (United States)

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


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

  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. Third trimester ultrasound soft-tissue measurements accurately predicts macrosomia. (United States)

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


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

  2. 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...

  3. 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 ...


    Directory of Open Access Journals (Sweden)



    Full Text Available It is well known that the skull helps in cephalic identification of an individual. Reconstruction of face from an available skull is one of the standard techniques that are often practiced to established the identity of a deceased person in Medico legal in vestigations

  5. Constraint-based soft tissue simulation for virtual surgical training. (United States)

    Tang, Wen; Wan, Tao Ruan


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

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

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

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


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

  8. 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.

  9. Soft and hard tissue changes after bimaxillary surgery in Japanese class III asymmetric patients (United States)

    Al-Gunaid, Talat; Yamaki, Masaki; Takagi, Ritsuo; Saito, Isao


    Objectives: To assess the effects of bimaxillary surgery on Class III subjects with mandibular asymmetry, and to compare the effects of the type of surgery performed in the mandible on the facial profile especially in the presence of facial asymmetry. Materials and Methods: Thirty-six patients in whom imbalance between the maxilla and the mandible were corrected by Le Fort I osteotomy combined with bilateral intraoral vertical ramus osteotomy (BIVRO group, n=9), bilateral sagittal split ramus osteotomy (BSSRO group, n=14), or a combination of intraoral vertical ramus osteotomy (IVRO) and sagittal split ramus osteotomy (SSRO) (IVRO + SSRO group, n=13). Cephalograms were taken before surgery (T1), and 1 year after surgery (T2). Hard and soft-tissue changes were compared. Results: The postsurgical findings showed that greater mandibular backward displacement and greater upper lip forward movement were more pronounced among BIVRO group when compared with BSSRO group. Upper lip relation to E-line showed greater improvement in BIVRO group than BSSRO and IVRO + SSRO groups. The ratios of corresponding mandibular soft to hard tissue movements were higher than that of maxillary movements and were more pronounced in IVRO + SSRO and BSSRO groups when compared with BIVRO group. Conclusion: IVRO surgical technique appears to be more effective in positioning the mandible more posteriorly and improving upper and lower lips position and competence. PMID:24987630

  10. Accuracy of three-dimensional soft tissue simulation in bimaxillary osteotomies. (United States)

    Liebregts, Jeroen; Xi, Tong; Timmermans, Maarten; de Koning, Martien; Bergé, Stefaan; Hoppenreijs, Theo; Maal, Thomas


    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 patients (mean age 26.0 years) who had undergone bimaxillary osteotomy, participated in this study. Cone beam CT scans were acquired pre- and one year postoperatively. The 3D rendered pre- and postoperative scans were matched. The maxilla and mandible were segmented and aligned to the postoperative position. 3D distance maps and cephalometric analyses were used to quantify the simulation error. The mean absolute error between the 3D simulation and the actual postoperative facial profile was 0.81 ± 0.22 mm for the face as a whole. The accuracy of the simulation (average absolute error ≤2 mm) for the whole face and for the upper lip, lower lip and chin subregions were 100%, 93%, 90% and 95%, respectively. The predictability was correlated with the magnitude of the maxillary and mandibular advancement, age and V-Y closure. It was concluded that the MTM-based soft tissue simulation for bimaxillary surgery was accurate for clinical use, though patients should be informed of possible variation in the predicted lip position. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  11. Human race as indicator of 3D planning of soft tissue of face and multidisciplinary approach. (United States)

    Nadazdyova, A; Samohyl, M; Stefankova, E; Pintesova, S; Stanko, P


    The aim of this study was to determine the optimal parameters for 3D soft tissue planning for ortognatic treatment by gender and increases the effectiveness of multidisciplinary cooperation. Craniofacial parameters which were analysed: nose breadth (al-al), bi-entocanthion breadth (en-en), bi-zygomatic breadth (zy-zy), bi-gonial breadth (go-go), total facial height (n-gn), mouth breadth (ch-ch), morphologic face height (sn-gn), upper-lip height (Ls-Stm), lower-lip height (Stm-Li) and pupils - mid-face (right). The statistically significant level was determined at p values maxilofacial surgeon. The gender and age influenced the variability of following parameters: bi-gonial breadth, total facial height and morphologic face height. The soft tissue values for craniofacial parameters can be used to identify the surgical-orthodontic goal for patient - europoid race. Due to the immigration and the mix of races it is necessary to take this fact into account (Tab. 3, Fig. 1, Ref. 41).

  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. How Are Soft Tissue Sarcomas Diagnosed? (United States)

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

  15. Changes in soft tissue profile using functional appliances in the treatment of skeletal class II malocclusion

    Directory of Open Access Journals (Sweden)

    Stamenković Zorana


    Full Text Available Introduction. The effects of orthodontic treatment are considered to be successful if the facial harmony is achieved, while the structures of soft tissue profile are in harmony with skeletal structures of neurocranium and viscerocranium. In patients with skeletal distal bite caused by mandibular retrognathism, facial esthetics is disturbed often, in terms of pronounced convexity of the profile and change in the position and relationship of the lips. Objective. The aim of this study was to determine the extent of soft tissue profile changes in patients with skeletal Class II malocclusion treated with three different orthodontic appliances: Fränkel functional regulator type I (FR-I, Balters’ Bionator type I and Hotz appliance. Methods. The study included 60 patients diagnosed with skeletal Class II malocclusion caused by mandibular retrognathism, in the period of early mixed dentition. Each subgroup of 20 patients was treated with a variety of orthodontic appliances. On the lateral cephalogram, before and after treatment, the following parameters were analyzed: T angle, H angle, the height of the upper lip, the position of the upper and lower lip in relation to the esthetic line. Within the statistical analysis the mean, maximum, minimum, standard deviation, coefficient of variation, two-factor analysis of variance with repeated measures and the factor analysis of variance were calculated using ANOVA, Bonferroni test and Student’s t-test. Results. A significant decrease of angles T and H was noticed in the application of FR-I, from 21.60° to 17.15°, and from 16.45° to 13.40° (p<0.001. FR-I decreased the height of the upper lip from 26.15 mm to 25.85 mm, while Hotz appliance and Balters’ Bionator type I increased the height of the upper lip, thereby deteriorating esthetics of the patient. Conclusion. All used orthodontic appliances lead to changes in soft tissue profile in terms of improving facial esthetics, with the most distinctive

  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. Soft Tissue Injuries in Hungarian and Austrian Clinical Diagnostic Reports

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    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.

  18. High Grade Myofibroblastic Sarcoma of Paratesticular Soft Tissues

    Directory of Open Access Journals (Sweden)

    Ioannis Anastasiou


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

  19. 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.

  20. 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

  1. Upper incisor to Soft Tissue Plane (UI-STP): a new reference for diagnosis and planning in dentofacial deformities. (United States)

    Hernandez-Alfaro, Federico


    Planning in orthognathic surgery has been and still is an open issue. We have evolved from 2D classical cephalometric hard-tissue planning to 2D soft tissue planning, and finally to 3D and hard and soft tissue evaluation. This, to our knowledge, is the first description of a new Soft Tissue Plane (STP) and its relationship with the anterior position of the upper incisor (UI). Profile photographs of 110 "attractive individuals" with lips at rest or smiling and with upper incisor shown were used. The photographs used were of 65 professional models from two international agencies and 45 individuals considered most attractive in the internet forums, which included catwalk models and actors. In 86 cases (78.18 %), the incisor was located in front of the STP (A). In 15 cases (13.63%), it was on the plane (N); and in the remaining 9 cases (8.18%), it was behind (P). Despite the limitations of this study and based on our series, we can conclude that the upper incisor is located at or in front of the Soft Tissue Plane (STP) in 91.81% of the attractive facial profiles studied. On the other hand, the relative position of the upper incisor to the soft tissue plane (UI-STP) could be a useful diagnostic and planning tool in orthodontic and surgical management of dentofacial deformities.

  2. 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.

  3. 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.

  4. 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.

