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Sample records for deep soft tissue

  1. Genetic heterogeneity in leiomyomas of deep soft tissue.

    PubMed

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

    2017-07-25

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

  2. Genetic heterogeneity in leiomyomas of deep soft tissue

    PubMed Central

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

    2017-01-01

    Leiomyoma of deep soft tissue is a rare type of benign smooth muscle tumor that mostly occurs in the retroperitoneum or abdominal cavity of women, and about which very little genetic information exists. In the present study, eight leiomyomas of deep soft tissue were genetically analyzed. G-banding showed that three tumors carried rearrangements of the long arm of chromosome 12, three others had 8q rearrangements, the 7th tumor had deletion of the long arm of chromosome 7, del(7)(q22), and the 8th had aberrations of chromosome bands 3q21∼23 and 11q21∼22. The target genes of the 12q and 8q aberrations were HMGA2 and PLAG1, respectively. In the leiomyomas with 12q rearrangements, both HMGA2 and PLAG1 were expressed whereas in the tumors with 8q aberrations, only PLAG1 was expressed. In the cases without 12q or 8q aberrations, the expression of HMGA2 was very low and PLAG1 was expressed only in the case with del(7)(q22). All eight leiomyomas of deep soft tissue expressed MED12 but none of them had mutation in exon 2 of that gene. In two tumors with 12q rearrangements, RPSAP52 on 12q14.3 was fused with non-coding RNA (accession number XR_944195) from 14q32.2 or ZFP36L1 from14q24.1. In a tumor with inv(12), exon 3 of HMGA2 was fused to a sequence in intron 1 of the CRADD gene from 12q22. The present data together with those of our two previous studies in which the fusions KAT6B-KANSL1 and EWSR1-PBX3 were described in two retroperitoneal leiomyomas carrying a t(10;17)(q22;q21) and a t(9;22)(q33;q12) translocation, respectively, show that leiomyomas of deep soft tissue are genetically heterogenous but have marked similarities to uterine leiomyomas. PMID:28591699

  3. Predictors of soft-tissue complications and deep infection in allograft reconstruction of the proximal tibia.

    PubMed

    Lozano-Calderón, Santiago A; Swaim, Sara O; Federico, Amy; Anderson, Megan E; Gebhardt, Mark C

    2016-06-01

    Reconstruction of the proximal tibia after wide resection of malignant tumors in the pediatric population is very challenging. Advocates of allograft reconstruction argue as advantages bone preservation, biological reconstruction that facilitates reattachment of the extensor mechanism and other soft-tissue structures, delay of metallic prosthesis use and preservation of the distal femoral growth plate. However, complications are significant, infection being very common. Under IRB-approved protocol, 32 patients (17 males, 15 females), 13 years old in average (2-20), who underwent 33 allograft reconstructions of the proximal tibia, were evaluated for the occurrence of soft-tissue complications and/or deep infection (infection affecting the allograft). Potential predictors of soft-tissue complications and deep infection, categorized as pre- and perioperative variables, were analyzed in relation to the risk for developing a soft-tissue complication or a deep infection. The prevalence of soft-tissue complications was 48% (16/33). However, we were not able to identify any significant predictors. The prevalence of deep (allograft) infection was 15% (5/33). Multivariate logistic regression determined higher BMI at the index surgical procedure and lower pre-operative WBC to be independent predictors of deep infection. For each unit of increase in BMI, the odds of deep infection increased by 40% (OR = 1.40; CI = 1.07-3.06; P < 0.05). For each one unit (1,000) of increase in the pre-operative white cell-count, the odds of deep infection decreased by 70% (OR = 0.30; 95%CI = 0.01-0.89; P < 0.05). Four of the five deep infections were in patients with soft-tissue complications, mainly wound dehiscence. However, wound dehiscence or soft-tissue complications were not predictive of deep infection. Soft-tissue complications are prevalent in allograft reconstruction of the proximal tibia. Prevention is important as these may progress to deep infection. Careful

  4. 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. PMID:27186256

  5. Detection of soft tissue densities from digital breast tomosynthesis: comparison of conventional and deep learning approaches

    NASA Astrophysics Data System (ADS)

    Fotin, Sergei V.; Yin, Yin; Haldankar, Hrishikesh; Hoffmeister, Jeffrey W.; Periaswamy, Senthil

    2016-03-01

    Computer-aided detection (CAD) has been used in screening mammography for many years and is likely to be utilized for digital breast tomosynthesis (DBT). Higher detection performance is desirable as it may have an impact on radiologist's decisions and clinical outcomes. Recently the algorithms based on deep convolutional architectures have been shown to achieve state of the art performance in object classification and detection. Similarly, we trained a deep convolutional neural network directly on patches sampled from two-dimensional mammography and reconstructed DBT volumes and compared its performance to a conventional CAD algorithm that is based on computation and classification of hand-engineered features. The detection performance was evaluated on the independent test set of 344 DBT reconstructions (GE SenoClaire 3D, iterative reconstruction algorithm) containing 328 suspicious and 115 malignant soft tissue densities including masses and architectural distortions. Detection sensitivity was measured on a region of interest (ROI) basis at the rate of five detection marks per volume. Moving from conventional to deep learning approach resulted in increase of ROI sensitivity from 0:832 +/- 0:040 to 0:893 +/- 0:033 for suspicious ROIs; and from 0:852 +/- 0:065 to 0:930 +/- 0:046 for malignant ROIs. These results indicate the high utility of deep feature learning in the analysis of DBT data and high potential of the method for broader medical image analysis tasks.

  6. Soft Tissue Sarcoma

    MedlinePlus

    ... muscles, tendons, fat, and blood vessels. Soft tissue sarcoma is a cancer of these soft tissues. There ... have certain genetic diseases. Doctors diagnose soft tissue sarcomas with a biopsy. Treatments include surgery to remove ...

  7. 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 ...

  8. Angiokeratoma circumscriptum naeviforme with soft tissue hypertrophy and deep venous malformation: A variant of Klippel-Trenaunay syndrome?

    PubMed

    Wankhade, Vaishali; Singh, Rajesh; Sadhwani, Venus; Kodate, Purnima; Disawal, Amit

    2014-12-01

    Klippel-Trenaunay syndrome (KTS) is a cutaneous capillary malformation on a limb in association with soft tissue swelling with or without bony hypertrophy and atypical varicosity. The capillary malformation associated with KTS is port wine stain. Angiokeratoma circumscriptum naeviforme (ACN) is a congenital variant of angiokeratoma commonly present on the lower limb as a hyperkeratotic plaque. ACN is rarely associated with KTS. We report a case of ACN with soft tissue hypertrophy and deep venous malformation (possibly a variant of Klippel-Trenaunay) in a 4-year-old male child.

  9. Angiokeratoma circumscriptum naeviforme with soft tissue hypertrophy and deep venous malformation: A variant of Klippel-Trenaunay syndrome?

    PubMed Central

    Wankhade, Vaishali; Singh, Rajesh; Sadhwani, Venus; Kodate, Purnima; Disawal, Amit

    2014-01-01

    Klippel-Trenaunay syndrome (KTS) is a cutaneous capillary malformation on a limb in association with soft tissue swelling with or without bony hypertrophy and atypical varicosity. The capillary malformation associated with KTS is port wine stain. Angiokeratoma circumscriptum naeviforme (ACN) is a congenital variant of angiokeratoma commonly present on the lower limb as a hyperkeratotic plaque. ACN is rarely associated with KTS. We report a case of ACN with soft tissue hypertrophy and deep venous malformation (possibly a variant of Klippel-Trenaunay) in a 4-year-old male child. PMID:25593797

  10. Ultrafine fibrous gelatin scaffolds with deep cell infiltration mimicking 3D ECMs for soft tissue repair.

    PubMed

    Jiang, Qiuran; Xu, Helan; Cai, Shaobo; Yang, Yiqi

    2014-07-01

    In this research, ultrafine fibrous scaffolds with deep cell infiltration and sufficient water stability have been developed from gelatin, aiming to mimic the extracellular matrices (ECMs) as three dimensional (3D) stromas for soft tissue repair. The ultrafine fibrous scaffolds produced from the current technologies of electrospinning and phase separation are either lack of 3D oriented fibrous structure or too compact to be penetrated by cells. Whilst electrospun scaffolds are able to emulate two dimensional (2D) ECMs, they cannot mimic the 3D ECM stroma. In this work, ultralow concentration phase separation (ULCPS) has been developed to fabricate gelatin scaffolds with 3D randomly oriented ultrafine fibers and loose structures. Besides, a non-toxic citric acid crosslinking system has been established for the ULCPS method. This system could endow the scaffolds with sufficient water stability, while maintain the fibrous structures of scaffolds. Comparing with electrospun scaffolds, the ULCPS scaffolds showed improved cytocompatibility and more importantly, cell infiltration. This research has proved the possibility of using gelatin ULCPS scaffolds as the substitutes of 3D ECMs.

  11. Surgery for Soft Tissue Sarcomas

    MedlinePlus

    ... Tissue Sarcomas Chemotherapy for Soft Tissue Sarcomas Targeted Therapy for Soft Tissue Sarcoma Treatment of Soft Tissue Sarcomas, by Stage ... Cancer Information Cancer Prevention & Detection Cancer Basics ...

  12. [Necrotizing dermatitis, infections of soft tissue and deep fascia: classification and treatment].

    PubMed

    Marszał, M; Bielecki, K

    1998-01-01

    Nectrotizing fasciitis is a mixed infection of skin and subcutaneous tissue with a characteristic clinical and pathological appearance. Necrotizing soft tissue infections, caused by aerobic, anaerobic and mixed bacterial flora are an increasing problem in medical and surgical practice. The apparently wide variety of these infections is systematized. Etiology and bacteriology are discussed, as the role of surgery, antibiotics and hyperbaric chamber in the treatment of the infections. Early and radical surgical excision of all affected tissue is the treatment of choice. Adjuvant hyperbaric oxygen appears to be important in refractory progressive bacterial gangrene. A combination of hyperbaric oxygen, surgical treatment and antibiotics gives the lowest mortality and morbidity in gas gangrene compared with other treatment modifications. Extensive clinical experience shows the efficacy of these treatment protocols.

  13. [Repair of large and deep skin and soft tissue defects around the knee joints with free latissimus dorsi musculocutaneous flaps].

    PubMed

    Zhang, Minghua; Cui, Xu; Zeng, Jizhang; Liu, Xiong; Huang, Mitao; Zhang, Pihong; Huang, Xiaoyuan

    2015-10-01

    To investigate the clinical efficacy of free latissimus dorsi musculocutaneous flaps in repairing large and deep skin and soft tissue defects around the knee joints. Twenty-five patients with large and deep skin and soft tissue defects around the knee joints were hospitalized from March 2005 to March 2014. The area of defects around the knee joints ranged from 10 cm × 8 cm to 43 cm × 23 cm. The free latissimus dorsi musculocutaneous flaps were used to repair the defects, with the area ranging from 12 cm × 10 cm to 45 cm × 25 cm. The thoracodorsal artery and its concomitant vein of the musculocutaneous flap were anastomosed to the descending branch of the lateral circumflex femoral artery and its concomitant vein respectively to reconstruct blood supply. Split-thickness skin grafts around the flap donor sites were harvested to cover the muscle surface of the musculocutaneous flaps. The flap donor sites were closed directly with suture, and the skin donor sites were healed by dressing change. All the 25 flaps survived without vascular crisis. The flaps were in satisfactory appearance. The flap donor sites were healed with linear scar. All the patients were followed up for 3 to 6 months. At last, they were able to stand up and walk. The free latissimus dorsi musculocutaneous flap transplantation is an effective treatment for the repair of large and deep soft tissue defects around the knee joints, and the descending branch of lateral circumflex femoral artery and its concomitant vein are the appropriate recipient vessels.

  14. Local recurrence and assessment of sentinel lymph node biopsy in deep soft tissue leiomyosarcoma of the extremities

    PubMed Central

    2011-01-01

    Background Leiomyosarcoma of deep soft tissues of the extremities is a rare malignant tumour treated primarily by surgery. The incidence of local recurrence and lymph node metastasis is uncertain and it is not known whether a sentinel lymph node biopsy is indicated in these tumours. Methods A retrospective review of patients treated for extremity deep soft tissue leiomyosarcoma at our institution over a 10-year period was conducted. Patients developing local recurrence or lymph node metastasis were identified. The presence or absence of lymphatics in the primary tumours was assessed by immunohistochemical expression of LYVE-1 and podoplanin. Results 27 patients (mean age 62 years) were included in the study. 15 were female and 12 male. Lymph node metastasis was seen in only two cases (7%); intratumoural lymphatics were identified in the primary tumours of both these cases. Local recurrence occurred in 25.9% of cases despite complete excision and post-operative radiotherapy; the mean time to recurrence was 10.1 months. Conclusion On the basis of this study, we do not advocate sentinel lymph node biopsy in this group of patients except in those cases in which intratumoural lymphatics can be demonstrated. Close follow up is important especially for high grade leiomyosarcomas, particularly in the first year, as these tumours have a high incidence of local recurrence. PMID:22612847

  15. 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.

  16. A role for iron and oxygen chemistry in preserving soft tissues, cells and molecules from deep time.

    PubMed

    Schweitzer, Mary H; Zheng, Wenxia; Cleland, Timothy P; Goodwin, Mark B; Boatman, Elizabeth; Theil, Elizabeth; Marcus, Matthew A; Fakra, Sirine C

    2014-01-22

    The persistence of original soft tissues in Mesozoic fossil bone is not explained by current chemical degradation models. We identified iron particles (goethite-αFeO(OH)) associated with soft tissues recovered from two Mesozoic dinosaurs, using transmission electron microscopy, electron energy loss spectroscopy, micro-X-ray diffraction and Fe micro-X-ray absorption near-edge structure. Iron chelators increased fossil tissue immunoreactivity to multiple antibodies dramatically, suggesting a role for iron in both preserving and masking proteins in fossil tissues. Haemoglobin (HB) increased tissue stability more than 200-fold, from approximately 3 days to more than two years at room temperature (25°C) in an ostrich blood vessel model developed to test post-mortem 'tissue fixation' by cross-linking or peroxidation. HB-induced solution hypoxia coupled with iron chelation enhances preservation as follows: HB + O2 > HB - O2 > -O2 > +O2. The well-known O2/haeme interactions in the chemistry of life, such as respiration and bioenergetics, are complemented by O2/haeme interactions in the preservation of fossil soft tissues.

  17. A role for iron and oxygen chemistry in preserving soft tissues, cells and molecules from deep time

    PubMed Central

    Schweitzer, Mary H.; Zheng, Wenxia; Cleland, Timothy P.; Goodwin, Mark B.; Boatman, Elizabeth; Theil, Elizabeth; Marcus, Matthew A.; Fakra, Sirine C.

    2014-01-01

    The persistence of original soft tissues in Mesozoic fossil bone is not explained by current chemical degradation models. We identified iron particles (goethite-αFeO(OH)) associated with soft tissues recovered from two Mesozoic dinosaurs, using transmission electron microscopy, electron energy loss spectroscopy, micro-X-ray diffraction and Fe micro-X-ray absorption near-edge structure. Iron chelators increased fossil tissue immunoreactivity to multiple antibodies dramatically, suggesting a role for iron in both preserving and masking proteins in fossil tissues. Haemoglobin (HB) increased tissue stability more than 200-fold, from approximately 3 days to more than two years at room temperature (25°C) in an ostrich blood vessel model developed to test post-mortem ‘tissue fixation’ by cross-linking or peroxidation. HB-induced solution hypoxia coupled with iron chelation enhances preservation as follows: HB + O2 > HB − O2 > −O2 ≫ +O2. The well-known O2/haeme interactions in the chemistry of life, such as respiration and bioenergetics, are complemented by O2/haeme interactions in the preservation of fossil soft tissues. PMID:24285202

  18. 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

  19. Soft tissue elastometer.

    PubMed

    Egorov, V; Tsyuryupa, S; Kanilo, S; Kogit, M; Sarvazyan, A

    2008-03-01

    We have developed a device entitled the 'Tissue Elastometer' (TE) for evaluating the Young's modulus of soft tissues. Soft tissue specimens are compressed between the object plate of an electronic balance and a linearly actuated indenter with a small rounded tip. The hardware of the device was designed such that a deformation model for semi-infinite media is applicable for calculating the Young's modulus of test specimens from their collected force-displacement data. Force-elongation measurements were performed on long strips of cured silicone mixtures to produce calibrated, tissue-mimicking test samples for the TE in a Young's modulus range of 10-400 kPa. When tested with the TE, the Young's moduli of the silicone samples demonstrated accuracy to within 1-10% of their calibrated values. Testing on excised tissue samples (fresh store-bought poultry breast; bovine liver, kidneys, hind shanks; porcine) was also performed, and a repeatability of elasticity measurements was demonstrated in the range of 8-14%. Results indicate that the TE can be effectively used in laboratory and clinical environments to evaluate the elasticity modulus of tissues.

  20. Reptile Soft Tissue Surgery.

    PubMed

    Di Girolamo, Nicola; Mans, Christoph

    2016-01-01

    The surgical approach to reptiles can be challenging. Reptiles have unique physiologic, anatomic, and pathologic differences. This may result in frustrating surgical experiences. However, recent investigations provided novel, less invasive, surgical techniques. The purpose of this review was to describe the technical aspects behind soft tissue surgical techniques that have been used in reptiles, so as to provide a general guideline for veterinarians working with reptiles.

  1. Can Soft Tissue Sarcomas Be Found Early?

    MedlinePlus

    ... Tissue Sarcoma Early Detection, Diagnosis, and Staging Can Soft Tissue Sarcomas Be Found Early? People who have ... Your Doctor About Soft Tissue Sarcomas? More In Soft Tissue Sarcoma About Soft Tissue Sarcoma Causes, Risk ...

