Science.gov

Sample records for irresectable soft tissue

  1. Necrotizing soft tissue infection

    MedlinePlus

    Necrotizing fasciitis; Fasciitis - necrotizing; Flesh-eating bacteria; Soft tissue gangrene; Gangrene - soft tissue ... Many different types of bacteria can cause this infection. A very severe and usually deadly form of necrotizing soft tissue infection is due to the ...

  2. Necrotizing soft tissue infection

    MedlinePlus

    Necrotizing fasciitis; Fasciitis - necrotizing; Flesh-eating bacteria; Soft tissue gangrene; Gangrene - soft tissue ... the bacteria Streptococcus pyogenes , which is sometimes called "flesh-eating bacteria." Necrotizing soft tissue infection develops when ...

  3. Avian Soft Tissue Surgery.

    PubMed

    Guzman, David Sanchez-Migallon

    2016-01-01

    Basic surgical instrumentation for avian soft tissue surgery includes soft tissue retractors, microsurgical instrumentation, surgical loupes, and head-mounted lights. Hemostasis is fundamental during the surgical procedures. The indications, approach, and complications associated with soft tissue surgeries of the integumentary (digit constriction repair, feather cyst excision, cranial wound repair, sternal wound repair, uropygial gland excision), gastrointestinal (ingluviotomy, crop biopsy, crop burn repair, celiotomy, coelomic hernia and pseudohernia repair, proventriculotomy, ventriculotomy, enterotomy, intestinal resection and anastomosis, cloacoplasty, cloacopexy), respiratory (rhinolith removal, sinusotomy, tracheotomy, tracheal resection and anastomosis, tracheostomy, pneumonectomy) and reproductive (ovocentesis, ovariectomy, salpingohysterectomy, cesarean section, orchidectomy, vasectomy, phallectomy) systems are reviewed. PMID:26611927

  4. Facial Soft Tissue Trauma

    PubMed Central

    Kretlow, James D.; McKnight, Aisha J.; Izaddoost, Shayan A.

    2010-01-01

    Traumatic facial soft tissue injuries are commonly encountered in the emergency department by plastic surgeons and other providers. Although rarely life-threatening, the treatment of these injuries can be complex and may have significant impact on the patient's facial function and aesthetics. This article provides a review of the relevant literature related to this topic and describes the authors' approach to the evaluation and management of the patient with facial soft tissue injuries. PMID:22550459

  5. Adult soft tissue sarcoma

    MedlinePlus

    ... free at 5 years. Most people who survive 5 years can expect to be cancer-free at 10 years. ... most soft tissue sarcomas, and there is no way to prevent it. ... them can increase your chance of surviving this type of cancer.

  6. Hypoelastic Soft Tissues

    PubMed Central

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

    2010-01-01

    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

  7. Soft tissue angiosarcomas

    SciTech Connect

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

    1981-12-01

    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.

  8. Drugs Approved for Soft Tissue Sarcoma

    MedlinePlus

    ... Professionals Questions to Ask about Your Treatment Research Drugs Approved for Soft Tissue Sarcoma This page lists ... soft tissue sarcoma that are not listed here. Drugs Approved for Soft Tissue Sarcoma Cosmegen (Dactinomycin) Dactinomycin ...

  9. Cytodiagnosis of soft tissue tumors.

    PubMed

    Oland, J; Rosen, A; Reif, R; Sayfan, J; Orda, R

    1988-03-01

    The only acceptable definitive diagnosis of a soft tissue mass is histologic or cytologic examination. In recent years, fine-needle aspiration cytology is used in more and more centers for diagnosis of soft tissue masses. We studied 196 aspiration cytologies performed on soft tissue lesions. Out of these, in 48 cases a definitive surgical procedure or open biopsy for histology and further evaluation were performed. There were 25 sarcomas and 23 benign tumors. There was one false negative cytologic result in this group; no false positive cytologies were detected. It seems that cytodiagnosis of soft tissue masses performed by an experienced pathologist is the method of choice, permitting a good diagnostic evaluation, with almost none of the traumatic and oncologic disadvantages of the other methods of biopsy. PMID:3352270

  10. [Skin and soft tissue infections].

    PubMed

    Piso, R J; Bassetti, S

    2012-03-14

    Skin- and Soft tissue infections are a frequent problem in hospital as well as in ambulatory care. Diagnostic procedures and treatment principles have to include the most frequent pathogens. While the acute forms of skin and soft tissue infections, with, necrotising fasciitis as important exception, rarely cause diagnostic or therapeutic problem, the treatment of patients with recurrent furunculosis, chronic wounds and diabetic feet is often difficult and frustration for patients and physicians. This article gives an overview of the most important problems and treatment strategies. PMID:22419138

  11. Soft tissue laser in orthodontics.

    PubMed

    Gracco, Antonio; Tracey, Stephen; Lombardo, Luca; Siciliani, Giuseppe

    2011-01-01

    Today a lot of minor cosmetic surgery operations on the gingiva can easily be carried out directly by the orthodontist with a small quantity of topical anaesthetic and the use of a soft tissue laser. The Diode laser is the most commonly used laser in dentistry for minor surgery to the soft tissues. This kind of laser offers numerous advantages with respect to traditional or electric scalpels. In this article the authors will analyse several typical uses of the diode laser in daily orthodontic practice. PMID:21515234

  12. Pediatric soft tissue oral lesions.

    PubMed

    Pinto, Andres; Haberland, Christel M; Baker, Suher

    2014-04-01

    This article provides an overview of common color changes and soft tissue oral nodular abnormalities in children and adolescents. The clinical presentation and treatment options to address these conditions are presented in a concise approach, highlighting key features relevant to the oral health care professional. PMID:24655531

  13. Childhood Soft Tissue Sarcoma: Treatment Information

    MedlinePlus

    ... Germ Cell Tumors Kidney/Wilms Tumor Liver Cancer Neuroblastoma Osteosarcoma Rhabdomyosarcoma Skin Cancer Soft Tissue Sarcoma Thyroid ... Tumor Liver Cancer Lymphoma (Non-Hodgkin) Lymphoma (Hodgkin) Neuroblastoma Osteosarcoma Retinoblastoma Rhabdomyosarcoma Skin Cancer Soft Tissue Sarcoma ...

  14. General Information about Adult Soft Tissue Sarcoma

    MedlinePlus

    ... Soft Tissue Sarcoma Treatment (PDQ®)–Patient Version General Information About Adult Soft Tissue Sarcoma Go to Health ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  15. General Information about Childhood Soft Tissue Sarcoma

    MedlinePlus

    ... Soft Tissue Sarcoma Treatment (PDQ®)–Patient Version General Information About Childhood Soft Tissue Sarcoma Go to Health ... the PDQ Pediatric Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  16. [Radiotherapy of adult soft tissue sarcoma].

    PubMed

    Le Péchoux, C; Moureau-Zabotto, L; Llacer, C; Ducassou, A; Sargos, P; Sunyach, M P; Thariat, J

    2016-09-01

    Incidence of soft tissue sarcoma is low and requires multidisciplinary treatment in specialized centers. The objective of this paper is to report the state of the art regarding indications and treatment techniques of main soft tissue sarcoma localisations. PMID:27523415

  17. Survival by Stage of Soft Tissue Sarcoma

    MedlinePlus

    ... Next Topic How are soft tissue sarcomas treated? Survival by stage of soft tissue sarcoma Survival rates ... observed, not relative survival): Stage 5-year observed survival rate I 90% II 81% III 56% IV ...

  18. Bone and Soft Tissue Ablation

    PubMed Central

    Foster, Ryan C.B.; Stavas, Joseph M.

    2014-01-01

    Bone and soft tissue tumor ablation has reached widespread acceptance in the locoregional treatment of various benign and malignant musculoskeletal (MSK) lesions. Many principles of ablation learned elsewhere in the body are easily adapted to the MSK system, particularly the various technical aspects of probe/antenna design, tumoricidal effects, selection of image guidance, and methods to reduce complications. Despite the common use of thermal and chemical ablation procedures in bone and soft tissues, there are few large clinical series that show longitudinal benefit and cost-effectiveness compared with conventional methods, namely, surgery, external beam radiation, and chemotherapy. Percutaneous radiofrequency ablation of osteoid osteomas has been evaluated the most and is considered a first-line treatment choice for many lesions. Palliation of painful metastatic bone disease with thermal ablation is considered safe and has been shown to reduce pain and analgesic use while improving quality of life for cancer patients. Procedure-related complications are rare and are typically easily managed. Similar to all interventional procedures, bone and soft tissue lesions require an integrated approach to disease management to determine the optimum type of and timing for ablation techniques within the context of the patient care plan. PMID:25053865

  19. Bone and soft tissue ablation.

    PubMed

    Foster, Ryan C B; Stavas, Joseph M

    2014-06-01

    Bone and soft tissue tumor ablation has reached widespread acceptance in the locoregional treatment of various benign and malignant musculoskeletal (MSK) lesions. Many principles of ablation learned elsewhere in the body are easily adapted to the MSK system, particularly the various technical aspects of probe/antenna design, tumoricidal effects, selection of image guidance, and methods to reduce complications. Despite the common use of thermal and chemical ablation procedures in bone and soft tissues, there are few large clinical series that show longitudinal benefit and cost-effectiveness compared with conventional methods, namely, surgery, external beam radiation, and chemotherapy. Percutaneous radiofrequency ablation of osteoid osteomas has been evaluated the most and is considered a first-line treatment choice for many lesions. Palliation of painful metastatic bone disease with thermal ablation is considered safe and has been shown to reduce pain and analgesic use while improving quality of life for cancer patients. Procedure-related complications are rare and are typically easily managed. Similar to all interventional procedures, bone and soft tissue lesions require an integrated approach to disease management to determine the optimum type of and timing for ablation techniques within the context of the patient care plan. PMID:25053865

  20. Skin and Soft Tissue Infections.

    PubMed

    Ramakrishnan, Kalyanakrishnan; Salinas, Robert C; Agudelo Higuita, Nelson Ivan

    2015-09-15

    Skin and soft tissue infections result from microbial invasion of the skin and its supporting structures. Management is determined by the severity and location of the infection and by patient comorbidities. Infections can be classified as simple (uncomplicated) or complicated (necrotizing or nonnecrotizing), or as suppurative or nonsuppurative. Most community-acquired infections are caused by methicillin-resistant Staphylococcus aureus and beta-hemolytic streptococcus. Simple infections are usually monomicrobial and present with localized clinical findings. In contrast, complicated infections can be mono- or polymicrobial and may present with systemic inflammatory response syndrome. The diagnosis is based on clinical evaluation. Laboratory testing may be required to confirm an uncertain diagnosis, evaluate for deep infections or sepsis, determine the need for inpatient care, and evaluate and treat comorbidities. Initial antimicrobial choice is empiric, and in simple infections should cover Staphylococcus and Streptococcus species. Patients with complicated infections, including suspected necrotizing fasciitis and gangrene, require empiric polymicrobial antibiotic coverage, inpatient treatment, and surgical consultation for debridement. Superficial and small abscesses respond well to drainage and seldom require antibiotics. Immunocompromised patients require early treatment and antimicrobial coverage for possible atypical organisms. PMID:26371732

  1. Injectable fillers for facial soft tissue enhancement.

    PubMed

    Sclafani, A P; Romo, T

    2000-01-01

    Soft tissue augmentation materials have been advocated for correction of post-surgical or post-traumatic facial defects, as well as for age-related folds and wrinkles. While autogenous tissues may be the safest option, they require a second operative site. Animal-derived or synthetic materials have been advocated since the late 19th century, and have waxed and waned in popularity. In recent years, we have gained a better understanding of the physical events that occur when material is placed within or below the skin. With this knowledge, we stand at the threshold of a new era, where soft tissue fillers can be designed and customized to suit the individual patient. This article will review the major materials that have been or are now advocated for use as soft tissue fillers, and will detail their relative strengths and weaknesses in order to give the clinician a better perspective when considering a material for soft tissue augmentation. PMID:11802343

  2. Malignant soft tissue tumors in children.

    PubMed

    Thacker, Mihir M

    2013-10-01

    Soft tissue masses are frequently seen in children. Although most are benign or reactive, soft tissue sarcomas (STS)-both rhabdomyosarcoma (most common) and non-rhabdo STS, do occur in the extremities. Appropriate evaluation of extremity soft tissue tumors often includes a biopsy as the clinical and imaging features may not be enough to establish a definitive diagnosis. Much needs to be done for improving the treatment of these rare but often devastating sarcomas. Given the small numbers of these cases seen at various centers, collaborative efforts should be made to further our understanding and improve the management of these challenging cases. PMID:24095080

  3. New Soft Tissue Implants Using Organic Elastomers

    NASA Astrophysics Data System (ADS)

    Ku, David N.

    Typical biomaterials are stiff, difficult to manufacture, and not initially developed for medical implants. A new biomaterial is proposed that is similar to human soft tissue. The biomaterial provides mechanical properties similar to soft tissue in its mechanical and physical properties. Characterization is performed for modulus of elasticity, ultimate strength and wear resistance. The material further exhibits excellent biocompatibility with little toxicity and low inflammation. The material can be molded into a variety of anatomic shapes for use as a cartilage replacement, heart valve, and reconstructive implant for trauma victims. The biomaterial may be suitable for several biodevices of the future aimed at soft-tissue replacements.

  4. Chondro-Osseous Lesions of Soft Tissue.

    PubMed

    Cho, Soo-Jin; Horvai, Andrew

    2015-09-01

    Soft tissue lesions can contain bone or cartilage matrix as an incidental, often metaplastic, phenomenon or as a diagnostic feature. The latter category includes a diverse group ranging from self-limited proliferations to benign neoplasms to aggressive malignancies. Correlating imaging findings with pathology is mandatory to confirm that a tumor producing bone or cartilage, in fact, originates from soft tissue rather than from the skeleton. The distinction can have dramatic diagnostic and therapeutic implications. This content focuses on the gross, histologic, radiographic, and clinical features of bone or cartilage-producing soft tissue lesions. Recent discoveries regarding tumor-specific genetics are discussed. PMID:26297064

  5. Soft tissue balancing in total knee arthroplasty

    PubMed Central

    MELONI, MARIA CHIARA; HOEDEMAEKER, RUSSALKA W.; VIOLANTE, BRUNO; MAZZOLA, CLAUDIO

    2014-01-01

    A good outcome in total knee arthroplasty depends on many factors: joint alignment, range of motion, patellar tracking and ligament stability. A correct soft tissue balance keeps the joint aligned in flexion and extension, and therefore constitutes the most important factor for durability of the implant. Indeed, incorrect soft tissue balancing is the primary cause of early implant failure necessitating revision surgery. Soft tissue releases, serving to correct imbalances, are performed until the flexion and extension gaps appear symmetrical and balanced. A knee is considered perfectly balanced when the flexion and extension gaps are perfectly rectangular and all the measurements are absolutely equal. PMID:25606540

  6. Raman Spectroscopy of Soft Musculoskeletal Tissues

    PubMed Central

    Esmonde-White, Karen

    2015-01-01

    Tendon, ligament, and joint tissues are important in maintaining daily function. They can be affected by disease, age, and injury. Slow tissue turnover, hierarchical structure and function, and nonlinear mechanical properties present challenges to diagnosing and treating soft musculoskeletal tissues. Understanding these tissues in health, disease, and injury is important to improving pharmacologic and surgical repair outcomes. Raman spectroscopy is an important tool in the examination of soft musculoskeletal tissues. This article highlights exciting basic science and clinical/translational Raman studies of cartilage, tendon, and ligament. PMID:25286106

  7. Soft Tissue Sarcomas and Agent Orange

    MedlinePlus

    ... survivors' benefits . Research on soft tissue sarcoma and herbicides The Health and Medicine Division (formally known as ... report " Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam " and other updates that there ...

  8. Local Recurrence of Extremity Soft Tissue Sarcoma.

    PubMed

    Guerrero, Whitney M; Deneve, Jeremiah L

    2016-10-01

    The management of recurrent soft tissue sarcoma is a challenging problem for clinicians and has a significant physical, mental, emotional, and oncologic impact for the patient. Despite excellent limb-preservation therapies, approximately one-quarter of patients may eventually develop recurrence of disease. How to most appropriately manage these patients is a matter of debate. Several treatment options exist, including surgical resection, irradiation, systemic chemotherapy, amputation, and regional therapies. This article highlights the management of recurrent extremity soft tissue sarcoma. PMID:27542648

  9. Injectable Silk Foams for Soft Tissue Regeneration

    PubMed Central

    Bellas, E.; Lo, T.J.; Fournier, E.P.; Brown, J.E.; Abbott, R.D.; Gil, E.S.; Marra, K.G.; Rubin, J.P.; Leisk, G.G.; Kaplan, D.L.

    2015-01-01

    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 for the implant and/or grafted tissue to be placed closer to existing vasculature. Here, we demonstrate the feasibility of an injectable silk foam for soft tissue regeneration. Adipose derived stem cells survive and migrate through the foam over a 10 day 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 was 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. PMID:25323438

  10. Application of Proteomics to Soft Tissue Sarcomas

    PubMed Central

    Kondo, Tadashi; Kubota, Daisuke; Kawai, Akira

    2012-01-01

    Soft tissue sarcomas are rare and account for less than 1% of all malignant cancers. Other than development of intensive therapies, the clinical outcome of patients with soft tissue sarcoma remains very poor, particularly when diagnosed at a late stage. Unique mutations have been associated with certain soft tissue sarcomas, but their etiologies remain unknown. The proteome is a functional translation of a genome, which directly regulates the malignant features of tumors. Thus, proteomics is a promising approach for investigating soft tissue sarcomas. Various proteomic approaches and clinical materials have been used to address clinical and biological issues, including biomarker development, molecular target identification, and study of disease mechanisms. Several cancer-associated proteins have been identified using conventional technologies such as 2D-PAGE, mass spectrometry, and array technology. The functional backgrounds of proteins identified were assessed extensively using in vitro experiments, thus supporting expression analysis. These observations demonstrate the applicability of proteomics to soft tissue sarcoma studies. However, the sample size in each study was insufficient to allow conclusive results. Given the low frequency of soft tissue sarcomas, multi-institutional collaborations are required to validate the results of proteomic approaches. PMID:22778956

  11. Heterogeneous genetic profiles in soft tissue myoepitheliomas.

    PubMed

    Hallor, Karolin H; Teixeira, Manuel R; Fletcher, Christopher D M; Bizarro, Susana; Staaf, Johan; Domanski, Henryk A; von Steyern, Fredrik Vult; Panagopoulos, Ioannis; Mandahl, Nils; Mertens, Fredrik

    2008-11-01

    Myoepithelioma, mixed tumor and parachordoma are uncommon soft tissue tumors thought to represent morphological variants of a single tumor type. The genetic basis of these neoplasms is poorly understood. However, they morphologically resemble mixed tumor of the salivary glands (also known as pleomorphic adenoma), a tumor characterized by deregulated expression of PLAG1 or HMGA2. To evaluate a possible genetic relationship between these soft tissue and salivary gland tumors, PLAG1 expression levels and the genomic status of PLAG1 and HMGA2 were investigated in five soft tissue myoepitheliomas and one pleomorphic adenoma. In addition, all tumors were cytogenetically investigated and whole genome DNA copy number imbalances were studied in five of them. The genetic profiles were heterogeneous and the only aberration common to all soft tissue myoepitheliomas was a minimally deleted region of 3.55 Mb in chromosome band 19p13. Recurrent deletion of CDKN2A suggests that inactivation of this tumor suppressor gene is pathogenetically important in a subset. Furthermore, PLAG1 rearrangement was found in a soft tissue tumor from a patient previously treated for a salivary pleomorphic adenoma, indicating either metastasis of the salivary gland lesion or that some soft tissue tumors develop through the same mechanisms as their salivary gland counterparts. PMID:18604193

  12. Soft tissue engineering in craniomaxillofacial surgery

    PubMed Central

    Kim, Roderick Y; Fasi, Anthony C; Feinberg, Stephen E

    2014-01-01

    Craniofacial soft tissue reconstruction may be required following trauma, tumor resection, and to repair congenital deformities. Recent advances in the field of tissue engineering have significantly widened the reconstructive armamentarium of the surgeon. The successful identification and combination of tissue engineering, scaffold, progenitor cells, and physiologic signaling molecules has enabled the surgeon to design, recreate the missing tissue in its near natural form. This has resolved the issues like graft rejection, wound dehiscence, or poor vascularity. Successfully reconstructed tissue through soft tissue engineering protocols would help surgeon to restore the form and function of the lost tissue in its originality. This manuscript intends to provide a glimpse of the basic principle of tissue engineering, contemporary, and future direction of this field as applied to craniofacial surgery. PMID:24987591

  13. [Soft tissue sarcomas and gastrointestinal stromal tumors].

    PubMed

    Reichardt, P

    2016-03-01

    Soft tissue sarcomas are rare tumors that represent a major challenge due to varying clinical presentations and often interdisciplinary treatment concepts. Gold standard for the treatment of localized resectable soft tissue sarcomas is complete surgical removal. In metastatic soft tissue sarcoma, systemic therapy is the treatment of choice. The most active drugs are anthracyclines and ifosfamide. Combination chemotherapy has improved both response rate and progression-free survival at the cost of increased toxicity. Imatinib at a dose of 400 mg/day is the gold standard for patients with advanced or metastatic gastrointestinal stromal tumors (GIST). In patients with a mutation in KIT exon 9, 800 mg/day is the recommended dose. In imatinib refractory or intolerant patients, sunitinib is recommended. Regorafenib has been approved for third-line therapy. PMID:26907871

  14. Adjuvant radiation for soft tissue sarcomas.

    PubMed

    Dickie, Colleen I; Haas, Rick; O'Sullivan, Brian

    2015-01-01

    Over recent decades, limb-preservation surgery in combination with radiotherapy achieves local control rates exceeding 90% for extremity soft tissue sarcoma (STS). Local control is not as successful for retroperitoneal sarcoma (approximately 60%) despite aggressive surgical approaches including en bloc resection of uninvolved adjacent organs combined with intensity modulated radiotherapy (IMRT). This review will discuss the indications for adjuvant radiation therapy (RT) for primary presentation of soft tissue sarcoma: "What," referring to the type and manner of planning and delivery of RT; "When," referring to the timing and scheduling of RT; and "Why," referring to the rationale for the use of RT will be addressed. From a practical stand point, this Educational Chapter on "adjuvant RT" will focus on pre- and postoperative RT in the context of gross total resection for extremity and retroperitoneal soft tissue sarcoma, the two most frequent paradigms for the use of adjuvant RT. PMID:25993234

  15. Phase contrast imaging of cochlear soft tissue.

    SciTech Connect

    Smith, S.; Hwang, M.; Rau, C.; Fishman, A.; Lee, W.; Richter, C.

    2011-01-01

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

  16. [Adjuvant chemotherapy of adults soft tissue sarcomas].

    PubMed

    Bui-Nguyen, B; Italiano, A; Delva, F; Toulmond, M

    2010-06-01

    The main progress in the management of soft tissue sarcomas have been obtained in the field of local control. Although the main evolutive, vital, risk of these diseases is metastatic dissemination, efficacy of adjuvant chemotherapy remains a controversial issue. Thus, adjuvant chemotherapy cannot be considered as a standard for any situation. The last results of clinical trials, meta-analysis and population studies are presented and discussed in this article. New therapeutic strategies are to be developed to prevent metastases in soft tissue sarcomas. This needs a better understanding of the biology of those tumors, of metastases risk factors and of the determinants of systemic therapies efficacy in these tumors. PMID:20547481

  17. Systemic Therapy for Advanced Soft Tissue Sarcoma.

    PubMed

    Sheng, Jennifer Y; Movva, Sujana

    2016-10-01

    Soft tissue sarcomas are rare tumors that present with distant metastasis in up to 10% of patients. Survival has improved significantly because of advancements in histologic classification and improved management approaches. Older agents such as doxorubicin, ifosfamide, gemcitabine, and paclitaxel continue to demonstrate objective response rates from 18% to 25%. Newer agents such as trabectedin, eribulin, aldoxorubicin, and olaratumab have demonstrated improvements in progression-free survival, overall survival, or toxicity profiles. Future studies on treatment of advanced soft tissue sarcoma will continue to concentrate on reducing toxicity, personalization of therapy, and targeting novel pathways. PMID:27542647

  18. Necrotizing Soft Tissue Infections: Surgeon's Prospective

    PubMed Central

    Mishra, Shashi Prakash; Gupta, Sanjeev Kumar

    2013-01-01

    Necrotizing soft tissue infections (NSTIs) are fulminant infections of any layer of the soft tissue compartment associated with widespread necrosis and systemic toxicity. Delay in diagnosing and treating these infections increases the risk of mortality. Early and aggressive surgical debridement with support for the failing organs significantly improves the survival. Although there are different forms of NSTIs like Fournier's gangrene or clostridial myonecrosis, the most important fact is that they share common pathophysiology and principles of treatment. The current paper summarizes the pathophysiology, clinical features, the diagnostic workup required and the treatment principles to manage these cases. PMID:24455410

  19. Soft tissue tumors of the sinonasal tract.

    PubMed

    Johncilla, Melanie; Jo, Vickie Y

    2016-03-01

    Primary soft tissue tumors arising in the sinonasal tract are rare. While many mesenchymal neoplasms have been reported in the nasal cavity, sinuses, and nasopharynx, few are distinctive to this anatomic region. Some tumor types are relatively more common in this area, such as schwannoma and rhabdomyosarcoma. Nasopharyngeal angiofibroma and sinonasal hemangiopericytoma are unique entities of the sinonasal tract, as well as the recently characterized biphenotypic sinonasal sarcoma. This review discusses the clinical, morphologic, and immunohistochemical features and currently known molecular data of the more frequently encountered soft tissue tumors of the sinonasal tract. PMID:26472693

  20. CCI-779 in Treating Patients With Soft Tissue Sarcoma or Gastrointestinal Stromal Tumor

    ClinicalTrials.gov

    2013-06-03

    Gastrointestinal Stromal Tumor; Recurrent Adult 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

  1. Soft tissue differentiation by diffuse reflectance spectroscopy

    NASA Astrophysics Data System (ADS)

    Zam, Azhar; Stelzle, Florian; Nkenke, Emeka; Tangermann-Gerk, Katja; Schmidt, Michael; Adler, Werner; Douplik, Alexandre

    2009-07-01

    Laser surgery gives the possibility to work remotely which leads to high precision, little trauma and high level sterility. However these advantages are coming with the lack of haptic feedback during the laser ablation of tissue. Therefore additional means are required to control tissue-specific ablation during laser surgery supporting the surgeon regardless of experience and skills. Diffuse Reflectance Spectroscopy provides a straightforward and simple approach for optical tissue differentiation. We measured diffuse reflectance from four various tissue types ex vivo. We applied Linear Discriminant Analysis (LDA) to differentiate the four tissue types and computed the area under the ROC curve (AUC). Special emphasis was taken on the identification of nerve as the most crucial tissue for maxillofacial surgery. The results show a promise for differentiating soft tissues as guidance for tissue-specific laser surgery by means of the diffuse reflectance.