  5. [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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.)

  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. 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

  12. 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.

  13. 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

  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 Augmentation with Autologous Platelet Gel and β-TCP: A Histologic and Histometric Study in Mice. (United States)

    Scarano, Antonio; Ceccarelli, Maurizio; Marchetti, Massimiliano; Piattelli, Adriano; Mortellaro, Carmen


    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 the biostimulating effect on fibroblasts and quicken resorption. Materials and Methods. Ten female, 6-8-week-old black-haired mice were selected. β-TCP/APG gel was injected into one cheek; the other was used as control. The animals were sacrificed at 8 weeks and histologically evaluated. Results. The new fibroblast was intensively stained with acid fuchsin and presented in contact with β-TCP. At higher magnification, actively secreting fibroblasts were observed at the periphery of β-TCP with a well differentiated fibroblast cell line and blood vessels. Acid fuchsin stained cutaneous structures in pink: no epidermal/dermal alterations or pathological inflammatory infiltrates were detected. The margins of β-TCP granules were clear and not diffused near tissues. Conclusion. APG with β-TCP preserves skin morphology, without immune response, with an excellent tolerability and is a promising scaffold for cells and biomaterial for soft tissue augmentation.

  17. Forensic facial approximation assessment: can application of different average facial tissue depth data facilitate recognition and establish acceptable level of resemblance? (United States)

    Herrera, Lara Maria; Strapasson, Raíssa Ananda Paim; da Silva, Jorge Vicente Lopes; Melani, Rodolfo Francisco Haltenhoff


    Facial soft tissue thicknesses (FSTT) are important guidelines for modeling faces from skull. Amid so many FSTT data, Forensic artists have to make a subjective choice of a dataset that best meets their needs. This study investigated the performance of four FSTT datasets in the recognition and resemblance of Brazilian living individuals and the performance of assessors in recognizing people, according to sex and knowledge on Human Anatomy and Forensic Dentistry. Sixteen manual facial approximations (FAs) were constructed using three-dimensional (3D) prototypes of skulls (targets). The American method was chosen for the construction of the faces. One hundred and twenty participants evaluated all FAs by means of recognition and resemblance tests. This study showed higher proportions of recognition by FAs conducted with FSTT data from cadavers compared with those conducted with medical imaging data. Targets were also considered more similar to FAs conducted with FSTT data from cadavers. Nose and face shape, respectively, were considered the most similar regions to targets. The sex of assessors (male and female) and the knowledge on Human Anatomy and Forensic Dentistry did not play a determinant role to reach greater recognition rates. It was possible to conclude that FSTT data obtained from imaging may not facilitate recognition and establish acceptable level of resemblance. Grouping FSTT data by regions of the face, as proposed in this paper, may contribute to more accurate FAs.

  18. 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.

  19. 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.

  20. [Progress on cervical muscle strength and soft tissue stiffness testing]. (United States)

    Ma, Ming; Zhang, Shi-min


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

  1. 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.)

  2. 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.

  3. 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

  4. [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,

  5. 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.

  6. [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.


    Abstract: Palatal organ culture provides an in vitro model for the study of the formation of the secondary palate, which forms the roof of the mouth in the developing fetus. The protocol describes the steps for culture of the mid-facial region of the fetal mouse or rat. In cult...

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

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


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

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.


    Directory of Open Access Journals (Sweden)

    Işıl ARAS


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

  18. 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...

  19. 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.

  20. 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...

  1. Analysis of 3D soft tissue changes after 1- and 2-jaw orthognathic surgery in mandibular prognathism patients. (United States)

    Kim, Bo-Ram; Oh, Kyung-Min; Cevidanes, Lucia H S; Park, Jeong-Eon; Sim, Hyoung-Seob; Seo, Sung-Kyung; Reyes, Mauricio; Kim, Yoon-Ji; Park, Yang-Ho


    Orthognathic surgery has the objective of altering facial balance to achieve esthetic results in patients who have severe disharmony of the jaws. The purpose was to quantify the soft tissue changes after orthognathic surgery, as well as to assess the differences in 3D soft tissue changes in the middle and lower third of the face between the 1- and 2-jaw surgery groups, in mandibular prognathism patients. We assessed soft tissue changes of patients who have been diagnosed with mandibular prognathism and received either isolated mandibular surgery or bimaxillary surgery. The quantitative surface displacement was assessed by superimposing preoperative and postoperative volumetric images. An observer measured a surface-distance value that is shown as a contour line. Differences between the groups were determined by the Mann-Whitney U test. The Spearman correlation coefficient was used to evaluate a potential correlation between patients' surgical and cephalometric variables and soft tissue changes after orthognathic surgery in each group. There were significant differences in the middle third of the face between the 1- and 2-jaw surgery groups. Soft tissues in the lower third of the face changed in both surgery groups, but not significantly. The correlation patterns were more evident in the lower third of the face. The overall soft tissue changes of the midfacial area were more evident in the 2-jaw surgery group. In 2-jaw surgery, significant changes would be expected in the midfacial area, but caution should be exercised in patients who have a wide alar base. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  2. The female soft tissue profile as presented in fashion magazines during the 1900s: a photographic analysis. (United States)

    Auger, T A; Turley, P K


    Numerous studies have emphasized the importance of the facial profile in orthodontic treatment planning, with some arguing that the esthetic ideal has remained unchanged for thousands of years. To evaluate changes in the white female facial profile, we measured 14 soft tissue variables on profile photographs presented in fashion magazines during the 1900s. Five time frames were studied, with a sample of 25 photographs from each period corrected for size and orientation. Between-group differences were examined by use of analysis of variance, using a P value corrected for a multivariable analysis. Significant between-group differences (P < 0.0001) were found for anteroposterior lip position, amount of visible lip tissue, and interlabial angle, with the more recent groups displaying fuller and more anteriorly positioned lips. No significant differences were found for measurements calculated superior to subnasale (frontonasal angle, nasal tip angle, and nasolabial angle) or in the relationship of the chin to the upper face (total facial angle). The results of this study suggest that standards for the esthetic white female facial profile are not static and show a trend in this century toward fuller and more anteriorly positioned lips.

  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. Characterisation of significant Gram positive bacilli from soft tissue infections. (United States)

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


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

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

    Directory of Open Access Journals (Sweden)

    Aditi Agarwal


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

  6. 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 ...

  7. 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.

  8. 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.

  9. 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.).

  10. [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.

  11. 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.

  12. 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

  13. 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...... devices. Here, we present a case of a previously healthy male presenting with NSTI caused by GAS. The infection persisted over 24 days, and the surgeon documented the presence of a "thick layer biofilm" in the fascia. Subsequent analysis of NSTI patient tissue biopsies prospectively included...

  14. Frontal soft tissue analysis using a 3 dimensional camera following two-jaw rotational orthognathic surgery in skeletal class III patients. (United States)

    Choi, Jong Woo; Lee, Jang Yeol; Oh, Tae-Suk; Kwon, Soon Man; Yang, Sung Joon; Koh, Kyung Suk


    Although two dimensional cephalometry is the standard method for analyzing the results of orthognathic surgery, it has potential limits in frontal soft tissue analysis. We have utilized a 3 dimensional camera to examine changes in soft tissue landmarks in patients with skeletal class III dentofacial deformity who underwent two-jaw rotational setback surgery. We assessed 25 consecutive Asian patients (mean age, 22 years; range, 17-32 years) with skeletal class III dentofacial deformities who underwent two-jaw rotational surgery without maxillary advancement. Using a 3D camera, we analyzed changes in facial proportions, including vertical and horizontal dimensions, facial surface areas, nose profile, lip contour, and soft tissue cheek convexity, as well as landmarks related to facial symmetry. The average mandibular setback was 10.7 mm (range: 5-17 mm). The average SNA changed from 77.4° to 77.8°, the average SNB from 89.2° to 81.1°, and the average occlusal plane from 8.7° to 11.4°. The mid third vertical dimension changed from 58.8 mm to 57.8 mm (p = 0.059), and the lower third vertical dimension changed from 70.4 mm to 68.2 mm (p = 0.0006). The average bigonial width decreased from 113.5 mm to 109.2 mm (p = 0.0028), the alar width increased from 34.7 mm to 36.1 mm (p-value = 0.0002), and lip length was unchanged. Mean mid and lower facial surface areas decreased significantly, from 171.8 cm(2) to 166.2 cm(2) (p = 0.026) and from 71.23 cm(2) to 61.9 cm(2) (p analysis for orthognathic surgery, and enabled quantitative analysis of changes in frontal soft tissue landmarks and facial proportions that were not possible with conventional 2D cephalometric analysis.