  2. Soft tissue vibrations within one soft tissue compartment.

    PubMed

    Boyer, Katherine A; Nigg, Benno M

    2006-01-01

    The concept of muscle tuning suggests that vibrations of the soft tissue compartments of the leg initiated by impacts are minimized by muscular activity prior to heel-strike of heel-toe running. For the quantification of muscle tuning it has been assumed (1) that the soft tissue compartment acts as one lumped mass and (2) that vibration energy dissipation does occur within one muscle. The purpose of this study was to test these two assumptions. It was hypothesized that (H1) the movement of the soft tissue compartment is not homogeneous, (H2) the vibration frequencies for different muscles within one soft tissue compartment are different and (3) attenuation of vibration movement within one muscle does occur. Soft tissue vibrations were measured using accelerometers on four locations on the quadriceps soft tissue compartment during heel-toe running. There were differences in the peak soft tissue acceleration and time of peak acceleration between accelerometer locations. The dominant frequency was similar throughout the soft tissue compartment, however; there was an attenuation of high-frequency vibration energy between distal and proximal points overlying one muscle. This evidence suggests that accelerometer placement is important when quantifying the acceleration magnitude and timing of peak soft tissue compartment but not when estimating the resonant vibration characteristics of a soft tissue compartment. It also provides initial evidence to support the idea that vibration control through muscle tuning may be achieved through changes in energy dissipating properties within the soft tissue compartment.

  3. Survival by Stage of Soft Tissue Sarcoma

    MedlinePlus

    ... Detection, Diagnosis, and Staging Survival by Stage of Soft Tissue Sarcoma Survival rates are often used by ... Your Doctor About Soft Tissue Sarcomas? More In Soft Tissue Sarcoma About Soft Tissue Sarcoma Causes, Risk ...

  4. Biomechanics of soft tissues.

    PubMed

    Miller, K

    2000-01-01

    Recent 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, call for closer examination of the mechanical properties of very soft tissues (such as brain, liver, kidney, etc.). Moreover, internal organs are very susceptible to trauma. In order to protect them properly against car crash and other impact consequences we need to be able to predict the organ deformation. Such prediction can be achieved by proper mathematical modelling followed by a computer simulation. The ultimate goal of our research into the biomechanics of these tissues is development of corresponding, realistic mathematical models. This paper contains experimental results of in vitro, uniaxial, unconfined compression of swine brain tissue obtained by the author in Mechanical Engineering Laboratory, Japan, and discusses liver and kidney in vivo compression experiments conducted in Highway Safety Research Institute and the Medical Centre of The University of Michigan. The stress-strain curves for investigated tissues are concave upward for all compression rates containing no linear portion from which a meaningful elastic modulus might be determined. The tissue response stiffened as the loading speed increased, indicating a strong stress (strain rate dependence. As the step in the direction towards realistic computer simulation of injuries and surgical procedures, this paper presents two mathematical representations of brain, liver and kidney tissue stiffness. Biphasic and single-phase models are discussed. The biphasic model is shown to be inappropriate due to its inability to account for strong stress-strain relationship. Agreement between the proposed single-phase models and experiment is good for compression levels reaching 30% and for loading velocities varying over five orders of magnitude. Presented mathematical models can find applications in computer and robot

  5. Adipose Tissue Engineering for Soft Tissue Regeneration

    PubMed Central

    Choi, Jennifer H.; Gimble, Jeffrey M.; Lee, Kyongbum; Marra, Kacey G.; Rubin, J. Peter; Yoo, James J.; Vunjak-Novakovic, Gordana

    2010-01-01

    Current treatment modalities for soft tissue defects caused by various pathologies and trauma include autologous grafting and commercially available fillers. However, these treatment methods present a number of challenges and limitations, such as donor-site morbidity and volume loss over time. As such, improved therapeutic modalities need to be developed. Tissue engineering techniques offer novel solutions to these problems through development of bioactive tissue constructs that can regenerate adipose tissue in both structure and function. Recently, a number of studies have been designed to explore various methods to engineer human adipose tissue. This review will focus on these developments in the area of adipose tissue engineering for soft tissue replacement. The physiology of adipose tissue and current surgical therapies used to replace lost tissue volume, specifically in breast tissue, are introduced, and current biomaterials, cell sources, and tissue culture strategies are discussed. We discuss future areas of study in adipose tissue engineering. PMID:20166810

  6. Stages of Adult Soft Tissue Sarcoma

    MedlinePlus

    ... soft tissue sarcomas: Childhood Soft Tissue Sarcoma Treatment Ewing Sarcoma Family of Tumors Treatment Gastrointestinal Stromal Tumors Treatment ... Sarcoma Home Page Childhood Soft Tissue Sarcoma Treatment Ewing Sarcoma Family of Tumors Treatment Gastrointestinal Stromal Tumors Treatment ...

  7. Treatment Options for Adult Soft Tissue Sarcoma

    MedlinePlus

    ... soft tissue sarcomas: Childhood Soft Tissue Sarcoma Treatment Ewing Sarcoma Family of Tumors Treatment Gastrointestinal Stromal Tumors Treatment ... Sarcoma Home Page Childhood Soft Tissue Sarcoma Treatment Ewing Sarcoma Family of Tumors Treatment Gastrointestinal Stromal Tumors Treatment ...

  8. Treatment Option Overview (Adult Soft Tissue Sarcoma)

    MedlinePlus

    ... soft tissue sarcomas: Childhood Soft Tissue Sarcoma Treatment Ewing Sarcoma Family of Tumors Treatment Gastrointestinal Stromal Tumors Treatment ... Sarcoma Home Page Childhood Soft Tissue Sarcoma Treatment Ewing Sarcoma Family of Tumors Treatment Gastrointestinal Stromal Tumors Treatment ...

  9. Soft tissue application of lasers.

    PubMed

    Holt, Timothy L; Mann, Fred A

    2002-05-01

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

  10. [Soft tissue rheumatism in erderly].

    PubMed

    Szczepański, Leszek

    2008-01-01

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

  11. Trabectedin in soft tissue sarcomas.

    PubMed

    Petek, Bradley J; Loggers, Elizabeth T; Pollack, Seth M; Jones, Robin L

    2015-02-12

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

  12. 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. Copyright © 2011 Società Italiana di Ortodonzia SIDO. Published by Elsevier Srl. All rights reserved.

  13. What Happens After Treatment for Soft Tissue Sarcomas?

    MedlinePlus

    ... Sarcoma After Treatment What Happens After Treatment for Soft Tissue Sarcomas? For some people with soft tissue ... for Soft Tissue Sarcoma Stops Working More In Soft Tissue Sarcoma About Soft Tissue Sarcoma Causes, Risk ...

  14. Soft tissue infections and the diabetic foot.

    PubMed

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

    1996-12-01

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

  15. 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 ...

  16. Drugs Approved for Soft Tissue Sarcoma

    MedlinePlus

    ... Your Treatment Research Drugs Approved for Soft Tissue Sarcoma This page lists cancer drugs approved by the ... not listed here. Drugs Approved for Soft Tissue Sarcoma Cosmegen (Dactinomycin) Dactinomycin Doxorubicin Hydrochloride Eribulin Mesylate Gleevec ( ...

  17. [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.

  18. Exercise and soft tissue injury.

    PubMed

    Hart, L E

    1994-02-01

    Once the almost exclusive domain of the orthopaedic surgeon, sports injuries are now being seen with increasing frequency by other specialists, including rheumatologists. It is therefore important for rheumatologists to be able to diagnose and manage the various musculoskeletal conditions that are associated with physical activity. Soft tissue injuries are a very common cause of morbidity in both competitive and recreational athletes. Most of these conditions are provoked by muscle-tendon overload (or overuse) that is usually the result of excessive training or improper training techniques. However, despite an emerging literature on the natural history of soft tissue overuse syndromes, relatively little is known about the causes, incidence and outcome of many of these injuries. Of the methodologically robust epidemiological studies that have been done, most have focused on habitual distance runners. In this population, it has been reported that the incidence of injury can be as high as 50% or more, and that overtraining and the presence of previous injury are the most significant predictors of future injury. In other popular forms of exercise, such as walking, swimming, cycling, aerobics and racquet sports, injuries are also reported with high frequency but, to date, no prospective studies have examined actual incidences in these populations, and risk factors for injury in these activities remain speculative. Several of the more commonly occurring soft tissue injuries (such as rotator cuff tendinitis, lateral and medial epicondylitis, patellar tendinitis, the iliotibial band friction syndrome, Achilles tendinitis and plantar fasciitis) exemplify the overuse concept and are therefore highlighted in this review. The management of these, and most other, exercise-related soft tissue injuries is directed towards promptly restoring normal function and preventing re-injury.

  19. Management of soft tissue injury.

    PubMed

    Edlich, R F; Rodeheaver, G T; Thacker, J G; Winn, H R; Edgerton, M T

    1977-04-01

    The fate of a surgical wound is held in a delicate balance between the host's resistance to infection and the causal factors of infection. Considerable insight into this relationship between the host and pathogen can be gained from the results of quantitative bacteriologic measurements. Newer rapid slide techniques have been developed which provide the surgeon with this information within 20 minutes. In most soft tissue injuries, the wound bacterial count gives an accurate prediction of subsequent infection. Wounds combining greater than 10(5) bacteria per gram of tissue are destined to develop infection. When the bacterial count is below that level, the wounds will usually heal per primam without infection. This large number of bacteria required to elicit infection reflects the remarkable ability of soft tissues to resist infection. This state of high resistance to infection can be reduced by several factors which include circulatory embarrassment, tissue injury, dead space, and the presence of foreign bodies (dirt, sutures, drains, etc.). When treating soft tissue injuries, the surgeon must employ specific therapeutic modalities that allow the wound to heal per primam without infection. On the basis of experimental studies supported by clinical experience, the following treatment protocol for soft tissue injuries is recommended. Using strict aseptic technique, the wound must be first anesthetized with 1 per cent Xylocaine to permit painless sound cleansing. All wounds should be subjected to high pressure syringe irrigation to remove bacteria, foreign bodies, and blood clots. When necessary, debridement of all devitalized tissue should be performed with a stainless steel scalpel. Many wounds caused by sharp wounding agents contain no foreign bodies and few bacteria and exhibit considerable resistance to infection. In these wounds, primary closure can be initiated after irrigation without the development of infection. Wounds resulting from impact forces have a

  20. Soft tissue coverage in abdominal wall reconstruction.

    PubMed

    Baumann, Donald P; Butler, Charles E

    2013-10-01

    Abdominal wall defects requiring soft tissue coverage can be either partial-thickness defects or full-thickness composite defects. Soft tissue flap reconstruction offers significant advantages in defects that cannot be closed primarily. Flap reconstruction is performed in a single-stage procedure obviating chronic wound management. If the defect size exceeds the availability of local soft tissue for coverage, regional pedicled flaps can be delivered into the abdominal wall while maintaining blood supply from their donor site. Microsurgical free tissue transfer increases the capacity to provide soft tissue coverage for abdominal wall defects that are not amenable to either local or regional flap coverage.

  1. Cephalometric soft tissue facial analysis.

    PubMed

    Bergman, R T

    1999-10-01

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

  2. Nasal Soft-Tissue Triangle Deformities.

    PubMed

    Foda, Hossam M T

    2016-08-01

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

  3. Pathology of soft tissue sarcomas.

    PubMed

    Thway, K

    2009-11-01

    Sarcomas are a rare, complex group of childhood and adult neoplasms with differentiation towards mesenchymal tissue, which may arise almost anywhere in the body. Although pathologically diverse, they frequently exhibit similar clinical presentations and radiological features. Correct histopathological diagnosis is therefore crucial, but there is overlap between histological patterns of malignant tumours, between benign and malignant lesions, and with non-mesenchymal tumours. Immunohistochemistry and molecular genetic techniques, the latter to detect tumour-specific alterations, add significantly to histological interpretation, but several groups of tumours still lack reliable immunohistochemical markers or reproducible genetic changes. The classification of sarcomas is incomplete and continues to evolve, and although the biology of many remains relatively poorly understood, our increasing insight into molecular events occurring in these tumours is certain to aid future diagnosis and therapy. This paper aims to give a broad overview of several of the main soft tissue sarcomas from a clinicopathological perspective, discussing laboratory diagnosis and the use and limitations of ancillary investigations, including recent developments in molecular diagnosis.

  4. Olaratumab for soft tissue sarcoma.

    PubMed

    Teyssonneau, Diego; Italiano, Antoine

    2017-08-01

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

  5. Recently characterized soft tissue tumors that bring biologic insight.

    PubMed

    Fletcher, Christopher D M

    2014-01-01

    Previously unrecognized but clinicopathologically (and often molecularly) distinct types of soft tissue tumor continue to be characterized, allowing wider recognition, more consistent application of diagnostic criteria, more reliable prediction of tumor behavior and enhancement of existing classification schemes. Examples of such 'entities' that have become much better understood over the past decade or so include deep 'benign' fibrous histiocytoma, hemosiderotic fibrolipomatous tumor, PEComa, spindle cell liposarcoma, myoepithelial tumors of soft tissue and spindle cell/sclerosing rhabdomyosarcoma. These tumor types, as well as the insights which they have engendered, are briefly reviewed here.

  6. 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.

  7. Soft tissue balancing in total shoulder replacement.

    PubMed

    Mueller, Maike; Hoy, Gregory

    2014-03-01

    Total shoulder arthroplasty is now capable of recreating near anatomic reproduction of native bony shoulder anatomy, but the function and longevity of anatomic shoulder replacement is dependent on a competent soft tissue envelope and adequate motoring of all musculo-tendinous units about the shoulder. Balancing the soft tissues requires understanding of the anatomy and pathology, as well as technical skills. The advent of reverse shoulder biomechanics has brought with it special requirements of understanding of the soft tissue elements still left in the shoulder despite major rotator cuff deficiency.

  8. 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

  9. What Is a Soft Tissue Sarcoma?

    MedlinePlus

    ... know has just been diagnosed with sarcoma, this short, simple guide can help. Downloadable PDFs Download free PDFs of our soft tissue sarcoma information About and ... Read More Latest Cancer News Read More Stories ...

  10. 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 ...

  11. Soft tissue sarcoma metastatic to pleura.

    PubMed

    Yildirim, Hüseyin; Metintaş, Muzaffer; Ak, Güntülü; Dündar, Emine; Erginel, Sinan

    2008-01-01

    Almost all cancers can cause distant pleural metastases. However, pleural metastases of soft tissue sarcoma that constitute less than 1% of adult solid malignancy are extremely rare. It is very difficult to distinguish them form sarcomatous malignant mesothelioma on histopathological features. We report a 57 year-old man who presented to us with left chest pain and progressive dyspnea and was diagnosed to have a pleural metastases of soft tissue sarcoma by thoracoscopic biopsy.

  12. Radionuclide imaging of soft tissue neoplasms

    SciTech Connect

    Chew, F.S.; Hudson, T.M.; Enneking, W.F.

    1981-10-01

    Two classes of radiopharmaceuticals may be used for imaging tumors of the musculoskeletal system. The first is comprised of soft tissue or tumor specific agents such as gallium-67, bleomycin, and radionuclide-labeled antibodies, which may be useful for detecting and localizing these tumors. The other class of tracer is comprised of those with avidity for bone. The 99mTc-labeled-phosphate skeletal imaging compounds have been found to localize in a variety of soft tissue lesions, including benign and malignant tumors. In 1972, Enneking began to include bone scans in the preoperative evaluation of soft tissue masses. Later, he and his associates reported that these scans were useful in planning operative treatment of sarcomas by detecting involvement of bone by the tumors. Nearly all malignant soft tissue tumors take up bone-seeking radiopharmaceuticals, and bone involvement was indicated in two-thirds of the scans we reviewed. About half of benign soft tissue lesions had normal scans, but the other half showed uptake within the lesion and a few also showed bone involvement. Careful, thorough imaging technique is essential to proper evaluation. Multiple, high-resolution static gamma camera images in different projections are necessary to adequately demonstrate the presence or absence of soft tissue abnormality and to define the precise relationship of the tumor to the adjacent bone.

  13. 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

  14. Injectable silk foams for soft tissue regeneration.

    PubMed

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

    2015-02-18

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

  15. 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

  16. [Physical therapy and rheumatism of soft tissues].

    PubMed

    Gross, D

    1982-08-28

    Soft tissue rheumatism (extraarticular rheumatism) is a group of common disorders found separately as independent disorders or as a symptom of systemic joint or spine diseases. The most frequent soft tissue rheumatisms are tendinopathies, rheumatism of muscles with myofascial pains, fibrositis of subcutaneous tissue and, finally, bursitis and inflammations of tendon sheaths. The commonest therapeutic procedures are non-steroidal anatirheumatic drugs, local infiltrations of corticosteroids, and physiotherapy. In the acute stages cold packs are the best physical measure against subjective pain. In subacute and chronic cases the pain in subcutaneous tissues can be lessened by connective tissue massage and underwater jet massage, muscle pain by heat and active exercises, and tendinopathies by ultrasonics and electrotherapy but very seldom by heat. In chronic bursitis and tendovaginitis, iontophoresis with potassium iodine may be helpful. Reflex pains in muscles are due to lesions of the spine and should therefore be treated by spine extension and manipulations. Every pain in soft tissue has one source in the anatomic lesion of the tissue and the second in psychogenic disorders. The latter must be sought when soft tissue pains are found all over the body on the lines of a generalized fibrositis syndrome.

  17. Soft tissue masses for the general orthopedic surgeon.

    PubMed

    Jernigan, Edward W; Esther, Robert J

    2015-07-01

    Soft tissue sarcomas are a rare, heterogeneous group of malignancies that should be included in the differential diagnosis for any patient presenting with a soft tissue mass. This article reviews strategies for differentiating between benign and malignant soft tissue masses. Epidemiology, appropriate workup, and treatment of soft tissue sarcomas are reviewed.