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

    PubMed

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

    2015-09-01

    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. PMID:26056727

  3. Equine Model for Soft Tissue Regeneration

    PubMed Central

    Moreau, J.E.; Lo, T.; Quinn, K.P.; Fourligas, N.; Georgakoudi, I.; Leisk, G.G.; Mazan, M.; Thane, K.E.; Taeymans, O.; Hoffman, A.M.; Kaplan, D. L.; Kirker-Head, C.A.

    2016-01-01

    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 six 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. PMID:25350377

  4. Soft tissue calcification in chronic dialysis patients.

    PubMed Central

    Kuzela, D. C.; Huffer, W. E.; Conger, J. D.; Winter, S. D.; Hammond, W. S.

    1977-01-01

    Autopsy protocols and microscopic slides of 56 dialyzed and 18 nondialyzed chronically uremic patients were reviewed to assess the presence, extent, and severity of extraosseous soft tissue calcification. Calcification was identified in 79% of the dialysis patients and 44% of the nondialysis patients (P iss less than .025). Soft tissue calcification most frequently involved the heart, lungs, stomach, and kidneys. Lesions were severe in 36% of the dialysis patients and, when strategically located within the myocardium, were life-threatening. The deaths of 6 dialysis patients were attributed to severe calcification of the cardiac conduction system and/or myocardium. The presence and severity of soft tissue calcification was not related to duration of dialysis, patients' age, degree of parathyroid gland hyperplasia, radiographic evidence of soft tissue calcification, serum calcium and phosphate levels, Ca X P products, or type or severity of metabolic bone disease. Images Figure 7 Figure 8 Figure 9 Figure 10 Figure 1 Figure 2 Figure 11 Figure 12 Figure 3 Figure 4 Figure 5 Figure 6 PMID:836675

  5. Molecular Genetics of Pediatric Soft Tissue Tumors

    PubMed Central

    Chang, Chung-Che; Shidham, Vinod B.

    2003-01-01

    The application of molecular genetics to pediatric soft tissue tumors has grown tremendously over the last decade. It has resulted in the identification of novel genes that have provided us with an increased understanding of oncogenesis. Furthermore, these findings have identified diagnostic and potentially prognostic factors for patient management. Molecular diagnostic techniques, such as reverse transcription PCR (RT-PCR) and fluorescence in situ hybridization (FISH), have become important tools for evaluating pediatric soft tissue tumors. By detecting characteristic fusion genes, these techniques have greatly increased the diagnostic accuracy of histopathological classification. One of the exciting promises of the development of these molecular techniques is their ability to detect micrometastasis and minimal residual disease. Monitoring of minimal residual disease in pediatric soft tissue tumors by quantitative RT-PCR may provide important prognostic information. Furthermore, the potential development of targeted therapy based on the understanding of the molecular pathology of a specific soft tissue tumor may complement existing treatments and improve disease outcome. PMID:12876204

  6. Lasers in soft tissue dental surgery

    NASA Astrophysics Data System (ADS)

    Pick, Robert M.

    1990-06-01

    In the field of periodontics and oral surgery, the laser is a relatively new, but rapidly emerging, surgical tool. In the new area of soft tissue surgery, i.e., benign lesion and growths, the laser can completely replace the scalpel and offer the periodontist and the oral and maxillofacial surgeon a new and exciting alternative.

  7. Multiscale mechanical modeling of soft biological tissues

    NASA Astrophysics Data System (ADS)

    Stylianopoulos, Triantafyllos

    2008-10-01

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

  8. Soft Tissue Tumours of the Retroperitoneum

    PubMed Central

    Van Roggen, J. Frans Graadt

    2000-01-01

    Purpose. This review summarizes the more prevalent soft tissue tumours arising in the retroperitoneum and highlights some recent fundamental and diagnostic developments relevant to mesenchymal tumours. Discussion. The retroperitoneum is an underestimated site for benign and malignant neoplastic disease, and represents the second most common site of origin of primary malignant soft tissue tumours (sarcomas) after the deep tissues of the lower extremity. In contrast to the predominance of benign soft tissue lesions over malignant sarcomas elsewhere, retroperitoneal mesenchymal lesions are far more likely to be malignant. The differential diagnosis is primarily with the more common lymphoproliferative and parenchymatous epithelial lesions arising in this area, and with metastatic disease from known or unknown primary sites elsewhere.The most prevalent mesenchymal tumours at this site are of a lipomatous, myogenic or neural nature.Their generally late clinical presentation and poorly accessible location provides numerous clinical challenges; optimal radiological imaging and a properly performed biopsy are essential cogs in the management route. Histopathological diagnosis may be complicated, but has been aided by developments in the fields of immunohistochemistry and tumour (cyto)genetics. Despite significant advances in oncological management protocols, the prognosis remains generally less favourable than for similar tumours at more accessible sites. PMID:18521430

  9. Supervised autonomous robotic soft tissue surgery.

    PubMed

    Shademan, Azad; Decker, Ryan S; Opfermann, Justin D; Leonard, Simon; Krieger, Axel; Kim, Peter C W

    2016-05-01

    The current paradigm of robot-assisted surgeries (RASs) depends entirely on an individual surgeon's manual capability. Autonomous robotic surgery-removing the surgeon's hands-promises enhanced efficacy, safety, and improved access to optimized surgical techniques. Surgeries involving soft tissue have not been performed autonomously because of technological limitations, including lack of vision systems that can distinguish and track the target tissues in dynamic surgical environments and lack of intelligent algorithms that can execute complex surgical tasks. We demonstrate in vivo supervised autonomous soft tissue surgery in an open surgical setting, enabled by a plenoptic three-dimensional and near-infrared fluorescent (NIRF) imaging system and an autonomous suturing algorithm. Inspired by the best human surgical practices, a computer program generates a plan to complete complex surgical tasks on deformable soft tissue, such as suturing and intestinal anastomosis. We compared metrics of anastomosis-including the consistency of suturing informed by the average suture spacing, the pressure at which the anastomosis leaked, the number of mistakes that required removing the needle from the tissue, completion time, and lumen reduction in intestinal anastomoses-between our supervised autonomous system, manual laparoscopic surgery, and clinically used RAS approaches. Despite dynamic scene changes and tissue movement during surgery, we demonstrate that the outcome of supervised autonomous procedures is superior to surgery performed by expert surgeons and RAS techniques in ex vivo porcine tissues and in living pigs. These results demonstrate the potential for autonomous robots to improve the efficacy, consistency, functional outcome, and accessibility of surgical techniques. PMID:27147588

  10. Radiation May Help After Surgery for 'Soft-Tissue' Cancers

    MedlinePlus

    ... nlm.nih.gov/medlineplus/news/fullstory_158322.html Radiation May Help After Surgery for 'Soft-Tissue' Cancers ... called soft-tissue sarcomas may benefit more from radiation therapy after surgery than younger patients do, a ...

  11. What's New in Soft Tissue Sarcomas Research and Treatment?

    MedlinePlus

    ... Topic Additional resources for soft tissue sarcoma What`s new in soft tissue sarcoma research and treatment? Research ... develop. This information is already being applied to new tests to diagnose and classify sarcomas. This is ...

  12. What Are the Key Statistics about Soft Tissue Sarcoma?

    MedlinePlus

    ... for soft tissue sarcomas? What are the key statistics about soft tissue sarcomas? The American Cancer Society's ... in the United States for 2016 are (these statistics include both adults and children): About 12,310 ...

  13. Physical Agents for Soft Tissue Injury.

    PubMed

    2016-07-01

    The clinical management of soft tissue injuries of the lower limb commonly includes physical agents such as electrotherapy or ultrasound. However, the evidence about the effectiveness of physical agents varies, and their use remains controversial. A systematic review of randomized clinical trials (RCTs), published in the July 2016 issue of JOSPT, examined the benefits and safety risks of various physical agents for soft tissue injuries of the lower limb. Importantly, the review looked closely at the quality of the RCTs and focused on studies with low risk of bias. In this Perspectives for Practice, the authors explain the impact of their findings for clinicians treating patients with such musculoskeletal conditions. J Orthop Sports Phys Ther 2016;46(7):555. doi:10.2519/jospt.2016.0503. PMID:27363571

  14. Soft tissue sarcoma of the extremity.

    PubMed Central

    Cooper, T. M.; Sheehan, M.; Collins, D.; O'Connor, T. P.

    1996-01-01

    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. PMID:8881731

  15. Fetal soft tissue examinations by microdissection.

    PubMed

    Leroy, Mariline; Jocteur-Monrozier, Audrey

    2013-01-01

    This chapter describes methods for the examination of fetal abdominal and thoracic soft tissues by microdissection on either fresh (non-rodent) or fixed (rodent) specimens in order to detect structural abnormalities. With hundreds of fetuses examined for each species (rodent and non-rodent) in regulatory reproductive toxicity assessments (ICH, http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/Multidisciplinary/M3_R2/Step4/M3_R2__Guideline.pdf, 2009; ICH, http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/Safety/S5_R2/Step4/S5_R2__Guideline.pdf, 2005), microdissection techniques allow a thorough and relatively rapid examination of fetuses for soft tissue abnormalities. PMID:23138910

  16. Biopsy of soft-tissue tumors.

    PubMed

    Shives, T C

    1993-04-01

    Biopsy is an integral part of the overall management of patients with soft-tissue sarcoma. The types of biopsy are fine needle, trocar, open incision or en bloc excision. There are advantages and disadvantages of each. Open biopsy requires strict adherence to a number of surgical principles. Proper execution requires determination of appropriate biopsy site, meticulous technique, and close collaboration with an experienced pathologist. Failure to adhere to these principles may result in untoward consequences for patients. PMID:8472430

  17. Fibre-Matrix Interaction in Soft Tissue

    SciTech Connect

    Guo, Zaoyang

    2010-05-21

    Although the mechanical behaviour of soft tissue has been extensively studied, the interaction between the collagen fibres and the ground matrix has not been well understood and is therefore ignored by most constitutive models of soft tissue. In this paper, the human annulus fibrosus is used as an example and the potential fibre-matrix interaction is identified by careful investigation of the experimental results of biaxial and uniaxial testing of the human annulus fibrosus. First, the uniaxial testing result of the HAF along the axial direction is analysed and it is shown that the mechanical behaviour of the ground matrix can be well simulated by the incompressible neo-Hookean model when the collagen fibres are all under contraction. If the collagen fibres are stretched, the response of the ground matrix can still be described by the incompressible neo-Hookean model, but the effective stiffness of the matrix depends on the fibre stretch ratio. This stiffness can be more than 10 times larger than the one obtained with collagen fibres under contraction. This phenomenon can only be explained by the fibre-matrix interaction. Furthermore, we find that the physical interpretation of this interaction includes the inhomogeneity of the soft tissue and the fibre orientation dispersion. The dependence of the tangent stiffness of the matrix on the first invariant of the deformation tensor can also be explained by the fibre orientation dispersion. The significant effect of the fibre-matrix interaction strain energy on mechanical behaviour of the soft tissue is also illustrated by comparing some simulation results.

  18. Imaging in Soft Tissue Sarcomas: Current Updates.

    PubMed

    Jagannathan, Jyothi P; Tirumani, Sree Harsha; Ramaiya, Nikhil H

    2016-10-01

    Soft tissue sarcomas (STS) are heterogeneous malignant tumors that have nonspecific imaging features. A combination of clinical, demographic, and imaging characteristics can aid in the diagnosis. Imaging provides important information regarding the tumor extent, pretreatment planning, and surveillance of patients with STS. In this article, we illustrate the pertinent imaging characteristics of the commonly occurring STS and some uncommon sarcomas with unique imaging characteristics. PMID:27591491

  19. Pulsed Laser Ablation of Soft Biological Tissues

    NASA Astrophysics Data System (ADS)

    Vogel, Alfred; Venugopalan, Vasan

    In this chapter we focus on the key elements that form our current understanding of the mechanisms of pulsed laser ablation of soft biological tissues. We present a conceptual framework providing mechanistic links between various ablation applications and the underlying thermodynamic and phase change processes [1]. We define pulsed laser ablation as the use of laser pulses with duration of ~1 ms or less for the incision or removal of tissue regardless of the photophysical or photochemical processes involved. However, we will confine this presentation to pulsed ablation performed on a tissue level that does not involve laser-induced plasma formation. Ablation processes within transparent tissues or cells resulting from non-linear absorption have been considered in reviews by Vogel and Venugopalan [1] and by Vogel and co-workers [2].

  20. The Genetics of Soft Connective Tissue Disorders.

    PubMed

    Vanakker, Olivier; Callewaert, Bert; Malfait, Fransiska; Coucke, Paul

    2015-01-01

    Over the last few years, the field of hereditary connective tissue disorders has changed tremendously. This review highlights exciting insights into three prototypic disorders affecting the soft connective tissue: Ehlers-Danlos syndrome, pseudoxanthoma elasticum, and cutis laxa. For each of these disorders, the identification and characterization of several novel but related conditions or subtypes have widened the phenotypic spectrum. In parallel, the vast underlying molecular network connecting these phenotypes is progressively being uncovered. Identification and characterization (both clinical and molecular) of new phenotypes within the connective tissue disorder spectrum are often key to further unraveling the pathways involved in connective tissue biology and delineating the clinical spectrum and pathophysiology of the disorders. Although difficult challenges remain, recent findings have expanded our pathophysiological understanding and may lead to targeted therapies in the near future. PMID:26002060

  1. Soft tissue cutting with ultrasonic mechanical waveguides

    NASA Astrophysics Data System (ADS)

    Wylie, Mark. P.; McGuinness, Garrett; Gavin, Graham P.

    2012-05-01

    The use of ultrasonic vibrations transmitted via small diameter wire waveguides represents a technology that has potential for minimally invasive procedures in surgery. This form of energy delivery results in distal tip mechanical vibrations with amplitudes of vibration of up to 50 μm and at frequencies between 20-50 kHz commonly reported. This energy can then be used by micro-cutting surgical tools and end effectors for a range of applications such as bone cutting, cement removal in joint revision surgery and soft tissue cutting. One particular application which has gained regulatory approval in recent years is in the area of cardiovascular surgery in the removal of calcified atherosclerotic plaques and chronic total occlusions. This paper builds on previous work that was focused on the ultrasonic perforation of soft vascular tissue using ultrasonically activated mechanical waveguides and the applied force required to initiate failure in soft tissue when compared with non-ultrasonic waveguides. An ultrasonic device and experimental rig was developed that can deliver ultrasonic vibrations to the distal tip of 1.0 mm diameter nickel-titanium waveguides. The operation of the ultrasonic device has been characterized at 22.5 kHz with achievable amplitudes of vibration in the range of 16 - 40μm. The experimental rig allows the ultrasonically activated waveguide to be advanced through a tissue sample over a range of feedrates and the waveguide-tissue interaction force can be measured during perforation into the tissue. Preliminary studies into the effects of feedrate on porcine aortic arterial tissue perforation forces are presented as part of this work. A range of amplitudes of vibration at the wire waveguide distal tip were examined. The resulting temperature increase when perforating artery wall when using the energized wire waveguides is also examined. Results show a clear multistage failure of the tissue. The first stage involves a rise in force up to some

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

    ClinicalTrials.gov

    2016-03-18

    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

  3. The fracture toughness of soft tissues.

    PubMed

    Taylor, David; O'Mara, Niamh; Ryan, Eoin; Takaza, Michael; Simms, Ciaran

    2012-02-01

    Fracture toughness is important for any material, but to date there have been few investigations of this mechanical property in soft mammalian tissues. This paper presents new data on porcine muscle tissue and a detailed analysis of all previous work. The conclusion is that, in most cases, fracture toughness has not in fact been measured for these tissues. Reanalysis of the previous work shows that failure of the test specimens generally occurred at the material's ultimate strength, implying that no information about toughness can be obtained from the results. This finding applied to work on cartilage, artificial neocartilage, muscle and the TMJ disc. Our own data, which was also found to be invalid, gave measured fracture toughness values which were highly variable and showed a strong dependence on the crack growth increment. The net-section failure stress and failure energy were relatively constant in large specimens, independent of crack length, whilst for smaller specimens they showed a strong size effect. These findings are explained by the fact that the process zone size, estimated here using the critical distance parameter L, was similar to, or larger than, critical specimen dimensions (crack length and specimen width). Whilst this analysis casts doubt on much of the published literature, a useful finding is that soft tissues are highly tolerant of defects, able to withstand the presence of cracks several millimetres in length without significant loss of strength. PMID:22301183

  4. Studying Genes in Tissue Samples From Younger and Adolescent Patients With Soft Tissue Sarcomas

    ClinicalTrials.gov

    2016-05-13

    Childhood Alveolar Soft-part Sarcoma; Childhood Angiosarcoma; Childhood Desmoplastic Small Round Cell Tumor; Childhood Epithelioid Sarcoma; Childhood Fibrosarcoma; Childhood Leiomyosarcoma; Childhood Liposarcoma; Childhood Malignant Mesenchymoma; Childhood Neurofibrosarcoma; Childhood Synovial Sarcoma; Chordoma; Desmoid Tumor; Metastatic Childhood Soft Tissue Sarcoma; Nonmetastatic Childhood Soft Tissue Sarcoma; Recurrent Childhood Soft Tissue Sarcoma

  5. Nasal soft tissue trauma and management.

    PubMed

    Immerman, Sara; Constantinides, Minas; Pribitkin, Edmund A; White, W Matthew

    2010-12-01

    The nose is the most prominent of all facial structures and is susceptible to many types of trauma. All soft tissue injuries of the nose have the potential to distort its appearance and adversely affect the patient's self-image and self-esteem. Once life-threatening injuries are stabilized, a careful history and physical exam should be completed and treatment individualized. The ultimate objective of treatment is to achieve both functional and cosmetic restoration with timely diagnosis and repair. Immediate nasal reconstruction is ideal when medically possible because this decreases long-term sequelae. PMID:21086240

  6. Bone and Soft Tissue Pathology: Diagnostic and Prognostic Implications.

    PubMed

    Gibbs, Julie; Henderson-Jackson, Evita; Bui, Marilyn M

    2016-10-01

    Soft tissue and bone tumors are a heterogeneous group of tumors most often classified according to the type of tissue they most closely histologically resemble. Although sarcomas are rare, greater than 100 histologic subtypes of benign and malignant soft tissue and bone tumors are currently recognized. In this article, the authors review the current pathologic definitions, the classification and grading systems, supportive ancillary techniques, and the prognostic implications for some of the more common soft tissue and bone tumors. PMID:27542635

  7. Nonlinear noise waves in soft biological tissues

    NASA Astrophysics Data System (ADS)

    Rudenko, O. V.; Gurbatov, S. N.; Demin, I. Yu.

    2013-09-01

    The study of intense waves in soft biological tissues is necessary both for diagnostics and therapeutic aims. Tissue represents an inherited medium with frequency-dependent dissipative properties, in which waves are described by nonlinear integro-differential equations. The equations for such waves are well known. Their group analysis has been performed, and a number of exact solutions have been found. However, statistical problems for nonlinear waves in tissues have hardly been studied. As well, for medical applications, both intense noise waves and waves with fluctuating parameters can be used. In addition, statistical solutions are simpler in structure than regular solutions; they are useful for understanding the physics of processes. Below a general approach is described for solving nonlinear statistical problems applied to the considered mathematical models of biological tissues. We have calculated the dependences of the intensities of the narrowband noise harmonics on distance. For wideband noise, we have calculated the dependence of the spectral integral intensity on distance. In all cases, wave attenuation is determined both by the specific dissipative properties of the tissue and the nonlinearity of the medium.

  8. Longitudinal nonlinear wave propagation through soft tissue.

    PubMed

    Valdez, M; Balachandran, B

    2013-04-01

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

  9. Soft Tissue Injections in the Athlete

    PubMed Central

    Nepple, Jeffrey J.; Matava, Matthew J.

    2009-01-01

    Background: Injections into or adjacent to soft tissue structures, including muscle, tendon, bursa, and fascia, for pain relief and an earlier return to play have become common in the field of sports medicine. Study Design: Clinical review. Results: Corticosteroids, local anesthetics, and ketorolac tromethamine (Toradol) are the most commonly used injectable agents in athletes. The use of these injectable agents have proven efficacy in some disorders, whereas the clinical benefit for others remain questionable. All soft tissue injections performed for pain control and/or an anti-inflammatory effect have potentially serious side effects, which must be considered, especially in the pregame setting. Conclusions: The primary concern regarding corticosteroid and local anesthetic injections is an increased risk of tendon rupture associated with the direct injection into the tendon. Intramuscular Toradol injections provide significant analgesia, as well as an anti-inflammatory effect via its inhibitory effect on the cyclooxygenase pathway. The risk of bleeding associated with Toradol use is recognized but not accurately quantified. PMID:23015899

  10. Vascular Compromise from Soft Tissue Augmentation

    PubMed Central

    Humphrey, Shannon; Carruthers, Jean D.A.; Carruthers, Alastair

    2014-01-01

    The popularity of soft tissue fillers is, in part, due to their favorable side-effect profile. However, serious complications can occur. The authors describe their extensive clinical experience with soft-tissue augmentation and the rare complication of vascular compromise, which can lead to necrosis and scarring. Over a 10-year period between January 2003 and January 2013, the authors observed a total of 12 cases of vascular compromise. Eight patients in their clinical practice showed evidence of vascular compromise out of a total of 14,355 filler injections (0.05%). In addition, four patients treated with an experimental particulate filler had vascular complications. All cases were examined for filler type, location of complication, risk factors, treatment, and outcomes. Although treatment plans differed for each patient in their series, all cases of vascular compromise resolved fully. The authors believe that an office-based protocol for both immediate and ongoing care—including a thorough individualized assessment and treatment plan for each patient—is critical to timely and effective resolution of side effects. They propose key recommendations for the prevention and management of vascular compromise to improve patient outcomes and reduce the risk of permanent complications. PMID:25276276

  11. Pericyte Antigens in Perivascular Soft Tissue Tumors

    PubMed Central

    Shen, Jia; Shrestha, Swati; Yen, Yu-Hsin; Asatrian, Greg; Mravic, Marco; Soo, Chia; Ting, Kang; Dry, Sarah M.; Peault, Bruno; James, Aaron W.

    2015-01-01

    Introduction Perivascular soft tissue tumors are relatively uncommon neoplasms of unclear line of differentiation, although most are presumed to originate from pericytes or modified perivascular cells. Among these, glomus tumor, myopericytoma, and angioleiomyoma share a spectrum of histologic findings and a perivascular growth pattern. In contrast, solitary fibrous tumor (previously termed hemangiopericytoma) was once hypothesized to have pericytic differentiation. Methods Here, we systematically examine pericyte immunohistochemical markers among glomus tumor (including malignant glomus tumor), myopericytoma, angioleiomyoma, and solitary fibrous tumor. Immunohistochemical staining and semiquantification was performed using well-defined pericyte antigens, including αSMA, CD146, and PDGFRβ. Results Glomus tumor and myopericytoma demonstrate diffuse staining for all pericyte markers, including immunohistochemical reactivity for αSMA, CD146, and PDGFRβ. Malignant glomus tumors all showed some degree of pericyte marker immunoreactivity, although it was significantly reduced. Angioleiomyoma shared a similar αSMA + CD146 + PDGFRβ+ immunophenotype; however, this was predominantly seen in the areas of perivascular tumor growth. Solitary fibrous tumors showed patchy PDGFRβ immunoreactivity only. Discussion In summary, pericyte marker expression is a ubiquitous finding in glomus tumor, myopericytoma, and angioleiomyoma. Malignant glomus tumor shows a comparative reduction in pericyte marker expression, which may represent partial loss of pericytic differentiation. Pericyte markers are essentially not seen in solitary fibrous tumor. The combination of αSMA, CD146, and PDGFRβ immunohistochemical stainings may be of utility for the evaluation of pericytic differentiation in soft tissue tumors. PMID:26085647

  12. Metachronous Bilateral Extremity Soft Tissue Sarcomas

    PubMed Central

    Nowrasteh, Ghodratollah; Aziz, Tanim; Assas, Mohammed Al; Nuaimi, Lateefa Al; Marzouqi, Saeeda; Quadri, Asif A.M.; Alrawi, Sadir

    2016-01-01

    Case series Patient: Male, 44 • Male, 58 Final Diagnosis: Soft tissue sarcomas Symptoms: Discomfort • swelling Medication: — Clinical Procedure: Image guided biopsy • metastatic work up • neoadjuvant radiotherapy • radical resection Specialty: Surgery Objective: Rare disease Background: Soft tissue sarcomas (STS) account for approximately 1% of adult malignancies, with 50 to 60% occurring in the extremities. Liposarcoma is the most common type of STS and represent about 20% of total adult sarcomas. There are rare syndromes associated with increased risk of developing STS. Further, chemical compounds such as chlorinated phenols and a few chemotherapeutic drugs have been linked to STS, along with ionizing radiation. Nevertheless, the etiology is uncertain for most of these lesions. Case Report: This report details 2 cases of metachronous bilateral STS of the lower extremities. The first of these presented as a local recurrence of a previously resected right thigh liposarcoma and a new liposarcoma in the left thigh. As mentioned above, among the different subtypes of STS, liposarcoma has the highest tendency for multifocality. The second patient had multifocal metachronous leiomyosarcoma with lung metastases occurring simultaneously with the second presentation. Leiomyosarcoma is another subtype reported to present with multi-focal disease. Conclusions: Despite the rarity of bilateral lesions, their occurrence should not be overlooked in the initial diagnosis and follow-up of the initially detected tumor. Early detection can affect patient survival because their presence predicts unfavorable outcomes. PMID:26744032

  13. Multidisciplinary Management of Soft Tissue Sarcoma

    PubMed Central

    Nystrom, Lukas M.; Reimer, Nickolas B.; Reith, John D.; Dang, Long; Zlotecki, Robert A.; Scarborough, Mark T.; Gibbs, C. Parker

    2013-01-01

    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. PMID:23983648

  14. Current management of pediatric soft tissue sarcomas.

    PubMed

    Sangkhathat, Surasak

    2015-11-01

    Pediatric soft tissue sarcomas are a group of malignant neoplasms arising within embryonic mesenchymal tissues during the process of differentiation into muscle, fascia and fat. The tumors have a biphasic peak for age of incidence. Rhabdomyosarcoma (RMS) is diagnosed more frequently in younger children, whereas adult-type non-RMS soft tissue sarcoma is predominately observed in adolescents. The latter group comprises a variety of rare tumors for which diagnosis can be difficult and typically requires special studies, including immunohistochemistry and molecular genetic analysis. Current management for the majority of pediatric sarcomas is based on the data from large multi-institutional trials, which has led to great improvements in outcomes over recent decades. Although surgery remains the mainstay of treatment, the curative aim cannot be achieved without adjuvant treatment. Pre-treatment staging and risk classification are of prime importance in selecting an effective treatment protocol. Tumor resectability, the response to induction chemotherapy, and radiation generally determine the risk-group, and these factors are functions of tumor site, size and biology. Surgery provides the best choice of local control of small resectable tumors in a favorable site. Radiation therapy is added when surgery leaves residual disease or there is evidence of regional spread. Chemotherapy aims to reduce the risk of relapse and improve overall survival. In addition, upfront chemotherapy reduces the aggressiveness of the required surgery and helps preserve organ function in a number of cases. Long-term survival in low-risk sarcomas is feasible, and the intensity of treatment can be reduced. In high-risk sarcoma, current research is allowing more effective disease control. PMID:26566481