  15. 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;…

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

    Energy Technology Data Exchange (ETDEWEB)

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


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

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

    Directory of Open Access Journals (Sweden)

    Giovanni Aloisio


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

  18. Immediate postextraction implant placement using plasma rich in growth factors technology in maxillary premolar region: a new strategy for soft tissue management. (United States)

    Rosano, Gabriele; Taschieri, Silvio; Del Fabbro, Massimo


    Achieving an excellent aesthetic outcome in postextraction dental implant placement in the anterior maxilla is a challenging procedure for clinicians. In fact, there is an increased risk for soft tissue recession at the facial aspect which may require supplementary connective tissue grafts to accomplish the final aesthetic result. The aim of this case report is to describe a regenerative technique using autologous plasma rich in growth factors fibrin plug for preservation of soft tissue architecture around an implant immediately placed into an extraction site in the anterior maxilla. Such a procedure allowed for guided bone regeneration without the need for vertical releasing incisions and primary healing, thus showing a pleasant gingival contour at the facial aspect after a single stage surgery. Integrating this technique into common practice could provide important benefits for the patients regarding aesthetics, without any risk of infection or transmission of diseases.

  19. 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.

  20. An augmented reality framework for soft tissue surgery. (United States)

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


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

  1. Development of stable peri-implant soft tissue and mentolabial sulcus depth with an implant-retained soft tissue conformer after osteocutaneous flap reconstruction. (United States)

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


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

  2. Craniofacial reconstruction using a combined statistical model of face shape and soft tissue depths: methodology and validation. (United States)

    Claes, Peter; Vandermeulen, Dirk; De Greef, Sven; Willems, Guy; Suetens, Paul


    Forensic facial reconstruction aims at estimating the facial outlook associated with an unidentified skull specimen. Estimation is generally based on tabulated average values of soft tissue thicknesses measured at a sparse set of landmarks on the skull. Traditional 'plastic' methods apply modeling clay or plasticine on a cast of the skull, approximating the estimated tissue depths at the landmarks and interpolating in between. Current computerized techniques mimic this landmark interpolation procedure using a single static facial surface template. However, the resulting reconstruction is biased by the specific choice of the template and no face-specific regularization is used during the interpolation process. We reduce the template bias by using a flexible statistical model of a dense set of facial surface points, combined with an associated sparse set of skull-based landmarks. This statistical model is constructed from a facial database of (N = 118) individuals and limits the reconstructions to statistically plausible outlooks. The actual reconstruction is obtained by fitting the skull-based landmarks of the template model to the corresponding landmarks indicated on a digital copy of the skull to be reconstructed. The fitting process changes the face-specific statistical model parameters in a regularized way and interpolates the remaining landmark fit error using a minimal bending thin-plate spline (TPS)-based deformation. Furthermore, estimated properties of the skull specimen (BMI, age and gender, e.g.) can be incorporated as conditions on the reconstruction by removing property-related shape variation from the statistical model description before the fitting process. The proposed statistical method is validated, both in terms of accuracy and identification success rate, based on leave-one-out cross-validation tests applied on the facial database. Accuracy results are obtained by statistically analyzing the local 3D facial surface differences of the

  3. 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.

  4. Soft tissue diagnosis in maxillofacial surgery: a preliminary study on three-dimensional face geometrical features-based analysis. (United States)

    Calignano, Flaviana; Vezzetti, Enrico


    To obtain the best surgical results in orthognathic surgery, treatment planning and evaluation of results should be performed. In these operations it is necessary to provide the physician with powerful tools that can underline the behavior of soft tissue. For this reason, considering the improvements provided by the use of 3D scanners in medical diagnosis, we propose a methodology for analyzing facial morphology working with geometrical features. The methodology has been tested on patients with malocclusion in order to analyze the reliability and efficiency of the provided diagnostic results.


    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.

  6. 3D soft tissue predictions with a tetrahedral mass tensor model for a maxillofacial planning system: a quantitative validation study (United States)

    Mollemans, W.; Schutyser, F.; Nadjmi, N.; Maes, F.; Suetens, P.


    In this paper we present an extensive quantitative validation on 3D facial soft tissue simulation for maxillofacial surgery planning. The study group contained 10 patients. In previous work we presented a new Mass Tensor Model to simulate the new facial appearance after maxillofacial surgery in a fast way. 10 patients were preoperatively CT-scanned and the surgical intervention was planned. 4 months after surgery, a post-operative control CT was acquired. In this study, the simulated facial outlook is compared with post-operative image data. After defining corresponding points between the predicted and actual post-operative facial skin surface, using a variant of the non-rigid TPS-RPM algorithm, distances between these correspondences are quantified and visualized in 3D. As shown, the average median distance measures only 0.60 mm and the average 90% percentile stays below 1.5 mm. We can conclude that our model clearly provides an accurate prediction of the real post-operative outcome and is therefore suitable for use in clinical practice.

  7. 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

  8. 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.

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

    DEFF Research Database (Denmark)

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


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

  10. Unexpected complication associated with balneotherapy: Skin and soft tissue infection (United States)

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


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

  11. Genetic heterogeneity in leiomyomas of deep soft tissue. (United States)

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


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

  12. 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

  13. 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

  14. Elastic-viscoplastic modeling of soft biological tissues using a mixed finite element formulation based on the relative deformation gradient. (United States)

    Weickenmeier, J; Jabareen, M


    The characteristic highly nonlinear, time-dependent, and often inelastic material response of soft biological tissues can be expressed in a set of elastic-viscoplastic constitutive equations. The specific elastic-viscoplastic model for soft tissues proposed by Rubin and Bodner (2002) is generalized with respect to the constitutive equations for the scalar quantity of the rate of inelasticity and the hardening parameter in order to represent a general framework for elastic-viscoplastic models. A strongly objective integration scheme and a new mixed finite element formulation were developed based on the introduction of the relative deformation gradient-the deformation mapping between the last converged and current configurations. The numerical implementation of both the generalized framework and the specific Rubin and Bodner model is presented. As an example of a challenging application of the new model equations, the mechanical response of facial skin tissue is characterized through an experimental campaign based on the suction method. The measurement data are used for the identification of a suitable set of model parameters that well represents the experimentally observed tissue behavior. Two different measurement protocols were defined to address specific tissue properties with respect to the instantaneous tissue response, inelasticity, and tissue recovery.

  15. Bone-anchored hearing device surgery: Linear incision without soft tissue reduction. A prospective study. (United States)

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


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

  16. Chemical facial cellulitis due to inadvertent injection of formalin into oral tissue space

    Directory of Open Access Journals (Sweden)

    Aditi Bector


    Full Text Available This paper reports the accidental injection of formalin into oral tissue space, in an 8-year old child resulting in chemical facial necrotizing cellulitis and its management. The common practice of keeping formalin in local anesthesia vials should be avoided by dental clinics, to prevent such unfortunate incidents.

  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. MRI evaluation of superficial soft tissue lesions in children

    Energy Technology Data Exchange (ETDEWEB)

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


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

  19. 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.

  20. 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

  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. 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.

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

    Directory of Open Access Journals (Sweden)

    Jun Nishio


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

  4. 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.

  5. 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.