  18. The diagnosis of soft tissue tumours.

    PubMed Central

    Serpell, J. W.; Fish, S. H.; Fisher, C.; Thomas, J. M.

    1992-01-01

    We prospectively analysed methods of diagnosis in 118 patients referred for definitive treatment with documented or presumed soft tissue sarcoma (STS). Of 65 patients with primary STS, 54 were biopsied before referral. Of these, 5 (9%) were biopsied by Tru-cut biopsy, 17 (32%) by incisional biopsy and 32 (59%) by excisional biopsy. The remaining 11 patients with primary STS, referred without biopsy, were all diagnosed by Tru-cut biopsy. An additional eight patients suspected of having STS were referred without biopsy and were found to have malignant tumours other than STS involving soft tissue by Tru-cut biopsy. Nineteen patients were proved to have benign soft tissue tumours; in 13 presumed to have STS, the diagnosis was unknown at referral. In four of these, biopsy was inappropriate. Of nine submitted to Tru-cut biopsy, an unequivocal diagnosis was made in 5 (56%) and incisional biopsy was required in the other four. Therefore, paradoxically, benign soft tissue tumours may be more difficult to diagnose with Tru-cut biopsy than malignant tumours. This study confirms the high degree of accuracy of Tru-cut biopsy in diagnosing malignant soft tissue tumours and highlights the disadvantages of open biopsy techniques. PMID:1416683

  19. Enabling Technologies for Advanced Soft Tissue Modeling

    DTIC Science & Technology

    2006-09-01

    Tools for measuring soft tissue properties. Workshop on Reality- Based Modeling of Tissues for Simulation and Robot -Assisted Surgery , at IEEE/RSJ IROS...protocols, mathematical models and tools, and validation techniques to determine and describe the biomechanical behavior of living tissues. The...surgical simulation systems that allow new doctors to experience their first surgeries without risk to real patients. They can be implemented in

  20. Phase contrast imaging of cochlear soft tissue

    NASA Astrophysics Data System (ADS)

    Shintani Smith, Stephanie; Hwang, Margaret; Rau, Christoph; Fishman, Andrew J.; Lee, Wah-Keat; Richter, Claus-Peter

    2011-03-01

    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.

  1. Soft Tissue Sarcomas of the Kidney

    PubMed Central

    Köhle, Olivia; Abt, Dominik; Rothermundt, Christian; Öhlschlegel, Christian; Brugnolaro, Christiane; Schmid, Hans-Peter

    2015-01-01

    Soft tissue sarcomas are rare mesenchymal tumors. Amongst others, primitive neuroectodermal tumors (PNET) of the kidney and synovial sarcoma of the kidney belong to the group of soft tissue sarcomas. Synovial sarcomas can occur almost anywhere in the body, most frequently, however, in the lower (62%) or upper extremities (21%). Metastases occur in 50-70% of cases, and thus the prognosis is poor. PNETs are rare, highly aggressive neoplastic lesions which mainly occur in the torso or axial skeleton in young adults. The prognosis is poor with a 5-year disease-free survival rate of 45-55%. The primary therapeutic approach is surgical resection. Most randomized studies assessing adjuvant chemotherapy for all types of localized soft tissue sarcomas did not show statistically significantly better overall survival times after chemotherapy, although they did show longer progression-free survival. We report on two cases of primary renal synovial sarcoma and one case of PNET of the kidney. PMID:25918607

  2. Soft-tissue amyloidoma with associated plasmacytoma.

    PubMed

    Dalal, Bibhas Saha; Sarkar, Piyabi; Maity, Namrata; Nadeem, Sayed Mahmood

    2016-01-01

    Soft tissue amyloidoma with features similar to plasmacytoma, in absence of systemic amyloidosis, is an extremely rare finding. We hereby report the case of a 77 year old man who presented with a painless, nodular swelling on chest wall, diagnosed as soft tissue amyloidoma with plasma cell infiltration. Congo red staining was done to prove the presence of amyloid which showed characteristic "apple-green" birefringence on polarized microscopy. The plasma cells were monoclonal in origin as demonstrated by serum protein and immunofixation electrophoresis. To the best of our knowledge, this is the second such reported case. However close follow up is required, as this patient may develop multiple myeloma in future.

  3. Reconstruction of Small Soft Tissue Nasal Defects

    PubMed Central

    Wolfswinkel, Erik M.; Weathers, William M.; Cheng, David; Thornton, James F.

    2013-01-01

    Nasal defect repair has been one of the more challenging areas of reconstructive surgery due to the lack of uniform nasal skin thickness and complex contours. Currently, algorithms for medium to large nasal soft tissue defects have been well defined by various authors. Small defects, arbitrarily defined as 1 cm or less, still present significant challenges. In this article, the authors examine the options available to repair small soft tissue nasal defects and the appropriate situations in which each method is best suited. PMID:24872751

  4. 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

  5. Soft tissue and epithelial models.

    PubMed

    Jansen, J A; den Braber, E T; Walboomers, X F; de Ruijter, J E

    1999-06-01

    The applicability of a biomaterial for the manufacturing of oral implants is determined by its physicochemical and geometric surface properties. Research, therefore, is concerned with the cellular reactions that occur when an implant material comes into contact with body tissues. For permucosal oral implants, this involves both the reaction of bone and gingival cells. In vitro cell culturing--including the use of various analytical techniques like light microscopy, scanning and transmission electron microscopy, confocal laser scanning microscopy, and digital image analysis--is a good tool whereby investigators can obtain more insight into the relevant components of implant-tissue adhesion. In the current overview, the role of cell models in oral implant research is discussed, specifically with reference to responses of epithelial cells and fibroblasts.

  6. 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.

  7. 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

  8. Supervised autonomous robotic soft tissue surgery.

    PubMed

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

    2016-05-04

    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.

  9. Equine model for soft-tissue regeneration.

    PubMed

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

    2015-08-01

    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 6 months to simultaneously evaluate many different implants, reducing the number of animals needed. Furthermore, we were able to tailor matrix degradation by varying the initial format of the implanted silk. Finally, we demonstrate ultrasound imaging of implants to be an effective means for tracking tissue regeneration and implant degradation.

  10. Soft Robotic Grippers for Biological Sampling on Deep Reefs.

    PubMed

    Galloway, Kevin C; Becker, Kaitlyn P; Phillips, Brennan; Kirby, Jordan; Licht, Stephen; Tchernov, Dan; Wood, Robert J; Gruber, David F

    2016-03-01

    This article presents the development of an underwater gripper that utilizes soft robotics technology to delicately manipulate and sample fragile species on the deep reef. Existing solutions for deep sea robotic manipulation have historically been driven by the oil industry, resulting in destructive interactions with undersea life. Soft material robotics relies on compliant materials that are inherently impedance matched to natural environments and to soft or fragile organisms. We demonstrate design principles for soft robot end effectors, bench-top characterization of their grasping performance, and conclude by describing in situ testing at mesophotic depths. The result is the first use of soft robotics in the deep sea for the nondestructive sampling of benthic fauna.

  11. Soft Robotic Grippers for Biological Sampling on Deep Reefs

    PubMed Central

    Galloway, Kevin C.; Becker, Kaitlyn P.; Phillips, Brennan; Kirby, Jordan; Licht, Stephen; Tchernov, Dan; Gruber, David F.

    2016-01-01

    Abstract This article presents the development of an underwater gripper that utilizes soft robotics technology to delicately manipulate and sample fragile species on the deep reef. Existing solutions for deep sea robotic manipulation have historically been driven by the oil industry, resulting in destructive interactions with undersea life. Soft material robotics relies on compliant materials that are inherently impedance matched to natural environments and to soft or fragile organisms. We demonstrate design principles for soft robot end effectors, bench-top characterization of their grasping performance, and conclude by describing in situ testing at mesophotic depths. The result is the first use of soft robotics in the deep sea for the nondestructive sampling of benthic fauna. PMID:27625917

  12. Soft tissue trauma and scar revision.

    PubMed

    Mobley, Steven R; Sjogren, Phayvanh P

    2014-11-01

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

  13. Olaratumab for advanced soft tissue sarcoma.

    PubMed

    Tobias, Alexander; O'brien, Michael P; Agulnik, Mark

    2017-07-01

    Olaratumab is a humanized IgG1 monoclonal antibody that blocks the platelet-derived growth factor receptor alpha (PDGFRα). Its antagonistic behavior inhibits the receptor's tyrosine kinase activity, thereby, turning off the downstream signaling cascades responsible for soft tissue sarcoma tumorigenesis. In October 2016, olaratumab received Food and Drug Administration (FDA) approval for its use in combination with doxorubicin for treatment of advanced soft tissue sarcoma. Areas covered: This drug profile takes a comprehensive look at the clinical studies leading to FDA approval of olaratumab as well as its safety and efficacy as a front-line treatment option for sarcoma patients. The literature search was primarily conducted using PubMed. Expert commentary: The combination of olaratumab plus doxorubicin has provided a new front-line therapeutic option for soft tissue sarcoma patients. An open-label phase Ib and randomized phase II trial in patients with advanced soft tissue sarcoma demonstrated that the addition of olaratumab to doxorubicin prolonged progression-free survival by 2.5 months and overall survival by 11.8 months when compared to doxorubicin alone. Of importance, this clinically meaningful increase in overall survival did not come at the expense of a significantly greater number of toxicities. A phase III confirmatory trial (ClinicalTrials.gov Identifier NCT02451943) will be completed in 2020.

  14. 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.

  15. Volumizing the face with soft tissue fillers.

    PubMed

    Jones, Derek

    2011-07-01

    This article discusses the role of injectable soft-tissue fillers in the aging face, and their clinical and chemical behavior. Temporary and permanent fillers are discussed, namely hyaluronic acids, calcium hydroxylapatite, poly-l-lactic acid, liquid silicone, and polymethylmethacrylate. Techniques and outcomes are presented. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Modeling of indentation into inhomogeneous soft tissues

    NASA Astrophysics Data System (ADS)

    Lyubicheva, A. N.; Goryacheva, I. G.; Dosaev, M. Z.; Su, F.-Ch.

    2017-01-01

    A simulation of a contact interaction of the indenter and inhomogeneous soft biological tissues is carried out. The soft tissue is modeled by the incompressible elastic body which contains structural inhomogeneities (spherical or longitudinal inclusions). The elastic moduli of inclusions are higher than the bulk soft tissue modulus. These inclusions may be considered, in particular, as the models of the pathological growths. The indenter has the form of a hollow hemisphere (shell). It is the model of the mechanoreceptor developed in [1] to study the mechanical properties of soft tissues. The hydrostatic pressure can be applied inside the shell. Based on the numerical analysis, the dependences of the contact area size, and contact pressure on penetration of the indenter into the sample for several values of the inclusion size, depth, its location, the ratio of the elastic moduli of inclusion and the surrounding material, but also for various values of hydrostatic pressure inside the shell were obtained. The possibility of an inverse problem solution for determining the mechanical properties of the inclusion, and its size by measuring the contact characteristics is discussed.

  17. Photoacoustic tomography of foreign bodies in soft biological tissue

    NASA Astrophysics Data System (ADS)

    Cai, Xin; Kim, Chulhong; Pramanik, Manojit; Wang, Lihong V.

    2011-04-01

    In detecting small foreign bodies in soft biological tissue, ultrasound imaging suffers from poor sensitivity (52.6%) and specificity (47.2%). Hence, alternative imaging methods are needed. Photoacoustic (PA) imaging takes advantage of strong optical absorption contrast and high ultrasonic resolution. A PA imaging system is employed to detect foreign bodies in biological tissues. To achieve deep penetration, we use near-infrared light ranging from 750 to 800 nm and a 5-MHz spherically focused ultrasonic transducer. PA images were obtained from various targets including glass, wood, cloth, plastic, and metal embedded more than 1 cm deep in chicken tissue. The locations and sizes of the targets from the PA images agreed well with those of the actual samples. Spectroscopic PA imaging was also performed on the objects. These results suggest that PA imaging can potentially be a useful intraoperative imaging tool to identify foreign bodies.

  18. Non-linear micromechanics of soft tissues

    PubMed Central

    Chen, Huan; Zhao, Xuefeng; Lu, Xiao; Kassab, Ghassan

    2013-01-01

    Microstructure-based constitutive models have been adopted in recent studies of non-linear mechanical properties of biological soft tissues. These models provide more accurate predictions of the overall mechanical responses of tissues than phenomenological approaches. Based on standard approximations in non-linear mechanics, we classified the microstructural models into three categories: (1) uniform-field models with solid-like matrix, (2) uniform-field models with fluid-like matrix, and (3) second-order estimate models. The first two categories assume affine deformation field where the deformation of microstructure is the same as that of the tissue, regardless of material heterogeneities; i.e., they represent the upper bounds of the exact effective strain energy and stress of soft tissues. In addition, the first type is not purely structurally motivated and hence cannot accurately predict the microscopic mechanical behaviors of soft tissues. The third category considers realistic geometrical features, material properties of microstructure and interactions among them and allows for flexible deformation in each constituent. The uniform-field model with fluid-like matrix and the second-order estimate model are microstructure-based, and can be applied to different tissues based on micro-structural features. PMID:24817769

  19. 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.

  20. Thermomechanical analysis of soft-tissue thermotherapy.

    PubMed

    Aksan, Alptekin; McGrath, John J

    2003-10-01

    Soft-tissue thermotherapy based on sub-ablative heating of collagenous tissues finds wide-spread application in medicine such as tissue welding, thermokeratoplasty, skin resurfacing, elimination of discogenic pain in the spine and treatment of joint instability. In this paper, heat-induced thermomechanical response characteristics of collagenous tissues are quantified by means of in vitro experimentation with a representative model tissue (New Zealand white rabbit patellar tendon). Three distinct heat-induced thermomechanical response regimes (defined by the rate of deformation and the variation of material properties) are identified. Arrhenius damage integral representation of collagenous tissue thermal history is shown to be adequate in establishing the master response curves for quantification of thermomechanical response for modeling purposes. The trade-off between the improved kinematical stability and compromised mechanical stability of the heated collagenous tissue is shown to be the major challenge hindering the success of subablative thermotherapies.

  1. 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.

  2. [Soft tissue defects treated with perforator flaps].

    PubMed

    Weum, Sven; de Weerd, Louis; Klein, Steven; Hage, J Joris

    2008-01-31

    Treatment of soft tissue defects caused by trauma, tumour surgery or pressure sores is a challenge to the reconstructive surgeon. Although contour and function may be restored by tissue transposition, traditional methods often cause significant donor site morbidity. This article describes how increased understanding of vascular anatomy has led to the development of new techniques. The article is based on textbooks of plastic surgery, selected articles and own clinical experience. Pedicled and free perforator flaps represent the latest development in surgical treatment of soft tissue defects. The use of perforator flaps can considerably reduce the disadvantages that are associated with other surgical methods. The use of perforator flaps demands microsurgical skills, but has many advantages. Reliable vascular supply and a good aesthetical result can be combined with minimal donor site morbidity. In many cases this technique may even give sensibility to the reconstructed area.

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

    PubMed

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

    2017-07-01

    Staphylococcus aureus is the most common cause of soft tissue infections. It is unknown, however, if a patient who has had such an infection is at greater risk for future soft tissue infections with S. aureus. We conducted an epidemiological survey of adult patients hospitalized in the only public hospital in Geneva for treatment (usually combined surgical and medical) of a soft tissue infection caused by S. aureus. By reviewing nursing and medical records from the emergency department and hospital wards, we assessed whether or not they developed any other soft tissue infections (excluding a recurrence) after or before the index one. Among 1023 index episodes of soft tissue infections, 670 (65%) were caused by S. aureus, of which 47 were caused by methicillin-resistant strains (30 healthcare-associated and 17 community-acquired). The patients' median age was 51 years and 334 (34%) were immune-compromised. The median time span between the patient's first and last consultation (for any reason) in our hospital was 21.4 years (interquartile range, 10-30 years). In addition to their index infection, 124 patients (12%) developed a new nosocomial or community-acquired soft tissue infection. Among the index cases with an S. aureus infection, 92 (14%) had another soft tissue infection, compared to 32 (9%) who had a non-staphylococcal index infection (Pearson-χ(2)-test; p=0.03). Similarly, patients with an index S. aureus infection, compared to those with a non-S. aureus infection, had a higher rate of another soft tissue infection caused by S. aureus (χ(2)-test; p<0.01). In multivariate analysis, an index infection due to S. aureus shows a high association to further S. aureus soft tissue infections (logistic regression; odds ratio 2.5, 95% confidence interval 1.4-4.6). Among adult patients hospitalised for a soft tissue infection, those infected with S. aureus (compared with other pathogens) may be at higher risk of a subsequent soft tissue infection, particularly with S

  4. Hard-Soft Tissue Interface Engineering.

    PubMed

    Armitage, Oliver E; Oyen, Michelle L

    2015-01-01

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

  5. Palmar Soft Tissue Infection From Shewanella putrefaciens.

    PubMed

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

    2017-08-25

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

  6. Recent advances in soft tissue augmentation.

    PubMed

    Krauss, M C

    1999-06-01

    Soft tissue augmentation has become increasingly important as more individuals seek aesthetic improvement without major surgical procedures. The choice of an appropriate subcutaneous implant, whether solid or injectable, requires a thorough understanding of the materials available. This review of the literature addresses autologous fat and dermis transplantation, autologous and allogeneic human collagen, bovine collagen, acellular dermal allograft, hyaluronic acid derivatives, expanded polytetrafluoroethylene, polymethyl-methacrylate microspheres, and other potential biomaterials. The search for the perfect material to eradicate rhytids, smooth scars, and fill traumatic detects continues. New products appear, sometimes with great fanfare, which fail to fulfill the promise of a better alternative to what we use now. For this reason, an in-depth understanding of implant materials is necessary for any physician performing soft-tissue augmentation procedures.