  15. Current management of pediatric soft tissue sarcomas

    PubMed Central

    Sangkhathat, Surasak

    2015-01-01

    Pediatric soft tissue sarcomas are a group of malignant neoplasms arising within embryonic mesenchymal tissues during the process of differentiation into muscle, fascia and fat. The tumors have a biphasic peak for age of incidence. Rhabdomyosarcoma (RMS) is diagnosed more frequently in younger children, whereas adult-type non-RMS soft tissue sarcoma is predominately observed in adolescents. The latter group comprises a variety of rare tumors for which diagnosis can be difficult and typically requires special studies, including immunohistochemistry and molecular genetic analysis. Current management for the majority of pediatric sarcomas is based on the data from large multi-institutional trials, which has led to great improvements in outcomes over recent decades. Although surgery remains the mainstay of treatment, the curative aim cannot be achieved without adjuvant treatment. Pre-treatment staging and risk classification are of prime importance in selecting an effective treatment protocol. Tumor resectability, the response to induction chemotherapy, and radiation generally determine the risk-group, and these factors are functions of tumor site, size and biology. Surgery provides the best choice of local control of small resectable tumors in a favorable site. Radiation therapy is added when surgery leaves residual disease or there is evidence of regional spread. Chemotherapy aims to reduce the risk of relapse and improve overall survival. In addition, upfront chemotherapy reduces the aggressiveness of the required surgery and helps preserve organ function in a number of cases. Long-term survival in low-risk sarcomas is feasible, and the intensity of treatment can be reduced. In high-risk sarcoma, current research is allowing more effective disease control. PMID:26566481

  16. Soft tissue modelling through autowaves for surgery simulation.

    PubMed

    Zhong, Yongmin; Shirinzadeh, Bijan; Alici, Gursel; Smith, Julian

    2006-09-01

    Modelling of soft tissue deformation is of great importance to virtual reality based surgery simulation. This paper presents a new methodology for simulation of soft tissue deformation by drawing an analogy between autowaves and soft tissue deformation. The potential energy stored in a soft tissue as a result of a deformation caused by an external force is propagated among mass points of the soft tissue by non-linear autowaves. The novelty of the methodology is that (i) autowave techniques are established to describe the potential energy distribution of a deformation for extrapolating internal forces, and (ii) non-linear materials are modelled with non-linear autowaves other than geometric non-linearity. Integration with a haptic device has been achieved to simulate soft tissue deformation with force feedback. The proposed methodology not only deals with large-range deformations, but also accommodates isotropic, anisotropic and inhomogeneous materials by simply changing diffusion coefficients. PMID:16960747

  17. Peri-implant soft tissue management: Where are we?

    PubMed

    Bhatavadekar, Neel

    2012-10-01

    Dental implants have evolved dramatically over the last decade, and so have our expectations from them in terms of functional and esthetic criteria. The maintenance and augmentation of the soft tissue has emerged as an area of concern and focus. The triad of anatomical peri-implant characteristics, soft tissue response to the implant material, and clinical skill form the fundamental principles in augmenting soft tissue. However, as clinicians, where are we with regards to the ability to augment and maintain soft tissue around dental implants, about 40 years after the first implants were placed? We now understand that peri-implant soft tissue management begins with extraction management. Our treatment modalities have evolved from socket compression post-extraction, to socket preservation with an aim to enhance the eventual peri-implant soft tissue. This short communication will assess the evolution of our thought regarding peri-implant soft tissue management, augmentation of keratinized mucosa around implants, and also look at some recent techniques including the rotated pedicle connective tissue graft for enhancing inter-implant papilla architecture. With newer research modalities, such as cyto-detachment technology, and cutting-edge bioengineering solutions (possibly a soft-tissue-implant construct) which might be available in the near future for enhancing soft tissue, we are certainly in an exciting era in dentistry. PMID:23493178

  18. Role of soft tissues in metacarpal fracture fixation.

    PubMed

    Ouellette, Elizabeth Anne; Dennis, Jay J; Milne, Edward L; Latta, Loren L; Makowski, Anna-Lena

    2003-07-01

    The contribution of soft tissues in stabilizing fracture fixation in metacarpals is appreciated clinically, but no quantitative biomechanical study of their role has been done. All previous studies of fracture fixation in vitro have been done on metacarpals denuded of soft tissues. To quantify the role of soft tissues in metacarpal fracture fixation, the biomechanical effectiveness of four fixation devices was examined in human cadaver metacarpals with and without soft tissues. Values were compared for three nonrigid methods (expandable intramedullary fixation devices, crossed Kirschner wires, and single half-pin frames) and one rigid method (dorsal plates) in 45 disarticulated metacarpals stripped of soft tissues (denuded) and in 46 metacarpals in whole hands with all soft tissues remaining (intact). Mechanical testing to complete failure in three-point apex dorsal bending was done in all specimens. Ultimate moment (strength) of each of the four fixation methods was significantly greater in intact specimens than in denuded specimens. Crossed Kirschner wires were most stable in intact specimens, and dorsal plates were more stable in denuded specimens. The results show that soft tissues contribute to the strength of fracture fixation. Clinically, surgeons may be able to use a less invasive fixation method than plating without compromising the strength of metacarpal fixation in patients whose soft tissues are not severely disrupted and the fracture configuration allows. Plating may offer optimum stability in patients whose soft tissues are damaged severely and provide less strengthening of the fracture construct. PMID:12838068

  19. Contemporary Management of Retroperitoneal Soft Tissue Sarcomas.

    PubMed

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

    2015-08-01

    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. PMID:26092408

  20. [Grading of soft tissue and bone sarcomas].

    PubMed

    Petersen, I; Wardelmann, E

    2016-07-01

    Malignancy grading is an essential element in the classification of sarcomas. It correlates with the prognosis of the disease and the risk of metastasis. This article presents the grading schemes for soft tissue, bone and pediatric sarcomas. It summarizes the histological criteria of the Federation Nationale des Centres de Lutte Contre le Cancer (FNCLCC) system and the Pediatric Oncology Group as well as the grading of bone tumors by the College of American Pathologists (CAP). Furthermore, the potential relevance of gene expression signatures, the complexity index in sarcoma (CINSARC) and single genetic alterations (p53, MDM2, p16, SWI/SNF, EWSR1 fusions and PAX3/PAX7-FOXO1 fusions) for the prognosis of sarcomas are discussed. PMID:27384333

  1. Completely extruded talus without soft tissue attachments.

    PubMed

    Choi, Young Rak; Jeong, Jae Jung; Lee, Ho Seong; Kim, Sang Woo; Suh, Jin-Soo

    2011-03-29

    A completely extruded talus without any remaining soft tissue attachments is extremely rare. The present report describes treatment of a 45-year-old man who sustained a completely extruded talus injury following a rock-climbing fall. Upon admission, the extruded talus was deep-frozen in our bone bank. The open ankle joint underwent massive wound debridement and irrigation for 3 days. Four days later we performed a primary subtalar fusion between the extruded talus and the calcaneus, anticipating revascularization from the calcaneus. However, aseptic loosening and osteolysis developed around the screw and talus. At 12 months post-trauma we performed a tibiocalcaneal ankle fusion with a femoral head allograft to fill the talar defect. Follow-up at 24 months post-trauma showed the patient had midfoot motion, tibio-talar-calcaneal fusion, and was able partake in 4-hour physical activity twice per week. PMID:24765266

  2. Fibroblast involvement in soft connective tissue calcification

    PubMed Central

    Ronchetti, Ivonne; Boraldi, Federica; Annovi, Giulia; Cianciulli, Paolo; Quaglino, Daniela

    2013-01-01

    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 pseudoxanthoma elasticum (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 fibers 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. PMID:23467434

  3. Retroperitoneal Castleman's disease mimicking soft tissue tumour.

    PubMed

    Pandya, B; Ghosh, S K; Chude, G; Rajmohan, M V; Narang, R

    2007-08-01

    Castleman's disease is a type of non-neoplastic lymphoproliferative disease having lymph nodal hyperplasia. It has two distinct microscopic types: hyaline-vascular type and plasma cell type. Clinically, it may present either as a solitary mass, most commonly in the mediastinum, or as a multicentric form whose features are generalized lymph-adenopathy, splenomegaly and involvement of other organs like the lungs and kidneys. Here we report a case of isolated retroperitoneal Castleman's disease, which presented as a lump in the iliac fossa in a young female. A clinico-radio-logical diagnosis of retroperitoneal soft tissue tumour was made and the patient underwent complete surgical excision. The exact diagnosis was only obtained at histopathology and there is no evidence of recurrence at six months follow-up. PMID:23132970

  4. Sarcomas of Soft Tissue and Bone.

    PubMed

    Ferrari, Andrea; Dirksen, Uta; Bielack, Stefan

    2016-01-01

    The definition of soft tissue and bone sarcomas include a large group of several heterogeneous subtypes of mesenchymal origin that may occur at any age. Among the different sarcomas, rhabdomyosarcoma, synovial sarcoma, Ewing sarcoma and osteosarcoma are aggressive high-grade malignancies that often arise in adolescents and young adults. Managing these malignancies in patients in this age bracket poses various clinical problems, also because different therapeutic approaches are sometimes adopted by pediatric and adult oncologists, even though they are dealing with the same condition. Cooperation between pediatric oncologists and adult medical oncologists is a key step in order to assure the best treatment to these patients, preferably through their inclusion into international clinical trials. PMID:27595362

  5. CT of soft-tissue neoplasms

    SciTech Connect

    Weekes, R.G.; McLeod, R.A.; Reiman, H.M.; Pritchard, D.J.

    1985-02-01

    The computed tomographic scans (CT) of 84 patients with untreated soft-tissue neoplasms were studied, 75 with primary and nine with secondary lesions. Each scan was evaluated using several criteria: homogeneity and density, presence and type of calcification, presence of bony destruction, involvement of multiple muscle groups, definition of adjacent fat, border definition, and vessel or nerve involvement. CT demonstrated the lesion in all 84 patients and showed excellent anatomic detail in 64 of the 75 patients with primary neoplasms. The CT findings were characteristic enough to suggest the histology of the neoplasm in only 13 lesions (nine lipomas, three hemangiomas, one neurofibroma). No malignant neoplasm had CT characteristics specific enough to differentiate it from any other malignant tumor. However, malignant neoplasms could be differentiated from benign neoplasms in 88% of the cases.

  6. Reconstruction of periorbital soft tissue defects.

    PubMed

    Berli, Jens U; Merbs, Shannath L; Grant, Michael P

    2014-10-01

    Because of the complex anatomy and fine mechanics of the periorbital soft tissues, the reconstruction of this region can be particularly daunting. Through a structured assessment of the defect, based on subunit analysis and thorough understanding of the surgical layers, we believe to allow the reconstructive surgeon to develop an algorithmic approach to these complex problems. The sequela of a suboptimal reconstruction do not only result in an inferior aesthetic result, but also have the potential for long-term functional problems such as epiphora, dry eye, ptosis, eyelid retraction, and thus requiring secondary surgery. There is no better time to aim for a perfect reconstruction than at the time of the initial surgery. In this chapter, we hope to encourage the reader to strengthen and recapitulate these analytical skills and present the most commonly used and studied techniques to help achieve a reproducible functional and aesthetically appealing result. PMID:25397712

  7. Soft tissue sarcoma and occupational exposures

    SciTech Connect

    Wingren, G.; Fredrikson, M.; Brage, H.N.; Nordenskjoeld, B.A.; Axelson, O. )

    1990-08-15

    The associations between soft tissue sarcoma (STS) and occupational exposures were studied in a case-referent study in the southeast of Sweden. Exposure information was obtained through mailed questionnaires to 96 cases, 450 randomly selected population referents, and 200 cancer referents. Odds ratios (OR), were calculated for various occupational groups, and particularly, for occupations with potential exposure to chlorinated phenoxy herbicides and chlorophenols. In the analyses based on population referents, increased risks for soft tissue sarcoma were seen for especially gardeners (OR = 4.1), but also railroad workers (OR = 3.1); construction workers with exposure to impregnating agents (OR = 2.3), asbestos (OR = 1.8), or pressure impregnating agents (OR = 1.7); and unspecified chemical workers with potential exposure to phenoxy herbicides and/or chlorophenols (OR = 1.6). A similar pattern appeared when cancer referents were used although the numerical values of the odds ratios became different. A grouping of jobs resulted in Mantel-Haensel OR from 1.5 to 1.9 for farmers and forestry workers, dependent on referents used and even more increased OR for railroad workers and unspecified chemical workers with potential exposure to phenoxy herbicides and chlorophenols. The results of the study confirm rather than refute that phenoxy herbicides and chlorophenols could be of etiologic importance for STS; the high risk for gardeners, although based on a small number of individuals, was unexpected and remains unclear. Also, since other cancers were used as referents, no definite problems of recall bias should obtain in this material. None of the exposed groups had a higher proportion of smokers than the unexposed group.

  8. Age determination of soft tissue hematomas.

    PubMed

    Neumayer, Bernhard; Hassler, Eva; Petrovic, Andreas; Widek, Thomas; Ogris, Kathrin; Scheurer, Eva

    2014-11-01

    In clinical forensic medicine, the estimation of the age of injuries such as externally visible subcutaneous hematomas is important for the reconstruction of violent events, particularly to include or exclude potential suspects. Since the estimation of the time of origin based on external inspection is unreliable, the aim of this study was to use contrast in MRI to develop an easy-to-use model for hematoma age estimation. In a longitudinal study, artificially created subcutaneous hematomas were repetitively imaged using MRI over a period of two weeks. The hemorrhages were created by injecting autologous blood into the subcutaneous tissue of the thigh in 20 healthy volunteers. For MRI, standard commercially available sequences, namely proton-density-weighted, T2 -weighted and inversion recovery sequences, were used. The hematomas' MRI data were analyzed regarding their contrast behavior using the most suitable sequences to derive a model allowing an objective estimation of the age of soft tissue hematomas. The Michelson contrast between hematoma and muscle in the proton-density-weighted sequence showed an exponentially decreasing behavior with a dynamic range of 0.6 and a maximum standard deviation of 0.1. The contrast of the inversion recovery sequences showed increasing characteristics and was hypointense for TI = 200ms and hyperintense for TI =1000ms. These sequences were used to create a contrast model. The cross-validation of the model finally yielded limits of agreement for hematoma age determination (corresponding to ±1.96 SD) of ±38.7h during the first three days and ±54 h for the entire investigation period. The developed model provides lookup tables which allow for the estimation of a hematoma's age given a single contrast measurement applicable by a radiologist or a forensic physician. This is a first step towards an accurate and objective dating method for subcutaneous hematomas, which will be particularly useful in child abuse. PMID:25208978

  9. Soft Tissue Augmentation with Silk Composite Graft

    PubMed Central

    Park, Yong-Tae; Kweon, Hae Yong; Kim, Seong-Gon

    2014-01-01

    Purpose: The objective of this study was to evaluate the interaction between 4-hexylresorcinol (4HR) and antibody as that affects the performance of a silk-4HR combination graft for soft tissue augmentation in an animal model. Methods: The silk graft materials consisted of four types: silk+10% tricalcium phosphate (TCP) (ST0), silk+10% TCP+1% 4HR (ST1), silk+10% TCP+3% 4HR (ST3), and silk+10% TCP+6% 4-HR (ST6). The antibody binding assay tested the 4HR effect and scanning electron microscopic (SEM) exam was done for silk grafts. The animal experiment used a subcutaneous pocket mouse model. The graft – SH0 or SH1 or SH3 or SH6 – was placed in a subcutaneous pocket. The animals were killed at one, two, and four weeks, postoperatively. The specimens were subjected to histological analysis and lysozyme assay. Results: Groups with 4HR applied showed lower antibody binding affinity to antigen compared to groups without 4HR. In the SEM examination, there was no significant difference among groups. Histological examinations revealed many foreign body giant cells in ST0 and ST1 group at four weeks postoperatively. Both ST3 and ST6 groups developed significantly lower levels of giant cell values compared to ST0 and ST1 groups (P <0.001) at four weeks postoperatively. In the lysozyme assay, the ST1 and ST3 groups showed denser signals than the other groups. Conclusion: 4HR combined silk implants resulted in high levels of vascular and connective tissue regeneration. PMID:27489833

  10. Biomechanical characterization of soft tissue injuries

    NASA Astrophysics Data System (ADS)

    Winnem, Andreas Meyer; Randeberg, Lise Lyngsnes; Larsen, Eivind L. P.; Lilledahl, Magnus B.; Haaverstad, Rune; Haugen, Olav A.; Skallerud, Bjørn; Svaasand, Lars O.

    2007-02-01

    Determining the cause of an injury and the force behind the impact may be of crucial importance in a court case. For non-penetrating soft tissue injuries there is a lack of information available in the literature. In this study controlled bruises were inflicted on an anesthetized pig by high speed, low-weight paintball projectiles (diameter 17.1 mm, weight 3.15 g). The speed of the object and the impact itself were monitored using a high speed camera. Punch biopsies (5 mm) were collected from the injury sites. A red and purple ring with a diameter of 1.5 cm appeared on the skin within 30 seconds after the paintball impact. The ring was visually fully established after 5-10 minutes. Numerical finite element simulations performed with ABAQUSExplicit showed a build up of shear stresses in the skin where the ring formed. Biopsies demonstrated severe dermal vessel damage in the same area. It is concluded that considerable shear stresses during the impact will create dermal vessel damage and thereby cause a visible bruise. Larger forces are required for compressive stresses to inflict equivalent vascular damage.

  11. Adjuvant chemotherapy for soft tissue sarcoma.

    PubMed

    Casali, Paolo G

    2015-01-01

    Adjuvant chemotherapy is not standard treatment in soft tissue sarcoma (STS). However, when the risk of relapse is high, it is an option for shared decision making with the patient in conditions of uncertainty. This is because available evidence is conflicting, even if several randomized clinical trials have been performed for 4 decades and also have been pooled into meta-analyses. Indeed, available meta-analyses point to a benefit in the 5% to 10% range in terms of survival and distant relapse rate. Some local benefit also was suggested by some trials. Placing chemotherapy in the preoperative setting may help gain a local advantage in terms of the quality of surgical margins or decreased sequelae. This may be done within a personalized approach according to the clinical presentation. Attempts to personalize treatment on the basis of the variegated pathology and molecular biology of STS subgroups are ongoing as well, according to what is done in the medical treatment of advanced STS. Thus, decision making for adjuvant and neoadjuvant indications deserves personalization in clinical research and in clinical practice, taking profit from all multidisciplinary clinical skills available at a sarcoma reference center, though with a degree of subjectivity because of the limitations of available evidence. PMID:25993233

  12. Treatment Options for Adult Soft Tissue Sarcoma

    MedlinePlus

    ... superficial (in subcutaneous tissue with no spread into connective tissue or muscle below) or deep (in the muscle ... superficial (in subcutaneous tissue with no spread into connective tissue or muscle below) or deep (in the muscle ...

  13. Treatment Option Overview (Adult Soft Tissue Sarcoma)

    MedlinePlus

    ... superficial (in subcutaneous tissue with no spread into connective tissue or muscle below) or deep (in the muscle ... superficial (in subcutaneous tissue with no spread into connective tissue or muscle below) or deep (in the muscle ...

  14. Stages of Adult Soft Tissue Sarcoma

    MedlinePlus

    ... superficial (in subcutaneous tissue with no spread into connective tissue or muscle below) or deep (in the muscle ... superficial (in subcutaneous tissue with no spread into connective tissue or muscle below) or deep (in the muscle ...

  15. Isolated Limb Perfusion of Melphalan With or Without Tumor Necrosis Factor in Treating Patients With Soft Tissue Sarcoma of the Arm or Leg

    ClinicalTrials.gov

    2012-03-14

    Stage IVB Adult Soft Tissue Sarcoma; Stage IIB Adult Soft Tissue Sarcoma; Stage IIC Adult Soft Tissue Sarcoma; Recurrent Adult Soft Tissue Sarcoma; Stage IVA Adult Soft Tissue Sarcoma; Stage III Adult Soft Tissue Sarcoma

  16. Soft tissue invasion of papillary thyroid carcinoma.

    PubMed

    Lin, Jen-Der; Hsueh, Chuen; Chao, Tzu-Chieh

    2016-08-01

    Extrathyroidal extension (ETE) of papillary thyroid carcinoma (PTC) is common and clinical presentation can vary from minimal to extensive locoregional involvement. Although PTC is generally considered the most benign among all thyroid carcinomas, it may present with local invasion with poor prognosis. Our retrospective study involved 3267 PTC patients undergoing regular follow-up at Chang Gung Medical Center in Linkou, Taiwan. Among them, 269 were PTC cases with ETE, having tumors greater than 1 cm in size and treated with total or complete thyroidectomy with or without lymph node dissection for which the follow-up period was over 10 years. The mean age of 269 cases was 46.8 ± 15.1 (range 11-83 years) years. The number of females was 204 (75.8 %). Patients were categorized into minimal ETE (175 cases) and extensive ETE (94 cases) groups according to surgical findings and pathological reports. Mean follow-up period was 13.3 ± 5.5 (range 0.2-29.3) years, during which 28 (10.4 %) patients died of thyroid cancer; and 63 (23.4 %) of all-cause mortality. Multivariate analysis showed that age, gender, extensive ETE, and lymph node metastasis had a statistically significant effect on thyroid cancer mortality. Survival rates were significantly different between minimal ETE and extensive ETE groups (p < 0.0001). In conclusion, perithyroidal soft tissue involvement by PTC is an important factor that determines patient prognosis and a closer follow-up and more aggressive treatment is necessary for patients who are old, male, extensive ETE, and with lymph node involvement. PMID:27154220

  17. Optical-Based Analysis of Soft Tissue Structures.

    PubMed

    Goth, Will; Lesicko, John; Sacks, Michael S; Tunnell, James W

    2016-07-11

    Fibrous structures are an integral and dynamic feature of soft biological tissues that are directly related to the tissues' condition and function. A greater understanding of mechanical tissue behavior can be gained through quantitative analyses of structure alone, as well as its integration into computational models of soft tissue function. Histology and other nonoptical techniques have traditionally dominated the field of tissue imaging, but they are limited by their invasiveness, inability to provide resolution on the micrometer scale, and dynamic information. Recent advances in optical modalities can provide higher resolution, less invasive imaging capabilities, and more quantitative measurements. Here we describe contemporary optical imaging techniques with respect to their suitability in the imaging of tissue structure, with a focus on characterization and implementation into subsequent modeling efforts. We outline the applications and limitations of each modality and discuss the overall shortcomings and future directions for optical imaging of soft tissue structure. PMID:27420574

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

    MedlinePlus

    ... soft tissue sarcoma. Exposure to dioxin and to herbicides that contain phenoxyacetic acid at high doses (such ... known for certain. There is no evidence that herbicides (weed killers) or insecticides, at levels encountered by ...

  19. Do We Know What Causes Soft Tissue Sarcomas?

    MedlinePlus

    ... that some of these risk factors affect the DNA of cells in the soft tissues. Researchers have ... great progress in understanding how certain changes in DNA can cause normal cells to become cancerous. Our ...

  20. Doxorubicin With Upfront Dexrazoxane for the Treatment of Advanced or Metastatic Soft Tissue Sarcoma

    ClinicalTrials.gov

    2016-07-11

    Sarcoma, Soft Tissue; Soft Tissue Sarcoma; Undifferentiated Pleomorphic Sarcoma; Leiomyosarcoma; Liposarcoma; Synovial Sarcoma; Myxofibrosarcoma; Angiosarcoma; Fibrosarcoma; Malignant Peripheral Nerve Sheath Tumor; Epithelioid Sarcoma

  1. Management of soft tissue defects of the hand.

    PubMed

    Yannascoli, Sarah M; Thibaudeau, Stephanie; Levin, L Scott

    2015-06-01

    Soft tissue coverage of the hand remains a challenging problem to the hand surgeon, but advances in the field of microsurgery have provided improved thin, pliable, durable flaps that offer cosmetic reconstructive options. The reconstructive elevator is poised to replace the reconstructive ladder, thereby allowing early reconstruction by the best available option. This reviews focus on the variety of pedicled, free fasciocutaneous, and venous flaps available for successful soft tissue coverage of the hand. PMID:25936734

  2. A case of Apophysomyces trapeziformis necrotizing soft tissue infection.

    PubMed

    Echaiz, Jose F; Burnham, Carey-Ann D; Bailey, Thomas C

    2013-12-01

    Mucormycosis is a rare and devastating disease. Apophysomyces trapeziformis is an environmental mold that was recently implicated in several cases of cutaneous and soft tissue mucormycosis in victims of a tornado in Joplin, Missouri. Here, we report a case of Apophysomyces trapeziformis necrotizing soft tissue infection in a resident of Joplin 10 months after the disaster and without preceding trauma. Aspects of histological and microbiological diagnosis are also reviewed. PMID:23891642

  3. Soft-tissue vessels and cellular preservation in Tyrannosaurus rex.

    PubMed

    Schweitzer, Mary H; Wittmeyer, Jennifer L; Horner, John R; Toporski, Jan K

    2005-03-25

    Soft tissues are preserved within hindlimb elements of Tyrannosaurus rex (Museum of the Rockies specimen 1125). Removal of the mineral phase reveals transparent, flexible, hollow blood vessels containing small round microstructures that can be expressed from the vessels into solution. Some regions of the demineralized bone matrix are highly fibrous, and the matrix possesses elasticity and resilience. Three populations of microstructures have cell-like morphology. Thus, some dinosaurian soft tissues may retain some of their original flexibility, elasticity, and resilience. PMID:15790853

  4. Soft tissue tumors of the penis: a review.

    PubMed

    Katona, Terrence M; Lopez-Beltran, Antonio; MacLennan, Gregory T; Cheng, Lirong; Montironi, Rodolfo; Cheng, Liang

    2006-08-01

    Penile soft tissue tumors comprise 5% of tumors at this site and most have been reported as isolated case reports. The purpose of this review is to aid the practicing surgical pathologist in distinguishing penile soft tissue tumors, such as sarcomatoid squamous cell carcinoma, from other prognostically and therapeutically important entities in the differential diagnosis. Clinical presentation, management, prognosis and factors influencing behavior are reviewed. The immunohistochemical profiles and salient morphologic clues that may help distinguish penile spindle cell tumors from sarcomatoid carcinomas are evaluated. Soft tissue tumors of the penis may be classified as benign or malignant, as superficial or deep and in terms of age at presentation. All are rare. The most common benign soft tissue tumors that affect the penis are vascular neoplasms, followed by tumors of neural, myoid and fibrous origin. Among reported cases, the most frequent malignant penile soft tissue tumors are Kaposi sarcoma and leiomyosarcoma. Correctly diagnosing penile soft tissue tumors is imperative, because the biologic behavior and the clinical management of these neoplasms vary considerably. Distinguishing sarcomas from sarcomatoid carcinoma and melanoma is particularly important. Accurate diagnosis is best facilitated by consideration of all available aspects of the case, including clinical information, histopathologic findings and immunohistochemical results. PMID:16927639

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

    PubMed

    Boonvisut, Pasu; Cavuşoğlu, M Cenk

    2013-10-01

    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. PMID:24031160

  6. What Is a Soft Tissue Sarcoma?

    MedlinePlus

    ... in between fibrosarcoma and benign tumors such as fibromas and superficial fibromatosis. They tend to grow slowly ... These include: Elastofibromas, benign tumor of fibrous tissue Fibromas, benign tumor of fibrous tissue Fibrous histiocytomas, benign ...