  6. [An observation on the histological structure of Oncomelania hupensis soft tissue by agar-paraffin double-embedding method]. (United States)

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


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

  7. Lateral facial cleft associated with accessory mandible having teeth, absent parotid gland and peripheral facial weakness. (United States)

    Ozçelik, D; Toplu, G; Türkseven, A; Senses, D A; Yiğit, B


    Transverse facial cleft is a very rare malformation. The Tessier no. 7 cleft is a lateral facial cleft which emanates from oral cavity and extends towards the tragus, involving both soft tissue and skeletal components. Here, we present a case having transverse facial cleft, accessory mandible having teeth, absent parotid gland and ipsilateral peripheral facial nerve weakness. After surgical repair of the cleft in 2-month of age, improvement of the facial nerve function was detected in 3-year of age. Resection of the accessory mandible was planned in 5-6 years of age.

  8. 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.)

  9. The role of facial skeletal augmentation and dental restoration in facial rejuvenation. (United States)

    Bains, J W; Elia, J P


    Facial aging is almost exclusively a result of soft tissue changes in patients with full dentition. Loss of teeth can hasten facial aging and make aging more pronounced as a result of bony erosion of the alveolar ridges. This article describes these changes and demonstrates that properly selected oral implants and precisely placed hydroxyapatite implants can integrate with facelifts to produce superior facial rejuvenation in edentulous patients.

  10. Management of maxillofacial hard and soft tissue discrepancy in Möbius sequence: clinical report and review of the literature. (United States)

    Guijarro-Martínez, Raquel; Hernández-Alfaro, Federico


    Möbius sequence implies significant maxillofacial hard and soft tissue anomalies which nevertheless have not been addressed thoroughly in the scientific literature. To report a case of complete Möbius sequence and discuss the management of maxillofacial hard and soft tissue anomalies. A 15-year-old girl with complete Möbius underwent bimaxillary orthognathic surgery, horizontal sliding genioplasty and mentalis muscles reinsertion. Vestibuloplasty and bilateral canthopexy were performed to address lip deficiency and attenuate hypotonic depression of the lower eyelids, respectively. Cheekbone augmentation was achieved with an autologous fat transfer. The authors review the scientific literature and discuss surgical planning for the correction of maxillofacial discrepancy. The patient exhibits significant functional and aesthetic improvement, with excellent integration of the transferred fat and adequate bone healing. Orthognathic bimaxillary surgery combined to soft tissue management can improve aesthetics and orofacial function in Möbius patients, thereby contributing to facilitate social interaction and increase patients' self-esteem. Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  11. 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 ...

  12. New methodology for mechanical characterization of human superficial facial tissue anisotropic behaviour in vivo. (United States)

    Then, C; Stassen, B; Depta, K; Silber, G


    Mechanical characterization of human superficial facial tissue has important applications in biomedical science, computer assisted forensics, graphics, and consumer goods development. Specifically, the latter may include facial hair removal devices. Predictive accuracy of numerical models and their ability to elucidate biomechanically relevant questions depends on the acquisition of experimental data and mechanical tissue behavior representation. Anisotropic viscoelastic behavioral characterization of human facial tissue, deformed in vivo with finite strain, however, is sparse. Employing an experimental-numerical approach, a procedure is presented to evaluate multidirectional tensile properties of superficial tissue layers of the face in vivo. Specifically, in addition to stress relaxation, displacement-controlled multi-step ramp-and-hold protocols were performed to separate elastic from inelastic properties. For numerical representation, an anisotropic hyperelastic material model in conjunction with a time domain linear viscoelasticity formulation with Prony series was employed. Model parameters were inversely derived, employing finite element models, using multi-criteria optimization. The methodology provides insight into mechanical superficial facial tissue properties. Experimental data shows pronounced anisotropy, especially with large strain. The stress relaxation rate does not depend on the loading direction, but is strain-dependent. Preconditioning eliminates equilibrium hysteresis effects and leads to stress-strain repeatability. In the preconditioned state tissue stiffness and hysteresis insensitivity to strain rate in the applied range is evident. The employed material model fits the nonlinear anisotropic elastic results and the viscoelasticity model reasonably reproduces time-dependent results. Inversely deduced maximum anisotropic long-term shear modulus of linear elasticity is G∞,max(aniso)=2.43kPa and instantaneous initial shear modulus at an

  13. Fine needle aspiration (FNA) of soft tissue tumours (STT). (United States)

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


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

  14. Advances and controversies in the management of soft tissue sarcomas. (United States)

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


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

  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 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.

  18. 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.

  19. 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.

  20. Postoperative External Beam Radiotherapy for Retroperitoneal Soft Tissue Sarcoma

    Energy Technology Data Exchange (ETDEWEB)

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


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

  1. Automatic segmentation of human facial tissue by MRI-CT fusion: a feasibility study. (United States)

    Kale, Emre H; Mumcuoglu, Erkan U; Hamcan, Salih


    The aim of this study was to develop automatic image segmentation methods to segment human facial tissue which contains very thin anatomic structures. The segmentation output can be used to construct a more realistic human face model for a variety of purposes like surgery planning, patient specific prosthesis design and facial expression simulation. Segmentation methods developed were based on Bayesian and Level Set frameworks, which were applied on three image types: magnetic resonance imaging (MRI), computerized tomography (CT) and fusion, in which case information from both modalities were utilized maximally for every tissue type. The results on human data indicated that fusion, thickness adaptive and postprocessing options provided the best muscle/fat segmentation scores in both Level Set and Bayesian methods. When the best Level Set and Bayesian methods were compared, scores of the latter were better. Number of algorithm parameters (to be trained) and computer run time measured were also in favour of the Bayesian method.

  2. 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.

  3. Facial animation on an anatomy-based hierarchical face model (United States)

    Zhang, Yu; Prakash, Edmond C.; Sung, Eric


    In this paper we propose a new hierarchical 3D facial model based on anatomical knowledge that provides high fidelity for realistic facial expression animation. Like real human face, the facial model has a hierarchical biomechanical structure, incorporating a physically-based approximation to facial skin tissue, a set of anatomically-motivated facial muscle actuators and underlying skull structure. The deformable skin model has multi-layer structure to approximate different types of soft tissue. It takes into account the nonlinear stress-strain relationship of the skin and the fact that soft tissue is almost incompressible. Different types of muscle models have been developed to simulate distribution of the muscle force on the skin due to muscle contraction. By the presence of the skull model, our facial model takes advantage of both more accurate facial deformation and the consideration of facial anatomy during the interactive definition of facial muscles. Under the muscular force, the deformation of the facial skin is evaluated using numerical integration of the governing dynamic equations. The dynamic facial animation algorithm runs at interactive rate with flexible and realistic facial expressions to be generated.

  4. 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.

  5. Free-tissue transfer reconstruction of midfacial and cranio-orbito-facial defects. (United States)

    Funk, G F; Laurenzo, J F; Valentino, J; McCulloch, T M; Frodel, J L; Hoffman, H T


    To review our results using free-tissue transfer to reconstruct midfacial and cranio-orbito-facial defects. Case series. The University of Iowa Hospitals and Clinics, Iowa City. Fourteen of 21 patients had defects that resulted from ablative oncologic surgery; six had severe mid-facial trauma; and one had Romberg's disease. Four latissimus dorsi, 11 rectus abdominis, three scapula, and four forearm free-tissue transfer flaps were used. Adequate flap separation of vital structures (intracranial contents and carotid artery) from the sinonasal or oropharyngeal cavities; restoration of palatal competence, oral diet, and speech intelligibility; maxillary dental rehabilitation; aesthetic results; complications; and the patient's return to social activities outside the home after surgery. The intracranial contents (six cases) or carotid artery (four cases) were protected from sinonasal or oropharyngeal contamination by the reconstructive flap in all cases in which this was required. Functional closure of the palate with the flap or a prosthesis was possible in 12 of the 13 patients with a palatal defect; seven of these 13 patients have had full maxillary dental rehabilitation. Twenty patients take an oral diet. Sixteen patients have normal or easily understood speech. Fourteen patients engage in social activities outside the home, and eight have returned to full-time employment. No vascular flap failures occurred in this series. The use of free-tissue transfer flaps is a safe and effective technique for repairing large midfacial and cranio-orbito-facial defects resulting from ablative oncologic surgery or trauma.