  7. Liquid injectable silicone for soft tissue augmentation.

    PubMed

    Prather, Chad L; Jones, Derek H

    2006-01-01

    Liquid injectable silicone is a unique soft tissue augmenting agent that may be effectively utilized for the correction of specific cutaneous and subcutaneous atrophies. Although historical complications have occurred, resulting likely from the presence of adulterants and impurities, modern purified silicone products approved by the Food and Drug Administration for injection into the human body may be employed with minimal complications when strict protocol is followed. In this article the present authors review the history and controversy regarding silicone as well as describe the appropriate indications, patient selection, instrumentation, treatment protocol, and anticipated complications involved with the use of liquid injectable silicone for soft tissue augmentation. Although its use is controversial, the present authors maintain that liquid injectable silicone is an important and effective augmenting agent for the long-term correction of scars and facial contour defects such as HIV facial lipoatrophy. Furthermore, it is a treatment modality deserving of continued investigation.

  8. 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.

  9. Modern Soft Tissue Pathology | Center for Cancer Research

    Cancer.gov

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

  10. 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

  11. Postextraction tissue management: a soft tissue punch technique.

    PubMed

    Jung, Ronald E; Siegenthaler, David W; Hämmerle, Christoph H F

    2004-12-01

    The aim of this prospective clinical study was to analyze graft-enhanced soft tissue healing during the initial phases after tooth extraction. Twenty patients in need of tooth extraction (incisors, canines, and premolars) and implant replacement were included. In patients with multiple extractions, one tooth was randomly selected for treatment. After administration of antibiotics, the selected tooth was gently removed. The socket was completely filled with deproteinized bovine bone mineral integrated in a 10% collagen matrix to fill out the space of the alveolus and support the soft tissue. A biopsy punch with a diameter corresponding to the socket orifice was chosen to harvest a free gingival graft of 2- to 3-mm thickness from the palate. The punched graft was carefully sutured to the deepithelialized soft tissue margins of the socket. One week after graft insertion, 64.3% of the mean graft area was fully integrated, 35.6% was fibrinoid, and 0.1% showed necrotic parts. Three and 6 weeks postsurgery, the mean integrated graft surface increased to 92.3% and 99.7%, respectively. After 6 weeks, a mean of 0.3% of the surface in four grafts showed incomplete wound closure, and no fibrin or necrosis was present. Colorimetry of the graft and adjacent tissue revealed a mean color match of deltaE = 2.91, lower than the critical threshold of 3.7 for intraoral visibility of different colors. This soft tissue punch technique led to successful biologic and esthetic integration of the transplanted graft into the local host tissues.

  12. Soft tissue management in endodontic surgery.

    PubMed

    Velvart, Peter; Peters, Christine I

    2005-01-01

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

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

    ClinicalTrials.gov

    2016-09-23

    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

  14. Soft tissue coverage of combat wounds.

    PubMed

    Tintle, Scott M; Gwinn, David E; Andersen, Romney C; Kumar, Anand R

    2010-01-01

    Warfare-related open fractures with large soft tissue defects create a significant reconstructive challenge. The objective of this article is to review current and evolving treatment strategies for soft tissue coverage of warfare-induced extremity wounds. A review of previously published literature and current data evaluating combat-injured personnel requiring extremity flap reconstruction performed by a single surgeon within the National Capital Area from 2004 to 2009 was performed. Collected data reviewed included injury patterns, methods of reconstruction, and success rates. Seventy-five (59 pedicled flaps and 16 free) extremity reconstructions employing flaps (34 fasciocutaneous, 34 muscle, and 7 adipofascial) were performed in the subacute time period between 7 days and 3 months. One hundred percent of the wounds were associated with open fractures. Early postoperative infections (<6 {\\it weeks from reconstruction) occurred in 10 patients (13%). Total flap loss occurred in two flaps (2.8%) and partial flap loss occurred in six flaps (8.3%). Two patients underwent early limb amputation after flap failure. Two additional patients underwent delayed amputation. Flap success was 97% and limb salvage rate was 94%. Based on the location of the extremity wounds, a reconstruction guide for flap type was created. Modern military limb reconstruction strategies in carefully selected patients with soft tissue defects have resulted in low flap loss rates and high limb salvage rates despite reconstruction in the subacute period between 7 days and 3 months. This limb salvage protocol is likely applicable in high-energy civilian motor vehicle accidents or industrial trauma when highly contaminated wounds are present.

  15. 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

  16. Diffuse soft tissue calcification in tumoral calcinosis

    SciTech Connect

    Feldman, E.S.; Schumacher, H.R.; Dalinka, M.K.

    1981-10-01

    Tumoral calcinosis is a rare disease characterized biochemically by hyperphosphatemia, normocalcemia, and reduced fractional excretion of phosphate. Radiographically, it has been defined by the presence of large, amorphous juxtaarticular calcific deposits. A 53-year-old woman with tumoral calcinosis was found to have unusual diffuse soft tissue calcification indistinguishable from that usually seen in collagen vascular disease and previously referred to as calcinosis universalis. It is suggested that tumoral calcinosis is a misnomer as the calcification seen in patients with this disease may be 'tumoral' or diffuse.

  17. 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.

  18. Augmentation rhinoplasty with soft tissue and cartilage.

    PubMed

    Megumi, Y

    1988-05-01

    Augmentation rhinoplasty using soft tissue and cartilage was performed on 120 patients and the results were reexamined. They were found to be satisfactory and without complication. To narrow a round tip, a resection of two-thirds of the lateral crus cephalad portion and a transection of the caudal portion with a strip resection was done. To elevate the tip, septal cartilage was sutured to one-third of the upper part of medial crus to form a columella cartilage strut. To maintain the strut and to prevent pointing, a fibrous muscle tissue stretching from the medial crus to the upper cartilage or a dermis was transplanted into the area surrounding the septal cartilage tip. For a simple elevation of the dorsum, an onlay graft of dermis was applied, but where further elevation was required, further dermis and conchal cartilage was added for suture and attachment to the dermis.

  19. Animal models of soft-tissue sarcoma

    PubMed Central

    Dodd, Rebecca D.; Mito, Jeffery K.; Kirsch, David G.

    2010-01-01

    Soft-tissue sarcomas (STSs) are rare mesenchymal tumors that arise from muscle, fat and connective tissue. Currently, over 75 subtypes of STS are recognized. The rarity and heterogeneity of patient samples complicate clinical investigations into sarcoma biology. Model organisms might provide traction to our understanding and treatment of the disease. Over the past 10 years, many successful animal models of STS have been developed, primarily genetically engineered mice and zebrafish. These models are useful for studying the relevant oncogenes, signaling pathways and other cell changes involved in generating STSs. Recently, these model systems have become preclinical platforms in which to evaluate new drugs and treatment regimens. Thus, animal models are useful surrogates for understanding STS disease susceptibility and pathogenesis as well as for testing potential therapeutic strategies. PMID:20713645

  20. Measurement of surface deformation of soft tissue.

    PubMed

    Stokes, I; Greenapple, D M

    1985-01-01

    A method is described for measuring the surface shape and deformations of soft tissue in three dimensions. The method uses close range stereophotogrammetry to record the three-dimensional locations of miniature optical targets applied to the tissue surface. This has been applied to study of human lumbar intervertebral disc. Measurements of the strain along surface annular fibers have been made under varying loads. In this case the maximum expected errors are about 0.15 mm, which corresponds to a strain of less than 1%. Preliminary findings have differed from predictions made in published mathematical models for the disc in that they show very little strain of the annulus in compression loading, but confirm axial torsional loading as liable to produce mechanical disruption of the disc annulus.

  1. 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

  2. Soft-tissue rheumatism: diagnosis and treatment.

    PubMed

    Reveille, J D

    1997-01-27

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

  3. New Therapeutic Targets in Soft Tissue Sarcoma

    PubMed Central

    Demicco, Elizabeth G; Maki, Robert G; Lev, Dina C.; Lazar, Alexander J

    2012-01-01

    Soft tissue sarcomas are an uncommon and diverse group of more than 50 mesenchymal malignancies. The pathogenesis of many of these is poorly understood, but others have begun to reveal the secrets of their inner workings. With considerable effort over recent years, soft tissue sarcomas have increasingly been classified on the basis of underlying molecular alterations. In turn, this has allowed the development and application of targeted agents in several specific, molecularly defined, sarcoma subtypes. This review will focus the rationale for targeted therapy in sarcoma, with emphasis on the relevance of specific molecular factors and pathways in both translocation-associated sarcomas and in genetically complex tumors. In addition, we will address some of the early successes in sarcoma targeted therapy as well as a few challenges and disappointments in this field. Finally we will discuss several possible opportunities represented by poorly understood, but potentially promising new therapeutic targets, as well as several novel biologic agents currently in preclinical and early phase I/II trials. This will provide the reader with context for understanding the current state this field and a sense of where it may be headed in the coming years. PMID:22498582

  4. Microwave soft tissue ablation (Invited Paper)

    NASA Astrophysics Data System (ADS)

    Clegg, Peter J.; Cronin, Nigel J.

    2005-04-01

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

  5. 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

  6. Targeted therapies for soft-tissue sarcomas.

    PubMed

    Tap, William D; Federman, Noah; Eilber, Fritz C

    2007-05-01

    The past several decades have revealed certain challenges that are inherent to soft-tissue sarcomas with regards to devising, testing and setting treatment paradigms for such a rare and heterogeneous malignancy. Despite this, significant advances have been made through the efforts of scientists, clinicians and patients alike. We are now entering a molecular era of cancer and current biotechnology is beginning to unravel the pathogenic enigma of these often devastating tumors. As our understanding of these malignancies improves, so does our list of potential treatment options. The impetus now lies with the medical/scientific community to direct translational research and subsequently the development and clinical testing of novel compounds in a fashion that best serves this unique patient population. To do so, we must continue to integrate the lessons of the past with the resources and promise of the future. This review will outline current areas of therapeutic interest in soft-tissue sarcomas with regard to agents that have reached clinical testing.

  7. 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

  8. 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

  9. The therapeutic challenges of degloving soft-tissue injuries

    PubMed Central

    Latifi, Rifat; El-Hennawy, Hany; El-Menyar, Ayman; Peralta, Ruben; Asim, Mohammad; Consunji, Rafael; Al-Thani, Hassan

    2014-01-01

    Background: Degloving soft-tissue injuries are serious and debilitating conditions. Deciding on the most appropriate treatment is often difficult. However, their impact on patients’ outcomes is frequently underestimated. Objectives: We aimed to study the incidence, clinical presentation, management and outcome of degloving soft-tissue injuries. Materials and Methods: We conducted a narrative traditional review using the key words; degloving injury and soft-tissue injuries through search engines PubMed, Science Direct, and Scopus. Results: There are several therapeutic options for treating degloving soft-tissue injuries; however, no evidence-based guidelines have been published on how to manage degloving soft-tissue injuries, although numerous articles outline the management of such injuries. Conclusion: Degloving soft-tissue injuries are underreported and potentially devastating. They require early recognition, and early management. A multidisciplinary approach is usually needed to ensure the effective rehabilitation of these patients. PMID:25114435

  10. 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.

  11. Fiber-reinforced scaffolds in soft tissue engineering

    PubMed Central

    Wang, Wei; Fan, Yubo; Wang, Xiumei; Watari, Fumio

    2017-01-01

    Abstract Soft tissue engineering has been developed as a new strategy for repairing damaged or diseased soft tissues and organs to overcome the limitations of current therapies. Since most of soft tissues in the human body are usually supported by collagen fibers to form a three-dimensional microstructure, fiber-reinforced scaffolds have the advantage to mimic the structure, mechanical and biological environment of natural soft tissues, which benefits for their regeneration and remodeling. This article reviews and discusses the latest research advances on design and manufacture of novel fiber-reinforced scaffolds for soft tissue repair and how fiber addition affects their structural characteristics, mechanical strength and biological activities in vitro and in vivo. In general, the concept of fiber-reinforced scaffolds with adjustable microstructures, mechanical properties and degradation rates can provide an effective platform and promising method for developing satisfactory biomechanically functional implantations for soft tissue engineering or regenerative medicine. PMID:28798872

  12. 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.

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

    PubMed Central

    Bhatavadekar, Neel

    2012-01-01

    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

  14. Ion induced deformation of soft tissue.

    PubMed

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

    1995-01-01

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

  15. Potential for immunotherapy in soft tissue sarcoma

    PubMed Central

    Tseng, William W; Somaiah, Neeta; Engleman, Edgar G

    2015-01-01

    Soft tissue sarcomas (STS) are rare, heterogeneous tumors of mesenchymal origin. Despite optimal treatment, a large proportion of patients will develop recurrent and metastatic disease. For these patients, current treatment options are quite limited. Significant progress has been made recently in the use of immunotherapy for the treatment of other solid tumors (e.g. prostate cancer, melanoma). There is a strong rationale for immunotherapy in STS, based on an understanding of disease biology. For example, STS frequently have chromosomal translocations which result in unique fusion proteins and specific subtypes have been shown to express cancer testis antigens. In this review, we discuss the current status of immunotherapy in STS, including data from human studies with cancer vaccines, adoptive cell therapy, and immune checkpoint blockade. Further research into STS immunology is needed to help design logical, subtype-specific immunotherapeutic strategies. PMID:25625925

  16. 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

  17. 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.

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

  19. 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.

  20. [Application of skin and soft tissue expansion in treatment of burn injury].

    PubMed

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

    2000-09-01

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

  1. Soft tissue facial anthropometry in Down syndrome subjects.

    PubMed

    Ferrario, Virgilio F; Dellavia, Claudia; Zanotti, Gianfranco; Sforza, Chiarella

    2004-05-01

    The three-dimensional coordinates of 50 selected soft tissue facial landmarks were digitized on 28 white Italian subjects with Down syndrome (17 male and 11 female subjects aged 12 to 45 years) and 429 healthy controls of comparable ages by an electromechanical instrument. From the landmarks, 16 facial dimensions were calculated. Data were compared with those collected in healthy individuals by computing z-scores. Overall, most variables were smaller in subjects with Down syndrome than in their normal controls selected for sex, age, and ethnicity (negative z-scores), even if not all of them reached statistical significance. Independently of sex, subjects with Down syndrome had faces that were significantly (P <0.05, paired Student t test) narrower (skull base and mandible), less deep (upper, middle, and lower face), and shorter (face and nose height) than the faces of normal subjects. Additionally, ear width and length were significantly reduced on both sides of the face. Only facial height was significantly different between sexes (P = 0.023, unpaired Student t test), with a female z-score that was more than two times the relevant male value. The present investigation represents the first detailed quantitative analysis of the facial soft tissue characteristics of Italian white subjects with Down syndrome.

  2. Multidisciplinary management of soft tissue sarcomas.

    PubMed

    Luis, Ángel Montero; Aguilar, Damián Pérez; Martín, José Antonio López

    2010-08-01

    Musculoskeletal sarcomas are a heterogeneous group of malignant neoplasms derived from connective tissue. Sarcomas represent about 1% of cancer in adults. The annual incidence in adults in Europe is around 14,000 new cases of soft tissue sarcomas (STS) and 4,800 new cases of bone sarcomas. Musculoskeletal tumours arise anywhere in the body, although lower extremities are the most common site of appearance, followed by upper extremities, trunk, retroperitoneum and head and neck area. Adequate management of STS is a stimulating challenge for oncologists. The aim of treatment should be focused on four main aspects: improving survival, avoiding local recurrence, maximising organ function and, finally, minimising morbidity. Surgery, radiotherapy and, sometimes though increasingly, chemotherapy are the pillars on which rests the modern treatment of sarcomas. The optimal management of musculoskeletal tumour requires a multidisciplinary integration of these different approaches in treatment planning right from the initial diagnoses. Referring patients to qualified centres should be desirable to achieve the maximum probability of control and even cure for STS.

  3. Soft tissue management of orbitotemporal neurofibromatosis.

    PubMed

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

    2013-01-01

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

  4. Primary Tuberculosis of Hand Soft Tissue

    PubMed Central

    Altaf Mir, Mohd; Ahmad, Imran; Yaseen, Mihd

    2016-01-01

    The musculoskeletal extrapulmonary tuberculosis is uncommon, the upper extremity tuberculosis is not common and the mycobacterial involvement of skin of hands and synovial sheath of tendons is rare. This prospective observational study was undertaken between August 2014 and December 2015 in a tertiary referral hospital. Patients attending with suspected primary tuberculosis of soft tissue of the hand were included. Anteroposterior and lateral radiographs of the hand, wrist and lung and MRI were undertaken. A diagnosis of tuberculosis was made based on histology, and positive culture for Mycobacterium. Split thickness skin grafting was done after excision of tubercular cutaneous ulcers of hand. Postoperatively patients were treated with home based anti-tubercular chemotherapy. Lesions of synovial sheath of tendons were excised. Splints or plaster slabs were used in all patients. There were 3 males and 2 females with a mean age of 44.75±6.61 years (19-48 years). Based on clinical suspicion, plain radiographs and MRI, there were 3 patients with involvement of synovial sheath of tendons and 2 patients with involvement of skin of hand. Tuberculosis was confirmed histologically and Mycobacterium bovis was confirmed microbiologically. The delayed diagnosis is often due to slow progression and numerous differential diagnoses, which often leads to complications. Early radical excision of the infected tissues combined with anti- tubercular multidrug therapy gives good functional results and prevents recurrence. PMID:27853698

  5. Expanding soft tissue with Osmed tissue expanders in the goat maxilla.

    PubMed

    Uijlenbroek, Henri J J; Liu, Yuelian; He, Jian Feng; Visscher, Corine; van Waas, Marinus A J; Wismeyer, Daniel

    2011-01-01

    soft tissue limitations are encountered in implant dentistry, due to the loss of alveolar bone. The aim of this study is to compare the outcome of soft tissue preparation using Osmed self-inflating soft tissue expanders with different in situ times in two implantation techniques. Osmed self-inflating soft tissue expanders were implanted in goats using a tunnel approach and a flap approach. The animals were sacrificed after 1h (controls) and 40 days (treated). A tattoo technique for stereographic measurements was used to look for soft tissue surface gain. Histological and histomorphometric analyses were performed to quantify and compare the changes in soft tissue volume and bone volume after 1h and 40 days of implantation. after 40 days, the expansion was visible and none of the goats had shown any inflammation. The space between the soft tissue and the bone was filled by the completely expanded expander and surrounding connective tissue. Between the test groups and the control groups, there was no histological difference in the structure of the soft tissue. all the tissue expanders expanded to their maximum size (2.8 times) and were a reliable product for creating a space between soft tissue and bone. The overlying soft tissue remained in excellent shape. There was no difference in the soft tissue volume and the bone volume between the tunnel and the flap approach after 40 days.