  7. Fluid-structure Interaction Simulations of Deformable Soft Tissue

    NASA Astrophysics Data System (ADS)

    Borazjani, Iman

    2011-11-01

    Soft tissue interacts with the surrounding fluid environment in many biological and biomedical applications. Simulating such an interaction is quite challenging due to the large non-linear deformations of tissue, flow pulsatility, transition to turbulence, and non-linear fluid-structure interaction. We have extended our previous three-dimensional fluid-structure interaction (FSI) framework for rigid bodies (Borazjani, Ge, and Sotiropoulos, Journal of Computational Physics, 2008) to deformable soft tissue by coupling our incompressible Navier-Stokes solver for fluids with a non-linear large deformation finite element method for soft tissue. We use Fung-type constitutive law for the soft tissue that can capture the stress-strain behavior of the tissue. The FSI solver adopts a strongly-coupled partitioned approach that is stabilized with under-relaxation and Aitken acceleration technique. We validate our solvers against the experimental data for tissue valves and elastic tubes. We show the capabilities of our solver by simulating the fluid-structure interaction of tissue valves implanted in the aortic positions and elastic collapsible tubes. This work was partly supported by the Center for Computational Research at the University at Buffalo.

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

    NASA Astrophysics Data System (ADS)

    Müller, Bert; Schulz, Georg; Deyhle, Hans; Stalder, Anja K.; Ilgenstein, Bernd; Holme, Margaret N.; Weitkamp, Timm; Beckmann, Felix; Hieber, Simone E.

    2016-01-01

    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.

  9. Management of facial soft tissue injuries in children.

    PubMed

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

    2011-07-01

    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. PMID:21772187

  10. Soft tissue coverage at the resource-challenged facility.

    PubMed

    Nguyen, Tuan Anh

    2008-10-01

    Covering soft tissue defects remains challenging for orthopaedic surgeons, especially those in resource-challenged facilities. Covering tissue defects follow a plan from simple to complex: primary closure, local flap, area flap, pedicle flap, and free flap. I will limit my discussion to the role of latter two. At the district-level hospital in Vietnam, pedicle flaps are generally more useful, so I will discuss free flaps only briefly. The choices of pedicle flaps include: kite flap, posterior interosseous flap, radial flap (Chinese flap), neurocutaneous flap, anterolateral thigh fasciocutaneous flap, gastrocnemius flap, sural flap, posterior leg flaps; we typically use a free flap with the latissimus dorsi. Soft tissue coverage with pedicle flaps has many advantages: reliability, relatively easy harvest, and good blood supply. Free flaps with microanastomosis have an important place in covering difficult medium- or large-sized soft tissue defects but also require more instruments and more highly trained surgeons. PMID:18665433

  11. Electrosurgical management of soft tissues and restorative dentistry.

    PubMed

    Flocken, J E

    1980-04-01

    Proper use of oral electrosurgery permits rapid, full management of soft-tissue problems related to mouth preparation for fixed and removable prosthodontics. The ability to control precisely the zone of coagulation enables the dentist to carve, sculpture, or modify the soft-tissue contours with or without hemorrhage. Restorative dentists possess a high degree of artistic sculpturing skills that can be effectively utilized to harmonize restorative and soft-tissue contours. The life expectancy and function of all fixed and removable restorations depend upon optimal health of the supporting tissues for biomechanical compatibility. Modern electrosurgical techniques and equipment make it possible for the general practitioner, as well as the specialist, to deliver more timely and more comfortable improved fixed and removable appliance therapy to their patients. PMID:6928834

  12. A Temporal View of Soft Tissue Quantitative Ultrasound

    NASA Astrophysics Data System (ADS)

    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.

  13. Ultrasound of soft tissue masses of the hand

    PubMed Central

    2012-01-01

    Most soft tissue mass lesions of the hand are benign. Ganglia are the commonest lesions encountered, followed by giant cell tumors of the tendon sheath. Malignant tumors are rare. Often a specific diagnosis can be achieved on imaging by considering the location and anatomical relations of the lesion within the hand or wrist, and assessing its morphology. Magnetic resonance imaging is an excellent modality for evaluating soft tissue tumors with its multiplanar capability and ability to characterize tissue. Ultrasound plays a complementary role to MRI. It is often the initial modality used for assessing masses as it is cheap and available, and allows reliable differentiation of cystic from solid lesions, along with a real time assessment of vascularity. This review describes the US appearances of the most frequently encountered soft tissue masses of the wrist and hand, correlating the findings with MRI where appropriate. PMID:26673615

  14. A microchannel flow model for soft tissue elasticity

    NASA Astrophysics Data System (ADS)

    Parker, K. J.

    2014-08-01

    A number of advances, including imaging of tissue displacements, have increased our ability to make measurements of tissue elastic properties of animal and human tissues. Accordingly, the question is increasingly asked, ‘should our data be fit to a viscoelastic model, and if so which one?’ In this paper we focus solely on soft tissues in a functional (non-pathological) state, and develop a model of elastic behavior that is based on the flow of viscous fluids through the extensive network of tissue microchannels in response to applied stress. This behavior can be captured in a 2-parameter model, and the model appears to predict the stress-relaxation behavior and the dispersive shear wave behavior of bovine liver specimens and other soft tissues and phantoms. The relationship of the microchannel flow model to more traditional models is also examined.

  15. Soft tissue cephalometric analysis applied to regional Indian population

    PubMed Central

    Upadhyay, Jay S.; Maheshwari, Sandhya; Verma, Sanjeev K.; Zahid, Syed Naved

    2013-01-01

    Introduction: Importance of soft tissue consideration in establishing treatment goals for orthodontics and orthognathic surgery has been recognized and various cephalometric analysis incorporating soft tissue parameters have evolved. The great variance in soft tissue drape of the human face and perception of esthetics exists and normative data based on one population group cannot be applied to all. The study was conducted to compare the standard soft tissue cephalometric analysis (STCA) norms with norms derived for population of western Uttar Pradesh region of India. Materials and Methods: The sample consisted of lateral cephalograms taken in natural head position of 33 normal subjects (16 males, 17 females). The cephalograms were analyzed with soft tissue cephalometric analysis for orthodontic diagnosis and treatment planning, and the Student's t test was used to compare the difference in means between study population and standard STCA norms. Results: Compared with established STCA norms, females in our study had steeper maxillary occlusal plane, more proclined mandibular incisors, and less protrusive lips. Both males and females showed an overall decrease in facial lengths, less prominent midface and mandibular structures and more convex profile compared with established norms for the White population. Conclusions: Statistically significant differences were found in certain key parameters of STCA for western Uttar Pradesh population when compared with established norms. PMID:24665169

  16. Radiation Therapy for Soft Tissue Sarcomas

    MedlinePlus

    ... called palliative treatment . Types of radiation therapy External beam radiation therapy: For this treatment, radiation delivered from ... impact on healthy tissue. In some centers, proton beam radiation is an option. This uses streams of ...

  17. Tumours of the soft (mesenchymal) tissues.

    PubMed

    Weiss, E

    1974-01-01

    This is a classification of tumours of fibrous tissue, fat, muscle, blood and lymph vessels, and mast cells, irrespective of the region of the body in which they arise. Tumours of fibrous tissue are divided into fibroma, fibrosarcoma (including "canine haemangiopericytoma"), other sarcomas, equine sarcoid, and various tumour-like lesions. The histological appearance of the tumours is described and illustrated with photographs. PMID:4371740

  18. Allografts in Soft Tissue Reconstructive Procedures

    PubMed Central

    Giedraitis, Andrius; Arnoczky, Steven P.; Bedi, Asheesh

    2014-01-01

    Context Allografts offer several important advantages over autografts in musculoskeletal reconstructive procedures, such as anterior cruciate ligament reconstruction. Despite growing widespread use of allograft tissue, serious concerns regarding safety and functionality remain. We discuss the latest knowledge of the potential benefits and risks of allograft use and offer a critical review of allograft tissue regulation, management, and sterilization to enable the surgeon to better inform athletes considering reconstructive surgery options. Evidence Acquisition A review of sources published in the past 10 years is the primary basis of this research. Study Design: Observational analysis (cohort study). Level of Evidence: Level 3. Results Comparable outcome data for autografts and allografts do not support universal standards for anterior cruciate ligament reconstruction, and physician recommendation and bias appear to significantly influence patient preference and satisfaction. Sterilization by gamma and electron-beam irradiation diminishes the biomechanical integrity of allograft tissue, but radioprotective agents such as collagen cross-linking and free radical scavengers appear to have potential in mitigating the deleterious effects of irradiation and preserving tissue strength and stability. Conclusion Allografts offer greater graft availability and reduced morbidity in orthopaedic reconstructive procedures, but greater expansion of their use by surgeons is challenged by the need to maintain tissue sterility and biomechanical functionality. Advances in the radioprotection of irradiated tissue may lessen concerns regarding allograft safety and structural stability. PMID:24790696

  19. Multiphase poroelastic finite element models for soft tissue structure

    SciTech Connect

    Simon, B.R.

    1992-06-01

    During the last two decades. biological structures with soft tissue components have been modeled using poroelastic or mixture-based constitutive laws, i.e., the material is viewed as a deformable (porous) solid matrix that is saturated by mobile tissue fluid. These structures exhibit a highly nonlinear, history-dependent material behavior; undergo finite strains-, and may swell or shrink when tissue ionic concentrations are altered. Given the geometric and material complexity of soft tissue structures and that they are subjected to complicated initial and boundary conditions, finite element models (FEMs) have been very useful for quantitative structural analyses. This paper surveys recent applications of poroelastic and mixture-based theories and the associated FEMs for the study of the biomechanics of soft tissues, and indicates future directions for research in this area. Equivalent finite-strain poroelastic and mixture continuum biomechanical models are presented. Special attention is given to the identification of material properties using a porohyperelastic constitutive law and a total Lagrangian view for the formulation. The associated FEMS are then formulated to include this porohyperelastic material response and finite strains. Extensions of the theory are suggested in order to include inherent viscoelasticity, transport phenomena, and swelling in soft tissue structures. A number of biomechanical research areas are identified, and possible applications of the porohyperelastic and mixture-based FEMs are suggested.

  20. Multiphase poroelastic finite element models for soft tissue structures

    SciTech Connect

    Simon, B.R.

    1992-12-01

    During the last two decades, biological structures with soft tissue components have been modeled using poroelastic or mixture-based constitutive laws, i.e., the material is viewed as a deformable (porous) solid matrix that is saturated by mobile tissue fluid. These structures exhibit a highly nonlinear, history-dependent material behavior; undergo finite strains; and may swell or shrink when tissue ionic concentrations are altered. Give the geometric and material complexity of soft tissue structures and that they are subjected to complicated initial and boundary conditions, finite element models (FEMs) have been very useful for quantitative structural analyses. This paper surveys recent applications of poroelastic and mixture-based theories and the associated FEMs for the study of the biomechanics of soft tissues, and indicates future directions for research in this area. Equivalent finite-strain poroelastic and mixture continuum biomechanical models are presented. Special attention is given to the identification of material properties using a porohyperelastic constitutive law ans a total Lagrangian view for the formulation. The associated FEMs are then formulated to include this porohyperelastic material response and finite strains. Extensions of the theory are suggested in order to include inherent viscoelasticity, transport phenomena, and swelling in soft tissue structures. A number of biomechanical research areas are identified, and possible applications of the porohyperelastic and mixture-based FEMs are suggested. 62 refs., 11 figs., 3 tabs.

  1. Diode Laser Application in Soft Tissue Oral Surgery

    PubMed Central

    Azma, Ehsan; Safavi, Nassimeh

    2013-01-01

    Introduction: Diode laser with wavelengths ranging from 810 to 980 nm in a continuous or pulsed mode was used as a possible instrument for soft tissue surgery in the oral cavity. Discussion: Diode laser is one of laser systems in which photons are produced by electric current with wavelengths of 810, 940 and 980nm. The application of diode laser in soft tissue oral surgery has been evaluated from a safety point of view, for facial pigmentation and vascular lesions and in oral surgery excision; for example frenectomy, epulis fissuratum and fibroma. The advantages of laser application are that it provides relatively bloodless surgical and post surgical courses with minimal swelling and scarring. We used diode laser for excisional biopsy of pyogenic granuloma and gingival pigmentation. Conclusion: The diode laser can be used as a modality for oral soft tissue surgery PMID:25606331

  2. Magnetic resonance imaging of pediatric soft-tissue vascular anomalies.

    PubMed

    Navarro, Oscar M

    2016-05-01

    Magnetic resonance (MR) imaging can be used in the management of pediatric soft-tissue vascular anomalies for diagnosing and assessing extent of lesions and for evaluating response to therapy. MR imaging studies often involve a combination of T1- and T2-weighted images in addition to MR angiography and fat-suppressed post-contrast sequences. The MR imaging features of these vascular anomalies when combined with clinical findings can aid in diagnosis. In cases of complex vascular malformations and syndromes associated with vascular anomalies, MR imaging can be used to evaluate accompanying soft-tissue and bone anomalies. This article reviews the MR imaging protocols and appearances of the most common pediatric soft-tissue vascular anomalies. PMID:27229506

  3. Necrotizing soft-tissue infection: laboratory risk indicator for necrotizing soft tissue infections score.

    PubMed

    Kulkarni, Madhuri; Vijay Kumar, Gs; Sowmya, Gs; Madhu, Cp; Ramya, Sr

    2014-01-01

    Necrotizing soft tissue infections (NSTI) can be rapidly progressive and polymicrobial in etiology. Establishing the element of necrotizing infection poses a clinical challenge. A 64-year-old diabetic patient presented to our hospital with a gangrenous patch on anterior abdominal wall, which progressed to an extensive necrotizing lesion within 1 week. Successive laboratory risk indicator for necrotizing softtissue infections (LRINEC) scores confirmed the necrotizing element. Cultures yielded Enterococci, Acinetobacter species and Apophysomyces elegans and the latter being considered as an emerging agent of Zygomycosis in immunocompromised hosts. Patient was managed with antibiotics, antifungal treatment and surgical debridement despite which he succumbed to the infection. NSTI's require an early and aggressive management and LRINEC score can be applied to establish the element of necrotizing pathology. Isolation of multiple organisms becomes confusing to establish the etiological role. Apophysomyces elegans, which was isolated in our patient is being increasingly reported in cases of necrotizing infections and may be responsible for high morbidity and mortality. This scoring has been proposed as an adjunct tool to Microbiological diagnosis when NSTI's need to be diagnosed early and managed promptly to decrease mortality and morbidity, which however may not come in handy in an immunocompromised host with polymicrobial aggressive infection. PMID:24696561

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

    PubMed

    Nam, Ki-Uk; Hong, Jongrak

    2015-11-01

    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. PMID:26594988

  5. Soft-tissue calcification after subcutaneus emphysema in a neonate

    SciTech Connect

    Naidech, H.J.; Chawla, H.S.

    1982-08-01

    Bilateral, almost symmetric, calcifications of the soft tissues after subcutaneous emphysema have not, to our knowledge, been described. Because of the close clinical and radiographic evaluation in our case, the finding of calcinosis was not a diagnostic problem. Several 1.5 mm computed tomographic (CT) sections of the thorax were scanned and they were confirmatory in showing the distribution of the calcifications. Since subcutaneous emphysema is commonplace, and calcification after it is apparently unknown, the literature was reviewed and an additional cause of soft-tissue calcinosis is presented.

  6. Soft and hard tissue management using lasers in esthetic restoration.

    PubMed

    Flax, Hugh D

    2011-04-01

    Laser technology has become preeminent in the evolution of appearance enhancements. Dentistry has seen a huge breakthrough with the introduction of a combination hard-soft tissue erbium wavelength. The conservative nature of this technique has created a firm footing in the antiaging trend that is spanning the globe. Among the many benefits of this technique are less invasive care and quicker healing responses. In this article, conservative laser and cosmetic modalities are discussed that allows a clinician to be more comfortable in buying a soft/hard tissue laser and also to more quickly become adept with implementing these techniques. PMID:21474000

  7. Age Changes of Jaws and Soft Tissue Profile

    PubMed Central

    Sharma, Padmaja; Arora, Ankit; Valiathan, Ashima

    2014-01-01

    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. PMID:25506064

  8. Radiologic Approach to Bone and Soft Tissue Sarcomas.

    PubMed

    Caracciolo, Jamie T; Letson, G Douglas

    2016-10-01

    Diagnostic imaging plays an important role in evaluation and treatment planning of patients with musculoskeletal tumors. This article discusses various imaging modalities available in the work-up, staging, and surveillance of patients with primary bone and soft tissue neoplasms. A systematic approach to initial evaluation of newly suspected bone lesions and soft tissue masses is presented. Reviewed are relevant imaging features of musculoskeletal neoplasms that help predict tumor biology and risk of malignancy and findings that define internal tumor composition and allow for accurate preoperative histopathologic diagnosis before intervention. Finally, the role of diagnostic imaging in tumor staging, evaluation of response to neoadjuvant therapy, and postoperative surveillance is discussed. PMID:27542636

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

    PubMed

    Han, S; Garner, M M

    2016-05-01

    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. PMID:26333294

  10. Soft Tissue Phantoms for Realistic Needle Insertion: A Comparative Study.

    PubMed

    Leibinger, Alexander; Forte, Antonio E; Tan, Zhengchu; Oldfield, Matthew J; Beyrau, Frank; Dini, Daniele; Rodriguez Y Baena, Ferdinando

    2016-08-01

    Phantoms are common substitutes for soft tissues in biomechanical research and are usually tuned to match tissue properties using standard testing protocols at small strains. However, the response due to complex tool-tissue interactions can differ depending on the phantom and no comprehensive comparative study has been published to date, which could aid researchers to select suitable materials. In this work, gelatin, a common phantom in literature, and a composite hydrogel developed at Imperial College, were matched for mechanical stiffness to porcine brain, and the interactions during needle insertions within them were analyzed. Specifically, we examined insertion forces for brain and the phantoms; we also measured displacements and strains within the phantoms via a laser-based image correlation technique in combination with fluorescent beads. It is shown that the insertion forces for gelatin and brain agree closely, but that the composite hydrogel better mimics the viscous nature of soft tissue. Both materials match different characteristics of brain, but neither of them is a perfect substitute. Thus, when selecting a phantom material, both the soft tissue properties and the complex tool-tissue interactions arising during tissue manipulation should be taken into consideration. These conclusions are presented in tabular form to aid future selection. PMID:26666228

  11. Dinosaurian Soft Tissues Interpreted as Bacterial Biofilms

    PubMed Central

    Kaye, Thomas G.; Gaugler, Gary; Sawlowicz, Zbigniew

    2008-01-01

    A scanning electron microscope survey was initiated to determine if the previously reported findings of “dinosaurian soft tissues” could be identified in situ within the bones. The results obtained allowed a reinterpretation of the formation and preservation of several types of these “tissues” and their content. Mineralized and non-mineralized coatings were found extensively in the porous trabecular bone of a variety of dinosaur and mammal species across time. They represent bacterial biofilms common throughout nature. Biofilms form endocasts and once dissolved out of the bone, mimic real blood vessels and osteocytes. Bridged trails observed in biofilms indicate that a previously viscous film was populated with swimming bacteria. Carbon dating of the film points to its relatively modern origin. A comparison of infrared spectra of modern biofilms with modern collagen and fossil bone coatings suggests that modern biofilms share a closer molecular make-up than modern collagen to the coatings from fossil bones. Blood cell size iron-oxygen spheres found in the vessels were identified as an oxidized form of formerly pyritic framboids. Our observations appeal to a more conservative explanation for the structures found preserved in fossil bone. PMID:18665236

  12. Soft Tissue Coverage of the Lower Limb following Oncological Surgery

    PubMed Central

    Radtke, Christine; Panzica, Martin; Dastagir, Khaled; Krettek, Christian; Vogt, Peter M.

    2016-01-01

    The treatment of lower limb tumors has been shifted by advancements in adjuvant treatment protocols and microsurgical reconstruction from limb amputation to limb salvage. Standard approaches include oncological surgery by a multidisciplinary team in terms of limb sparing followed by soft tissue reconstruction and adjuvant therapy when indicated. For the development of a comprehensive surgical plan, the identity of the tumor should first be determined by histology after biopsy. Then the surgical goal and comprehensive treatment concept should be developed by a multidisciplinary tumor board and combined with soft tissue reconstruction. In this article, plastic surgical reconstruction options for soft coverage of the lower extremity following oncological surgery will be described along with the five clinical cases. PMID:26793620

  13. Soft tissue attenuation in middle ear on HRCT: Pictorial review

    PubMed Central

    Anbarasu, Arangasamy; Chandrasekaran, Kiruthika; Balakrishnan, Sivasubramanian

    2012-01-01

    Middle ear disease is a common clinical entity; imaging, especially High resolution Computed Tomography (HRCT), plays a crucial role in diagnosis and assessing the disease extent, helping to decide appropriate management. Temporal bone imaging is challenging and involves thorough understanding of the anatomy, especially in relation to HRCT imaging. Most of the middle ear pathologies appear as “soft tissue” on imaging. Careful analysis of the soft tissue on the HRCT is crucial in achieving the right diagnosis; clinical information is essential and the imaging findings need correlation with clinical presentation and otoscopic findings. The purpose of this pictorial essay is to enlist the pathologies that present as soft tissue in middle ear and to provide a structured and practical imaging approach that will serve as a guide for confident reporting in daily practice. PMID:23833422

  14. Ultrasound elastography assessment of bone/soft tissue interface

    NASA Astrophysics Data System (ADS)

    Parmar, Biren J.; Yang, Xu; Chaudhry, Anuj; Shafeeq Shajudeen, Peer; Nair, Sanjay P.; Weiner, Bradley K.; Tasciotti, Ennio; Krouskop, Thomas A.; Righetti, Raffaella

    2016-01-01

    We report on the use of elastographic imaging techniques to assess the bone/soft tissue interface, a region that has not been previously investigated but may provide important information about fracture and bone healing. The performance of axial strain elastograms and axial shear strain elastograms at the bone/soft tissue interface was studied ex vivo on intact and fractured canine and ovine tibias. Selected ex vivo results were corroborated on intact sheep tibias in vivo. The elastography results were statistically analyzed using elastographic image quality tools. The results of this study demonstrate distinct patterns in the distribution of the normalized local axial strains and axial shear strains at the bone/soft tissue interface with respect to the background soft tissue. They also show that the relative strength and distribution of the elastographic parameters change in the presence of a fracture and depend on the degree of misalignment between the fracture fragments. Thus, elastographic imaging modalities might be used in the future to obtain information regarding the integrity of bones and to assess the severity of fractures, alignment of bone fragments as well as to follow bone healing.

  15. The effectiveness of distal soft tissue procedures in hallux valgus

    PubMed Central

    Ozturk, Hasan; Agus, Haluk; Altay, Taskin; Hancerli, Ozgur

    2008-01-01

    Background Hallux valgus is a common disorder affecting mostly women population. Distal soft tissue procedure in the treatment of hallux valgus is one of the main operative techniques described. The aim of this study is to evaluate the outcomes of McBride’s distal soft tissue procedure in hallux valgus cases. Materials and methods This study includes 30 patients (27 women) having 31 hallux valgus, who were treated between 1999 and 2004. Modified McBride’s distal soft tissue procedure was carried out in all cases. Pain status of the cases was recorded by using VAS, clinical assessment described by Bonney and Macnab, and American Orthopaedic Foot and Ankle Society’s (AOFAS) score at the last follow up. Results The mean hallux valgus and intermetatarsal angles decreased from 31.4° and 13.8° to 13.5° and 10.5°, respectively, with an average follow-up period of 54.4 months. AOFAS’s score displayed significant improvement from 57 to 87. The mean VAS showed a significant decrease from 8.75 preoperatively to 2.1 at the last follow-up. According to Bonney and Macnab criteria, only one case was accepted as poor result due to 5° hallux varus. Conclusions McBride’s distal soft tissue procedure yields high rate of satisfaction for mild to moderate hallux valgus with no bony complications related to osteotomy. PMID:19384606

  16. A novel treatment tool to address soft tissue dysfunction.

    PubMed

    Wagner, Jim; Olson, Kellye

    2015-01-01

    These authors describe how they use thermoplastic materials to augment home exercise programs for clients with chronic and post-surgical soft tissue dysfunction. They discuss how after thorough education is provided, this alternative tool may be given for patient use. -Victoria Priganc, PhD, OTR, CHT, CLT, Practice Forum Editor. PMID:25990441

  17. Dorsal finger joint soft tissue loss: two case reports.

    PubMed

    Bervar, M

    2003-01-01

    This article brings our experience, standpoints and management guidelines for early reconstruction of traumatic soft tissue loss on the dorsal aspect of the finger joints, with the aim of preserving acceptable late functional ability of the hand. Two interesting and unusual cases of reconstruction are presented. PMID:14989334

  18. Treatment of oral soft tissues benign tumors using laser

    NASA Astrophysics Data System (ADS)

    Crisan, Bogdan; Baciut, Mihaela; Crisan, Liana; Bran, Simion; Rotar, Horatiu; Dinu, Cristian; Moldovan, Iuliu; Baciut, Grigore

    2014-01-01

    The present study aimed to assess the efficacy and indications of surgical laser therapy in the treatment of oral soft tissues benign tumors compared to classic surgery. A controlled clinical study was conducted in a group of 93 patients presenting various forms of oral soft tissues benign tumors. These patients were examined pre-and postoperatively and the oral benign tumors were measured linearly and photographed. The surgery of laser-assisted biopsy excision of oral benign tumors was carried out using a diode laser device of 980 nm. In patients who received surgical laser treatment, therapeutic doses of laser to biostimulate the operated area were administered on the first day after the surgery. The interventions of conventional excision of oral soft tissues benign tumors consisted in removing them using scalpel. In patients who have received therapeutic doses of laser for biostimulation of the operated area, a faster healing of wound surfaces and tumor bed was observed during the first days after surgery. Two weeks after the surgical treatment, good healing without scarring or discomfort in the area of excision was documented. Surgical treatment of oral soft tissues benign tumors with laser assisted postoperative therapy confirms the benefits of this surgical procedure. A faster healing process of the excision area due to laser biostimulation of low intensity has been observed in patients with surgical laser assisted treatment in the postoperative period.