  6. Facial Scar Revision: Understanding Facial Scar Treatment (United States)

    ... a facial plastic surgeon Facial Scar Revision Understanding Facial Scar Treatment When the skin is injured from a cut or tear the body heals by forming scar tissue. The appearance of the scar can range from ...

  7. 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.)

  8. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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


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

  10. 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

  11. Benign vs malignant soft tissue neoplasms: Limitations of magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    J Sen


    Full Text Available Aims: Various features have been described in the literature to differentiate benign from malignant lesions. The aim of the present study was to study the accuracy of each of these features and that of magnetic resonance imaging (MRI in diagnosing malignant lesions. Materials and Methods: Fifty-five consecutive patients presenting with neoplastic (both benign and malignant lesions diagnosed clinically and on ultrasound were studied and their MRI features were compared with the findings on surgical exploration and histopathologic examination. Results: There were 32 (58% benign and 23 (42% malignant masses. Malignant masses were more common in patients older than 20 years (83%, and these had symptoms of less than 6 months duration (75%, as against benign lesions. The swelling was painful in 8 malignant masses and these were more common in the upper limbs (61%. Various features of malignant lesions were size more than 5 cm in 83%, change in signal intensity from homogenous on T1-weighted images to heterogenous on T2-weighted images in 74%, irregular margins in 74%, and heterogenous contrast enhancement in 91%. The accuracy of these features was 76%, 58%, 78%, and 60%, respectively. Most benign and malignant lesions were intramuscular in location. A significant number (38% of benign lesions were located in the intermuscular facial plane. Definitive diagnosis was made in 42% of the lesions. Conclusions: MRI is an excellent modality for evaluating soft tissue neoplasms; however, prediction of a specific diagnosis and differentiation of malignant and benign lesions is not always possible.

  12. Lasers in Esthetic Dentistry: Soft Tissue Photobiomodulation, Hard Tissue Decontamination, and Ceramics Conditioning (United States)

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


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

  13. 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.

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

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


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

  15. 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.

  16. Prognostic impact of lymphocytes in soft tissue sarcomas.

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    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.

  17. Microscopic histological characteristics of soft tissue sarcomas: analysis of tissue features and electrical resistance. (United States)

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


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

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

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    Chance Witt


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

  19. 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.

  20. Torsional Ultrasound Sensor Optimization for Soft Tissue Characterization

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    Juan Melchor


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

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

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    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.

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

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    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. 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

  4. 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.

  5. The obesity paradox in patients with severe soft tissue infections. (United States)

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


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

  6. Nasal Soft Tissue Change Following Bimaxillary Orthognathic Surgery. (United States)

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


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

  7. Light ion irradiation for unfavorable soft tissue sarcoma

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    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.

  8. 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.

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    Korambayil Pradeoth


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

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

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    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.

  12. 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.

  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. Deep plane facelifting for facial rejuvenation. (United States)

    Gordon, Neil; Adam, Stewart


    The purpose of this article is to provide the facial plastic surgeon with anatomical and embryologic evidence to support the use of the deep plane technique for optimal treatment of facial aging. A detailed description of the procedure is provided to allow safe and consistent performance. Insights into anatomical landmarks, technical nuances, and alternative approaches for facial variations are presented. The following points will be further elucidated in the article. The platysma muscle/submuscular aponeurotic system/galea are the continuous superficial cervical fascia encompassing the majority of facial fat, and this superficial soft tissue envelope is poorly anchored to the face. The deep cervical fascia binds the structural aspects of the face and covers the facial nerve and buccal fat pad. Facial aging is mainly due to gravity's long-term effects on the superficial soft tissue envelope, with more subtle effects on the deeper structural compartments. The deep plane is the embryologic cleavage plane between these fascial layers, and is the logical place for facial dissection. The deep plane allows access to the buccal fat pad for treatment of jowling. Soft tissue mobilization is maximized in deep plane dissections and requires careful hairline planning. Flap advancement creates tension only at the fascia level allowing natural, tension-free skin closure, and long-lasting outcomes. The deep plane advancement flap is well vascularized and resistant to complications.

  15. Soft tissue profile changes after mandibular vestibuloplasty. A two-year follow-up study comparing the Edlan flap, mucosal and skin graft methods. (United States)

    Hillerup, S; Solow, B


    It is the aim of the present study to examine the pattern of postoperative changes in the soft tissue profile of 50 edentulous patients after 3 common types of mandibular vestibuloplasty, the Edlan flap operation (n = 15), the buccal mucosal graft (n = 19), and the skin graft vestibuloplasty (n = 16). The soft tissue profile changes were recorded on lateral cephalometric radiographs taken preoperatively, and after 1, 3, 6, 12, and 24 months post surgery. The 3 groups did not differ with respect to clinical features or presurgical cranio-facial morphology. Neither was any significant difference in postoperative profile changes found between the groups. The surgery gave rise, directly and indirectly, to a number of changes in the facial soft tissue profile many of which were interrelated. The chin thickness increased by 2.3 mm, and the lower lip height exhibited a reduction of 1.8 mm at 1 month after surgery as a direct consequence of the operation. After 3 months the profile changes were mostly associated with the reduction of the anterior face height (overclosure).

  16. Anatomical considerations to prevent facial nerve injury. (United States)

    Roostaeian, Jason; Rohrich, Rod J; Stuzin, James M


    Injury to the facial nerve during a face lift is a relatively rare but serious complication. A large body of literature has been dedicated toward bettering the understanding of the anatomical course of the facial nerve and the relative danger zones. Most of these prior reports, however, have focused on identifying the location of facial nerve branches based on their trajectory mostly in two dimensions and rarely in three dimensions. Unfortunately, the exact location of the facial nerve relative to palpable or visible facial landmarks is quite variable. Although the precise location of facial nerve branches is variable, its relationship to soft-tissue planes is relatively constant. The focus of this report is to improve understanding of facial soft-tissue anatomy so that safe planes of dissection during surgical undermining may be identified for each branch of the facial nerve. Certain anatomical locations more prone to injury and high-risk patient parameters are further emphasized to help minimize the risk of facial nerve injury during rhytidectomy.

  17. Effect of bone-soft tissue friction on ultrasound axial shear strain elastography (United States)

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


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

  18. 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

  19. 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


    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

  1. 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-...

  2. Ribociclib and Doxorubicin in Treating Patients With Metastatic or Advanced Soft Tissue Sarcomas That Cannot Be Removed by Surgery (United States)


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

  3. The Angle at Which the Facial Nerve Leaves the Mastoid


    Holt, James J.


    Some skull base procedures require extensive dissection of the facial nerve. This can be difficult at the mastoid tip, where the nerve is approximated to soft tissues. The nerve was dissected in this area in 15 cadaver specimens. The mean angle at which the facial nerve leaves the mastoid tip in 117°. This information should aid the skull base surgeon in the identification of the facial nerve at the mastoid tip.

  4. 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

  5. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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


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

  7. Reproducibility of transcutaneous oximetry and laser Doppler flowmetry in facial skin and gingival tissue. (United States)

    Svalestad, J; Hellem, S; Vaagbø, G; Irgens, A; Thorsen, E


    Laser Doppler flowmetry (LDF) and transcutaneous oximetry (TcPO(2)) are non-invasive techniques, widely used in the clinical setting, for assessing microvascular blood flow and tissue oxygen tension, e.g. recording vascular changes after radiotherapy and hyperbaric oxygen therapy. With standardized procedures and improved reproducibility, these methods might also be applicable in longitudinal studies. The aim of this study was to evaluate the reproducibility of facial skin and gingival LDF and facial skin TcPO(2). The subjects comprised ten healthy volunteers, 5 men, aged 31-68 years. Gingival perfusion was recorded with the LDF probe fixed to a custom made, tooth-supported acrylic splint. Skin perfusion was recorded on the cheek. TcPO(2) was recorded on the forehead and cheek and in the second intercostal space. The reproducibility of LDF measurements taken after vasodilation by heat provocation was greater than for basal flow in both facial skin and mandibular gingiva. Pronounced intraday variations were observed. Interweek reproducibility assessed by intraclass correlation coefficient ranged from 0.74 to 0.96 for LDF and from 0.44 to 0.75 for TcPO(2). The results confirm acceptable reproducibility of LDF and TcPO(2) in longitudinal studies in a vascular laboratory where subjects serve as their own controls. The use of thermoprobes is recommended. Repeat measurements should be taken at the same time of day.