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

    PubMed

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

    2013-04-01

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

  7. Adult Soft Tissue Sarcoma Treatment (PDQ®)—Patient Version

    Cancer.gov

    Soft tissue sarcomas can form almost anywhere in the body, but are most common in the head, neck, arms, legs, truck, and abdomen. Find out about risk and genetic factors, symptoms, tests to diagnose, prognosis, staging, and treatment for soft tissue sarcoma.

  8. The management of soft tissue tumours of the abdominal wall.

    PubMed

    Smith, H G; Tzanis, D; Messiou, C; Benson, C; van der Hage, J A; Fiore, M; Bonvalot, S; Hayes, A J

    2017-09-01

    Soft tissue tumours of the abdominal wall account for approximately 10% of all soft tissue tumours. Tumours at this site comprise a heterogeneous group of pathologies with distinct clinical behaviours and responses to treatment. The management of these tumours has largely been extrapolated from studies of soft tissue tumours at other sites. This review aims to summarise the existing data relating to abdominal wall tumours and suggest principles for managing soft tissue tumours at this site. Relevant articles were retrieved from a comprehensive literature search using the PubMed database. Key words included abdominal wall, soft tissue tumours, surgery, radiotherapy and chemotherapy. No restrictions on publication date were used. The most common pathologies presenting in the abdominal wall are desmoid tumours, soft-tissue sarcoma and dermatofibrosarcoma protuberans (DFSP). Desmoid tumours should be managed with an initial period of observation, with surgery reserved for progressive lesions. Surgery should be the primary treatment for soft-tissue sarcomas and DFSP, with radiotherapy reserved for large-high grade tumours and preferentially given pre-operatively. Abdominal wall tumours are rare and should be managed in centres with experience in the management of soft tissue tumours. Management should be tailored to the biological behaviour of specific pathologies. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  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. [Soft tissues, hormones and the skeleton].

    PubMed

    Zofková, I

    2012-02-01

    Mechanical load activates bone modeling and increases bone strength. Thus physical activity is extremely important for overall bone health. Muscle volume and muscle contraction are closely related to bone mineral density in men and women, although these relationships are more significat in men. The muscle-bone unit has been defined as a functional system, in which both components are under control of the somatotropin-IGF-I system, androgens and D hormone. These endocrine systems play, via the muscle-bone unit, an important role in development of the skeleton and its stability in adulthood. That is why deficiency of any of these hormonal systems, or reduced physical activity (mainly in childhood) could seriously affect bone density and quality. Bone is also under control of adipose tissue, which modulates its metabolism via mechanical load and more importantly via adipocytokines (leptin, adiponectin and rezistin). Leptin increases bone formation by activation of osteoblasts. This direct effect of leptin is amplified by stimulation of the β-1 adrenergic system, which inhibits the negative osteotropic effects of neuropeptide Y. On the other hand, leptin also activates β-2 adrenergic receptors, which increase bone resorption. In humans, the overall osteo-anabolic effect of leptin tends to be dominant. Furthermore, leptin has a principal role in the start of puberty in girls and maturation, remodeling and development of the female skeleton. Adiponectin (and probably rezistin) has an unambiguous deteriorating effect on the skeleton. Further studies are needed to confirm the clinical importance of soft tissues relative to the integrity of the skeleton.

  11. Quantitative morphology in canine cutaneous soft tissue sarcomas.

    PubMed

    Simeonov, R; Ananiev, J; Gulubova, M

    2015-12-01

    Stained cytological specimens from 24 dogs with spontaneous soft tissue sarcomas [fibrosarcoma (n = 8), liposarcoma (n = 8) and haemangiopericytoma (n = 8)], and 24 dogs with reactive connective tissue lesions [granulation tissue (n = 12) and dermal fibrosis (n = 12)] were analysed by computer-assisted nuclear morphometry. The studied morphometric parameters were: mean nuclear area (MNA; µm(2)), mean nuclear perimeter (MNP; µm), mean nuclear diameter (MND mean; µm), minimum nuclear diameter (Dmin; µm) and maximum nuclear diameter (Dmax; µm). The study aimed to evaluate (1) possibility for quantitative differentiation of soft tissue sarcomas from reactive connective tissue lesions and (2) by using cytomorphometry, to differentiate the various histopathological soft tissue sarcomas subtypes in dogs. The mean values of all nuclear cytomorphometric parameters (except for Dmax) were statistically significantly higher in reactive connective tissue processes than in soft tissue sarcomas. At the same time, however, there were no considerable differences among the different sarcoma subtypes. The results demonstrated that the quantitative differentiation of reactive connective tissue processes from soft tissue sarcomas in dogs is possible, but the same was not true for the different canine soft tissue sarcoma subtypes. Further investigations on this topic are necessary for thorough explication of the role of quantitative morphology in the diagnostics of mesenchymal neoplasms and tumour-like fibrous lesions in dogs. © 2014 John Wiley & Sons Ltd.

  12. TERT promoter mutations in soft tissue sarcomas.

    PubMed

    Campanella, Nathália C; Penna, Valter; Abrahão-Machado, Lucas Faria; Cruvinel-Carloni, Adriana; Ribeiro, Guilherme; Soares, Paula; Scapulatempo-Neto, Cristovam; Reis, Rui M

    2016-02-28

    Oncogenic hotspot mutations in the promoter region of the TERT gene have been identified in several cancer types as being associated with a worse outcome. Additionally, a polymorphism (rs2853669) in the TERT promoter region was reported to modify the survival of TERT-mutated patients. Our aim is to determine the frequency of c.-124 C>T and c.-146 C>T TERT mutations and to genotype the rs2853669 polymorphism in a series of 68 soft tissue sarcomas (STS) comprising 22 histological subtypes. PCR was performed, followed by direct sequencing of a fragment of TERT containing the hotspots and the rs2853669. We found TERT mutations in 4/68 (5.9%) STSs including 1 pleomorphic liposarcoma (1/1), 1 dedifferentiated liposarcoma (1/1) and 2 myxoid liposarcomas (2/9). The variant C allele of rs2853669 was found in 54.8% (34/62) of all STSs and in 75% (3/4) of TERT-mutated cases. TERT mutations were associated with younger age, and the C allele of the rs2853669 was associated with high histological grade (2 and 3). No association was found between TERT mutation status or rs2853669 genotype and patient prognosis. We showed that TERT promoter mutation is not a recurrent event in STS and is present in particular histological subtypes.

  13. 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.

  14. A systematic review assessing soft tissue augmentation techniques.

    PubMed

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

    2009-09-01

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

  15. Use of synchrotron based diffraction enhanced imaging for visualization of soft tissues in invertebrates

    SciTech Connect

    Rao, D.; Zhong, Z.; Swapna, M.; Cesareo, R.; Brunetti, A.; Akatsuka, T.; Yuasa, T.; Takeda, T.; Gigante, G.

    2010-04-04

    Images of terrestrial and marine invertebrates (snails and bivalves) have been obtained by using an X-ray phase-contrast imaging technique, namely, synchrotron-based diffraction-enhanced imaging. Synchrotron X-rays of 20, 30 and 40 keV were used, which penetrate deep enough into animal soft tissues. The phase of X-ray photons shifts slightly as they traverse an object, such as animal soft tissue, and interact with its atoms. Biological features, such as shell morphology and animal physiology, have been visualized. The contrast of the images obtained at 40 keV is the best. This optimum energy provided a clear view of the internal structural organization of the soft tissue with better contrast. The contrast is higher at edges of internal soft-tissue structures. The image improvements achieved with the diffraction-enhanced imaging technique are due to extinction, i.e., elimination of ultra-small-angle scattering. They enabled us to identify a few embedded internal shell features, such as the origin of the apex, which is the firmly attached region of the soft tissue connecting the umbilicus to the external morphology. Diffraction-enhanced imaging can provide high-quality images of soft tissues valuable for biology.

  16. Bilateral iliopsoas haemophilic "soft tissue pseudotumours": A case report.

    PubMed

    Kamal, Achmad Fauzi; Pradana, Ananto Satya; Prabowo, Yogi

    2015-01-01

    Haemophilic soft tissue pseudotumour is one of the rarest complications of haemophilia that caused by repetitive bleeding resulting in an encapsulated mass of clotted blood and necrotic tissue. Soft tissue pseudotumour may not only cause flexion contracture but also chronic pain and femoral nerve compression that cause severe disability. Thus, surgical excision is the treatment of choice. It should only be carried out in a major haemophilic center by an integrated multidisciplinary surgical team.

  17. Myolipoma of Soft Tissue: Clinicopathologic Analysis of 34 Cases.

    PubMed

    Fukushima, Mana; Schaefer, Inga-Marie; Fletcher, Christopher D M

    2017-02-01

    Myolipoma of soft tissue, which was first described by Meis and Enzinger (1991), is a rare benign neoplasm characterized by the admixture of mature adipocytes and well-differentiated smooth muscle cells. Recently, cytogenetic alteration of the HMGA2 gene has been reported in 2 myolipomas. We present the clinicopathologic features of 34 cases of myolipoma of soft tissue, study immunoreactivity for HMGA2, and review the previous literature. In our series, there were 32 women and 2 men, with age at presentation ranging from 35 to 94 years (median, 55 y). The most frequently affected site was retroperitoneum (47%), followed by pelvis (15%), abdominal wall (12%), and intra-abdominal sites (9%). Follow-up information was available for 17 patients (50%), ranging from 1 to 202 months (mean, 41 mo). None has developed local recurrence or metastasis. Grossly, tumors were well circumscribed, and the cut surface showed an admixture of yellowish adipose tissue and tan-whitish nodules. The size ranged from 2.4 to 60 cm (median 10.5 cm). Histologically, the tumors were composed of an intimate admixture of mature fat cells and bland spindle-shaped cells with brightly eosinophilic cytoplasm, arranged in fascicles. Some cases showed the following unusual features focally: hypercellular fascicular pattern (N=2), degenerative nuclear atypia (N=1), round cell morphology (N=1), hemosiderin deposition (N=1), metaplastic cartilage (N=1), metaplastic bone (N=1), and eosinophil infiltrates (N=1). Immunohistochemically, spindle cells showed strong and diffuse positivity for desmin (26/26 cases), SMA (20/21), and ER (13/15). Nuclear positivity for HMGA2 was identified in 15 of 25 cases (60%). MDM2 and CDK4 were usually negative (14/15, 8/9, respectively). In summary, myolipoma of soft tissue is a distinctive benign tumor composed of mature fat cells and smooth muscle cells and arises most commonly in deep-seated locations of middle-aged women. In our study, 60% of cases showed nuclear

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

    PubMed

    Kravitz, Neal D; Kusnoto, Budi

    2008-04-01

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

  19. Outbreak of Mycobacterium abscessus infection after soft tissue augmentation.

    PubMed

    Toy, Brian R; Frank, Paul Jarrod

    2003-09-01

    Illicit soft-tissue augmentation performed in New York City resulted in an outbreak of Mycobacterium abscessus infection in 2002. To report two cases of women who developed tender, subcutaneous nodules of the face and buttocks after illicit soft-tissue augmentation with a hyaluronic acid derivative. Two case reports are presented, and the literature is reviewed. Empiric treatment with clarithromycin (for M. abscessus infection) and prednisone (for foreign body reaction) resulted in clearance of lesions. Contaminated or impure material used for soft-tissue augmentation can result in a clustered outbreak of infection or foreign body reaction.

  20. Shaping field for deep tissue microscopy

    NASA Astrophysics Data System (ADS)

    Colon, J.; Lim, H.

    2015-05-01

    Information capacity of a lossless image-forming system is a conserved property determined by two imaging parameters - the resolution and the field of view (FOV). Adaptive optics improves the former by manipulating the phase, or wavefront, in the pupil plane. Here we describe a homologous approach, namely adaptive field microscopy, which aims to enhance the FOV by controlling the phase, or defocus, in the focal plane. In deep tissue imaging, the useful FOV can be severely limited if the region of interest is buried in a thick sample and not perpendicular to the optic axis. One must acquire many z-scans and reconstruct by post-processing, which exposes tissue to excessive radiation and is also time consuming. We demonstrate the effective FOV can be substantially enhanced by dynamic control of the image plane. Specifically, the tilt of the image plane is continuously adjusted in situ to match the oblique orientation of the sample plane within tissue. The utility of adaptive field microscopy is tested for imaging tissue with non-planar morphology. Ocular tissue of small animals was imaged by two-photon excited fluorescence. Our results show that adaptive field microscopy can utilize the full FOV. The freedom to adjust the image plane to account for the geometrical variations of sample could be extremely useful for 3D biological imaging. Furthermore, it could facilitate rapid surveillance of cellular features within deep tissue while avoiding photo damages, making it suitable for in vivo imaging.

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

    PubMed

    Danicki, Eugene; Nowicki, Andrzej; Tasinkevych, Yuriy

    2013-06-01

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

  2. Therapeutic response in musculoskeletal soft tissue sarcomas: evaluation by MRI.

    PubMed

    Wang, Xin; Jacobs, Michael A; Fayad, Laura

    2011-07-01

    This article provides a literature review of the use of MRI in monitoring the treatment response of soft tissue sarcomas. The basic classification and physiology of soft tissue tumors are introduced. Then, the major treatment options for soft tissue sarcomas are summarized with brief coverage of possible responses and grading systems. Four major branches of MRI techniques are covered, including conventional T(1) - and T(2) -weighted imaging, contrast-enhanced MRI, MR diffusion and perfusion imaging, and MRS, with a focus on the tumor microenvironment. Although this literature survey focuses on recent clinical developments using these MRI techniques, research venues in preclinical studies, as well as in potential applications other than soft tissue sarcomas, are also included when comparable and/or mutually supporting. Examples from other less-discussed MRI modalities are also briefly covered, not only to complement, but also to expand, the scope and depth of information for various kinds of lesions. Copyright © 2011 John Wiley & Sons, Ltd.

  3. [Soft tissue balancing in total condylar knee arthroplasty].

    PubMed

    Trepte, C T; Pfanzelt, K

    2003-01-01

    Soft tissue balancing and correct bone cuts are an entity in correcting malalignment in total knee arthroplasty, and cannot be considered isolated. Distinct bony deformations/deviations need enlarged soft tissue management. The extent of resection of the bone stock has to be planned exactly before the operation. Exact soft tissue balancing is necessary to stabilize the corrected knee. Soft tissue balancing has to be done primarily on the side of the contracture by lengthening of the shortened and contracted structures. After balancing the ligaments should have the same tension in extension and flexion together with the same height of the extension and flexion gap. Because of the classic resection of the tibial head, the femoral resection must follow the Insall-Line, that means 3 degrees to 5 degrees outer rotation in relation to the condyles. Only in this way a symmetric flexion gap can be achieved in combination with ligamentous stability in extension and flexion.

  4. 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 ...

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

    PubMed

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

    2012-06-01

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

  6. Doxorubicin With Upfront Dexrazoxane Plus Olaratumab for the Treatment of Advanced or Metastatic Soft Tissue Sarcoma

    ClinicalTrials.gov

    2017-08-29

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

  7. Optical-Based Analysis of Soft Tissue Structures

    PubMed Central

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

    2017-01-01

    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

  8. 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.

  9. [Diagnosis and therapy of soft tissue sarcomas of the extremities].

    PubMed

    Bachmann, S; Panzica, M; Brunnemer, U; Stueber, V; Länger, F; Kaltenborn, A; Schrem, H; Bektaş, H

    2013-07-01

    The diagnosis of unclear soft tissue tumors represents a common problem in everyday clinical practice. Magnetic resonance imaging often reveals some first information about soft tissue tumors; however, clarification of the dignity can only be achieved by histopathological examination. Most of the lesions are benign but should be treated as a malignant tumor until this can be excluded as unnecessary surgery or biopsies can complicate treatment and worsen the prognosis. These aspects in particular are summarized and discussed in this article.

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

    PubMed

    Ollerton, J; Hodgetts, T; Russell, R

    2007-12-01

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

  11. Periorbital Soft Tissue Anthropometric Analysis of Young Adults.

    PubMed

    Ozdemir, Turan; Can, Fatma Ezgi; Isiklar, Sefa; Ercan, Ilker; Cankur, Nedim Simsek

    2017-06-01

    The authors aim to determine the periorbital soft tissue anthropometric norms for Turkish young adults for right and left eyes using a noninvasive two-dimensional photogrammetric analysis. Anthropometric measurements of the periorbital soft tissue were taken from 172 female and 56 male Turkish adults aged between 18 and 24 years. The periorbital soft tissue profiles (ocular and palpebral) for males and females were digitally analyzed using linear measurements made with standardized photographic records, taken in a natural head position. Statistically significant differences were found for ocular soft tissue measurements according to gender except inner intercanthal distance (P = 0.125) and right horizontal palpebral aperture (P = 0.240). Statistically significant differences were found for palpebral soft tissue measurements according to gender except right pretarsal skin height (P = 0.112) and left pretarsal skin height (P = 0.056). Results were compared with other ethnic groups. Normal periorbital soft tissue measurements are fundamental anatomical parameters utilized in ophthalmology, optometry, ophthalmic industry, oculoplastic surgery, clinical genetics, dermatocosmetology. Further, normal anthropometric measurements generate reference data for studies in craniofacial dysmorphology, oculoplastic surgery, dermatocosmetology, and comparative physical anthropology.