  19. Computer navigation of soft tissues in total knee replacement.

    PubMed

    Kamat, Yogeesh D; Aurakzai, Kamran M; Adhikari, Ajeya R

    2013-06-01

    Following the success of computer navigation in producing consistently accurate alignment, the focus has shifted to use of these techniques for soft tissue assessment during total knee replacement (TKR). We undertook a prospectively randomized clinical study to compare two methods of tissue balancing in TKR. One method, called bone referencing (BR) employed independent cutting of the femur and tibia followed by subjective assessment with trial prostheses and soft tissue release as deemed necessary. The other method, termed ligament balancing (LB), involved cutting the tibia first and titration of tissue balance and alignment parameters to guide femoral cuts. Our total sample comprised 77 subjects with 80% statistical power. To assess tissue balance we used (a) coronal laxity testing and (b) computer navigation generated passive knee range of movement graphs. The graphical assessment was validated with coronal laxity testing. There was no difference between the resultant tissue balances achieved. However, correlation with preoperative status revealed the LB technique to show better results in a smaller subgroup of knees with greater preoperative tissue imbalance. We advocate variation of tissue balancing technique to suit the individual knee, based on preoperative assessment, to achieve an optimal result in all TKR. PMID:23288758

  20. Rheology of blood cells as soft tissues.

    PubMed

    Skalak, R; Chien, S

    1982-01-01

    Erythrocytes are unusual in that the cell membrane plays a large and direct role in observed rheological properties. The cell membrane is not a three dimensional material or tissue in the usual sense but being only two molecules thick. It behaves like a liquid sheet of constant thickness and surface area with some elastic properties due in part to protein networks of spectrin and actin on the interior face of the cell membrane. Packed red cells form a viscoelastic fluid which can be sheared, but exhibits a considerable elastic response. The elastic component decreases as the hematocrit is reduced, but is present at all hematocrits. Leukocytes also exhibit viscoelasticity but the properties are primarily dependent on the cell cytoplasm. The cell membrane plays a role only when it is stretched taut. The normal white cell properties have been explored over a wide range of osmolarities, becoming much less viscous and less elastic as the fluid content of the cell increases. White cells also may show spontaneous deformation during which the rheological properties become much stiffer than in the normal passive state. PMID:7104483

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

    PubMed Central

    Wells, Peter N. T.; Liang, Hai-Dong

    2011-01-01

    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. PMID:21680780

  2. Dynamic finite element modeling of poroviscoelastic soft tissue.

    PubMed

    Yang, Zhaochun; Smolinski, Patrick

    2006-02-01

    Clinical evidences relative to biomechanical factors have demonstrated their important contribution to the behaviour of soft tissues. Finite element (FE) analysis is used to study the mechanical behaviour of soft tissue because it can provide numerical solutions to problems that are intractable to analytic solutions. This study focuses on the development of a FE model of a poroelastic biological tissue, which incorporates the viscoelastic material behaviour, finite deformation and inertial effect. The FE formulation is based on the weak form derived from the governing equation, and Newmark-beta method as well as Newton's method is incorporated into the implicit non-linear solutions. One-dimensional analytical solutions were used to verify the theoretical formulation and the numerical implementation of the proposed model. This study was further extended to analyze two-dimensional biomechanical models and the results clearly demonstrate the importance of including finite deformation, viscoelasticity and inertial effects. PMID:16880152

  3. Finite-element modeling of soft tissue rolling indentation.

    PubMed

    Sangpradit, Kiattisak; Liu, Hongbin; Dasgupta, Prokar; Althoefer, Kaspar; Seneviratne, Lakmal D

    2011-12-01

    We describe a finite-element (FE) model for simulating wheel-rolling tissue deformations using a rolling FE model (RFEM). A wheeled probe performing rolling tissue indentation has proven to be a promising approach for compensating for the loss of haptic and tactile feedback experienced during robotic-assisted minimally invasive surgery (H. Liu, D. P. Noonan, B. J. Challacombe, P. Dasgupta, L. D. Seneviratne, and K. Althoefer, "Rolling mechanical imaging for tissue abnormality localization during minimally invasive surgery, " IEEE Trans. Biomed. Eng., vol. 57, no. 2, pp. 404-414, Feb. 2010; K. Sangpradit, H. Liu, L. Seneviratne, and K. Althoefer, "Tissue identification using inverse finite element analysis of rolling indentation," in Proc. IEEE Int. Conf. Robot. Autom. , Kobe, Japan, 2009, pp. 1250-1255; H. Liu, D. Noonan, K. Althoefer, and L. Seneviratne, "The rolling approach for soft tissue modeling and mechanical imaging during robot-assisted minimally invasive surgery," in Proc. IEEE Int. Conf. Robot. Autom., May 2008, pp. 845-850; H. Liu, P. Puangmali, D. Zbyszewski, O. Elhage, P. Dasgupta, J. S. Dai, L. Seneviratne, and K. Althoefer, "An indentation depth-force sensing wheeled probe for abnormality identification during minimally invasive surgery," Proc. Inst. Mech. Eng., H, vol. 224, no. 6, pp. 751-63, 2010; D. Noonan, H. Liu, Y. Zweiri, K. Althoefer, and L. Seneviratne, "A dual-function wheeled probe for tissue viscoelastic property identification during minimally invasive surgery," in Proc. IEEE Int. Conf. Robot. Autom. , 2008, pp. 2629-2634; H. Liu, J. Li, Q. I. Poon, L. D. Seneviratne, and K. Althoefer, "Miniaturized force indentation-depth sensor for tissue abnormality identification," IEEE Int. Conf. Robot. Autom., May 2010, pp. 3654-3659). A sound understanding of wheel-tissue rolling interaction dynamics will facilitate the evaluation of signals from rolling indentation. In this paper, we model the dynamic interactions between a wheeled probe and a

  4. Soft tissue imaging with photon counting spectroscopic CT

    NASA Astrophysics Data System (ADS)

    Shikhaliev, Polad M.

    2015-03-01

    The purpose of this work was experimental investigation of photon counting spectroscopic CT (PCS-CT) imaging of anatomical soft tissue with clinically relevant size. The imaging experiments were performed using a spectroscopic CT system based on CdZnTe photon counting detector with two rows of pixels, 256 pixels in each row, 1  ×  1 mm2 pixel size, and 25.6 cm detector length. The detector could split the x-ray energy spectrum to 5 regions (energy bins), and acquire 5 multi-energy (spectroscopic) CT images in a single CT scan. A sample of round shaped anatomical soft tissue of 14 cm diameter including lean and fat was used for imaging. To avoid the negative effect of anatomical noise on quantitative analysis, a spectroscopic CT phantom with tissue equivalent solid materials was used. The images were acquired at 60, 90, and 120 kVp tube voltages, and spectroscopic image series were acquired with 3 and 5 energy bins. Spectroscopic CT numbers were introduced and used to evaluate an energy selective image series. The anatomical soft tissue with 14 cm diameter was visualized with good quality and without substantial artifacts by the photon counting spectroscopic CT system. The effects of the energy bin crosstalk on spectroscopic CT numbers were quantified and analyzed. The single and double slice PCS-CT images were acquired and compared. Several new findings were observed, including the effect of soft tissue non-uniformity on image artifacts, unique status of highest energy bin, and material dependent visualization in spectroscopic image series. Fat-lean decomposition was performed using dual energy subtraction and threshold segmentation methods, and compared. Using K-edge filtered x-rays improved fat-lean decomposition as compared to conventional x-rays. Several new and important aspects of the PCS-CT were investigated. These include imaging soft tissue with clinically relevant size, single- and double-slice PCS-CT imaging, using spectroscopic CT

  5. Soft tissue imaging with photon counting spectroscopic CT.

    PubMed

    Shikhaliev, Polad M

    2015-03-21

    The purpose of this work was experimental investigation of photon counting spectroscopic CT (PCS-CT) imaging of anatomical soft tissue with clinically relevant size. The imaging experiments were performed using a spectroscopic CT system based on CdZnTe photon counting detector with two rows of pixels, 256 pixels in each row, 1  ×  1 mm(2) pixel size, and 25.6 cm detector length. The detector could split the x-ray energy spectrum to 5 regions (energy bins), and acquire 5 multi-energy (spectroscopic) CT images in a single CT scan. A sample of round shaped anatomical soft tissue of 14 cm diameter including lean and fat was used for imaging. To avoid the negative effect of anatomical noise on quantitative analysis, a spectroscopic CT phantom with tissue equivalent solid materials was used. The images were acquired at 60, 90, and 120 kVp tube voltages, and spectroscopic image series were acquired with 3 and 5 energy bins. Spectroscopic CT numbers were introduced and used to evaluate an energy selective image series. The anatomical soft tissue with 14 cm diameter was visualized with good quality and without substantial artifacts by the photon counting spectroscopic CT system. The effects of the energy bin crosstalk on spectroscopic CT numbers were quantified and analyzed. The single and double slice PCS-CT images were acquired and compared. Several new findings were observed, including the effect of soft tissue non-uniformity on image artifacts, unique status of highest energy bin, and material dependent visualization in spectroscopic image series. Fat-lean decomposition was performed using dual energy subtraction and threshold segmentation methods, and compared. Using K-edge filtered x-rays improved fat-lean decomposition as compared to conventional x-rays. Several new and important aspects of the PCS-CT were investigated. These include imaging soft tissue with clinically relevant size, single- and double-slice PCS-CT imaging, using spectroscopic CT

  6. Injectable PolyMIPE Scaffolds for Soft Tissue Regeneration

    PubMed Central

    Moglia, Robert S.; Robinson, Jennifer L.; Muschenborn, Andrea D.; Touchet, Tyler J.; Maitland, Duncan J.; Cosgriff-Hernandez, Elizabeth

    2013-01-01

    Injury caused by trauma, burns, surgery, or disease often results in soft tissue loss leading to impaired function and permanent disfiguration. Tissue engineering aims to overcome the lack of viable donor tissue by fabricating synthetic scaffolds with the requisite properties and bioactive cues to regenerate these tissues. Biomaterial scaffolds designed to match soft tissue modulus and strength should also retain the elastomeric and fatigue-resistant properties of the tissue. Of particular design importance is the interconnected porous structure of the scaffold needed to support tissue growth by facilitating mass transport. Adequate mass transport is especially true for newly implanted scaffolds that lack vasculature to provide nutrient flux. Common scaffold fabrication strategies often utilize toxic solvents and high temperatures or pressures to achieve the desired porosity. In this study, a polymerized medium internal phase emulsion (polyMIPE) is used to generate an injectable graft that cures to a porous foam at body temperature without toxic solvents. These poly(ester urethane urea) scaffolds possess elastomeric properties with tunable compressive moduli (20–200 kPa) and strengths (4–60 kPa) as well as high recovery after the first conditioning cycle (97–99%). The resultant pore architecture was highly interconnected with large voids (0.5–2 mm) from carbon dioxide generation surrounded by water-templated pores (50–300 μm). The ability to modulate both scaffold pore architecture and mechanical properties by altering emulsion chemistry was demonstrated. Permeability and form factor were experimentally measured to determine the effects of polyMIPE composition on pore interconnectivity. Finally, initial human mesenchymal stem cell (hMSC) cytocompatibility testing supported the use of these candidate scaffolds in regenerative applications. Overall, these injectable polyMIPE foams show strong promise as a biomaterial scaffold for soft tissue repair. PMID

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

    ClinicalTrials.gov

    2014-04-01

    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

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

    PubMed

    Pei, T T; Yu, H Q; Wen, C J; Guo, T Q; Zhou, Y M; Peng, H M

    2016-05-01

    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. PMID:27220393

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

    PubMed

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

    2010-08-01

    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. Angular photogrammetric analysis of the soft tissue facial profile.

    PubMed

    Fernández-Riveiro, Paula; Smyth-Chamosa, Ernesto; Suárez-Quintanilla, David; Suárez-Cunqueiro, Mercedes

    2003-08-01

    All medical specialties interested in improving facial appearance need to measure the face to quantify the desired facial changes. The purpose of this investigation was to obtain objective average measurements of the soft tissue facial profile to use them as a guide for aesthetic treatment goals. The analysis of the soft tissue facial profile from photographic records provides information on the morphology of the profile and its relationship with the underlying dentoskeletal tissues. In this investigation the soft tissue facial profile of a young adult European Caucasian population (212 individual, 50 males and 162 females, 18-20 years of age) was studied by means of standardized photographic records taken in the natural head position (NHP). Angular measurements were analysed digitally. Sexual dimorphism was found for several angles: nasofrontal (G-N-Prn: P < 0.01), vertical nasal (Cm-Sn/N-Prn: P < 0.01), nasal (N-Prn/TV: P < 0.01), nasal dorsum (N-Mn-Prn: P < 0.05), and mandibular contour (C-Me/G-Pg: P < 0.01). Wide individual variations in nasolabial and mentolabial angles were also observed. PMID:12938846

  11. Method of testing very soft biological tissues in compression.

    PubMed

    Miller, Karol

    2005-01-01

    Mechanical properties of very soft tissues, such as brain, liver, kidney and prostate have recently joined the mainstream research topics in biomechanics. This has happened in spite of the fact that these tissues do not bear mechanical loads. The interest in the biomechanics of very soft tissues has been motivated by the developments in computer-integrated and robot-aided surgery--in particular, the emergence of automatic surgical tools and robots-as well as advances in virtual reality techniques. Mechanical testing of very soft tissues provides a formidable challenge for an experimenter. Very soft tissues are usually tested in compression using an unconfined compression set-up, which requires ascertaining that friction between sample faces and stress-strain machine platens is close to zero. In this paper a more reliable method of testing is proposed. In the proposed method top and bottom faces of a cylindrical specimen with low aspect ratio are rigidly attached to the platens of the stress-strain machine (e.g. using surgical glue). This arrangement allows using a no-slip boundary condition in the analysis of the results. Even though the state of deformation in the sample cannot be treated as orthogonal the relationships between total change of height (measured) and strain are obtained. Two important results are derived: (i) deformed shape of a cylindrical sample subjected to uniaxial compression is independent on the form of constitutive law, (ii) vertical extension in the plane of symmetry lambda(z) is proportional to the total change of height for strains as large as 30%. The importance and relevance of these results to testing procedures in biomechanics are highlighted. PMID:15519351

  12. Mechanical Behavior of Tissue Simulants and Soft Tissues Under Extreme Loading Conditions

    NASA Astrophysics Data System (ADS)

    Kalcioglu, Zeynep Ilke

    Recent developments in computer-integrated surgery and in tissue-engineered constructs necessitate advances in experimental and analytical techniques in characterizing properties of mechanically compliant materials such as gels and soft tissues, particularly for small sample volumes. One goal of such developments is to quantitatively predict and mimic tissue deformation due to high rate impact events typical of industrial accidents and ballistic insults. This aim requires advances in mechanical characterization to establish tools and design principles for tissue simulant materials that can recapitulate the mechanical responses of hydrated soft tissues under dynamic contact-loading conditions. Given this motivation, this thesis studies the mechanical properties of compliant synthetic materials developed for tissue scaffold applications and of soft tissues, via modifying an established contact based technique for accurate, small scale characterization under fully hydrated conditions, and addresses some of the challenges in the implementation of this method. Two different engineered material systems composed of physically associating block copolymer gels, and chemically crosslinked networks including a solvent are presented as potential tissue simulants for ballistic applications, and compared directly to soft tissues from murine heart and liver. In addition to conventional quasistatic and dynamic bulk mechanical techniques that study macroscale elastic and viscoelastic properties, new methodologies are developed to study the small scale mechanical response of the aforementioned material systems to concentrated impact loading. The resistance to penetration and the energy dissipative constants are quantified in order to compare the deformation of soft tissues and mechanically optimized simulants, and to identify the underlying mechanisms by which the mechanical response of these tissue simulant candidates are modulated. Finally, given that soft tissues are biphasic in

  13. Micromechanics and constitutive modeling of connective soft tissues.

    PubMed

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

    2016-07-01

    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. PMID:26807767

  14. Functional Attachment of Soft Tissues to Bone: Development, Healing, and Tissue Engineering

    PubMed Central

    Lu, Helen H.; Thomopoulos, Stavros

    2014-01-01

    Connective tissues such as tendons or ligaments attach to bone across a multitissue interface with spatial gradients in composition, structure, and mechanical properties. These gradients minimize stress concentrations and mediate load transfer between the soft and hard tissues. Given the high incidence of tendon and ligament injuries and the lack of integrative solutions for their repair, interface regeneration remains a significant clinical challenge. This review begins with a description of the developmental processes and the resultant structure-function relationships that translate into the functional grading necessary for stress transfer between soft tissue and bone. It then discusses the interface healing response, with a focus on the influence of mechanical loading and the role of cell-cell interactions. The review continues with a description of current efforts in interface tissue engineering, highlighting key strategies for the regeneration of the soft tissue–to-bone interface, and concludes with a summary of challenges and future directions. PMID:23642244

  15. Roentgen Examination of Soft Tissues of the Pelvis

    PubMed Central

    Noonan, Charles D.

    1964-01-01

    With meticulous preparation of the patient and with careful technique, the soft tissues of the pelvis are identifiable in most cases. Search should be made for the traces of abnormal pelvic structures on plain-film studies. Once the normal is recognized, any variations are easily identified. The fundamental differences between various radiologic densities—air, fat, fluid, muscle, calcium, bone and metal—should be observed. Special procedures can be used to enhance the contrasts after adequate evaluation of the simplest and, on many occasions, the invaluable, plain-film study of the soft tissues of the pelvis. ImagesFigure 2.Figure 3.Figure 3.Figure 4.Figure 5.Figure 6.Figure 7.Figure 8. PMID:14232160

  16. [Metastasis and progression mechanisms of soft tissue tumors].

    PubMed

    Steinestel, K; Wardelmann, E

    2015-11-01

    Invasion and metastatic dissemination of tumor cells defines prognosis not only in patients with epithelial, but also mesenchymal neoplasms. Early and clinically inapparent micrometastases occur in many patients, and the risk for metastasis correlates with the tumor subtype and histologic tumor grade. In recent years and analogous to the situation in epithelial tumors, mechanisms of tumor cell dissemination in soft tissue tumors have been increasingly understood, and it has been shown that reorganization of the actin cytoskeleton plays a key role in these processes. This review summarizes current knowledge on the mechanisms of progression and metastasis of soft tissue tumors and points out possible targets for novel anti-invasive and anti-metastatic therapies. PMID:26324521

  17. Soft tissue malignant lymphoma at sites of previous surgery.

    PubMed Central

    Radhi, J M; Ibrahiem, K; al-Tweigeri, T

    1998-01-01

    Three diffuse centroblastic lymphomas developed at the site of previous surgery. Two were preceded by atypical lymphoid infiltrates. Clinical data, microscopic features, and immunophenotypic studies were reviewed. All three patients presented with soft tissue masses at the site of previous surgery and metallic implants, with no evidence of lymphadenopathy, hepatosplenomegaly, or bone marrow involvement. There was no history of immunosuppression or risk factors. In two cases the initial diagnosis was of atypical lymphoid infiltrate progressing to lymphoma. Pathological examination showed a diffuse centroblastic lymphoma with an angiocentric pattern in one case. Phenotypic studies confirmed B cell origin. Soft tissue malignant lymphoma, though uncommon, can occur at the site of previous orthopaedic surgery, in particular joint replacement. Atypical lymphoid infiltrate may signal such an event. Images PMID:9828826

  18. Recurrent Soft Tissue Abscesses Caused by Legionella cincinnatiensis

    PubMed Central

    Gubler, Jacques G. H.; Schorr, Mirjam; Gaia, V.; Zbinden, R.; Altwegg, M.

    2001-01-01

    Recurrent soft tissue abscesses of the jaw, wrist, and arm developed in a 73-year-old housewife with nephrotic syndrome and immunoglobulin A(κ) gammopathy of unknown etiology. Conventional cultures remained negative, despite visible gram-negative rods on microscopy. Broad-spectrum PCR revealed Legionella cincinnatiensis, which was confirmed by isolation of the organism on special Legionella medium. Infections due to Legionella species outside the lungs are rare. L. cincinnatiensis has been implicated in only four cases of clinical infection; these involved the lungs in three patients and the central nervous system in one patient. We conclude that broad-spectrum PCR can be a valuable tool for the evaluation of culture-negative infections with a high probability of bacterial origin and that Legionella might be an underdiagnosed cause of pyogenic soft tissue infection. PMID:11724886

  19. Radiographic features of osseous metastases of soft-tissue sarcomas

    SciTech Connect

    Wong, W.S.; Kaiser, L.R.; Gold, R.H.; Fon, G.T.

    1982-04-01

    In contrast to most other neoplastic processes of bone, in our study osseous metastases from soft-tissue sarcomas (STS) were more reliably detected by radiography than by scintigraphy. The radiographic manifestations of 65 skeletal metastases in 23 patients with STS were reveiwed. Although most metastases (88%) were osteolytic, eight (12%) lesions were osteoblastic. The destructive patterns were geographic in 29%, moth-eaten in 55%, and permeative in 12% of the lesions. The axial skeleton was most commonly involved. In the long bones the diaphyses were the predominant sites of involvement. The bony cortex was frequently breached, with resultant soft-tissue swelling and pathologic fractures. Noteworthy features included subarticular location, involvement of the sarcoiliac joint, and an expansile appearance.

  20. Soft Tissue Coverage of the Mangled Upper Extremity

    PubMed Central

    Ng, Zhi Yang; Salgado, Christopher J.; Moran, Steven L.; Chim, Harvey

    2015-01-01

    Mangled upper extremity injuries usually involve high-impact trauma with crushing and tearing of the limb and its associated soft tissue structures. Such trauma is particularly mutilating because of the nature of the injury and the involvement of structures vital for proper function. Although advancements in flap technique and improvements in bone fixation methods have enabled good functional and clinical outcomes in limb salvage reconstruction, this remains a challenging area. Attempts at limb preservation should be fully exhausted before consideration is given for amputation, which results in significantly decreased function. Here the authors focus on the various modalities of soft tissue coverage available including allogenic substitutes, the adjunctive use of negative pressure wound therapy, and the design and utilization of flaps to address various defect configurations for the goals of wound healing, aesthetics, and functional restoration in the mangled upper extremity. PMID:25685103

  1. Photoacoustic imaging in both soft and hard biological tissue

    NASA Astrophysics Data System (ADS)

    Li, T.; Dewhurst, R. J.

    2010-03-01

    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.

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

    PubMed Central

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

    2016-01-01

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

  3. Necrotizing Soft Tissue Infection Caused by Spilled Gallstones

    PubMed Central

    Pandit, Narendra; Kumar, Hemanth; Verma, GR

    2016-01-01

    We report a case of a 57-year-old woman who presented with a necrotizing soft tissue infection of the right anterior abdominal wall, 1 year after open cholecystectomy for gallbladder perforation. Surgical exploration revealed pigmented gallstones along with pus in the abdominal wall and gallbladder fossa. Intraoperative spillage of gallstones is common during both open and laparoscopic cholecystectomy, but, in rare cases, can lead to serious complications including necrotizing infection of the abdominal wall. PMID:27144208

  4. Phase dispersion X-ray imaging of murine soft tissue

    NASA Astrophysics Data System (ADS)

    Ingal, V. N.; Ingal, E. A.

    2013-12-01

    The generation of phase-contrast (PC) images in the phase-dispersion introscopy (PDI) technique is the subject of this paper. Conditions for extreme sensitivity to murine soft-tissue anatomy are discussed. The unique information content and good contrast of the minutest details of anatomy, together with the high brilliance of X-ray optics, give the authors confidence that the PDI method can be successfully applied for medical diagnostics.

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

    PubMed

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

    2008-01-01

    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. PMID:18391343

  6. Polyacrylamide soft tissue filler nodule mimicking a mucoepidermoid carcinoma.

    PubMed

    Karagozoglu, K H; van der Waal, I

    2008-06-01

    A 39-year-old woman is described in whom histopathologic examination of a nodule of the cheek mucosa was suggestive of a mucoepidermoid carcinoma. Only after the availability of a wider surgical specimen was a distinct foreign body reaction to polyacrylamide soft tissue filler observed. On inquiry, the patient admitted to having this filler injected into her nasolabial folds 3 years previously. PMID:18313268

  7. Injectable carboxymethylcellulose hydrogels for soft tissue filler applications.

    PubMed

    Varma, Devika M; Gold, Gittel T; Taub, Peter J; Nicoll, Steven B

    2014-12-01

    Disease, trauma and aging all lead to deficits in soft tissue. As a result, there is a need to develop materials that safely and effectively restore areas of deficiency. While autogenous fat is the current gold standard, hyaluronic acid (HA) fillers are commonly used. However, the animal and bacterial origin of HA-based materials can induce adverse reactions in patients. With the aim of developing a safer and more affordable alternative, this study characterized the properties of a plant-derived, injectable carboxymethylcellulose (CMC) soft tissue filler. Specifically, methacrylated CMC was synthesized and crosslinked to form stable hydrogels at varying macromer concentrations (2-4% w/v) using an ammonium persulfate and ascorbic acid redox initiation system. The equilibrium Young's modulus was shown to vary with macromer concentration (ranging from ∼2 to 9.25kPa), comparable to values of native soft tissue and current surgical fillers. The swelling properties were similarly affected by macromer concentration, with 4% gels exhibiting the lowest swelling ratio and mesh size, and highest crosslinking density. Rheological analysis was performed to determine gelation onset and completion, and was measured to be within the ISO standard for injectable materials. In addition, hydrolytic degradation of these gels was sensitive to macromer concentration, while selective removal using enzymatic treatment was also demonstrated. Moreover, favorable cytocompatibility of the CMC hydrogels was exhibited by co-culture with human dermal fibroblasts. Taken together, these findings demonstrate the tunability of redox-crosslinked CMC hydrogels by varying fabrication parameters, making them a versatile platform for soft tissue filler applications. PMID:25152355

  8. A viscoelastic model to simulate soft tissue materials

    NASA Astrophysics Data System (ADS)

    Espinoza Ortiz, J. S.; Lagos, R. E.

    2015-09-01

    Continuum mechanic theories are frequently used to simulate the mechanical behavior of elastic and viscous materials, specifically soft tissues typically showing incompressibility, nonlinear deformation under stress, fading memory and insensitivity to the strain-rate. The time dependence of a viscoelastic material could be better understood by considering it as composed by an elastic solid and a viscous fluid. Different types of mechanical devices can be constructed provided a particular configuration of elastic springs and dashpots. In this work our aim is to probe many of the soft tissue mechanical behavior, by considering a Kelvin's device coupled to a set of in parallel Maxwell's devices. Then, the resulting model composed of a long series of modified Kelvin bodies must span a broad range of characteristic times resulting in a suitable model for soft tissue simulation. Under driving static and dynamic stress applied to a 2-Dim system, its time dependence strain response is computed. We obtain a set of coupled Volterra integral equations solved via the extended trapezoidal rule scheme, and the Newton-Raphson method to solve nonlinear coupled equations.