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

    Directory of Open Access Journals (Sweden)

    Paolo Francesco Manicone


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

  9. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  11. 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.

  12. 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.)

  13. 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....

  14. 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.

  15. 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.

  16. 中国青年女性软组织侧貌特征研究%Study on soft tissue profile of features in Chinese young females

    Institute of Scientific and Technical Information of China (English)

    孙兆霞; 梁丽


    Objective To study the facial profile of aesthetic features about soft tissue in the normal young fe-males,evaluation of the young females′soft tissue of angles in facial profile,establish the relationship of the facial profile angles.The aim of this study was to provide a reference basis for aesthetics and plastic surgery of field op-eration treatment.Methods Seventy-two females in Grade 2010-2012 were selected randomly.The facial profile of angles in normal young females was measured and analyzed in the FreeHand MX software.Results The fron-tonasal angle,nasolabial angle and nasal tip angle were no difference in NoESR and E,ES,ESR (P>0.05).Up-per lip inclination angle,mentolabial sulcus inclination angle and ∠Z were significant difference between NoESR and E,ES,ESR (P0.05).Facial convexity angle and total facial convexity angle of soft tissue were significant difference between NoESR and E,ES,ESR (P0.05).The mean values of soft tissue of angles in facial profile were obtained from the ESR sample u-sing FreeHand MX software.Conclusion Young women facial profile of soft tissue of angles with ESR standard was harmonious,and the positive correlation between facial convexity angle,full facial convexity angle and ∠Z;the relations of forehead,nose,lips and chin were in harmony.The distance between trichion,soft tissue of nasal tip point,soft tissue pogonion and the tragus center was to equal.On the other hand facial profile of soft tissue of angles with NoESR,E,ES,standard was no harmonious,the position was been varied in forehead,nose,upper lips and chin.%目的:探讨正常青年女性侧貌软组织特征,建立符合侧貌美的青年女性侧面角度均值及各角度之间关系。方法选择72例2010-2012级在校汉族女学生,采用 FreeHand MX 软件对青年女学生面侧貌外部软组织角度进行测量分析。结果鼻额角、鼻唇角及鼻尖角在 NoESR 与 E、ES、ESR 之间差异无统计学意义(P >0.05);上唇

  17. A systematic review on soft-to-hard tissue ratios in orthognathic surgery part II: Chin procedures. (United States)

    San Miguel Moragas, Joan; Oth, Olivier; Büttner, Michael; Mommaerts, Maurice Y


    evidence level IIIb, three were evidence level IIb, and the rest were evidence level IV. Three studies were prospective in nature. A high variability of soft-to-hard tissue ratios regarding genioplasty seemed to disappear if data were stratified according to confounding factors. With the available data, a soft-to-hard pogonion ratio of 0.9:1 and 0.55:1 could be used for chin advancement and chin setback surgery, respectively. Advancement and extrusion movements of the chin segment show respectively a 0.9:1 of sPg:Pg horizontally and 0.95:1 of sMe:Me vertically. Setback and impaction movements show respectively a -0.52:1 of sPg:Pg horizontally and -0.43:1 of sMe:Me vertically. Prospective studies are needed that stratify by confounding factors such as type of osteotomy technique, magnitude of the movement, age, sex, race/ethnicity, and quantity and quality of the soft tissues. More specifically, studies are needed regarding soft-to-hard tissue changes after chin extrusion ("downgrafting"), intrusion ("impaction"), and widening and narrowing surgery. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  18. Evaluation of minimal disseminated disease in cryopreserved ovarian tissue from bone and soft tissue sarcoma patients. (United States)

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


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

  19. 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.

  20. Presentation and outcomes of necrotizing soft tissue infections

    Directory of Open Access Journals (Sweden)

    Chen KJ


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

  1. 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

  2. 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

  3. 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

  4. 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.

  5. 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

  6. 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.

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

    NARCIS (Netherlands)

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


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

  8. 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

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

    National Research Council Canada - National Science Library

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


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


    Directory of Open Access Journals (Sweden)

    T. I. Vitkina


    Full Text Available Abstract. We performed a clinical and immunological study of patients from senior age group suffering with protracted purulent inflammation of soft tissues in maxillo-facial area. The patients underwent either common medication, or combined treatment including ozone therapy. Application of medicinal ozone, along with basic treatment schedule, resulted into more marked and rapid normalization of non-specific resistance markers, Т-cell immunity. This approach allows of reducing the terms of inpatient care and variety of possible complications. (Med. Immunol., 2008, vol. 10, N 2-3, pp 277-282.

  11. 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.

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

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Szkudlarek, Marcin


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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  15. 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 ...

  16. 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.)

  17. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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. 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.

  20. 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.

  1. 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.

  2. Evaluation of Soft Tissue Landmark Reliability between Manual and Computerized Plotting Methods. (United States)

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


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

  3. Dynamic simulation of viscoelastic soft tissues in harmonic motion imaging application. (United States)

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


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

  4. Approach to the management of soft tissue tumors of the foot and ankle. (United States)

    DeGroot, Henry


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

  5. Characterization of p75{sup +} ectomesenchymal stem cells from rat embryonic facial process tissue

    Energy Technology Data Exchange (ETDEWEB)

    Wen, Xiujie; Liu, Luchuan; Deng, Manjing; Zhang, Li; Liu, Rui; Xing, Yongjun; Zhou, Xia [Department of Stomatology, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing 400042 (China); Nie, Xin, E-mail: [Department of Stomatology, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing 400042 (China)


    Highlights: Black-Right-Pointing-Pointer Ectomesenchymal stem cells (EMSCs) were found to migrate to rat facial processes at E11.5. Black-Right-Pointing-Pointer We successfully sorted p75NTR positive EMSCs (p75{sup +} EMSCs). Black-Right-Pointing-Pointer p75{sup +} EMSCs up to nine passages showed relative stable proliferative activity. Black-Right-Pointing-Pointer We examined the in vitro multilineage potential of p75{sup +} EMSCs. Black-Right-Pointing-Pointer p75{sup +}EMSCs provide an in vitro model for tooth morphogenesis. -- Abstract: Several populations of stem cells, including those from the dental pulp and periodontal ligament, have been isolated from different parts of the tooth and periodontium. The characteristics of such stem cells have been reported as well. However, as a common progenitor of these cells, ectomesenchymal stem cells (EMSCs), derived from the cranial neural crest have yet to be fully characterized. The aim of this study was to better understand the characteristics of EMSCs isolated from rat embryonic facial processes. Immunohistochemical staining showed that EMSCs had migrated to rat facial processes at E11.5, while the absence of epithelial invagination or tooth-like epithelium suggested that any epithelial-mesenchymal interactions were limited at this stage. The p75 neurotrophin receptor (p75NTR), a typical neural crest marker, was used to select p75NTR-positive EMSCs (p75{sup +} EMSCs), which were found to show a homogeneous fibroblast-like morphology and little change in the growth curve, proliferation capacity, and cell phenotype during cell passage. They also displayed the capacity to differentiate into diverse cell types under chemically defined conditions in vitro. p75{sup +} EMSCs proved to be homogeneous, stable in vitro and potentially capable of multiple lineages, suggesting their potential for application in dental or orofacial tissue engineering.

  6. 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.