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

    PubMed

    Norton, Cormac

    2016-08-24

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

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

    PubMed

    Brecht, I B; Treuner, J

    2004-10-01

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

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

    PubMed

    Boonvisut, Pasu; Jackson, Russell; Cavuşoğlu, M Cenk

    2012-12-31

    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.

  15. 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.

  16. Role of microbial mats in the fossilization of soft tissues

    NASA Astrophysics Data System (ADS)

    Wilby, Philip R.; Briggs, Derek E. G.; Bernier, Paul; Gaillard, Christian

    1996-09-01

    It has been speculated that microbial mats are an important agent in the fossilization of soft tissues, particularly when apatite (Ca5[CO3, PO4]3[OH, F]) is involved. This has been tested by chemical analyses of the Jurassic limestones of Cerin, France, where phosphatized soft tissues are abundant and are associated with unequivocal microbial mats. The sedimentary distribution of P, K, and Fe following deposition was controlled by the presence of the mats. P concentrations in the mats may approach 2.5 times those elsewhere in the sediment. The highest P concentrations correlate with the occurrence of phosphatized soft tissues. This is the first analytical evidence to demonstrate a fundamental role for microbial mats in the preservation of soft-bodied fossils.

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

    PubMed

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

    2016-01-01

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

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

    PubMed

    Riddick, R C; Kuo, A D

    2016-02-08

    During human running, softer parts of the body may deform under load and dissipate mechanical energy. Although tissues such as the heel pad have been characterized individually, the aggregate work performed by all soft tissues during running is unknown. We therefore estimated the work performed by soft tissues (N=8 healthy adults) at running speeds ranging 2-5 m s(-1), computed as the difference between joint work performed on rigid segments, and whole-body estimates of work performed on the (non-rigid) body center of mass (COM) and peripheral to the COM. Soft tissues performed aggregate negative work, with magnitude increasing linearly with speed. The amount was about -19 J per stance phase at a nominal 3 m s(-1), accounting for more than 25% of stance phase negative work performed by the entire body. Fluctuations in soft tissue mechanical power over time resembled a damped oscillation starting at ground contact, with peak negative power comparable to that for the knee joint (about -500 W). Even the positive work from soft tissue rebound was significant, about 13 J per stance phase (about 17% of the positive work of the entire body). Assuming that the net dissipative work is offset by an equal amount of active, positive muscle work performed at 25% efficiency, soft tissue dissipation could account for about 29% of the net metabolic expenditure for running at 5 m s(-1). During running, soft tissue deformations dissipate mechanical energy that must be offset by active muscle work at non-negligible metabolic cost. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    PubMed

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

    2017-04-01

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

  20. Talimogene Laherparepvec and Radiation Therapy in Treating Patients With Newly Diagnosed Soft Tissue Sarcoma That Can Be Removed by Surgery

    ClinicalTrials.gov

    2017-01-31

    Leiomyosarcoma; Liposarcoma; Sarcoma Differentiation Score 2; Sarcoma Differentiation Score 3; Stage IA Soft Tissue Sarcoma; Stage IB Soft Tissue Sarcoma; Stage IIA Soft Tissue Sarcoma; Stage IIB Soft Tissue Sarcoma; Undifferentiated Pleomorphic Sarcoma

  1. Dynamic soft tissue deformation estimation based on energy analysis

    NASA Astrophysics Data System (ADS)

    Gao, Dedong; Lei, Yong; Yao, Bin

    2016-10-01

    The needle placement accuracy of millimeters is required in many needle-based surgeries. The tissue deformation, especially that occurring on the surface of organ tissue, affects the needle-targeting accuracy of both manual and robotic needle insertions. It is necessary to understand the mechanism of tissue deformation during needle insertion into soft tissue. In this paper, soft tissue surface deformation is investigated on the basis of continuum mechanics, where a geometry model is presented to quantitatively approximate the volume of tissue deformation. The energy-based method is presented to the dynamic process of needle insertion into soft tissue based on continuum mechanics, and the volume of the cone is exploited to quantitatively approximate the deformation on the surface of soft tissue. The external work is converted into potential, kinetic, dissipated, and strain energies during the dynamic rigid needle-tissue interactive process. The needle insertion experimental setup, consisting of a linear actuator, force sensor, needle, tissue container, and a light, is constructed while an image-based method for measuring the depth and radius of the soft tissue surface deformations is introduced to obtain the experimental data. The relationship between the changed volume of tissue deformation and the insertion parameters is created based on the law of conservation of energy, with the volume of tissue deformation having been obtained using image-based measurements. The experiments are performed on phantom specimens, and an energy-based analytical fitted model is presented to estimate the volume of tissue deformation. The experimental results show that the energy-based analytical fitted model can predict the volume of soft tissue deformation, and the root mean squared errors of the fitting model and experimental data are 0.61 and 0.25 at the velocities 2.50 mm/s and 5.00 mm/s. The estimating parameters of the soft tissue surface deformations are proven to be useful

  2. Emergency Soft Tissue Reconstruction Algorithm in Patients With Open Tibia Fractures

    PubMed Central

    Ivanov, P.A.; Shibaev, E.U.; Nevedrov, A.V.; Vlasov, A.P.; Lasarev, M.P.

    2016-01-01

    Introduction: Tactic of emergency closing of soft tissue defect allows to significantly improve the treatment results concerning patients with severe open fractures. However, a number of certain factors make the implementation of this tactic rather difficult. Injured people’s unstable conditions are mong these crucial factors which include, polytrauma in lots of cases, absence of exact recommendations for recovery terms, choice of definite tissue flaps and a type of circulation. The Aim of Study: is to develop exact, usable and in practice algorithm of emergency reconstruction of leg soft tissues in patients with severe open tibia fractures, based on the usage of the most foolproof and simple methods. Data (Patients) and Methods: 85 patients with open tibia fractures complicated by soft tissue defects were included in our study. Patients were divided into two groups. The control group consisted of 56 patients. Soft tissue reconstruction in this group was provided without an exact algorithm, after continuous attempts on local healing. After analyzing the treatment process and the treatment results we have developed the algorithm of emergency soft tissue reconstruction. It was used in 29 patients (the study group). This algorithm allows choosing optimal timing for tissue reconstruction and appropriate method to be applied, depending on the patient’s condition, the mechanism of soft tissue defect formation, and its square and localization. Results: We observed a statistical decrease in deep wound infection frequency, partial tibia necrosis frequency, chronic osteomyelitis frequency, duration of hospitalization in patients with severe open tibia fractures because of using our algorithm. PMID:27583057

  3. New swine model of infected soft tissue blast injury.

    PubMed

    Li, Jinqing; Topaz, Morris; Xun, Wenxing; Li, Wangzhou; Wang, Xiaolin; Liu, Haibo; Yuan, Yanqin; Chen, Shaozong; Li, Yuejun; Li, Xueyong

    2012-10-01

    War injuries, especially blast injuries, have a high risk of infection. However, no animal models of infected war injuries have been built in large animals, which retards both the understanding and the treatment optimization of infected war injuries. Soft tissue blast injuries were created by explosion of electric detonators in white domestic pigs. The ultra structure of the tissue around the wound was determined by transmission electron microscope. To develop infection of blast injury wounds, the pigs were housed in a standard animal house which was disinfected periodically, and the wounds were left untreated for 3 days. Wound specimens were collected daily to determine the bacterial load and bacterial components. To determine whether infection induces tissue necrosis in infected soft tissue blast injury wounds, uninfected blast injury wounds were created as controls of infected wounds by surgical debridement daily, and the wound area and wound depth of both wounds were measured. The wound area and the wound depth of the soft tissue blast injury created in this study fell in the range of human moderate soft tissue war injuries, and the ultra structure of the wounds was comparable with that of human blast injury wounds. The bacterial load of uninfected wounds was under 10 colony forming unit/g during the first 3 days of injury, while that of infected wounds was over 10 colony forming unit/g after 2 days of injury. The infected soft tissue blast injury wounds contained most of the bacteria frequently isolated in battlefield wounds. In addition, infection induced evident tissue necrosis in infected blast injury wounds. The infected soft tissue blast injury wounds mimic those in human, and they can be used to address key points of treatment optimization.

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

    PubMed

    Tang, Wen; Wan, Tao Ruan

    2014-11-01

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

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

    PubMed Central

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

    2014-01-01

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

  6. Presternal soft tissue calcifications following mediastinal radiotherapy for Hodgkin's disease

    SciTech Connect

    Vainright, J.R.; Diaconis, J.N.; Haney, P.J.

    1987-01-01

    A patient is described in whom dense calcifications developed in the presternal soft tissues of the chest four years after mediastinal radiotherapy. This is believed to represent dystrophic calcification in previously normal but incidentally radiated tissues following standard dose radiotherapy to the mediastinum for stage IIA Hodgkin's disease.

  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

    SciTech Connect

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

    2016-01-28

    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. 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.

  10. 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.

  11. 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.

  12. 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

  13. Prognostic factors in soft tissue sarcoma.

    PubMed

    Maretty-Nielsen, Katja

    2014-11-01

    Despite major advances in the knowledge of soft tissue sarcoma (STS) during the last decades, no significant improvement in survival has been observed. Detailed data on the prognosis of STS are crucial in order to identify patients who might benefit from more aggressive treatment. Such data can be obtained from properly designed databases; however, the validation of data is crucial in order to obtain valid, reliable results. Furthermore, the majority of prognostic studies in STS have been limited by potential selection bias, low power, and biased estimates due to the statistical methods used, e.g., dichotomizing continuous variables, censoring competing events, as well as not adjusting for important confounders. The overall aim of this thesis was to investigate the prognosis of STS patients using data from the Aarhus Sarcoma Registry (ASR), covering western Denmark in the period from 1979 to 2008. In study I, we systematically validated data in the ASR and evaluated the validity, including completeness of patient registration and accuracy of data. In study II, we investigated the prognostic impact of patient-, tumor-, and treatment-related factors on local recurrence and disease-specific mortality. These were analyzed in a competing risk model in which continuous variables were included as cubic splines and possible confounders were selected based on directed acyclic graphs. In study III, we examined the impact of comorbidity on overall and disease-specific mortality. In study IV, we compared mortality in patients with abnormal biomarkers to those with normal values, assessed the significance of adjusting for comorbidity, as well as constructed a prognostic biomarker score. In study V, we described the relative mortality, i.e., the mortality in STS patients compared with the mortality in a general population, and compared relative and disease-specific estimates. The mortality in the general population was determined using an individually age- and sex

  14. Soft-tissue manifestations of aesthetic defects of the jaws: diagnosis and treatment.

    PubMed

    Lehman, J A

    1987-10-01

    Treatment planning for patients with dentofacial deformities should include a skeletal and a soft-tissue analysis. This article collates and summarizes several different soft-tissue analyses. In addition, it correlates the anticipated soft-tissue profile changes with various skeletal and soft-tissue surgical procedures.

  15. Soft tissue and wound management of blast injuries.

    PubMed

    Sheean, Andrew J; Tintle, Scott M; Rhee, Peter C

    2015-09-01

    The management of blast-related soft tissue wounds requires a comprehensive surgical approach that acknowledges extensive zones of injury and the likelihood of massive contamination. The experiences of military surgeons during the last decade of war have significantly enhanced current understandings of the optimal means of mitigating infectious complications, the timing of soft tissue coverage attempts, and the reconstructive options available for definitive wound management. Early administration of antibiotics in the setting of soft tissue wounds and associated open fractures is the single most important aspect of open fracture care. Both civilian and military reports have elucidated the incidence of invasive fungal infection in the setting of high-energy injuries with significant wound burdens, and novel treatment protocols have emerged. The type of reconstruction is predicated upon the zone of injury and location of the soft tissue defect. Multiple reports of military cohorts have suggested the equivalency of various techniques and types of soft tissue coverage. Longer-term follow-up will inform future perspectives on the durability of these surgical approaches.

  16. Principles of soft tissue augmentation for the aging face

    PubMed Central

    Burgess, Cheryl M

    2006-01-01

    In the quest for the “ideal” soft tissue filler, many diverse products have been developed. The expanding market of available fillers is a testament that no one product will ideally suit all patients or clinicians. In addition, the challenge of satisfying the criteria of an ideal filler has driven researchers to take a variety of development paths. This has resulted in multiple categories to characterize soft tissue fillers. These fillers are categorized according to: (1) filler material, eg, autologous, natural, synthetic; (2) mechanism of action, eg, void filler, neocollagenesis, fibroblast stimulation; (3) patient type and profile, eg, younger versus older patient, rhytids versus “sinking and sagging” skin; or (4) durability of treatment effects, eg, temporary, semi-permanent, or permanent. Although strategies for soft tissue augmentation may be quite diverse, strategies should share a universal goal to address fat redistribution (atrophy and hypertrophy), the primary underlying morphological cause of facial aging. To accomplish this, volumizers are now available that are injected more deeply, resulting in the restoration of supportive structure and foundation. These can be used in combination with other products that are used more superficially for smoothing skin surfaces. As numerous soft tissue fillers enter the market, mechanisms and injection techniques become more divergent, and therefore require that the dermatologist and cosmetic surgeon receive adequate training to use products safely and effectively. This manuscript provides an overview of soft tissue fillers and their proper use. PMID:18046912

  17. Soft tissue gas gangrene: a severe complication of emphysematous cholecystitis.

    PubMed

    Safioleas, Michael; Stamatakos, Michael; Kanakis, Meletios; Sargedi, Constantina; Safioleas, Constantinos; Smirnis, Anastasios; Vaiopoulos, George

    2007-12-01

    Soft tissue gas gangrene with myonecrosis is a severe complication of traumatic and non-traumatic conditions with a potentially lethal outcome. Emphysematous cholecystitis is a complication of acute cholecystitis, which is characterized by air accumulation in the gallbladder wall and is reported in the literature as a rare causative factor of soft tissue gas gangrene. Here we report 4 patients who developed soft tissue gas gangrene as a complication of emphysematous cholecystitis. Two patients were female octogenarians (one with a history of diabetes mellitus), and underwent percutaneous trans-gallbladder drainage and fascia incisions of the affected soft tissue with prompt administration of antibiotics. Finally, both of them died. The other two patients were male (32 years old diabetic and 47 years old with a history of chronic alcoholism). They underwent open cholecystectomy. Fascia incisions of the gangrenous areas and antibiotic therapy administration were also performed. Both of them were discharged from the hospital and are currently in excellent clinical status. We also present the ultrasonographic and/or radiologic images of these four patients. Soft tissue gas gangrene may complicate emphysematous cholecystitis, and clinicians should be aware of the coexistence of these two clinical conditions, since immediate management is needed in order to prevent fatal outcome.

  18. Deep UV autofluorescence microscopy for cell biology and tissue histology.

    PubMed

    Jamme, Frédéric; Kascakova, Slavka; Villette, Sandrine; Allouche, Fatma; Pallu, Stéphane; Rouam, Valérie; Réfrégiers, Matthieu

    2013-07-01

    Autofluorescence spectroscopy is a powerful tool for molecular histology and for following metabolic processes in biological samples as it does not require labelling. However, at the microscopic scale, it is mostly limited to visible and near infrared excitation of the samples. Several interesting and naturally occurring fluorophores can be excited in the UV and deep UV (DUV), but cannot be monitored in cellulo nor in vivo due to a lack of available microscopic instruments working in this wavelength range. To fulfil this need, we have developed a synchrotron-coupled DUV microspectrofluorimeter which is operational since 2010. An extended selection of endogenous autofluorescent probes that can be excited in DUV, including their spectral characteristics, is presented. The distribution of the probes in various biological samples, including cultured cells, soft tissues, bone sections and maize stems, is shown to illustrate the possibilities offered by this system. In this work we demonstrate that DUV autofluorescence is a powerful tool for tissue histology and cell biology. To fulfil this need, we have developed a synchrotron-coupled DUV microspectrofluorimeter which is operational since 2010. An extended selection of endogenous autofluorescent probes that can be excited in DUV, including their spectral characteristics, is presented. The distribution of the probes in various biological samples, including cultured cells, soft tissues, bone sections and maize stems, is shown to illustrate the possibilities offered by this system. In this work we demonstrate that DUV autofluorescence is a powerful tool for tissue histology and cell biology. In this work we demonstrate that DUV autofluorescence is a powerful tool for tissue histology and cell biology. © 2013 Société Française des Microscopies and Société de Biologie Cellulaire de France. Published by John Wiley & Sons Ltd.

  19. Prediction accuracy of soft tissue profile in orthognathic surgery.

    PubMed

    Mankad, B; Cisneros, G J; Freeman, K; Eisig, S B

    1999-01-01

    The purpose of this study was to compare soft tissue prediction accuracy of model surgery combined with computer software prediction with that of computer software prediction alone and to assess surgical accuracy by comparing the immediate postsurgical cephalogram with the planned movement of skeletal hard tissue. The predicted and actual soft tissue changes and the corresponding skeletal changes of 16 patients were compared using the Quick Ceph Image cephalometric treatment simulation software. A custom analysis was created to measure the hard tissue and soft tissue changes that occurred as a result of the surgical procedure. On average, the predictions were not significantly different from the actual postsurgical profile changes. Surgical changes of hard tissues from presurgery to postsurgery were accurate as planned except for the position of N-ANS. All lower soft tissue points moved significantly during treatment. Quick Ceph Image offers a rapid and reliable method of profile prediction that does not require artistic skill. If predictions are interpreted with caution and transferred accurately to the model surgery, they can provide an excellent visual aid during presurgical treatment planning and patient presentation.