  9. Pazopanib in the management of advanced soft tissue sarcomas

    PubMed Central

    Cranmer, Lee D; Loggers, Elizabeth T; Pollack, Seth M

    2016-01-01

    Therapy of soft tissue sarcomas represents an area of significant unmet need in oncology. Angiogenesis has been explored as a potential target both preclinically and clinically, with suggestions of activity. Pazopanib is a multitargeted tyrosine kinase inhibitor with prominent antiangiogenic effects. In a Phase II study, pazopanib demonstrated activity in strata enrolling patients with leiomyosarcomas, synovial sarcomas, or other sarcomas but not those enrolling adipocytic sarcomas. PALETTE, the pivotal Phase III trial, demonstrated improved progression-free survival versus placebo in pazopanib-treated patients previously treated for advanced soft tissue sarcomas. No survival benefit was observed, and adipocytic sarcomas were excluded. Health-related quality-of-life assessments indicated significant decrements in several areas affected by pazopanib toxicities, but no global deterioration. Cost-effectiveness analyses indicate that pazopanib therapy may or may not be cost-effective in different geographic settings. Pazopanib provides important proof-of-concept for antiangiogenic therapy in soft tissue sarcomas. Its use can be improved by further biological studies of its activity profile in sarcomas, studies of biological rational combinations, and clinicopathologic/biological correlative studies of activity to allow better drug targeting. PMID:27354810

  10. Translational research in diagnosis and management of soft tissue tumours.

    PubMed

    Rimondi, Eugenio; Benassi, Maria Serena; Bazzocchi, Alberto; Balladelli, Alba; Facchini, Giancarlo; Rossi, Giuseppe; Taieb, Sophie; Vanel, Daniel

    2016-01-01

    Finding a soft tissue mass in the superficial regions is a common event in daily clinical practice. Correct management of the diagnostic process is crucial to avoid blunders. Diagnosis is posed by pathology, although both imaging and a better understanding of the cellular and molecular mechanisms play an important a role in the characterization, staging and follow-up of soft tissue masses. Cellular and molecular mechanisms can explain either the development of chemo-resistance and the underlying pre- and post-surgery metastasis formation. These are mandatory to improve prognosis and unveil novel parameters predicting therapeutic response. Imaging mainly involves ultrasound and MR and is fundamental not only in diagnosis but also in the first step of therapy: the biopsy. Novel imaging techniques like Ultrasound Elastosonography, Dynamic Contrast-Enhanced MR imaging (DCE), Diffusion Weighted MR imaging (DWI) and MR Spectroscopy (MRS) are discussed. This paper aims at reviewing and discussing pathological methods and imaging in the diagnosis of soft tissue masses underscoring that the most appropriate treatment depends on advanced molecular and radiological studies. PMID:27266712

  11. Soft Tissue Esthetic Norms for Mahabubnagar Population of Southern India

    PubMed Central

    Sinojiya, Jay; Aileni, Kaladhar Reddy; Rachala, Madhukar Reddy; Pyata, Jaipal Reddy; Mallikarjun, Vankre; Reddy, C. Manjunatha

    2014-01-01

    Aims: The Aim of the study was to establish Soft Tissue Cephalometric Norms for skeletal and dental relationships amongst the Mahabubnagar adult population. Materials and Methods: Sixty subjects (30 Males & 30 Females) subjects from different part of Mahabubnagar in the age group 18-25 Years (Mean age 21.3 Years) were selected at random for the study and lateral cephalograms were taken. All the cephalograms were traced by two operators using conventional hand tracing. The parameters used in the study were taken from Arnett and Bergman soft tissue cephalometric analysis (STCA). Overall 46 measurements including 40 linear, 6 angular parameters were used. Mean and standard deviation values were calculated. The difference between males and females were evaluated using student t-test. Results: The values obtained from the study showed significant difference in most of the parameters from that of Arnett et al., norms and between males and females within Mahabubnagar population. Conclusion: Males had thicker soft tissue structures, acute nasolabial angle, increased facial lengths and heights, increased midface deficiency, recessive lower face, more convex profile and less upright mandibular incisors than females within Mahabubnagar population. PMID:24596789

  12. Soft Tissue Surgical Procedures for Optimizing Anterior Implant Esthetics

    PubMed Central

    Ioannou, Andreas L.; Kotsakis, Georgios A.; McHale, Michelle G.; Lareau, Donald E.; Hinrichs, James E.; Romanos, Georgios E.

    2015-01-01

    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. PMID:26124837

  13. Role of chemotherapy in patients with soft tissue sarcomas.

    PubMed

    Maki, Robert G

    2004-04-01

    The management of soft tissue sarcomas has been highlighted in the last few years by the responsiveness of gastrointestinal stromal tumors to imatinib (Gleevec, Novartis). In this article, the use of chemotherapeutic agents in the management of this and some of the 50 or more subtypes of sarcomas are discussed, and a brief review of the use of chemotherapy in the adjuvant or neoadjuvant setting for people with large extremity sarcomas is provided. Doxorubicin and ifosfamide (Mitoxana, Bristol-Myers Squibb) remain the best individual drugs for sarcomas overall, although dacarbazine and gemcitabine (Gemzar, Eli Lilly) with or without a taxane has activity in at least a subset of sarcomas. The data regarding adjuvant chemotherapy for extremity soft tissue sarcomas is still quite mixed, with little if any overall survival advantage found to support its incorporation into disease management. The finding of tyrosine kinase inhibitors such as imatinib with demonstrated activity in gastrointestinal stromal tumors and dermatofibrosarcoma protuberans, as well as the finding of new agents such as ecteinascidin-743 (Yondelis, PharmaMar) with at least some activity against soft tissue sarcomas, reinforces the idea that we should target individual subtypes of sarcoma, just as treatment varies by subtype for the hematological malignancies. PMID:15056053

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

    PubMed Central

    Agarwal, Aditi; Prakash, Mahesh; Gupta, Pankaj; Tripathy, Satyaswarup; Kakkar, Nandita; Srinivasan, Radhika; Khandelwal, Niranjan

    2015-01-01

    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. PMID:26421187

  15. The pericyte antigen RGS5 in perivascular soft tissue tumors.

    PubMed

    Shen, Jia; Shrestha, Swati; Yen, Yu-Hsin; Scott, Michelle A; Soo, Chia; Ting, Kang; Peault, Bruno; Dry, Sarah M; James, Aaron W

    2016-01-01

    Perivascular soft tissue tumors are relatively uncommon neoplasms of unclear lineage of differentiation, although most are presumed to originate from or differentiate to pericytes or a modified perivascular cell. Among these, glomus tumor, myopericytoma, and angioleiomyoma share a spectrum of histologic findings and a perivascular growth pattern. In contrast, solitary fibrous tumor was once hypothesized to have pericytic differentiation--although little bona fide evidence of pericytic differentiation exists. Likewise the perivascular epithelioid cell tumor (PEComa) family shares a perivascular growth pattern, but with distinctive dual myoid-melanocytic differentiation. RGS5, regulator of G-protein signaling 5, is a novel pericyte antigen with increasing use in animal models. Here, we describe the immunohistochemical expression patterns of RGS5 across perivascular soft tissue tumors, including glomus tumor (n = 6), malignant glomus tumor (n = 4), myopericytoma (n = 3), angioleiomyoma (n = 9), myofibroma (n = 4), solitary fibrous tumor (n = 10), and PEComa (n = 19). Immunohistochemical staining and semi-quantification was performed, and compared to αSMA (smooth muscle actin) expression. Results showed that glomus tumor (including malignant glomus tumor), myopericytoma, and angioleiomyoma shared a similar diffuse immunoreactivity for RGS5 and αSMA across all tumors examined. In contrast, myofibroma, solitary fibrous tumor and PEComa showed predominantly focal to absent RGS5 immunoreactivity. These findings further support a common pericytic lineage of differentiation in glomus tumors, myopericytoma and angioleiomyoma. The pericyte marker RGS5 may be of future clinical utility for the evaluation of pericytic differentiation in soft tissue tumors. PMID:26558691

  16. Sorafenib in advanced, heavily pretreated patients with soft tissue sarcomas.

    PubMed

    Brämswig, Kira; Ploner, Ferdinand; Martel, Alexandra; Bauernhofer, Thomas; Hilbe, Wolfgang; Kühr, Thomas; Leitgeb, Clemens; Mlineritsch, Brigitte; Petzer, Andreas; Seebacher, Veronika; Stöger, Herbert; Girschikofsky, Michael; Hochreiner, Gerhard; Ressler, Sigrun; Romeder, Franz; Wöll, Ewald; Brodowicz, Thomas

    2014-08-01

    Therapeutic options for patients with advanced pretreated soft tissue sarcomas are limited. However, in this setting, sorafenib has shown promising results. We reviewed the data of 33 patients with soft tissue sarcoma treated with sorafenib within a named patient program in Austria. Twelve physicians from eight different hospitals provided records for the analysis of data. Among the 33 patients, the predominant histological subtype of sarcoma was leiomyosarcoma (n=18, 55%). Other subtypes were represented by only one or two cases. Fifteen patients presented with metastases at the time of diagnosis. Another 17 patients developed metastases later in the course of the disease (data on one patient are missing). Most of the 33 patients had undergone resection of the primary (n=29, 88%) and half of the patients had received radiotherapy (n=17, 52%). Chemotherapy for metastatic disease had been administered to 30 patients (91%). The majority had received two or more regimens of chemotherapy (n=25, 76%) before sorafenib treatment. The use of sorafenib resulted in a median time to treatment failure of 92 days in patients with leiomyosarcoma and 45 days in patients with other histological subtypes. One-third of the patients derived benefits from treatment: four patients were documented with partial response and six with stabilized disease. In terms of treatment-related toxicity, skin problems of various degrees and gastrointestinal disturbances were frequently reported. In this retrospective analysis of heavily pretreated patients with advanced soft tissue sarcomas, sorafenib was associated with some antitumor activity and an acceptable toxicity profile. PMID:24667659

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

    NASA Astrophysics Data System (ADS)

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

    2016-08-01

    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.

  18. Local Ablative Therapies to Metastatic Soft Tissue Sarcoma.

    PubMed

    Gronchi, Alessandro; Guadagnolo, B Ashleigh; Erinjeri, Joseph Patrick

    2016-01-01

    The approach to metastatic soft tissue sarcoma is complex and depends upon several factors, such as the extent of the disease, the histologic subtype of the primary tumor, the disease-free interval, patient status and comorbidities, and previous treatments. The effect of systemic chemotherapy is suboptimal, therefore local ablative therapies are often considered when the disease is limited, especially if confined to a single site/organ. Historically, surgery has been considered the treatment of choice for isolated lung metastases. This approach also has been extended to metastases in the liver, although a formal demonstration of its benefit has never been provided. Radiation therapy instead has been mainly used to obtain pain control and to reduce the risk of bone fracture and cord compression. Advances in techniques, such as the development of more precise conformational modalities and the employment of particles, may change the role of this modality in the strategic approach to metastatic soft tissue sarcoma. Recently, the use of interventional radiology in this scenario has expanded. Ablative approaches, such as radiofrequency ablation and cryoablation, have shown durable eradication of tumors. Catheter-directed therapies, such as hepatic artery embolization, are potential techniques for treating the patient who has multiple unresectable liver metastases. Understanding the timing and role of these three different modalities in the multidisciplinary approach to metastatic soft tissue sarcoma is critical to provide better care and to personalize the approach to the single patient. PMID:27249769

  19. Transmission ultrasonography. [time delay spectrometry for soft tissue transmission imaging

    NASA Technical Reports Server (NTRS)

    Heyser, R. C.; Le Croissette, D. H.

    1973-01-01

    Review of the results of the application of an advanced signal-processing technique, called time delay spectrometry, in obtaining soft tissue transmission images by transmission ultrasonography, both in vivo and in vitro. The presented results include amplitude ultrasound pictures and phase ultrasound pictures obtained by this technique. While amplitude ultrasonographs of tissue are closely analogous to X-ray pictures in that differential absorption is imaged, phase ultrasonographs represent an entirely new source of information based on differential time of propagation. Thus, a new source of information is made available for detailed analysis.

  20. Extremity Soft Tissue Sarcoma: Tailoring Resection to Histologic Subtype.

    PubMed

    Cable, Matthew G; Randall, R Lor

    2016-10-01

    Soft tissue sarcomas comprise tumors originating from mesenchymal or connective tissue. Histologic grade is integral to prognosis. Because sarcoma management is multimodal, histologic subtype should inform optimum treatment. Appropriate biopsy and communication between surgeon and pathologist can help ensure a correct diagnosis. Treatment often involves surgical excision with wide margins and adjuvant radiotherapy. There is no consensus on what constitutes an adequate margin for histologic subtypes. An appreciation of how histology corresponds with tumor biology and surgical anatomic constraints is needed for management of this disease. Even with the surgical goal of wide resection being obtained, many patients do not outlive their disease. PMID:27591492

  1. Gingival abscess removal using a soft-tissue laser.

    PubMed

    Prasad, Soni; Monaco, Edward A; Andreana, Sebastiano

    2011-02-01

    A case of acute inflammatory enlargement of gingival tissue in the form of a gingival abscess is presented in this paper. Its clinical features and histopathologic presentation are described. The etiology of this condition could be a variety of sources such as microbial plaque infection, trauma, and foreign body impaction. In this case, treatment included complete excision by the means of a 810-nm soft-tissue diode laser, which resulted in resolution of the abscess and clinical wound healing within approximately 2 to 3 weeks. Prognosis was excellent due to early diagnosis and immediate treatment. PMID:21400991

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

    ERIC Educational Resources Information Center

    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;…

  3. Deep soft-tissue leiomyoma of the forearm mimicking a primary bone tumor of the ulna

    PubMed Central

    Ramachandran, Rajoo; Rangaswami, Rajeswaran; Raja, Dorai Kumar; Shanmugasundaram, Gouthaman

    2015-01-01

    Leiomyomas of the soft tissues are rare in general, and extremely uncommon in the forearm. In general, leiomyomas are benign soft-tissue tumors that occur where smooth muscles are present. We present a case of soft-tissue leiomyoma of the forearm eroding the midshaft of the ulna, with emphasis on radiological diagnosis and histopathological correlation.

  4. A PROGRESSIVE RUPTURE MODEL OF SOFT TISSUE STRESS RELAXATION

    PubMed Central

    Bates, Jason H.T.; Ma, Baoshun

    2013-01-01

    A striking feature of stress relaxation in biological soft tissue is that it frequently follows a power law in time with an exponent that is independent of strain even when the elastic properties of the tissue are highly nonlinear. This kind of behavior is an example of quasi-linear viscoelasticity, and is usually modeled in a purely empirical fashion. The goal of the present study was to account for quasi-linear viscoelasticity in mechanistic terms based on our previously developed hypothesis that it arises as a result of isolated micro-yield events occurring in sequence throughout the tissue, each event passing the stress it was sustaining on to other regions of the tissue until they themselves yield. We modeled stress relaxation computationally in a collection of stress-bearing elements. Each element experiences a stochastic sequence of either increases in elastic equilibrium length or decreases in stiffness according to the stress imposed upon it. This successfully predicts quasi-linear viscoelastic behavior, and in addition predicts power-law stress relaxation that proceeds at the same slow rate as observed in real biological soft tissue. PMID:23508634

  5. Plantar soft tissue thickness during ground contact in walking

    NASA Technical Reports Server (NTRS)

    Cavanagh, P. R.

    1999-01-01

    A technique is introduced for the measurement of plantar soft tissue thickness during barefoot walking. Subjects stepped into an adjustable Plexiglas frame which ensured that the required bony landmarks were appropriately positioned relative to a linear ultrasound probe connected to a conventional 7.5 MHz ultrasound scanner. Clear images of the metatarsal condyles or other foot bones were obtained throughout ground contact. Subsequent analysis of the video taped images using a motion analysis system allowed the tissue displacement to be calculated as a function of time. The tissue underneath the second metatarsal head was shown to undergo an average maximum compression of 45.7% during the late stages of ground contact during first step gait in a group of five normal subjects with a mean unloaded tissue thickness of 15.2 mm. The technique has a number of applications, including use in the validation of deformation predicted by finite element models of the soft tissue of the foot, and the study of alterations in the cushioning properties of the heel by devices which constrain the displacement of the heel pad.

  6. Characterisation of matrix vesicles in skeletal and soft tissue mineralisation.

    PubMed

    Cui, L; Houston, D A; Farquharson, C; MacRae, V E

    2016-06-01

    The importance of matrix vesicles (MVs) has been repeatedly highlighted in the formation of cartilage, bone, and dentin since their discovery in 1967. These nano-vesicular structures, which are found in the extracellular matrix, are believed to be one of the sites of mineral nucleation that occurs in the organic matrix of the skeletal tissues. In the more recent years, there have been numerous reports on the observation of MV-like particles in calcified vascular tissues that could be playing a similar role. Therefore, here, we review the characteristics MVs possess that enable them to participate in mineral deposition. Additionally, we outline the content of skeletal tissue- and soft tissue-derived MVs, and discuss their key mineralisation mediators that could be targeted for future therapeutic use. PMID:27072517

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

    PubMed Central

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

    2016-01-01

    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. PMID:27446642

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

    PubMed

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

    2016-04-01

    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. PMID:27446642

  9. An augmented reality framework for soft tissue surgery.

    PubMed

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

    2014-01-01

    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. PMID:25333146

  10. Bayesian calibration of hyperelastic constitutive models of soft tissue.

    PubMed

    Madireddy, Sandeep; Sista, Bhargava; Vemaganti, Kumar

    2016-06-01

    There is inherent variability in the experimental response used to characterize the hyperelastic mechanical response of soft tissues. This has to be accounted for while estimating the parameters in the constitutive models to obtain reliable estimates of the quantities of interest. The traditional least squares method of parameter estimation does not give due importance to this variability. We use a Bayesian calibration framework based on nested Monte Carlo sampling to account for the variability in the experimental data and its effect on the estimated parameters through a systematic probability-based treatment. We consider three different constitutive models to represent the hyperelastic nature of soft tissue: Mooney-Rivlin model, exponential model, and Ogden model. Three stress-strain data sets corresponding to the deformation of agarose gel, bovine liver tissue, and porcine brain tissue are considered. Bayesian fits and parameter estimates are compared with the corresponding least squares values. Finally, we propagate the uncertainty in the parameters to a quantity of interest (QoI), namely the force-indentation response, to study the effect of model form on the values of the QoI. Our results show that the quality of the fit alone is insufficient to determine the adequacy of the model, and due importance has to be given to the maximum likelihood value, the landscape of the likelihood distribution, and model complexity. PMID:26751706

  11. Measurement of Mechanical Properties of Soft Tissue with Ultrasound Vibrometry

    NASA Astrophysics Data System (ADS)

    Nenadich, I.; Bernal, M.; Greenleaf, J. F.

    The cardiovascular diseases atherosclerosis, coronary artery disease, hypertension and heart failure have been related to stiffening of vessels and myocardium. Noninvasive measurements of mechanical properties of cardiovascular tissue would facilitate detection and treatment of disease in early stages, thus reducing mortality and possibly reducing cost of treatment. While techniques capable of measuring tissue elasticity have been reported, the knowledge of both elasticity and viscosity is necessary to fully characterize mechanical properties of soft tissues. In this article, we summarize the Shearwave Dispersion Ultrasound Vibrometry (SDUV) method developed by our group and report on advances made in characterizing stiffness of large vessels and myocardium. The method uses radiation forceFadiation force to excite shear waves in soft tissue and pulse echo ultrasound to measure the motion. The speed of propagation of shear waves at different frequencies is used to generate dispersions curves for excised porcine left-ventricular free-wall myocardium and carotid arteries. An antisymmetric Lamb wave model was fitted to the LV myocardium dispersion curves to obtain elasticity and viscosity moduli. The results suggest that the speed of shear wave propagation in four orthogonal directions on the surface of the excised myocardium is similar. These studies show that the SDUV method has potential for clinical application in noninvasive quantification of elasticity and viscosity of vessels and myocardium.

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

    PubMed

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

    2008-04-01

    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. PMID:18366319

  13. Design and analysis of tissue engineering scaffolds that mimic soft tissue mechanical anisotropy.

    PubMed

    Courtney, Todd; Sacks, Michael S; Stankus, John; Guan, Jianjun; Wagner, William R

    2006-07-01

    Tissue engineered constructs must exhibit tissue-like functional properties, including mechanical behavior comparable to the native tissues they are intended to replace. Moreover, the ability to reversibly undergo large strains can help to promote and guide tissue growth. Electrospun poly (ester urethane) ureas (ES-PEUU) are elastomeric and allow for the control of fiber diameter, porosity, and degradation rate. ES-PEUU scaffolds can be fabricated to have a well-aligned fiber network, which is important for applications involving mechanically anisotropic soft tissues. We have developed ES-PEUU scaffolds under variable speed conditions and modeled the effects of fiber orientation on the macro-mechanical properties of the scaffold. To illustrate the ability to simulate native tissue mechanical behavior, we demonstrated that the high velocity spun scaffolds exhibited highly anisotropic mechanical properties closely resembling the native pulmonary heart valve leaflet. Moreover, use of the present fiber-level structural constitutive model allows for the determination of electrospinning conditions to tailor ES-PEUU scaffolds for specific soft tissue applications. The results of this study will help to provide the basis for rationally designed mechanically anisotropic soft tissue engineered implants. PMID:16545867

  14. A Structural, Kinetic Model of Soft Tissue Thermomechanics☆

    PubMed Central

    Stylianopoulos, Triantafyllos; Aksan, Alptekin; Barocas, Victor H.

    2008-01-01

    Abstract A structure-based kinetic model was developed to predict the thermomechanical response of collagenous soft tissues. The collagen fibril was represented as an ensemble of molecular arrays with cross-links connecting the collagen molecules within the same array. A two-state kinetic model for protein folding was employed to represent the native and the denatured states of the collagen molecule. The Monte Carlo method was used to determine the state of the collagen molecule when subjected to thermal and mechanical loads. The model predictions were compared to existing experimental data for New Zealand white rabbit patellar tendons. The model predictions for one-dimensional tissue shrinkage and the corresponding mechanical property degradation agreed well with the experimental data, showing that the gross tissue behavior is dictated by molecular-level phenomena. PMID:17890379

  15. Gemcitabine Hydrochloride With or Without Pazopanib Hydrochloride in Treating Patients With Refractory Soft Tissue Sarcoma

    ClinicalTrials.gov

    2016-04-05

    Adult Alveolar Soft Part Sarcoma; Adult Angiosarcoma; Adult Desmoplastic Small Round Cell Tumor; Adult Epithelioid Hemangioendothelioma; Adult Epithelioid Sarcoma; Adult Extraskeletal Myxoid Chondrosarcoma; Adult Extraskeletal Osteosarcoma; Adult Fibrosarcoma; Adult Leiomyosarcoma; Adult Liposarcoma; Adult Malignant Mesenchymoma; Adult Malignant Peripheral Nerve Sheath Tumor; Adult Rhabdomyosarcoma; Adult Synovial Sarcoma; Adult Undifferentiated Pleomorphic Sarcoma; Malignant Adult Hemangiopericytoma; Recurrent Adult Soft Tissue Sarcoma; Stage III Adult Soft Tissue Sarcoma; Stage IV Adult Soft Tissue Sarcoma

  16. Depsipeptide (Romidepsin) in Treating Patients With Metastatic or Unresectable Soft Tissue Sarcoma

    ClinicalTrials.gov

    2014-08-26

    Adult Alveolar Soft-part Sarcoma; Adult Angiosarcoma; Adult Epithelioid Sarcoma; Adult Extraskeletal Chondrosarcoma; Adult Extraskeletal Osteosarcoma; Adult Fibrosarcoma; Adult Leiomyosarcoma; Adult Liposarcoma; Adult Malignant Fibrous Histiocytoma; Adult Malignant Hemangiopericytoma; Adult Malignant Mesenchymoma; Adult Neurofibrosarcoma; Adult Rhabdomyosarcoma; Adult Synovial Sarcoma; Gastrointestinal Stromal Tumor; Metastatic Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor; Recurrent Adult Soft Tissue Sarcoma; Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor; Stage III Adult Soft Tissue Sarcoma; Stage IV Adult Soft Tissue Sarcoma

  17. Dermatofibrosarcoma Protuberans: Insights into a Rare Soft Tissue Tumor

    PubMed Central

    Al Barwani, Aliya Sarhan; Taif, Sawsan; Al Mazrouai, Reem Ahmed; Al Muzahmi, Khamis Salim; Alrawi, Asif

    2016-01-01

    Dermatofibrosarcoma protuberans (DFSP) is a rare soft tumor which originally represents a cutaneous sarcoma. It grows slowly and presents usually as nodular superficial lesion on the trunk or the extremities. Although these tumors are locally aggressive with high rate of recurrence following surgery; the prognosis is considered excellent when it is effectively treated. The radiological appearance of this tumor has rarely been studied and findings infrequently discussed in the literature probably because many lesions underwent resection before imaging. Although imaging is infrequently performed for this lesion; it can show characteristic features and demonstrate the full extent. Imaging may also play a role in the differentiation of this tumor from more serious soft tissue lesions such as more aggressive sarcomas and hemangioma. In this article, we discuss the imaging findings of DFSP that can aid in its diagnosis and its variable appearances. In addition; the clinical presentation and treatment options are also described with review of the previous literature. PMID:27195182

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

    NASA Technical Reports Server (NTRS)

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

    2014-01-01

    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.