  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. Bullous leukemia cutis mimicking facial cellulitis* (United States)

    Caldato, Luciana de Sales; Britto, Juliana de Sousa; Niero-Melo, Ligia; Miot, Hélio Amante


    Bullous leukemia cutis is an uncommon clinical manifestation of cutaneous infiltration by leukemic cells, from B-cell chronic lymphocytic leukemia. We present the case of a 67-year-old, female, chronic lymphocytic leukemia patient. She was taking chlorambucil and developed facial edema with erythema and warmth, misjudged as facial cellulitis. Two days later, she developed bullous lesions in the arms, legs, neck and face. The histopathology of facial and bullous lesions confirmed leukemia cutis. All lesions disappeared following the administration of rituximab combined with cycles of fludarabine and cyclophosphamide. Although soft tissue infections are common complications in patients undergoing chemotherapy, leukemia cutis can also resemble cellulitis. PMID:27192532

  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. 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.

  11. Polymer structure-property requirements for stereolithographic 3D printing of soft tissue engineering scaffolds. (United States)

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


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

  12. 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.

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. 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


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    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. 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.

  20. Facial asymmetry: a case report of localized linear scleroderma patient with muscular strain and spasm. (United States)

    Kim, Jae-Hyung; Lee, Suck-Chul; Kim, Chul-Hoon; Kim, Bok-Joo


    Facial asymmetry is found in patients with or without cosmetic facial alterations. Some patients have facial asymmetry that manifests underlying skeletal problems, while others have only limited soft-tissue facial asymmetry. Orthognathic surgery brings about a dermatic change, as soft tissue covers underlying bones. Limited soft-tissue asymmetry, meanwhile, is difficult to correct. The treatment modalities for the creation or restoration of an esthetically pleasing appearance were autogenous fat grafts, cartilage graft, and silicon injections. A young female patient had right-side facial asymmetry. The clinical assessment involved visual inspection of the face and palpation to differentiate soft tissue and bone. Although the extra-oral examination found facial asymmetry with skin atrophy, the radiographic findings revealed no mandibular atrophy or deviation. She was diagnosed as localized scleroderma with muscle spasm. In conclusion, facial asymmetry patients with skeletal asymmetry can be esthetically satisfied by orthognathic surgery; however, facial atrophy patients with skin or subdermal tissue contraction need treatment by cosmetic dermatological surgery and orthodontic correction.

  1. 浅表肌腱膜系统悬吊联合脂肪颗粒移植除皱术%Combined surgery of facial fat tissue remodel with SMAS-suspended rhytidectomy

    Institute of Scientific and Technical Information of China (English)

    杨明勇; 金骥; 李斌斌; 房林; 侯典举


    目的 探讨通过浅表肌腱膜系统(SMAS)悬吊,并行面部脂肪抽吸和面部脂肪颗粒移植将面部脂肪组织移位、塑形的面部除皱术的效果.方法 对12例面部老化者,先用脂肪抽吸术将面部脂肪提取,并行SMAS悬吊除皱术后,再将游离的脂肪颗粒重新移植于提升术后的面部其他区域,以达到对面部软组织年轻化重塑.结果 术后随访6个月至2年,面部软组织提升,并且面部因老化流失的软组织量得到补充,获得显著的面部年轻化效果,12例受术者均较满意,无并发症发生.结论 脂肪组织重塑结合SMAS悬吊的面部提升术,在提升松弛软组织的同时,还针对面部流失的软组织量进行修复,解除了导致面部老化的多种因素,是面部除皱比较满意的方法.%Objective To evaluate the effect of facial fat tissue grafting and remodeling with SMAS suspension in facial rejuvenation.Methods The treatment process of 12 patients with facial fat tissue grafting and SMAS-suspended rhytidectomy were reviewed retrospectively,the surgical operative procedure and treatment results of facial liposuction and autologous fat grafting with SMAS-suspended rhytidectomy were analyzed and evaluated.Results 12 patients underwent facial liposuction,SMAS-suspended rhytidectomy and autologous free fat tissue grafting and remodeling.All the followed-up cases obtained good results without complications.Conclusions Combined surgery of facial fat tissue remodel with SMAS-suspended rhytidectomy not only corrects the soft tissue laxity,but also modifies the faical volume loss.It solves the aging problems in different angles through soft tissue lift and volume restoration.It is a relatively ideal surgical method of facialplasty for those aged patients.

  2. Ionizing radiation exposure and the development of soft-tissue sarcomas in atomic-bomb survivors. (United States)

    Samartzis, Dino; Nishi, Nobuo; Cologne, John; Funamoto, Sachiyo; Hayashi, Mikiko; Kodama, Kazunori; Miles, Edward F; Suyama, Akihiko; Soda, Midori; Kasagi, Fumiyoshi


    Very high levels of ionizing radiation exposure have been associated with the development of soft-tissue sarcoma. The effects of lower levels of ionizing radiation on sarcoma development are unknown. This study addressed the role of low to moderately high levels of ionizing radiation exposure in the development of soft-tissue sarcoma. Based on the Life Span Study cohort of Japanese atomic-bomb survivors, 80,180 individuals were prospectively assessed for the development of primary soft-tissue sarcoma. Colon dose in gray (Gy), the excess relative risk, and the excess absolute rate per Gy absorbed ionizing radiation dose were assessed. Subject demographic, age-specific, and survival parameters were evaluated. One hundred and four soft-tissue sarcomas were identified (mean colon dose = 0.18 Gy), associated with a 39% five-year survival rate. Mean ages at the time of the bombings and sarcoma diagnosis were 26.8 and 63.6 years, respectively. A linear dose-response model with an excess relative risk of 1.01 per Gy (95% confidence interval [CI]: 0.13 to 2.46; p = 0.019) and an excess absolute risk per Gy of 4.3 per 100,000 persons per year (95% CI: 1.1 to 8.9; p = 0.001) were noted in the development of soft-tissue sarcoma. This is one of the largest and longest studies (fifty-six years from the time of exposure to the time of follow-up) to assess ionizing radiation effects on the development of soft-tissue sarcoma. This is the first study to suggest that lower levels of ionizing radiation may be associated with the development of soft-tissue sarcoma, with exposure of 1 Gy doubling the risk of soft-tissue sarcoma development (linear dose-response). The five-year survival rate of patients with soft-tissue sarcoma in this population was much lower than that reported elsewhere.

  3. 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

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

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    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.

  5. Impact of plasma fibrinogen levels in benign and malignant soft tissue tumors. (United States)

    Asanuma, Kunihiro; Matsumine, Akihiko; Nakamura, Tomoki; Matsubara, Takao; Asanuma, Yumiko; Oi, Toru; Goto, Mikinobu; Okuno, Kazuma; Kakimoto, Takuya; Yada, Yuuki; Sudo, Akihiro


    Fibrinogen, a 340 kDa glycoprotein synthesized in the liver, is known to be involved in tumor angiogenesis, enlargement, and metastasis. Elevated plasma fibrinogen levels are associated with tumor progression in many cancer patients. However, there are no reports about differences in fibrinogen levels between benign and malignant soft tissue tumors. The purpose of this study was to clarify whether preoperative plasma fibrinogen levels can be used for differential diagnosis of benign or malignant soft tissue tumors. The plasma fibrinogen levels from 102 primary soft tissue tumor patients were measured before biopsy or treatment. Fibrinogen levels were analyzed and compared to various clinical parameters. According to receiver operating characteristic (ROC) curve analysis, a threshold of serum fibrinogen of 315 mg/dL identified malignant patients with 60.9% sensitivity and 87.5% specificity. The diagnostic accuracy was evaluated by area under the curve (AUC: 0.805). Over 315 mg/dL of fibrinogen was associated with a significantly increased risk of malignancy by multiple logistic regression analysis (OR: 6.452, p= 0.0004). We demonstrated that plasma fibrinogen levels have a relationship with tumor malignancy of soft tissue tumors. High fibrinogen levels can be a helpful subsidiary tool for the prediction of malignant soft tissue tumors with other diagnostic tools.

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

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    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.