  20. Principles of definitive soft tissue coverage with flaps.

    PubMed

    Levin, L Scott

    2008-01-01

    Despite the emergence of negative pressure wound therapy with reticulated open cell foam (NPWT/ROCF) as delivered by V.A.C.(R) Therapy (KCI, San Antonio, TX) for orthopaedic trauma, vascularized tissue transfer whether it be pedicle, free, or tissue transfer using the operating microscope or as an island, remains the mainstay of soft tissue reconstruction for orthopaedic traumatology. The critisism of microvascular procedures has been that they are lengthy, costly, and required technical expertise to perform. While technical skills are required, microsurgical care has evolved into a routine operation with high degrees of success in experienced hand. The problem that still remains is access to surgeons who are interested in soft tissue reconstruction and can perform definitive coverage with flaps. There is a need in the orthopaedic community to solve the problem of lack of flap surgeons and as a result, NPWT/ROCF has been touted as the answer to flap reconstruction. NPWT/ROCF is an important addition to soft tissue reconstruction but it serves as a bridge rather than definitive coverage in many hands. Just as wound technology is evolving with tissue substitutes, growth factors and NPWT/ROCF flaps technology continues to advance with new perforator flaps and local regional flaps, particularly the sural flap, coming on line as mainstays of soft tissue reconstruction.

  1. A Prospective Study of Soft Tissue Tumors Histocytopathology Correlation

    PubMed Central

    Soni, Priyanka Bhatia; Verma, Anand Kumar; Chandoke, Raj Kumar; Nigam, Jitendra Singh

    2014-01-01

    Background. Soft tissue tumors are defined as nonepithelial extraskeletal tissue of the body exclusive of the reticuloendothelial system, glia, and supporting tissue of various parenchymal organs. The absence of recognizable tissue architectural patterns in cytological preparation makes diagnosis by FNAC more difficult. Aims. To assess the utility of FNAC in diagnosing soft tissue tumors and to determine their patterns compared with with the respective histopathology results. Materials and Methods. 150 cases of soft tissue tumors were included in this study for cytologic and histologic correlation. FNAC air dried smears were stained with Giemsa stain and 95% ethanol fixed smears were stained with Papanicolaou stain. The smears were studied for cytological diagnosis and were categorized as benign, suspicious of malignancy, and malignant along with specific subtyping of the lesion. All diagnostic FNAC results were compared for diagnostic concordance using histology results as the “gold standard.” Results. The sensitivity, specificity, positive predictive value, negative predictive value, and efficiency were 70%, 100%, 97.90%, 100%, and 98%, respectively. P value was <0.0001 which shows statistically extreme significant correlation. Conclusion. FNAC is a very important preliminary diagnostic tool in palpable soft tissue lumps with high degree of correlation with the final histopathology report. PMID:24876987

  2. 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.

  3. Treatment Options for Childhood Soft Tissue Sarcoma

    MedlinePlus

    ... to check for certain genes, proteins, or other molecules in a sample of tissue, blood, or other ... anti-inflammatory drugs (NSAIDs) are drugs (such as aspirin , ibuprofen , and naproxen ) that are commonly used to ...

  4. Stages of Childhood Soft Tissue Sarcoma

    MedlinePlus

    ... to check for certain genes, proteins, or other molecules in a sample of tissue, blood, or other ... anti-inflammatory drugs (NSAIDs) are drugs (such as aspirin , ibuprofen , and naproxen ) that are commonly used to ...

  5. General Information about Childhood Soft Tissue Sarcoma

    MedlinePlus

    ... to check for certain genes, proteins, or other molecules in a sample of tissue, blood, or other ... anti-inflammatory drugs (NSAIDs) are drugs (such as aspirin , ibuprofen , and naproxen ) that are commonly used to ...

  6. Treatment Option Overview (Childhood Soft Tissue Sarcoma)

    MedlinePlus

    ... to check for certain genes, proteins, or other molecules in a sample of tissue, blood, or other ... anti-inflammatory drugs (NSAIDs) are drugs (such as aspirin , ibuprofen , and naproxen ) that are commonly used to ...

  7. Containment-enhanced Ho:YAG photofragmentation of soft tissues

    NASA Astrophysics Data System (ADS)

    Christens-Barry, William A.; Guarnieri, Michael; Carson, Benjamin S.

    1998-01-01

    Laser surgery of soft tissue can exploit the power of brief, intense pulses of light to cause localized disruption of tissue with minimal effect upon surrounding tissue. In particular, studies of Ho:YAG laser surgery have shown that the effects of cavitation upon tissues and bone depend upon the physical composition of structures in the vicinity of the surgical site. For photofragmentation of occluding structures within catheters and other implant devices, it is possible to exploit the particular geometry of the catheter to amplify the effects of photofragmentation beyond those seen in bulk tissue. A Ho:YAG laser was used to photofragment occlusive material (tissue and tissue analogs) contained in glass capillary tubing and catheter tubing of the kind used in ventricular shunt implants for the management of hydrocephalus. Occluded catheters obtained from patient explants were also employed. Selection of operational parameters used in photoablation and photofragmentation of soft tissue must consider the physical composition and geometry of the treatment site. In the present case, containment of the soft tissue within relatively inelastic catheters dramatically alters the extent of photofragmentation relative to bulk (unconstrained) material. Our results indicate that the disruptive effect of cavitation bubbles is increased in catheters, due to the rapid displacement of material by cavitation bubbles comparable in size to the inner diameter of the catheter. The cylindrical geometry of the catheter lumen may additionally influence the propagation of acoustic shock waves that result from the collapse of the condensing cavitation bubbles.

  8. Olaratumab for the treatment of advanced soft tissue sarcoma.

    PubMed

    Okuno, Scott H; Maran, Avudaiappan; Robinson, Steven I

    2017-10-01

    Olaratumab, a human monoclonal antibody against platelet derived growth factor receptor alpha (PDGFR- α), is the first drug that in combination with doxorubicin for the treatment of patients with advanced/metastatic soft tissue sarcoma (STS) that has showed an improved overall survival compared to doxorubicin alone. These initial results are exciting and have the potential to change the landscape of treatment for patients with STS. Areas covered: This article reviews the development of olaratumab for oncology use by reviewing articles in PubMed for 'platelet derived growth factor' and 'receptor' and 'soft tissue sarcoma'. We provide an overview of the published studies to date for olaratumab and specifically the use in soft tissue sarcoma. Expert commentary: Olaratumab is a well-tolerated drug that, when combined with doxorubicin, has shown an improved overall survival compared to doxorubicin alone and the phase III confirmatory study is eagerly awaited.

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

    PubMed

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

    2009-01-01

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

  10. Molecular diagnostics in soft tissue sarcomas and gastrointestinal stromal tumors.

    PubMed

    Smith, Stephen M; Coleman, Joshua; Bridge, Julia A; Iwenofu, O Hans

    2015-04-01

    Soft tissue sarcomas are rare malignant heterogenous tumors of mesenchymal origin with over fifty subtypes. The use of hematoxylin and eosin stained sections (and immunohistochemistry) in the morphologic assessment of these tumors has been the bane of clinical diagnosis until recently. The last decade has witnessed considerable progress in the understanding and application of molecular techniques in refining the current understanding of soft tissue sarcomas and gastrointestinal stromal tumors beyond the limits of traditional approaches. Indeed, the identification of reciprocal chromosomal translocations and fusion genes in some subsets of sarcomas with potential implications in the pathogenesis, diagnosis and treatment has been revolutionary. The era of molecular targeted therapy presents a platform that continues to drive biomarker discovery and personalized medicine in soft tissue sarcomas and gastrointestinal stromal tumors. In this review, we highlight how the different molecular techniques have enhanced the diagnosis of these tumors with prognostic and therapeutic implications.

  11. 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.

  12. Soft tissue tumors of the anorectum: rare, complex and misunderstood

    PubMed Central

    Nassif, Mohammed O.; Trabulsi, Nora H.; Bullard Dunn, Kelli M.; Nahal, Ayoub

    2013-01-01

    Anorectal soft tissue tumors are uncommon and often present both diagnostic and therapeutic challenges. Although many of these tumors are identified with imaging performed for unrelated reasons, most present with nonspecific symptoms that can lead to a delay in diagnosis. Historically, radical surgery (abdominoperineal resection) has been the mainstay of treatment for both benign and malignant anorectal soft tissue tumors. However, a lack of proven benefit in benign disease along with changes in technology has called this practice into question. In addition, the role of radiation and/or chemotherapy remains controversial. In this manuscript, we review the history and current status of anorectal soft tissue tumor management, with a particular focus on challenges in optimizing survival. PMID:23450454

  13. 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

  14. Facial soft-tissue thicknesses in the adult male Zulu.

    PubMed

    Aulsebrook, W A; Becker, P J; Işcan, M Y

    1996-05-31

    The morphometric method of forensic facial reconstruction rests heavily on the use of facial soft tissue depth measurements. In reconstructing the Negroid face, much use has been made of the tables of soft tissue thickness of American Negroid cadavers. However, the genetic complexities of American blacks are well known. In addition it is felt that measurements made on the living are of more value than those made on the dead. In view of this it was decided to set up a table of norms for facial soft tissue depths of the living Zulu, an African Negroid who has remained relatively free from genetic admixture with other populations. The tightly controlled sample consisted of 55 healthy male Zulus, aged 20 to 35. Tissue depths at established landmarks were measured from lateral and oblique cephalometric radiographs. These were then combined with ultrasonic readings at other landmarks on the subject's face to yield a comprehensive set of tissue depth data. This paper presents a set of average facial soft tissue depth measurements from the Zulu face that results in the development of a new profile. It also provides a method for linking two systems of measurement.

  15. Ultrasonic assessment of facial soft tissue thicknesses in adult Egyptians.

    PubMed

    El-Mehallawi, I H; Soliman, E M

    2001-03-01

    The production of a three-dimensional plastic face on an unknown human skull has been practiced sporadically since the latter part of the last century. In recent years, the technique has been revived and applied to forensic science cases. The morphometric method of forensic facial reconstruction rests heavily on the use of facial soft tissue depth measurements. Moreover, it has been established that measurements made on the living are of more value than those made on the dead. In view of the well-known genetic complexities of the Egyptians, and the lack of knowledge of average facial soft tissue depths of the Egyptians that makes facial reconstruction questionable, it was decided to set up a table of norms for facial tissue thicknesses in 204 adult Egyptians aged 20-35 years. Tissue depths at 17 established landmarks (according to Aulsebrook et al. [Forensic Sci. Int. 79 (1996) 83]) were obtained using ultrasonic probing. The study revealed a unique spectrum of measurements for the Egyptians that might be useful for facial reconstruction purposes with obvious sexual dimorphism in facial soft tissue thickness. Additionally, the study provided evidence for the presence of interpopulation differences in average facial soft tissue thicknesses as evidenced from the comparison of the present data of Egyptians with those previously reported for some other populations.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. Musculoskeletal lymphoma: MRI of bone or soft tissue presentations.

    PubMed

    Carroll, Gemma; Breidahl, William; Robbins, Peter

    2013-12-01

    To assess the MRI findings of musculoskeletal lymphoma primarily presenting clinically as a bone lesion or soft tissue mass. Magnetic resonance imaging of 23 cases of musculoskeletal lymphoma were retrospectively reviewed. Features assessed included tumour location, morphology, signal intensity (SI) characteristics, cortical destruction, involvement of multiple anatomic compartments, encasement of adjacent neurovascular structures/tendons and subcutaneous oedema. Osseous lesions were typically poorly defined and hypointense on T1-weighted imaging. T2-weighted SI was usually heterogeneous, with 54% of cases having a 'mosaic' pattern of marrow replacement. Ninety-two per cent of osseous tumours had cortical abnormalities, most commonly a permeative pattern. A periosseous soft tissue cuff was present in 46% of cases while 38% had a more significant extraosseous component. All cases of soft tissue lymphoma were iso-/slightly hyperintense to muscle on T1-weighted images and hyperintense on T2-weighted images. Multicompartment involvement by extraosseous tumour was present in 75% of cases, and 67% had subcutaneous oedema. Eighty-three per cent of soft tissue tumours showed encasement of adjacent structures. Multifocal lymphoma had similar morphology and SI characteristics to single-site lesions. Histopathologically, there were 21 cases of non-Hodgkin's lymphoma and two of Hodgkin's lymphoma. Magnetic resonance imaging features of primary osseous lymphoma include T2 heterogeneity, a periosseous soft tissue cuff or a more substantial mass, and cortical disruption often disproportionate to the extent of extraosseous tumour. Features characteristic of soft tissue lymphoma include relative homogeneity on T1- and T2-weighted imaging, multicompartment involvement and encasement of neurovascular structures. © 2013 The Authors. Journal of Medical Imaging and Radiation Oncology © 2013 The Royal Australian and New Zealand College of Radiologists.

  1. Soft Tissue Wounds and Principles of Healing

    DTIC Science & Technology

    2007-01-01

    dermis has undergone a significant separation from the superficial fascia , creating a ‘‘flap of der- mis.’’ This wound can compromise the flap of tissue...Full-thickness skin loss involving damage or necrosis of sub- cutaneous tissue that may extend down to but not through the under- lying fascia . STAGE 4...round matrix model. J Dermatol Sci 2006; 41(2):97–108. [55] Lee AR. Enhancing dermal matrix regeneration and biomechanical properties of 2nd degree-burn

  2. 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.

  3. 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. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Spontaneous soft tissue haemorrhage in systemic lupus erythematosus.

    PubMed

    Abdulla, M C

    2016-12-31

    Diversity in clinical presentations and complications of systemic lupus erythematosus (SLE) make the diagnosis and management challenging. The mechanisms of haemorrhagic manifestations in SLE have not been well elucidated. A 47-year-old woman with no comorbidities was admitted after suffering fatigue and low grade fever for six months. She had bilateral soft tissue haemorrhage over the forearm and intra retinal haemorrhages. She was assessed and diagnosed as having SLE based on positive antinuclear antibody, strongly positive anti double stranded DNA, thrombocytopenia and low C3 and C4 levels. We describe a case of spontaneous bilateral soft tissue haemorrhage in SLE and discuss the various mechanisms causing bleeding in lupus.

  5. Porcine dermis implants in soft-tissue reconstruction: current status

    PubMed Central

    Smart, Neil J; Bryan, Nicholas; Hunt, John A; Daniels, Ian R

    2014-01-01

    Soft-tissue reconstruction for a variety of surgical conditions, such as abdominal wall hernia or pelvic organ prolapse, remains a challenge. There are numerous meshes available that may be simply categorized as either synthetic or biologic. Within biologic meshes, porcine dermal meshes have come to dominate the market. This review examines the current evidence for their use and the limitations of knowledge. Although there is increasing evidence to support their safety, long-term follow-up studies that support their efficacy are lacking. Numerous clinical trials that remain ongoing may help elucidate their precise role in soft-tissue reconstruction. PMID:24648721

  6. 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

  7. Distinctive Head and Neck Bone and Soft Tissue Neoplasms.

    PubMed

    Purgina, Bibianna; Lai, Chi K

    2017-03-01

    Benign and malignant primary bone and soft tissue lesions of the head and neck are rare. The uncommon nature of these tumors, combined with the complex anatomy of the head and neck, pose diagnostic challenges to pathologists. This article describes the pertinent clinical, radiographic, and pathologic features of selected bone and soft tissue tumors involving the head and neck region, including angiofibroma, glomangiopericytoma, rhabdomyosarcoma, biphenotypic sinonasal sarcoma, chordoma, chondrosarcoma, and osteosarcoma. Emphasis is placed on key diagnostic pitfalls, differential diagnosis, and the importance of correlating clinical and radiographic information, particularly for tumors involving bone.

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

    PubMed

    Patel, Shivani S; Tavana, M Lance; Boger, M Sean; Win, Soe Soe; Rimawi, Bassam H

    2014-01-01

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

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

    PubMed Central

    Patel, Shivani S.; Tavana, M. Lance; Boger, M. Sean; Win, Soe Soe; Rimawi, Bassam H.

    2014-01-01

    Cutaneous infections caused by Mycobacterium marinum have been attributed to aquarium or fish exposure after a break in the skin barrier. In most instances, the upper limbs and fingers account for a majority of the infection sites. While previous cases of necrotizing soft tissue infections related to M. marinum have been documented, the importance of our presenting case is to illustrate the aggressive nature of M. marinum resulting in a persistent necrotizing soft tissue infection of a finger that required multiple aggressive wound debridements, followed by an amputation of the affected extremity, in order to hasten recovery. PMID:25506004

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

    PubMed

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

    1990-01-01

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

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

    PubMed

    Romanos, Georgios E

    2013-01-01

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

  12. A multi-physics model for ultrasonically activated soft tissue.

    PubMed

    Suvranu De, Rahul

    2017-02-01

    A multi-physics model has been developed to investigate the effects of cellular level mechanisms on the thermomechanical response of ultrasonically activated soft tissue. Cellular level cavitation effects have been incorporated in the tissue level continuum model to accurately determine the thermodynamic states such as temperature and pressure. A viscoelastic material model is assumed for the macromechanical response of the tissue. The cavitation model based equation-of-state provides the additional pressure arising from evaporation of intracellular and cellular water by absorbing heat due to structural and viscoelastic heating in the tissue, and temperature to the continuum level thermomechanical model. The thermomechanical response of soft tissue is studied for the operational range of frequencies of oscillations and applied loads for typical ultrasonically activated surgical instruments. The model is shown to capture characteristics of ultrasonically activated soft tissue deformation and temperature evolution. At the cellular level, evaporation of water below the boiling temperature under ambient conditions is indicative of protein denaturation around the temperature threshold for coagulation of tissues. Further, with increasing operating frequency (or loading), the temperature rises faster leading to rapid evaporation of tissue cavity water, which may lead to accelerated protein denaturation and coagulation.