  19. Constitutive modeling of crimped collagen fibrils in soft tissues.

    PubMed

    Grytz, Rafael; Meschke, Günther

    2009-10-01

    A microstructurally oriented constitutive formulation for the hyperelastic response of crimped collagen fibrils existing in soft connective tissues is proposed. The model is based on observations that collagen fibrils embedded in a soft matrix crimp into a smooth three-dimensional pattern when unloaded. Following ideas presented by Beskos and Jenkins [Beskos, D., Jenkins, J., 1975. A mechanical model for mammalian tendon. ASME Journal of Applied Mechanics 42, 755-758] and Freed and Doehring [Freed, A., Doehring, T., 2005. Elastic model for crimped collagen fibrils. Journal of Biomechanical Engineering 127, 587-593] the collagen fibril crimp is approximated by a cylindrical helix to represent the constitutive behavior of the hierarchical organized substructure of biological tissues at the fibrillar level. The model is derived from the nonlinear axial force-stretch relationship of an extensible helical spring, including the full extension of the spring as a limit case. The geometrically nonlinear solution of the extensible helical spring is carried out by an iterative procedure. The model only requires one material parameter and two geometrical parameters to be determined from experiments. The ability of the proposed model to reproduce the biomechanical response of fibrous tissues is demonstrated for fascicles from rat tail tendons, for porcine cornea strips, and for bovine Achilles tendons. PMID:19627859

  20. Bacteremic skin and soft tissue infection caused by Prevotella loescheii

    PubMed Central

    2014-01-01

    Background Anaerobes are a major component of gut flora. They play an important role in the pathogenesis of infections resulting from breaches in mucus membranes. Because of the difficulties in cultivating and identifying it, their role continues to be undermined. The purpose of this paper is to report a case of Prevotella loescheii bacteremic skin and soft tissue infection and review the literature. Case presentation A 42-year-old Caucasian man was admitted for an elective bariatric surgery. A lengthy intensive care unit stay and buttocks decubitus ulcers complicated his post-operative course. After being transferred to a long-term care facility, the decubitus ulcer became secondarily infected with multiple bacteria including P. loescheii; an anaerobe that grew in blood and wound cultures. The patient was treated successfully with aggressive surgical debridement, antibiotics and subsequent wound care. Conclusion P. loescheii colonizes the gut and plays an important role in periodontal infections. In rare occasions and under suitable circumstances, it can infect skin and soft tissues as well as joints. Given the difficulties in isolating anaerobes in the microbiology lab, considering this bacterium alongside other anaerobes in infections of devitalized tissue is indicated even if cultures were reported negative. PMID:24661318

  1. Scalp Rotation Flap for Reconstruction of Complex Soft Tissue Defects.

    PubMed

    Costa, Dary J; Walen, Scott; Varvares, Mark; Walker, Ronald

    2016-02-01

    Importance Scalp reconstructions may be required after tumor resection or trauma. The inherent anatomy of the scalp presents challenges and may limit reconstructive options. Objective To describe and investigate the scalp rotation flap as a reconstructive technique for complex soft tissue defects. Design Retrospective case series with a mean follow-up of 13 months. Setting Tertiary academic center. Participants A total of 22 patients with large scalp soft tissue defects undergoing scalp rotation flap reconstruction. Interventions The flap is designed adjacent to the defect and elevated in the subgaleal plane. The flap is rotated into the defect, and a split-thickness skin graft is placed over the donor site periosteum. Main Outcomes and Measure Data points collected included defect size, operative time, hospital stay, and patient satisfaction with cosmetic outcome. Results Mean patient age was 71 years. Mean American Society of Anesthesiologist classification was 2.8. Mean defect size was 41 cm(2) (range: 7.8-120 cm(2)), and 19 of 22 defects resulted from a neoplasm resection. Mean operative time was 181 minutes, and mean hospital stay was 2.4 days. There were no intraoperative complications. Three patients with previous radiation therapy had distal flap necrosis. Twenty-one patients (95%) reported an acceptable cosmetic result. Conclusions and Relevance The scalp rotation flap is an efficient and reliable option for reconstructing complex soft tissue defects. This can be particularly important in patients with significant medical comorbidities who cannot tolerate a lengthy operative procedure. PMID:26949586

  2. Collateral soft tissue release in primary total knee replacement

    PubMed Central

    Deep, Kamal

    2014-01-01

    The aim of this study was to assess the rate of collateral soft tissue release required in navigated total knee arthroplasty (TKA) to achieve an intra-operative coronal femoral tibial mechanical axis (FTMA) in extension of 0 ± 2°. The primary outcomes assessed were post-operative coronal plane alignment and rate of collateral soft tissue release. The secondary outcomes were range of motion, function, patient satisfaction, and complication rates at one-year follow-up. This is a prospective study of 224 knees. No exclusions were made on the basis of pathology or severity of deformity. Pre-operative FTMA ranged from 27° valgus to 25° varus (mean: −4.5° SD 7.6). Soft tissue release was carried out in 5 of 224 knees (2.2%). Post-operative weight-bearing radiological FTMA ranged from 7° valgus to 8° varus (mean: −0.4° SD 2.5°). Two hundred and ten knees (96%) were within 0 ± 5° of neutral. At one year, median maximum flexion was 100° (IQR 15°) and extension was 0°; mean post-operative Oxford Knee Score had improved from 42 to 23; and 91% of patients were satisfied or very satisfied, with only 2% being dissatisfied. We have found that in the vast majority of cases, including those with large pre-operative coronal deformity in extension, good outcomes in terms of coronal alignment, range of movement, function and patient satisfaction can be achieved. PMID:24720493

  3. Endotine Midface for Soft Tissue Suspension in Zygoma Fracture.

    PubMed

    Shim, Hyung-Sup; Seo, Bommie F; Rha, Eun-Young; Byeon, Jun Hee

    2015-09-01

    Treatment of zygomatic fractures necessitates dissection beneath the soft tissues of the cheek. Inadequate resuspension may lead to deformities, including cheek ptosis, lower lid ectropion, and lateral canthal dystopia. The authors present their experience using a biodegradable suspension device for cheek flap resuspension. Patients who received open reduction for unilateral zygomatic fracture between January, 2006 and December, 2013 at a single center were included in the study. Patients could choose whether or not to have Endotine midface inserted. Patients rated satisfaction on facial symmetry. Computed tomography (CT) at 15 months was assessed for soft tissue thickness at the level of the midpoint of the nasolabial fold on each side. Photographs at 15 months were viewed by 3 blinded plastic surgeons and rated for cheek drooping. The results for all 3 parameters were compared between the Endotine group and the control group. A total of 83 patients were included (43 in the Endotine group and 39 in the control group). Patient satisfaction scores were statistically higher (P = 0.03) in the Endotine group (3.70 ± 0.76) than the control group (2.85 ± 0.96). Computed tomography soft tissue thickness score ratio between affected and unaffected side was significantly lower (P < 0.001) in the Endotine group than the ratio in the control group. Photography evaluation score difference between affected and unaffected side for the Endotine group (0.70 ± 0.77) was significantly (P = 0.041) smaller than the control group (1.92 ± 1.24). Endotine midface is easy to apply and effective in repositioning the elevated cheek flap in zygomatic fracture patients. PMID:26267573

  4. Imaging of soft tissue lesions of the foot and ankle.

    PubMed

    Bancroft, Laura W; Peterson, Jeffrey J; Kransdorf, Mark J

    2008-11-01

    Differential diagnosis of soft tissue lesions of the foot can 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 can suggest Morton's neuroma, giant cell tumor of 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 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. PMID:19038615

  5. Necrotizing Craniocervical Soft Tissue Infections: Clinical Experience and Personal Considerations

    PubMed Central

    Lenzi, Riccardo; Castelnuovo, Paolo; Dallan, Iacopo

    2012-01-01

    Necrotizing cervical soft tissue infections (NCSTIs) are devastating uncommon clinical entities that are often life threatening. We report two patients suffering from NCSTI and treated at our institution. Diagnosis of NCSTI has been confirmed histologically and surgically. Both patients were managed with very aggressive treatment (medical and surgical) and survived with minimal morbidity. Early diagnosis and aggressive, multimodality treatment can reduce mortality and morbidity rates. Thoracic and mediastinal involvement requires appropriate management. A strong clinical suspicion remains one of the most important aspects of the management of such shattering conditions. PMID:23304596

  6. Skin and soft tissue infections in the military.

    PubMed

    Lamb, Lucy; Morgan, M

    2013-09-01

    Skin and soft tissue infections (SSTI) are common in military populations regularly living and training in close contact with each other. The majority of such infections are simple and can be easily treated with antibiotics and appropriate infection control practices. Some, however, can progress to become complex and even life threatening, such as Panton-Valentine Leukocidin (PVL)-associated staphylococcus aureus pneumonia, or Streptococcus pyogenes necrotising fasciitis, which carry a mortality rate of up to 65% and 30%, respectively. This review focuses on the most important SSTIs and those more commonly affecting military personnel with advice on how they are best managed. PMID:24109144

  7. Soft tissue sarcomas in skin: presentations and management.

    PubMed

    Patt, Joshua C; Haines, Nikkole

    2016-06-01

    Soft tissue sarcomas are a rare but heterogeneous family of malignant tumors that are predominantly found deep to the integumentary layer. Only a small number of these primary mesenchymal tumors actually originate from the dermal layers. A systematic approach to the evaluation and workup of these neoplasms can prevent inappropriate management. After staging evaluation, most of these tumors are primarily managed with en-bloc surgical resection. Other adjuvant therapies routinely employed include chemotherapy and radiation therapy. Proper treatment typically involves participation of a multidisciplinary care team for optimal outcome. General principles and treatment strategies will be discussed along with a review of the more common cutaneous manifestations of sarcoma. PMID:27178697

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

    SciTech Connect

    Sheng, Ke Qi, Sharon X.; Gou, Shuiping; Wu, Jiaolong

    2014-10-15

    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

  9. Soft Tissue Tumours: Their Natural History and Treatment

    PubMed Central

    Cade, Stanford

    1951-01-01

    A series of 153 patients, the largest yet recorded from a single source, suffering from soft tissue sarcoma is discussed. References to the literature show the rarity of such tumours, the vagueness of the nomenclature and the disappointing results of treatment. Of the 153 patients only 7 have no histological confirmation of the diagnosis. In 146, sections and histological reports are available. 148 patients have been followed up either to death or to date. ImagesFig. 1Fig. 2Fig. 3Fig. 4 PMID:14808223

  10. Elastomeric biodegradable polyurethane blends for soft tissue applications.

    PubMed

    Fromstein, J D; Woodhouse, K A

    2002-01-01

    Four biodegradable polyurethane blends were made from segmented polyurethanes that contain amino acid-based chain extender and diisocyanate groups. The soft segments of these parent polyurethanes were either polyethylene oxide (PEO) or polycaprolactone (PCL) diols. The blends were developed to investigate the effect of varying soft segment compositions on the overall morphological, mechanical, and degradative properties of the materials, with a view to producing a family of materials with a wide range of properties. The highly hydrophilic PEO material was incorporated to increase the blend's susceptibility to degradation, while the PCL polyurethane was selected to provide higher moduli and percent elongations (strains) than the PEO parent materials can achieve. All four blends were determined to be semi-crystalline, elastomeric materials that possess similarly shaped stress-strain curves to that of the PCL-based parent polyurethane. As the percent composition of PEO polyurethane within the blend increased, the material became weaker and less extensible. The blends demonstrated rapid initial degradation in buffer followed by significantly slower, prolonged degradation, likely corresponding to an initial loss of primarily PEO-containing polymer, followed by the slower degradation of the PCL polyurethane. All four blends were successfully formed into three-dimensional porous scaffolds utilizing solvent casting/particulate leaching methods. Since these new blends possess a range of mechanical and degradation properties and can be shaped into three-dimensional objects, these materials may hold potential for use in soft tissue engineering scaffold applications. PMID:12160300

  11. Force modeling for needle insertion into soft tissue.

    PubMed

    Okamura, Allison M; Simone, Christina; O'Leary, Mark D

    2004-10-01

    The modeling of forces during needle insertion into soft tissue is important for accurate surgical simulation, preoperative planning, and intelligent robotic assistance for percutaneous therapies. We present a force model for needle insertion and experimental procedures for acquiring data from ex vivo tissue to populate that model. Data were collected from bovine livers using a one-degree-of-freedom robot equipped with a load cell and needle attachment. computed tomography imaging was used to segment the needle insertion process into phases identifying different relative velocities between the needle and tissue. The data were measured and modeled in three parts: 1) capsule stiffness, a nonlinear spring model; 2) friction, a modified Karnopp model; and 3) cutting, a constant for a given tissue. In addition, we characterized the effects of needle diameter and tip type on insertion force using a silicone rubber phantom. In comparison to triangular and diamond tips, a bevel tip causes more needle bending and is more easily affected by tissue density variations. Forces for larger diameter needles are higher due to increased cutting and friction forces. PMID:15490818

  12. Stress-dependent finite growth in soft elastic tissues.

    PubMed

    Rodriguez, E K; Hoger, A; McCulloch, A D

    1994-04-01

    Growth and remodeling in tissues may be modulated by mechanical factors such as stress. For example, in cardiac hypertrophy, alterations in wall stress arising from changes in mechanical loading lead to cardiac growth and remodeling. A general continuum formulation for finite volumetric growth in soft elastic tissues is therefore proposed. The shape change of an unloaded tissue during growth is described by a mapping analogous to the deformation gradient tensor. This mapping is decomposed into a transformation of the local zero-stress reference state and an accompanying elastic deformation that ensures the compatibility of the total growth deformation. Residual stress arises from this elastic deformation. Hence, a complete kinematic formulation for growth in general requires a knowledge of the constitutive law for stress in the tissue. Since growth may in turn be affected by stress in the tissue, a general form for the stress-dependent growth law is proposed as a relation between the symmetric growth-rate tensor and the stress tensor. With a thick-walled hollow cylinder of incompressible, isotropic hyperelastic material as an example, the mechanics of left ventricular hypertrophy are investigated. The results show that transmurally uniform pure circumferential growth, which may be similar to eccentric ventricular hypertrophy, changes the state of residual stress in the heart wall. A model of axially loaded bone is used to test a simple stress-dependent growth law in which growth rate depends on the difference between the stress due to loading and a predetermined growth equilibrium stress. PMID:8188726

  13. Enhancing Aesthetic Outcomes of Soft Tissue Coverage of the Hand

    PubMed Central

    Rehim, Shady A.; Kowalski, Evan; Chung, Kevin C.

    2016-01-01

    Hand aesthetics in general and aesthetic refinements of soft-tissue coverage of the hand in particular have been increasingly considered over the past few years. Advancements of microsurgery together with the traditional methods of tissue transfer have expanded the armamentarium of the reconstructive surgeon, thus shifting the reconstructive paradigm from simply ‘filling the defect’ to reconstructive refinement to provide the best functional and aesthetic results. However, drawing the boundary between what does and what does not constitute ‘aesthetic’ reconstruction of the hand is not straightforward. The selection amongst the vast amount of currently available reconstructive methods and the difficulties in objectively measuring or quantifying aesthetics has made this task complex and rather arbitrary. In this article we divide the hand into several units and subunits to simplify our understanding of the basic functional and aesthetic requirements of these regions that may ultimately bring order to complexity. PMID:25626826

  14. Therapeutic Ultrasound Enhancement of Drug Delivery to Soft Tissues

    NASA Astrophysics Data System (ADS)

    Lewis, George; Wang, Peng; Lewis, George; Olbricht, William

    2009-04-01

    Effects of exposure to 1.58 MHz focused ultrasound on transport of Evans Blue Dye (EBD) in soft tissues are investigated when an external pressure gradient is applied to induce convective flow through the tissue. The magnitude of the external pressure gradient is chosen to simulate conditions in brain parenchyma during convection-enhanced drug delivery (CED) to the brain. EBD uptake and transport are measured in equine brain, avian muscle and agarose brain-mimicking phantoms. Results show that ultrasound enhances EBD uptake and transport, and the greatest enhancement occurs when the external pressure gradient is applied. The results suggest that exposure of the brain parenchyma to ultrasound could enhance penetration of material infused into the brain during CED therapy.

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

    PubMed

    Pelteret, J-P V; Reddy, B D

    2012-01-01

    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. PMID:25830209

  16. Management of soft tissue wounds of the face

    PubMed Central

    Bhattacharya, V.

    2012-01-01

    Since time, immemorial soft-tissue injuries to the face have been documented in literature and even depicted in sculptures, reflecting the image of society. In a polytrauma the face may be involved or there may be isolated injury to the face. The face consists of several organs and aesthetic units. The final outcome depends on initial wound care and primary repair. So one should know the “do's and don’ts”. Disfigurement following trauma, becomes a social stigma and has the gross detrimental effect on the personality and future of the victim. Therefore, such cases are most appropriately managed by Plastic Surgeons who have a thorough knowledge of applied anatomy, an aesthetic sense and meticulous atraumatic tissue handling expertise, coupled with surgical skill to repair all the composite structures simultaneously. PMID:23450264

  17. Massive soft tissue infections: necrotizing fasciitis and purpura fulminans.

    PubMed

    Edlich, Richard F; Winters, Kathryne L; Woodard, Charles R; Britt, L D; Long, William B

    2005-01-01

    Necrotizing fasciitis and purpura fulminans are two destructive infections that involve both skin and soft tissue. Necrotizing fasciitis is characterized by widespread necrosis of subcutaneous tissue and the fascia. Historically, group A beta-hemolytic streptococcus has been identified as a major cause of this infection. However, this monomicrobial infection is usually associated with some underlying cause, such as diabetes mellitus. During the last two decades, scientists have found that the pathogenesis of necrotizing fasciitis is polymicrobial. The diagnosis of necrotizing fasciitis must be made as soon as possible by examining the skin inflammatory changes. Magnetic resonance imaging is strongly recommended to detect the presence of air within the tissues. Percutaneous aspiration of the soft tissue infection followed by prompt Gram staining should be conducted with the "finger-test" and rapid-frozen section biopsy examination. Intravenous antibiotic therapy is one of the cornerstones of managing this life-threatening skin infection. Surgery is the primary treatment for necrotizing fasciitis, with early surgical fasciotomy and debridement. Following debridement, skin coverage by either Integra Dermal Regeneration Template or AlloDerm should be undertaken. Hyperbaric oxygen therapy complemented by intravenous polyspecific immunoglobulin are useful adjunctive therapies. Purpura fulminans is a rare syndrome of intravascular thrombosis and hemorrhagic infarction of the skin; it is rapidly progressive and accompanied by vascular collapse. There are three types of purpura fulminans: neonatal purpura fulminans, idiopathic or chronic purpura fulminans, and acute infectious purpura fulminans. Clinical presentation of purpura fulminans involves a premonitory illness followed by the rapid development of a septic syndrome with fever, shock, and disseminated intravascular coagulation. The diagnosis and treatment of these conditions is best accomplished in a regional burn

  18. Observation, Radiation Therapy, Combination Chemotherapy, and/or Surgery in Treating Young Patients With Soft Tissue Sarcoma

    ClinicalTrials.gov

    2014-09-08

    Adult Alveolar Soft-part Sarcoma; Adult Angiosarcoma; Adult Epithelioid Sarcoma; Adult Extraskeletal Chondrosarcoma; Adult Extraskeletal Osteosarcoma; Adult Fibrosarcoma; Adult Leiomyosarcoma; Adult Liposarcoma; Adult Malignant Fibrous Histiocytoma; Adult Malignant Hemangiopericytoma; Adult Malignant Mesenchymoma; Adult Neurofibrosarcoma; Adult Synovial Sarcoma; Childhood Alveolar Soft-part Sarcoma; Childhood Angiosarcoma; Childhood Epithelioid Sarcoma; Childhood Fibrosarcoma; Childhood Leiomyosarcoma; Childhood Liposarcoma; Childhood Malignant Mesenchymoma; Childhood Neurofibrosarcoma; Childhood Synovial Sarcoma; Dermatofibrosarcoma Protuberans; Metastatic Childhood Soft Tissue Sarcoma; Nonmetastatic 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

  19. Satisfying patient expectations with soft-tissue augmentation.

    PubMed

    Mandy, Stephen H

    2009-01-01

    The popularity of cosmetic procedures for rejuvenating the face has undergone enormous growth over the past few years, such that at least one in four cosmetic procedures involves the use of soft-tissue augmentation. Of note is the trend away from surgical interventions and toward noninvasive cosmetic procedures, which now account for the majority of all cosmetic procedures performed in the United States. Adult patients of all ages are selecting soft-tissue augmentation, either as a precursor to or a substitute for surgery; there is a trend toward the use of injectable devices in younger patients (aged 35 - 50 years). Patients in different age groups have diverse treatment needs ranging from the correction of fine lines and wrinkles in younger patients to volume restoration in older patients. Thus, the treatment needs will dictate the treatment approach, particularly with injectable filler treatments. The aesthetic physician needs to help the patient understand and select the most appropriate rejuvenating treatment based on a variety of factors, specifically, patient age, motivating factors, timing, cosmetic area to be addressed, and desired outcome. This article suggests a series of steps to help determine the most appropriate approach for volume restoration with injectable devices for satisfying patient treatment expectations. PMID:19903429

  20. Adult Head and Neck Soft Tissue Sarcomas: Treatment and Outcome

    PubMed Central

    Singh, Rabindra P.; Grimer, Robert J.; Bhujel, Nabina; Carter, Simon R.; Tillman, Roger M.; Abudu, Adesegun

    2008-01-01

    We have retrospectively analysed the experience of a musculoskeletal oncological unit in the management of adult head and neck soft tissue sarcomas from 1990 to 2005. Thirty-six patients were seen, of whom 24 were treated at this unit, the remainder only receiving advice. The median age of the patients was 46 years. Most of the sarcomas were deep and of high or intermediate grade with a median size of 5.5 cm. Eleven different histological subtypes were identified. Wide excision was possible only in 21% of the cases. 42% of the patients developed local recurrence and 42% developed metastatic disease usually in the lungs. Overall survival was 49% at 5 years. Tumour size was the most important prognostic factor. Adult head and neck soft tissue sarcomas have a high mortality rate with a high risk of local recurrence and metastatic disease. The rarity of the disease would suggest that centralisation of care could lead to increased expertise and better outcomes. PMID:18382622

  1. Method for Fabricating Soft Tissue Implants with Microscopic Surface Roughness

    NASA Technical Reports Server (NTRS)

    Banks, Bruce A. (Inventor); Rutledge, Sharon K. (Inventor)

    1999-01-01

    A method for fabricating soft tissue implants using a mold. The cavity surface of an initially untextured mold. made of an organic material such as epoxy. is given a thin film coating of material that has pinholes and is resistant to atomic particle bombardment. The mold cavity surface is then subjected to atomic particle bombardment, such as when placed in an isotropic atomic oxygen environment. Microscopic depressions in the mold cavity surface are created at the pinhole sites on the thin film coating. The thin film coating is removed and the mold is then used to cast the soft tissue implant. The thin film coating having pinholes may be created by chilling the mold below the dew point such that water vapor condenses upon it; distributing particles, that can partially dissolve and become attached to the mold cavity surface, onto the mold cavity surface; removing the layer of condensate, such as by evaporation; applying the thin film coating over the entire mold surface; and, finally removing the particles, such as by dissolving or brushing it off. Pinholes are created in the thin film coating at the sites previously occupied by the particles.

  2. War wounds management--early reconstruction of soft tissue defects.

    PubMed

    Stanec, Z; Skrbić, S; Dzepina, I; Hulina, D; Ivrlac, R

    1994-01-01

    The authors emphasize that the knowledge of terminal ballistics is important for understanding the pathophysiology of war wounds. They present their own experiences in the treatment of war wounds in 504 casualties treated at the Institute of Plastic and Reconstructive Surgery, Department of Surgery, Clinical Hospital Center in Zagreb. The locations of soft-tissue defects were: head and neck, 103; trunk, 90; and extremities, 903. War wounds were divided into four main categories with regard to the type of the injury and the extension of soft-tissue defect, thus showing the differences in primary excision and reconstruction of the wounds. About 30% of head and neck injuries were treated by primary or delayed primary reconstruction. All thoraco-abdominal wounds were type I or II, and most of them (53.3%) were reconstructed with split-thickness skin grafts. The greatest number of sophisticated reconstructions were performed on extremity injuries (63 wounds were reconstructed by local flaps, while free flaps were used in 40 cases). The authors emphasize the importance of proper primary treatment, which is the condition for early reconstruction. This results in significantly shorter hospitalization, so that 62% of the patients were cured in 20 days and then discharged to early rehabilitation. PMID:7532048

  3. Changes in soft tissue profile following treatment with the bionator.

    PubMed

    Lange, D W; Kalra, V; Broadbent, B H; Powers, M; Nelson, S

    1995-01-01

    The purpose of this study was to determine the changes in the soft tissue profile in patients treated in the mixed dentition with a bionator. Two groups of 30 individuals, between 9 and 12 years old and with Class II, Division 1, malocclusion were matched for age, sex, observation time, and dentofacial characteristics. Patients in the first group were treated with a bionator for an average of 18.7 months, resulting in a Class I molar relationship and reduction of overjet. The second group acted as a control and individuals did not receive any form of orthodontic treatment. Pretreatment and posttreatment cephalograms were analyzed and paired t-tests were used to compare the significance of changes between the two groups. Compared with the control group, the treated group demonstrated 1.97 degrees decrease in ANB, a 3.35 mm increase in anterior facial height, 2.22 degrees decrease in soft tissue profile convexity, and 17.4 degrees increase in mentolabial angle. PMID:8702068

  4. Prevalence of oral soft tissue lesions in Vidisha

    PubMed Central

    2010-01-01

    Background The purpose of this study was to determine the prevalence of oral soft tissue lesions in patients and to assess their clinicopathological attributes. 3030 subjects belonging to a semi-urban district of Vidisha in Central India were screened. Patients were examined with an overhead examination light and those who were identified with a questionable lesion underwent further investigations. Statistical analysis was done using the SPSS software. Findings 8.4 percent of the population studied had one or more oral lesions, associated with prosthetic use, trauma and tobacco consumption. With reference to the habit of tobacco use, 635(21%) were smokers, 1272(42%) tobacco chewers, 341(11%) smokers and chewers, while 1464(48%) neither smoked nor chewed. 256 patients were found to have significant mucosal lesions. Of these, 216 cases agreed to undergo scalpel biopsy confirmation. 88 had leukoplakia, 21 had oral submucous fibrosis, 9 showed smoker's melanosis, 6 patients had lichen planus, 17 had dysplasia, 2 patients had squamous cell carcinoma while there was 1 patient each with lichenoid reaction, angina bullosa hemorrhagica, allergic stomatitis and nutritional stomatitis. Conclusions The findings in this population reveal a high prevalence of oral soft tissue lesions and a rampant misuse of variety of addictive substances in the community. Close follow up and systematic evaluation is required in this population. There is an urgent need for awareness programs involving the community health workers, dentists and allied medical professionals. PMID:20181008

  5. Updates on the cytogenetics and molecular cytogenetics of benign and intermediate soft tissue tumors

    PubMed Central

    NISHIO, JUN

    2013-01-01

    Soft tissue tumors are classified according to their histological resemblance to normal adult tissues and can be grouped into the following categories based on metastatic potential: benign, intermediate (locally aggressive), intermediate (rarely metastasizing) and malignant. Over the past two decades, considerable progress has been made in our understanding of the genetic background of soft tissue tumors. Traditional laboratory techniques, such as cytogenetic analysis and fluorescence in situ hybridization (FISH), can be used for diagnostic purposes in soft tissue pathology practice. Moreover, cytogenetic and molecular studies are often necessary for prognostics and follow-up of soft tissue sarcoma patients. This review provides updated information on the applicability of laboratory genetic testing in the diagnosis of benign and intermediate soft tissue tumors. These tumors include nodular fasciitis, chondroid lipoma, collagenous fibroma (desmoplastic fibroblastoma), giant cell tumor of tendon sheath (GCTTS)/pigmented villonodular synovitis (PVNS), angiofibroma of soft tissue, myxoinflammatory fibroblastic sarcoma (MIFS) and ossifying fibromyxoid tumor (OFMT). PMID:23255885

  6. Optimisation of the biology of soft tissue repair.

    PubMed

    Frank, C; Shrive, N; Hiraoka, H; Nakamura, N; Kaneda, Y; Hart, D

    1999-10-01

    As identified in this review, over the past twenty years there have been a number of very exciting new developments in the quest to optimise soft tissue repair. Comparing fetal soft tissue injuries, which heal by regeneration, to the adult processes of healing by inflammation-induced scar formation has led to a number of insights into how the latter may be improved. Seeding wounds with embryonic stem cells, bridging gaps with cell-derived "engineered tissues", addition of exogenous hyaluronic acid and modification of wounds to either enhance the growth factors which have been implicated in regeneration (e.g. TGF-B3) or block those implicated in scar formation (eg. TGF-B1) have all shown promise. Our group has quantified numerous cellular, molecular, biomechanical and matrix abnormalities of scar in a rabbit model of ligament healing. Based on these studies which we review here, three matrix deficiencies have been identified which appear to have specific implications to scar weakness: organisational "flaws", abnormal hydroxypyridinoline collagen cross-link densities and abnormally small, slow-maturing collagen fibrils. In tests aimed at finding therapeutic solutions in this model, the addition of a 7ug bolus of TGF-B1 at day 21 or 2.5ng/day of TGF-B1 being pumped into a wound x 21 days increased the size of ligament scars but did not improve their material strength. It also did not alter any of the above-noted matrix deficiencies. A liposome-mediated anti-sense gene therapy approach aimed at decreasing the expression of the proteoglycan decorin in 21-day scars, however, has significantly increased the size of scar collagen fibrils as well as improved these scars mechanically. Based on these positive results from a single dose of only one targeted molecule, we believe that this gene therapy approach has great potential for further scar improvement. If combined with some of the other biological strategies reviewed above, a repair which is closer to true regenerative

  7. Multiple-Image Radiography for Human Soft Tissue

    SciTech Connect

    Muehleman,C.; Li, J.; Zhong, Z.; Brankov, J.; Wernick, M.