  7. [Application of skin and soft tissue expansion in treatment of burn injury]. (United States)

    Wang, N Z; Shen, Z Y; Ma, C X


    To evaluate the application of skin and soft tissue expansion in the treatment of deformity due to extensive severe burn injury and repair of severe deep electrical burned scalp and skull with fresh wound. From 1988, 83 cases of application of skin and soft tissue expansion were reported. In those patients with deformity due to severe burn of large area and with whole nasal defect, soft tissue expander was used under the forehead skin graft and venter frontalis, followed by reconstruction of nose with the expanded vascularized skin flap and carved cartilago costalis as nasal frame. In patients of severe deep electrical burned scalp and skull with fresh wound, skin and soft tissue expansion were used to repair the wound simultaneously with scalp burn alopecia, anesthetics and antibiotics injected into the extracapsular space of the expander in case of pain and infection. All of the cases were successfully treated with little pain and minimized infection. Skin and soft tissue expansion in a safe and reliable measure in the treatment of deformity due to extensive severe burn injury and repair of severe deep electrical burned scalp and skull with fresh wound.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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...

  14. 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.

  15. 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...

  16. Candida Albicans Infection Masquerading as a Soft Tissue Tumour Diagnosed by Fine Needle Aspiration Cytology (United States)

    Govind, Abhishek Mandya; Pechiat, Tony; Manchaih, Sanjay; Shankar, Shivshankar Vijay


    A 60-year-old male, diabetic presented with a soft tissue mass over the right forearm of 15 days duration. The swelling was 5 x 3 cm and a clinical diagnosis of neurofibroma was made. Fine Needle Aspiration Cytology (FNAC) was done using standard technique. Smears showed predominantly suppurative inflammation, foreign body giant cells, granulomas and fungal hyphae. KOH mount, culture and germ tube test was positive. Final diagnosis of fungal granuloma was made. Fungal infections should be included in the differential diagnosis of a soft tissue mass lesion. All soft tissue suppurative inflammatory lesions should be diligently screened to look for pathogens if any. Diagnostics in medicine have taken a major leap with advent of molecular technologies. Despite this, simple old traditional methods like FNAC supplemented by other basic laboratory techniques like KOH mount and culture still form the cream of a diagnostic laboratory and can come as a savior for the pathologist, the clinicians and the patients.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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)

  2. Soft tissue sarcomas in adolescents and young adults: a comparison with their paediatric and adult counterparts. (United States)

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


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

  3. 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.

  4. Modelling of global boundary effects on harmonic motion imaging of soft tissues. (United States)

    Zhao, Xiaodong; Pelegri, Assimina A


    Biomechanical imaging techniques have been developed for soft tissue characterisation and detection of breast tumours. Harmonic motion imaging (HMI) uses a focused ultrasound technology to generate a harmonic radiation force in a localised region inside a soft tissue. The resulting dynamic response is used to map the local distribution of the mechanical properties of the tissue. In this study, a finite element (FE) model is developed to investigate the effect of global boundary conditions on the dynamic response of a soft tissue during HMI. The direct-solution steady-state dynamic analysis procedure is used to compute the harmonic displacement amplitude in FE simulations. The model is parameterised in terms of boundary conditions and viscoelastic properties, and the corresponding raster-scan displacement amplitudes are captured to examine its response. The effect of the model's global dimensions on the harmonic response is also investigated. It is observed that the dynamic response of soft tissue with high viscosity is independent of the global boundary conditions for regions remote to the boundary; thus, it can be subjected to local analysis to estimate the underlying mechanical properties. However, the dynamic response is sensitive to global boundary conditions for tissue with low viscosity or regions located near to the boundary.

  5. Non-O1, non-O139 Vibrio cholerae bacteremic skin and soft tissue infections. (United States)

    Maraki, Sofia; Christidou, Athanasia; Anastasaki, Maria; Scoulica, Efstathia


    Non-O1, non-O139 Vibrio cholerae can cause sporadic cases of gastroenteritis and extra-intestinal invasive infections, following exposure to contaminated seawater or freshwater or after consumption of raw seafood. Bacteremic infections with skin and soft tissue manifestations are uncommon and in most cases are associated with liver cirrhosis, haematologic malignancies, diabetes mellitus and other immunosuppressed conditions. The medical literature was reviewed and we found 47 published cases of non-O1, non-O139 Vibrio cholerae bacteremic skin and soft tissue infections. A fatal case of bacteremia with bullous cellulitis in a 43-year-old patient with liver cirrhosis is described, which is the first reported in Greece. From January 1974 to May 2015, a total of 48 patients with non-O1, non-O139 Vibrio cholerae bacteremia with skin and soft tissue infections were reported. Males predominated. Liver cirrhosis, chronic liver disease and alcohol abuse were common comorbidities. The soft tissue lesions most commonly described were localised cellulitis, with or without bullous and haemorrhagic lesions (66.7%), while necrotising fasciitis was more rare (29.2%). Of the 48 patients with non-O1, non-O139 V. cholerae bacteremic skin and soft tissue infections, 20 (41.7%) died despite treatment. Although rarely encountered, non-O1, non-O139 Vibrio cholerae should be included in the differential diagnosis of bacteremic skin and soft tissue infections in patients with underlying illnesses and epidemiologic risk factors. Timely and appropriate antibiotic and surgical treatments are important in the management of the infection.

  6. 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

  7. 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

  8. 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

  9. Bone and Soft Tissue Changes after Two-Jaw Surgery in Cleft Patients

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    Yung Sang Yun


    Full Text Available BackgroundOrthognathic surgery is required in 25% to 35% of patients with a cleft lip and palate, for whom functional recovery and aesthetic improvement after surgery are important. The aim of this study was to examine maxillary and mandibular changes, along with concomitant soft tissue changes, in cleft patients who underwent LeFort I osteotomy and sagittal split ramus osteotomy (two-jaw surgery.MethodsTwenty-eight cleft patients who underwent two-jaw surgery between August 2008 and November 2013 were included. Cephalometric analysis was conducted before and after surgery. Preoperative and postoperative measurements of the bone and soft tissue were compared.ResultsThe mean horizontal advancement of the maxilla (point A was 6.12 mm, while that of the mandible (point B was -5.19 mm. The mean point A-nasion-point B angle was -4.1° before surgery, and increased to 2.5° after surgery. The mean nasolabial angle was 72.7° before surgery, and increased to 88.7° after surgery. The mean minimal distance between Rickett's E-line and the upper lip was 6.52 mm before surgery and 1.81 mm after surgery. The ratio of soft tissue change to bone change was 0.55 between point A and point A' and 0.93 between point B and point B'.ConclusionsPatients with cleft lip and palate who underwent two-jaw surgery showed optimal soft tissue changes. The position of the soft tissue (point A' was shifted by a distance equal to 55% of the change in the maxillary bone. Therefore, bone surgery without soft tissue correction can achieve good aesthetic results.

  10. 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.

  11. Benign soft tissue masses of the wrist and hand: MRI appearances

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    Miller, T.T. (Depts. of Radiology and Nuclear Medicine, Hospital for Special Surgery, Cornell Univ. Medical Coll., New York, NY (United States)); Potter, H.G. (Depts. of Radiology and Nuclear Medicine, Hospital for Special Surgery, Cornell Univ. Medical Coll., New York, NY (United States)); McCormack, R.R. Jr. (Dept. of Orthopedic Surgery, Hospital for Special Surgery, Cornell Univ. Medical Coll., New York, NY (United States))


    We reviewed 20 cases of soft tissue masses of the hand and wrist, and compared the impressions from the original magnetic resonance (MR) imaging reports with the preoperative clinical impression and postoperative pathological diagnoses. The most commonly occurring masses were ganglia, lipomas, and giant cell tumors of tendon sheaths. MR imaging suggested the correct diagnosis in 16 of the 20 cases, whereas the clinical impression was correct in 10 instances. Confident preoperative diagnosis may be made with MR imaging due to the characteristic appearances of many benign soft tissue tumors. (orig.)