    2006-01-01

    Conventional radiography only provides a measure of the X-ray attenuation caused by an object; thus, it is insensitive to other inherent informative effects, such as refraction. Furthermore, conventional radiographs are degraded by X-ray scatter that can obscure important details of the object being imaged. The novel X-ray technology diffraction-enhanced imaging (DEI) has recently allowed the visualization of nearly scatter-free images displaying both attenuation and refraction properties. A new method termed multiple-image radiography (MIR) is a significant improvement over DEI, corrects errors in DEI, is more robust to noise and produces an additional image that is entirely new to medical imaging. This new image, which portrays ultra-small-angle X-ray scattering (USAXS) conveys the presence of microstructure in the object, thus differentiating homogeneous tissues from tissues that are irregular on a scale of micrometers. The aim of this study was to examine the use of MIR for evaluation of soft tissue, and in particular to conduct a preliminary investigation of the USAXS image, which has not previously been used in tissue imaging.

  8. An Overview of Vascular Adverse Events Associated With Facial Soft Tissue Fillers: Recognition, Prevention, and Treatment.

    PubMed

    Ferneini, Elie M; Ferneini, Antoine M

    2016-08-01

    Minimally invasive facial cosmetic surgery procedures have seen an exponential increase in numbers over the past decade. The most commonly performed procedures are neuromodulator and soft tissue filler procedures. Although soft tissue fillers have a high safety and predictability profile, these procedures recently have been associated with serious and dire adverse events. This article will discuss some of the vascular complications associated with facial soft tissue fillers. Management and prevention of these adverse events also will be discussed. PMID:27067061

  9. Papilla preserving modified roll technique for stage 2 soft tissue augmentation

    PubMed Central

    Dhir, Sangeeta

    2014-01-01

    The aim of the article is to describe a modification of the roll flap, performed at the implant second surgical stage, allowing the correction of small horizontal defects by enhancing the soft-tissue thickness and improving the buccal soft-tissue profile. The advantages for this modification lies in the fact to preserve the papilla morphology and enhancement of the soft-tissue esthetic results. PMID:25210270

  10. Large Osteoarthritic Cyst Presenting as Soft Tissue Tumour – A Case Report

    PubMed Central

    Kosuge, DD; Park, DH; Cannon, SR; Briggs, TW; Pollock, RC; Skinner, JA

    2007-01-01

    Large osteoarthritic cysts can sometimes be difficult to distinguish from primary osseous and soft tissue tumours. We present such a case involving a cyst arising from the hip joint and eroding the acetabulum which presented as a soft tissue malignancy referred to a tertiary bone and soft tissue tumour centre. We discuss the diagnostic problems it may pose, and present a literature review of the subject. PMID:17535605

  11. Enamel matrix derivative, inflammation and soft tissue wound healing.

    PubMed

    Miron, R J; Dard, M; Weinreb, M

    2015-10-01

    Over 15 years have now passed since enamel matrix derivative (EMD) emerged as an agent capable of periodontal regeneration. Following thorough investigation, evidenced-based clinical application is now established for a multitude of clinical settings to promote regeneration of periodontal hard tissues. Despite the large number of studies and review articles written on this topic, no single review has compiled the influence of EMD on tissue inflammation, an area of research that merits substantial attention in periodontology. The aim of the present review was to gather all studies that deal with the effects of EMD on tissue inflammation with particular interest in the cellular mechanisms involved in inflammation and soft tissue wound healing/resolution. The effects of EMD on monocytes, macrophages, lymphocytes, neutrophils, fibroblasts and endothelial cells were investigated for changes in cell behavior as well as release of inflammatory markers, including interleukins, prostaglandins, tumor necrosis factor-α, matrix metalloproteinases and members of the OPG-RANKL pathway. In summary, studies listed in this review have reported that EMD is able to significantly decrease interleukin-1b and RANKL expression, increase prostaglandin E2 and OPG expression, increase proliferation and migration of T lymphocytes, induce monocyte differentiation, increase bacterial and tissue debris clearance, as well as increase fibroplasias and angiogenesis by inducing endothelial cell proliferation, migration and capillary-like sprout formation. The outcomes from the present review article indicate that EMD is able to affect substantially the inflammatory and healing responses and lay the groundwork for future investigation in the field. PMID:25418917

  12. The control of bone induction in soft tissues.

    PubMed

    Gray, D H; Speak, K S

    1979-09-01

    The induction of bone at the boundary of parenchymal organs has been studied using acid demineralized rib implants in rabbits. The induction of bone is usually confined to that portion of an implant protruding from such an organ though both scant cartilage induction and the induction of bone within the territory of parenchymal organs were seen on a few occasions. Neonatal splenectomy does not influence the inductive properties of bone matrix in muscle or other soft tissues. The inclusion of composite autografts of liver and acid demineralized bone in muscle results in a reduction in the induction rate. It is postulated that the parenchymal organs exclude osteoprogenitor cells and possibly blood-bone bone-marrow-derived osteoinductor releasing cells by some mechanism that is diffusable, thus preventing the initial inductive event. Composite grafts of matrix and muscle produce bone in these tissue, demonstrating that once bone cell differentiation by induction is initiated bone tissue develops even in spleen, liver and kidney parenchyma. PMID:389518

  13. Gelatin-Modified Polyurethanes for Soft Tissue Scaffold

    PubMed Central

    Kucińska-Lipka, Justyna; Janik, Helena

    2013-01-01

    Recently, in the field of biomaterials for soft tissue scaffolds, the interest of their modification with natural polymersis growing. Synthetic polymers are often tough, and many of them do not possess fine biocompatibility. On the other hand, natural polymers are biocompatible but weak when used alone. The combination of natural and synthetic polymers gives the suitable properties for tissue engineering requirements. In our study, we modified gelatin synthetic polyurethanes prepared from polyester poly(ethylene-butylene adipate) (PEBA), aliphatic 1,6-hexamethylene diisocyanate (HDI), and two different chain extenders 1,4-butanediol (BDO) or 1-ethoxy-2-(2-hydroxyethoxy)ethanol (EHEE). From a chemical point of view, we replaced expensive components for building PU, such as 2,6-diisocyanato methyl caproate (LDI) and 1,4-diisocyanatobutane (BDI), with cost-effective HDI. The gelatin was added in situ (in the first step of synthesis) to polyurethane to increase biocompatibility and biodegradability of the obtained material. It appeared that the obtained gelatin-modified PU foams, in which chain extender was BDO, had enhanced interactions with media and their hydrolytic degradation profile was also improved for tissue engineering application. Furthermore, the gelatin introduction had positive impact on gelatin-modified PU foams by increasing their hemocompatibility. PMID:24363617

  14. The New Kids on the Block: Recently Characterized Soft Tissue Tumors.

    PubMed

    Riddle, Nicole N; Gardner, Jerad M

    2015-09-01

    Soft tissue pathology is a rapidly changing subspecialty. New entities are described relatively often, and new molecular findings for soft tissue tumors are reported in the literature almost every month. This article summarizes the major features and diagnostic approach to several recently characterized entities: superficial CD34-positive fibroblastic tumor, fibrosarcoma-like lipomatous neoplasm, angiofibroma of soft tissue, low-grade sinonasal sarcoma with neural and myogenic features, malignant gastrointestinal neuroectodermal tumor, hemosiderotic fibrolipomatous tumor, and epithelioid inflammatory myofibroblastic sarcoma. Additionally, the article also provides a summary table of recent molecular findings in soft tissue tumors. PMID:26297066

  15. Fractures and Soft Tissue Injuries of the Feet and Ankle

    PubMed Central

    English, Edward

    1985-01-01

    An accurate clinical diagnosis of foot and ankle pain can be made by a history, physical examination and routine X-rays of the affected part. Each problem has a specific treatment; however, fractures and dislocations around the foot and ankle can be thought of in an organized fashion by proper physical examination and then the appropriate treatment. Fractures and soft tissue injuries can be treated rationally by understanding the mechanism of injury and the possibility of subsequent deformity. This article classifies specific injuries as a group and indicates a treatment program for each problem. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7aFig. 7bFig. 8Fig. 9Fig. 10 PMID:21274230

  16. Microbiology and management of soft tissue and muscle infections.

    PubMed

    Brook, Itzhak

    2008-08-01

    This review summarizes the microbiological aspects and management of soft tissue and muscle infections. The infections presented are: impetigo, folliculitis, furunculosis and carbuncles, cellulitis, erysipelas, infectious gangrene (includes necrotizing fasciitis or streptococcal gangrene, gas gangrene or clostridium myonecrosis, anaerobic cellulites, progressive bacterial synergistic gangrene, synergistic necrotizing cellulitis or perineal phlegmon, gangrenous balanitis, and gangrenous cellulitis in the immunocompromised patient), secondary bacterial infections complication skin lesions, diabetic and other chronic superficial skin ulcers and subcutaneous abscesses and myositis. These infections often occur in body sites or in those that have been compromised or injured by foreign body, trauma, ischemia, malignancy or surgery. In addition to Group A streptococci and Staphylococcus aureus, the indigenous aerobic and anaerobic cutaneous and mucous membranes local microflora usually is responsible for polymicrobial infections. These infections may occasionally lead to serious potentially life-threatening local and systemic complications. The infections can progress rapidly and early recognition and proper medical and surgical management is the cornerstone of therapy. PMID:17720643

  17. [Soft tissue tumors - the view of the molecular biologist].

    PubMed

    Krsková, Lenka; Mrhalová, Marcela; Kalinová, Markéta; Campr, Vít; Capková, Linda; Grega, Marek; Háček, Jaromír; Hornofová, Ludmila; Chadimová, Mária; Chmelová, Renata; Kodetová, Daniela; Zámečník, Josef; Kodet, Roman

    2014-07-01

    Soft tissue tumors (SSTs) constitute a broad spectrum of neoplasms with diverse biological properties. Rare or unusual types are often difficult to classify. Recent studies show, that a significant subset of SSTs including many types of sarcomas are associated with specific genetic changes such as chromosomal translocations producing chimeric genes, which play a role in the pathogenesis of SSTs. Because SSTs represent a diagnostically challenging group of tumors, molecular-genetic techniques (FISH or PCR) are useful as supplementary and/or confirmatory diagnostic tools. In the present paper we demonstrate the usefulness of a combined diagnostic approach using the tools of classical histopathology and immunohistochemistry together with the molecular diagnostic approach in selected nosologic entites. PMID:25186594

  18. [Pediatric soft tissue sarcomas: analysis of non rhabdomyosarcoma group].

    PubMed

    Farfalli, Germán Luis; Iriberry, Angeles; Albergó, José Ignacio; Ayerza, Miguel Ángel; Muscolo, Domingo Luis; Aponte-Tinao, Luis Alberto

    2014-12-01

    We evaluated 29 patients with non rhabdomyosarcoma soft tissue sarcomas treated with surgery between 2000 and 2010; we analyzed overall survival and which factors affect the prognosis. The mean age was 11.6 years (range 3 months-17 years); 16 patients were males and the median follow-up was 56 months (8 to 132 months). Eight different histological malignant tumors were identified, being synovial sarcoma the most prevalent one (14 patients). Twenty-eight patients were treated with limb salvage surgery and in 26 cases, adjuvant therapy was used. Five years overall survival was 72%. Nine of the 29 patients presented a local recurrence. The presence of metastases (p <0.0001) and local recurrence (p <0.007) were negative prognostic factors for overall survival. PMID:25362924

  19. Facial soft tissue thicknesses in the present Czech Population.

    PubMed

    Drgáčová, Anna; Dupej, Ján; Velemínská, Jana

    2016-03-01

    The aim of this study was to find any relation between soft facial tissue thickness (FSTT) and sex, age and asymmetry in the contemporary Czech population. The studied sample consisted of head CT scans of 102 adult Czech individuals between the ages of 21 and 83. Forty FSTTs were evaluated and analysed using PCA, Hotelling's T(2) test, LDA, the Kolmogorov-Smirnov test, MANOVA, the Kruskal-Wallis test and Wilcoxon's paired test. The greatest sexual dimorphism was detected in the lower part of the face, which had discriminant power almost the same as the entire faces (approximately 80%). On the other hand, a significant influence of aging was shown, mostly in the area of the upper face (In females, twice as many landmarks displayed a significant influence, compared with males). The influence of asymmetry was confirmed in seven bilateral landmarks, five of them favouring the right side. PMID:26860069

  20. Current utilities of imaging in grading musculoskeletal soft tissue sarcomas.

    PubMed

    Fisher, Stephen M; Joodi, Robert; Madhuranthakam, Ananth J; Öz, Orhan K; Sharma, Rohit; Chhabra, Avneesh

    2016-07-01

    The care of patients with musculoskeletal malignancies has increasingly become a multidisciplinary function. Radiologists play an important role in many areas of these patients' care including initial diagnosis, staging, in many cases guiding therapy, and monitoring treatment response. However, the gold standard for the final diagnosis of these diseases remains the histopathologic proof. Intense efforts have been made to develop non-invasive methods of determining the tumor grade, or a surrogate, in order to predict biologic behavior, aid early treatment decisions, and provide prognostic information. Multiple imaging modalities have been employed in this domain-including computed tomography (CT); anatomic magnetic resonance (MR) imaging techniques; functional MR imaging sequences such as dynamic contrast enhancement (DCE), diffusion weighted imaging (DWI), MR spectroscopy (MRS); and positron emission tomography (PET). This article reviews current available literature in this realm and highlights future directions towards the potential of non-invasive imaging in grading of soft tissue sarcomas. PMID:27235882

  1. Soft tissue tumors of the head and neck.

    PubMed

    Katenkamp, D

    1987-01-01

    From the tumor register of the Institute of Pathology of Jena all soft tissue tumors of the head and neck collected between 1959 and 1984 were retrieved and reclassified. 562 out of 646 tumors (87%) were benign. Three quarter of these growths could be diagnosed as nerve sheath tumors (schwannomas and neurofibromas), hemangiomas, fibrohistiocytic tumors and lipomas. 84 tumors were malignant (13%). As the most frequent subtypes we found fibrohistiocytic sarcomas (malignant fibrous histiocytomas and atypical fibroxanthomas), muscularly differentiated sarcomas (rhabdo- and leiomyosarcomas) and unclassified sarcomas. The age and sex distribution as well as the localization and histologic peculiarities were analysed and compared with findings reported in the literature. The significance of knowing such data for diagnostic and differential diagnostic considerations is stressed and exemplified. PMID:3592924

  2. Head and Neck Soft Tissue Sarcomas Treated with Radiation Therapy

    PubMed Central

    Vitzthum, Lucas K.; Brown, Lindsay C.; Rooney, Jessica W.; Foote, Robert L.

    2016-01-01

    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. PMID:27441072

  3. [Treatments of Soft Tissue Sarcomas by Orthopaedic Surgeons in Japan].

    PubMed

    Tanaka, Kazuhiro

    2016-01-01

    In Japan, the treatment of soft tissue sarcomas (STS) has been performed mainly by orthopaedic surgeons. The standard therapy for all cases of STS is surgical resection of the tumor. The prognosis of patients with unresectable tumors or distant metastases is poor despite treatment with intensive chemotherapy. Adjuvant chemotherapy is indicated for patients with resectable tumors. Round-cell STS, including extraskeletal Ewing sarcoma and rhabdomyosarcoma, have high sensitivity to chemotherapy. The standard treatment for round-cell STS is multimodal therapy with surgery and chemotherapy, with or without radiotherapy. On the other hand, non-round cell STS, including leiomyosarcoma, synovial sarcoma, and liposarcoma, have low sensitivity to chemotherapy. Thus, the standard treatment for non-round cell STS is essentially, surgery. Large and high-grade non-round cell STS are also treated using adjuvant chemotherapy along with surgery. In this review, the standard therapies for STS and the future perspective in Japan are discussed. PMID:26809525

  4. Pseudotumoral form of soft-tissue tuberculosis of the wrist.

    PubMed

    Sbai, Mohamed Ali; Benzarti, Sofien; Msek, Hichem; Boussen, Monia; Khorbi, Adel

    2016-03-01

    Tuberculosis is a major public health problem in developing countries. Hand and wrist is a rare localization for extra-pulmonary tuberculosis, a pseudotumoral form of soft tissue tuberculosis of the wrist is exceptional. We report the case of a 45-year-old male presenting with a painful swelling of the dorsal aspect of the right wrist evolving for six months. Clinical study was evoking a ganglion cyst of the wrist. Intraoperatively a pseudotumoral mass with rice bodies was found, suggesting tuberculous tenosynovitis. The histopathological study revealed caseating giant cell granulomas with epithelioid cells. Cultures on Löwenstein-Jensen medium detected Mycobacterium tuberculosis. Synovectomy with removal of all the rice bodies followed by anti-tuberculous chemotherapy provided uneventful recovery. PMID:26927998

  5. Lameness associated with coxofemoral soft tissue masses in six dogs.

    PubMed

    Layton, C E; Ferguson, H R

    1987-01-01

    Six cases of mechanical lameness involving the coxofemoral joint are presented. All dogs had a history of chronic rear leg pain and lameness, and decreased range of motion of the hip. On physical examination, ventral subluxation of the coxofemoral joint during extension was present in three dogs. A radiographic diagnosis of subluxation was made in five dogs. In each dog, surgical exploration of the area caudal to the coxofemoral joint revealed a fibrous mass between the lesser or third trochanters and the ischium, diagnosed as a nonneoplastic fibrous reaction by microscopic examination. The clinical, radiographic, and histopathologic signs were similar to previously described cases of myositis ossificans. Five dogs returned to normal function after excision of the soft tissue mass, and one dog was normal when lost to follow-up 4 weeks postoperatively. PMID:3507121

  6. Muscle Articulations: Flexible Jaw Joints Made of Soft Tissues.

    PubMed

    Uyeno, T A; Clark, A J

    2015-08-01

    This study surveys animals that use soft tissues rather than rigid links to build jaw joints. Hard biting elements are useful; they are used in piercing or shearing during feeding and interactive behaviors and can directly impact survival and reproduction. The best understood biting systems include biting elements that are mounted on rigid jaw links that form a joint capable of transmitting the bite reaction forces. As such, jaws must incorporate joints that resist compression. Many jaw joints are "sliding joints", in which jaw links come into direct contact and the shape of the sliding contact surfaces dictates possible motions. There are, however, organisms that have biting elements on jaws that are made of flexible muscle and connective tissues. If arranged as a muscular hydrostat, in which multiple orientations of the muscle fibers may co-contract to provide turgid skeletal support, the multifunctional joint not only (a) provides the force to move the biting elements, but also (b) creates repositionable pivots and (c) transmits bite reaction forces. Such flexible joints, termed "muscle articulations", may be important to a number of soft-bodied animals. In this survey, we review the function of previously described muscle articulations: the joints found between inarticulate brachiopods' valves, cephalopods' beaks, the hooks of kalyptorhynch flatworms, and errant polychaetes' jaws. We also review the morphology, physiology, and feeding behaviors of the hagfish as a putative muscle articulation in an effort to understand how this jawless craniate is capable of biting with surprising force, seemingly without the benefit of any obvious method of opposing the force of the dental plate that is used to remove portions of food. Initial analysis suggests that a muscle articulation may be a key feature in coordinating head and body movements to provide the leverage needed for strong "bites". PMID:25912361

  7. Grading of soft tissue sarcomas: from histological to molecular assessment.

    PubMed

    Neuville, Agnes; Chibon, Frédéric; Coindre, Jean-Michel

    2014-02-01

    Several histological grading systems for soft tissue sarcomas have been described since the early 1980s. Their main objective is to select patients for adjuvant chemotherapy. Two histological grading systems are used in daily practice, the National Cancer Institute (NCI) and the French Federation of Cancer Centers Sarcoma Group (FNCLCC) systems. They have been devised by combining histological parameters: number of mitoses per high-power field, the presence of necrosis, cellular and nuclear morphology and the degree of cellularity for the NCI grading; and tumour differentiation, mitotic index and extent of necrosis for the French system. Histological grading is far more appropriate to assess the risk of metastasis. However, several limitations prevent its use: grade cannot be applied to all histological types, its reproducibility is not perfect, a three-grade system generates an intermediate grade with undetermined prognosis, and finally the core needle biopsy, now widely used for the diagnosis of soft tissue sarcoma, is not the best sample to assess the grade. The development of molecular grading in addition to histological grading probably represents the next step. Molecular signatures based on quantitative evaluation of chromosomal complexity such as CINSARC (complexity index in sarcomas) appear as a strong independent predictive factor for metastasis in several types of sarcoma, and even in several other types of cancer. When they can be instituted in daily practice on formalin fixed, paraffin embedded material, molecular signatures will not only provide information on risk of metastasis, but also better understanding of cancer development, response or resistance to evaluated drugs, and potential targets for future treatments. PMID:24378389

  8. Development of photocrosslinked methylcellulose hydrogels for soft tissue reconstruction.

    PubMed

    Stalling, Simone S; Akintoye, Sunday O; Nicoll, Steven B

    2009-07-01

    A variety of materials have been used as fillers for soft tissue augmentation. In this study, methylcellulose (MC), a water-soluble derivative of the polysaccharide cellulose, was modified with functional methacrylate groups and photocrosslinked to produce hydrogels for potential application in plastic and reconstructive surgery. Purified macromer (5% theoretical modification, 2.3% actual) was resuspended in 0.05wt.% of the photoinitiator, 2-methyl-1-[4-(hydroxyethoxy)phenyl]-2-methyl-1-propanone, cast into custom molds, and exposed to long-wavelength UV light for 10min to form gels. Photocrosslinked MC hydrogels at varying weight/volume percentages displayed equilibrium weight swelling ratios (wet weight/dry weight) and elastic moduli of 30+/-3 to 17+/-2 and 8.48+/-0.25kPa to 23.21+/-1.55kPa, respectively, demonstrating the formation of stable gels with tunable properties. Human dermal fibroblasts grown in the presence of MC hydrogels in vitro exhibited no significant changes in cell viability after 5days of co-culture, indicating that the materials are non-cytotoxic. Higher weight percentage MC hydrogels (6%) implanted subcutaneously in CD-1 mice maintained their integrity and original dimensions after 80days in vivo, eliciting a mild inflammatory response with no observed inflammatory exudate, minimal vascular infiltration and thin translucent fibrous capsule formation of approximately 50microm in thickness. Taken together, the material and biological properties of photocrosslinked MC hydrogels suggest that they may be of use in soft tissue reconstruction. PMID:19303378

  9. CT-Based Assessment of Relative Soft-Tissue Alteration in Different Types of Ancient Mummies.

    PubMed

    Sydler, Christina; Öhrström, Lena; Rosendahl, Wilfried; Woitek, Ulrich; Rühli, Frank

    2015-06-01

    Mummification leads to alteration of soft-tissue morphology. No research has focused specifically on differences in soft-tissue shrinkage depending on mummification type. This study evaluated whether soft-tissue alteration is dependent on type of mummification. A total of 17 human mummies have been investigated by computed tomography (CT). Samples included artificially embalmed ancient Egyptian mummies, naturally mummified South American corpses, ice mummies (including the Iceman, South Tyrol Museum of Archeology, Bolzano, Italy, ca. 3,300 BC), bog bodies and a desiccated mummy of possibly Asian provenance. The acquired data were compared to four contemporary bodies. The extent of soft-tissue shrinkage was evaluated using CT data. Shrinkage was defined as soft-tissue relative to area of bone (in number of voxels). Measurements were taken at 13 anatomically defined locations. Ice mummies show the highest degree of preservation. This finding is most likely explained due to frozen water within tissues. All other types of mummies show significantly (at P < 0.05) smaller relative area of preserved soft-tissue. Variation between different anatomical structures (e.g., upper lip vs. mid-femur) is significant, unlike variation within one compartment (e.g., proximal vs. distal humerus). Mummification type strongly affects the degree of soft-tissue alteration, surprisingly mostly independent of overall historical age. These results highlight the unique morphological impact of taphonomy on soft-tissue preservation and are of particular interest in tissue research as well as in forensics. PMID:25998649

  10. Fine-needle aspiration cytology of soft tissue lesions: diagnostic challenges.

    PubMed

    Domanski, Henryk A

    2007-12-01

    Clinical and radiographic data provide important information in the evaluation of soft tissue lesions/neoplasms. Morphologic tissue and cytologic examination is considered to be a necessary part of the diagnostic work-up. The standard procedure for obtaining tumor tissue for morphologic evaluation has been incisional (open) or core needle biopsy. An increasing use of minimally invasive diagnostic procedures has resulted in better acceptance of fine-needle aspiration cytology (FNAC) in the diagnosis of soft tissue lesions. This article discusses challenges in FNAC of soft tissue lesions based on the experience at a multidisciplinary referral sarcoma center. Obtaining sufficient specimens from deeply seated small and necrotic/cystic lesions is technically a potential pitfall and misdiagnosis of cells from reactive zones surrounding the tumor as well as the correct evaluation of spindle cell lesions, rare soft tissue neoplasms, and "new entities" lacking reproducible cytological criteria are other important challenges in FNAC of soft tissues. The successful cytological evaluation of soft tissue lesions requires the application of strict, reproducible morphological criteria in the context of the clinical findings as well as ancillary techniques. The minimal criteria for diagnostic intervention in various clinical settings and the relative advantages and disadvantages of FNAC must be understood. FNAC of soft tissue lesions is facilitated when limited to specialized orthopedic-oncologic centers with a well-integrated multidisciplinary team and experience in the evaluation and therapy of soft tissue lesions. PMID:18008345