  13. The compressive material properties of the plantar soft tissue.

    PubMed

    Ledoux, William R; Blevins, Joanna J

    2007-01-01

    The plantar soft tissue is the primary means of physical interaction between a person and the ground during locomotion. Dynamic loads greater than body weight are borne across the entire plantar surface during each step. However, most testing of these tissues has concentrated on the structural properties of the heel pad. The purpose of this study was to determine the material properties of the plantar soft tissue from six locations beneath: the great toe (subhallucal), the 1st, 3rd and 5th metatarsal heads (submetatarsal), the lateral midfoot (lateral submidfoot) and the heel (subcalcaneal). We obtained specimens from these locations from 11 young, non-diabetic donors; the tissue was cut into 2 cm x 2 cm blocks and the skin was removed. Stress relaxation experiments were conducted and the data were fit using the quasi-linear viscoelastic (QLV) theory. To determine tissue modulus, energy loss and the effect of test frequency, we also conducted displacement controlled triangle waves at five frequencies ranging from 0.005 to 10 Hz. The subcalcaneal tissue was found to have an increased relaxation time compared to the other areas. The subcalcaneal tissue was also found to have an increased modulus and decreased energy loss compared to the other areas. Across all areas, the modulus and energy loss increased for the 1 and 10 Hz tests compared to the other testing frequencies. This study is the first to generate material properties for all areas of the plantar soft tissue, demonstrating that the subcalcaneal tissue is different than the other plantar soft tissue areas. These data will have implications for foot computational modeling efforts and potentially for orthotic pressure reduction devices.

  14. 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.

  15. Soft-tissue cephalometric norms for the Lambada population in Telangana Region of Andhra Pradesh.

    PubMed

    Thomas, Mayuri; Reddy, Val Deepti; Lakshmi, Hanumantu Vidyadar

    2012-01-01

    Facial contours were traditionally considered to be the result of positioning of underlying hard tissue followed by the soft tissue. However, current trend shows a paradigm shift from the conventional hard tissue analysis to also include both hard- and soft-tissue analysis. The objective of our study was to determine the soft-tissue cephalometric norms for the Lambada population, to define gender differences and to correlate the variables, skeletal convexity (SC), and H angle (HA). Fifty subjects of Lambada ethnic group between 18 and 26 years old, grouped into 25 males and 25 females were taken. Their lateral cephalograms were obtained and analyzed using Holdaway's analysis. Descriptive statistics and the student's t-test were used. Soft-tissue facial angle (SFA), superior sulcus depth (SSD), lower lip to H line (LL-H), and soft-tissue subnasale to H line (S-H) were well within the range given by Holdaway. The variable, lip strain showed that the upper denture is protrusive (P<0.001). Skeletal convexity and HA were significantly correlated in the female sample. HA revealed that a slightly more protrusive profile was acceptable for this ethnic group. Although established Caucasian norms are applicable to the Lambada ethnic tribe, few parameters like basic upper lip thickness (ULT) and upper lip strain (ULS), skeletal convexity, inferior sulcus to H line (LS-H) were significantly different. The male group exhibited straighter profile, thicker lips, prominent nose, deep mentolabial sulcus, and a prominent chin than females. The differences could be considered in diagnosis and treatment planning for orthodontic practice and for orthognathic surgery.

  16. IMAGING GUIDED PERCUTANEAL CORE BIOPSY OF THORACIC BONE AND SOFT TISSUE LESIONS - TECHNIQUE AND COMPLICATIONS.

    PubMed

    Azrumelashvili, T; Mizandari, M; Magalashvili, D; Dundua, T

    2016-01-01

    The purpose of the paper is to present our experience of Imaging Guided Percutaneal Core Biopsy (IGPCB) of thoracic bone and soft tissue lesions in terms of procedure planning, biopsy technique, procedure complications and their management. The results of investigation of 81 patients are presented. According to imaging guidance type the patients were subdivided in two main groups - US guided biopsy (26 patients, 26 procedures) and CT guided biopsy (55 patients, 59 procedures). 85 procedures were performed. In 4 cases the repeated biopsy procedure has been performed as the obtained specimen appeared to be non-informative. Adequate tissue material was obtained at the first attempt in 77 (95.1 %) cases; in 4 (4.9%) cases the repeated procedure was needed (when the target size was above 2-5 or >5 cm using CT guided biopsy and it was due to tumor necrosis. Procedure related complications were detected in 1 (%) case (CT guided biopsy). In 1 case the significant pain, requiring administration of additional analgetics in postprocedure period was mentioned. Percutaneous US and CT guided bone and soft tissue lesions biopsy is an effective, highly accurate, and safe method of tissue obtaining for the diagnosis of indeterminate lesions. US is fast, cheap, avoids ionizing radiation, and allows the needle tip to be monitored throughout the procedure. CT has the ability to visualize both bone and soft tissue with the advantage of making easier needle localization into lesions too deep to see on US. CT also allows for better visualization lesions with a large amount of overlying cortex, and deep-seated lesions with extensive overlying soft tissue. CT-guided percutaneous biopsy is a safe and accurate method. US is the preferable tool for biopsy procedure guidance if the target is adequately imaged by US. CT should be used in cases when US imaging is not possible due to visualization problem.

  17. 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.

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

    PubMed

    Habib, Ali; Hisham, Ahmed

    2013-01-01

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

  19. Newer medical therapies for metastatic soft tissue sarcoma.

    PubMed

    Tiwari, Akash; Gupta, Vineet Govinda; Bakhshi, Sameer

    2017-03-01

    Metastatic/advanced soft tissue sarcoma has a poor prognosis conventionally, treatment options have been limited. In recent years, this area has been a rich ground for research with many new drugs being approved and several more in the pipeline. With multiple new treatment options available, it is vital to keep up pace with this rapidly changing field. Areas covered: Recent data regarding use of novel agents in advanced soft tissue sarcoma is reviewed with a focus on clinical applicability. The goal is to guide the clinician into choosing appropriate lines of therapy for the individual patient in light of recent availability of multiple new treatment options. Expert commentary: Patients with advanced soft tissue sarcoma can expect to receive several lines of therapy in the modern era. Tumor histology should ideally guide the choice of therapy. The new FDA approved second line drugs viz, trabectedin, pazopanib and eribulin should be considered first after failure of doxorubicin-based chemotherapy. Additional options have become available, such as antiangiogenic agents, mTOR inhibitors, and several new molecules targeting specific oncogenic pathways. All these agents have a role in treating soft tissue sarcoma, and careful individualization of therapy can help achieve optimal outcomes in these challenging patients.

  20. Arthroscopy for anterolateral soft tissue impingement of the ankle joint.

    PubMed

    Koczy, Bogdan; Pyda, Michał; Stołtny, Tomasz; Mielnik, Michał; Pajak, Jan; Hermanson, Jacek; Pasek, Jarosław; Widuchowski, Jerzy

    2009-01-01

    Anterolateral soft tissue impingement of the ankle joint is a common consequence of ankle sprain due to excessive supination and adduction of the foot, injuries to the tibiofibular syndesmosis and lateral malleolus fractures. Twenty-two arthroscopic procedures to treat anterolateral soft tissue impingement of the ankle joint were performed at the Independent Public Regional Hospital of Trauma Surgery in Piekary Slaskie between 2006 and 2007. The study group included male patients at the mean age of 34 (17 to 55) years. Medical histories revealed ankle sprain in 13 patients, lateral malleolus fracture in 7, and isolated tibiofibular syndesmotic disruption in 2. The mean time from the injury to the arthroscopic treatment was 5 years (range 2 to 8 years). All patients that underwent arthroscopy were evaluated according to the AOFAS score at baseline (before surgery), and at 3 and 12 months after the treatment. The procedure consisted in the removal of hypertrophic, inflamed and scarred soft tissue from the lateral recess. The mean preoperative AOFAS score was 75.4 points. Post-operatively, the AOFAS functional scores increased to 90.6 and 92 points in the third and twelfth month after the procedure respectively. One patient showed temporary neurapraxia of the dorsal intermediate nerve and the ramus cutaneus branch of the superficial peroneal nerve. These results show that arthroscopic treatment of anterolateral soft tissue impingement of the ankle joint produces satisfactory early outcomes.

  1. Neoplastic fever in patients with bone and soft tissue sarcoma

    PubMed Central

    Nakamura, Tomoki; Matsumine, Akihiko; Matsubara, Takao; Asanuma, Kunihiro; Sudo, Akihiro

    2016-01-01

    The development of fever is a common complication in the clinical course of cancer. If all other potential causes of fever are excluded, the possibility of neoplastic fever should be considered. The aim of the present study was to determine the incidence of neoplastic fever in patients with bone and soft tissue sarcomas. Between January 2009 and December 2014, 195 patients with bone and soft tissue sarcoma (111 men and 84 women; mean age, 55 years) were admitted to the Department of Orthopaedic Surgery of Mie University Graduate School of Medicine (Tsu, Japan). Episodes of fever were observed in 58 patients (30%), of whom 11 (5.5%) had neoplastic fever (mean maximum temperature, 38.9°C). The causes of neoplastic fever were as follows: Primary tumor (n=3), local recurrence (n=1), metastasis (n=5), and local recurrence with metastasis (n=2). Of the 11 patients, 9 were treated with naproxen and 8 exhibited a complete response, with their temperature normalizing to <37.3°C within 24 h. The 2 patients who were not treated with naproxen underwent surgical tumor resection, which resulted in prompt and complete lysis of the fever. In conclusion, neoplastic fever occurred in 5.5% of the 195 patients with bone and soft tissue sarcomas investigated herein. Naproxen may be effective for treating neoplastic fever in patients with bone and soft tissue sarcoma; however, radical tumor treatment may have to be considered to achieve permanent lysis of the fever. PMID:27900101

  2. Skin and Soft Tissue Infections (Patera Foot) in Immigrants, Spain

    PubMed Central

    Ternavasio-de la Vega, Hugo-Guillermo; Ángel-Moreno, Alfonso; Hernández-Cabrera, Michele; Pisos-Álamo, Elena; Bolaños-Rivero, Margarita; Carranza-Rodriguez, Cristina; Calderín-Ortega, Antonio; Pérez-Arellano, José-Luis

    2009-01-01

    An unusual skin and soft tissue infection of the lower limbs has been observed in immigrants from sub-Saharan Africa who cross the Atlantic Ocean crowded on small fishing boats (pateras). Response to conventional treatment is usually poor. Extreme extrinsic factors (including new pathogens) may contribute to the etiology of the infection and its pathogenesis. PMID:19331742

  3. 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.

  4. 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

  5. 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.

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

    PubMed Central

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

    2017-01-01

    This article reviews the mechanism and effects of instrument-assisted soft tissue mobilization (IASTM), along with guidelines for its practical application. IASTM refers to a technique that uses instruments to remove scar tissues from injured soft tissues and facilitate healing process through formation of new extracellular matrix proteins such as collagen. Recently, frequent use of this instrument has increased in the fields of sports rehabilitation and athlete training. Some experimental studies and case reports have reported that IASTM can significantly improve soft tissue function and range of motion following sports injury, while also reducing pain. Based on the previous studies, it is thought that IASTM can help shorten the rehabilitation period and time to return to sports among athletes and ordinary people who have suffered sports injuries. However, few experimental studies of the mechanisms and effects of IASTM have examined, while case reports have accounted for the majority of articles. In the future, the scientific basis of IASTM and its reliability should be provided through well-designed experimental studies on humans. Moreover, IASTM studies that have mostly focused on tendons need to broaden their scope toward other soft tissues such as muscles and ligaments. PMID:28349028

  7. Mechanics of Flexible Needles Robotically Steered through Soft Tissue

    PubMed Central

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

    2010-01-01

    The tip asymmetry of a bevel-tip needle results in the needle naturally bending when it is inserted into soft tissue. This enables robotic needle steering, which can be used in medical procedures to reach subsurface targets inaccessible by straight-line trajectories. However, accurate path planning and control of needle steering requires models of needle-tissue interaction. Previous kinematic models required empirical observations of each needle and tissue combination in order to fit model parameters. This study describes a mechanics-based model of robotic needle steering, which can be used to predict needle behavior and optimize system design based on fundamental mechanical and geometrical properties of the needle and tissue. We first present an analytical model for the loads developed at the tip, based on the geometry of the bevel edge and material properties of soft-tissue simulants (gels). We then present a mechanics-based model that calculates the deflection of a bevel-tipped needle inserted through a soft elastic medium. The model design is guided by microscopic observations of needle-gel interactions. The energy-based formulation incorporates tissue-specific parameters, and the geometry and material properties of the needle. Simulation results follow similar trends (deflection and radius of curvature) to those observed in experimental studies of robotic needle insertion. PMID:21170164

  8. A New Soft Tissue Volume Measurement Strategy Using Ultrasonography

    PubMed Central

    Hwang, Ji Hye; Lee, Hae Hyun; Kim, Soo Yeon

    2014-01-01

    Abstract Various techniques are available for measuring the status of lymphedema. A modified imaging technique using ultrasonography was developed to measure the structure of soft tissue area in a cost-effective manner. The purpose of this study was to measure the reliability and the accuracy of this new method. Ultrasonography was performed on both arms of twenty healthy female participants. At 10 cm above (AE) and below (BE) the elbow crease, soft tissue thickness at medial, lateral, inferior, and superior locations were measured by two examiners with minimal unnecessary pressure. After measuring twice on 16 sites for each participant, the amount of soft tissue in the cross-sectional area (ΔCSA) was acquired by a designed formulation. The ΔCSA was also compared with volumetry data (Perometer®). Cronbach's alpha coefficient test was used for statistics. The intra-class and inter-class reliability measurements for all soft tissue areas were very strong (α=0.980 and 0.960, respectively; p<0.01). All AE and BE reliabilities showed very strong correlation and strong correlation of inter-BE measurement. All reliabilities of ΔCSA were very strong (≥0.950). All CCs (correlation coefficients) between ΔCSA, circumference, and volumetry were strong for AE and BE measurements, except for ΔCSA and circumference at BE. The strongest CC was between volumetry and circumference measurements. This study suggests that measuring the ΔCSA by ultrasonography could be an alternative way to measure the status of soft tissue indirectly with structural consideration. PMID:24521479

  9. 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

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

    PubMed

    Ma, Ming; Zhang, Shi-min

    2015-08-01

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

  11. Treatment of bone and soft tissue defects in infected nonunion.

    PubMed

    Fleischmann, W; Suger, G; Kinzl, L

    1992-01-01

    In the treatment of infected pseudarthroses the general principles of osteitis treatment are applied. This includes radical excision of pseudarthrotic and infected bone tissue, and of diseased surrounding soft tissue. External fixation devices are the preferred method of stabilization of the bone. Based on the data of a retrospective study of 31 Papineau procedures, 65 local flap transfers, and 46 free flap transfers we found that the Papineau procedure works in minor bone and soft tissue defects. Unstable scar formation is a major disadvantage of this method. Local muscular flaps are indicated in the treatment of soft tissue defects in the proximal and medial portions of the lower leg. A prerequisite for free flap transfers is the availability of trained personnel and suitable technical equipment. The option is limited by the patient's vascular situation. This kind of tissue transfer seems to be superior to other methods. For the substitution of bone defects corticocancellous bone transplantation may be used. A promising alternative method to deal with extensive bone defects is osteogenesis produced by callus distraction.

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

    PubMed

    Wells, Peter N T; Liang, Hai-Dong

    2011-11-07

    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.

  13. Pathologic and molecular aspects of soft tissue sarcomas.

    PubMed

    Czerniak, Bogdan

    2003-04-01

    This article retains the conventional approach to the classification of soft tissue sarcomas, dividing them into several major histogenetic categories based on their overall microscopic appearance, tissue differentiation pattern, and biologic potential. The author advocates a multimodal approach, in which four distinctive data sets--clinical, radiographic, microscopic, and, in some cases, molecular--are considered to establish the diagnosis and treatment plan. Such step-wise analysis is more likely to lead to consistency and accuracy as compared with an intuitive approach based on fragmentary data. The author describes individual lesions of soft tissue as clinicopathologic entities and believes that they can be more accurately diagnosed and appropriately treated with the help of data generated by a multidisciplinary team. In addition, this article emphasizes the need to use emerging molecular techniques that can provide important clues for both diagnosis and prognosis.

  14. Complicated skin, skin structure and soft tissue infections - are we threatened by multi-resistant pathogens?

    PubMed Central

    2010-01-01

    Tissue infections or skin, skin structure, and deep seated soft tissue infections are general terms for infections of the entire skin layer including the subcutaneous and muscle tissue layers and their respective fascia structures. Infections of the different mediastinal fascias (mediastinitis) and retroperitoneal fascia infections also belong to this category. Due to the variability of their clinical presentation, skin and soft tissue infections can be classified according to different features. The following aspects can be used for classification: - anatomical structures - pathogens - necessity for urgent treatment - extent of infection The incidence of skin and soft tissue infections in which MRSA (methicillin-resistent Staphylococcus aureus) is involved has been steadily increasing over the past 15 years. These wounds should be treated according to the same open treatment principles as other infected wounds. Since these infections are often superficial contaminations, antibiotic therapy is not indicated. If systemic infection occurs in form of MRSA sepsis, antibiotic therapy is indicated. Several recent reports identified MRSA as the leading pathogen in SSTIs. It also causes 20% to 50% of diabetes-associated foot infections in several countries and is associated with worse outcomes than other pathogens. PMID:21163729

  15. Soft tissue engineering with micronized-gingival connective tissues.

    PubMed

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

    2017-02-24

    The free gingival graft (FGG) and connective tissue graft (CTG) are currently considered to be the gold standards for keratinized gingival tissue reconstruction and augmentation. However, these procedures have some disadvantages in harvesting large grafts, such as donor-site morbidity as well as insufficient gingival width and thickness at the recipient site post-treatment. To solve these problems, we focused on an alternative strategy using micronized tissue transplantation (micro-graft). In this study, we first investigated whether transplantation of micronized gingival connective tissues (MGCTs) promotes skin wound healing. MGCTs (≤100 µm) were obtained by mincing a small piece (8 mm(3) ) of porcine keratinized gingiva using the RIGENERA system. The MGCTs were then transplanted to a full skin defect (5 mm in diameter) on the dorsal surface of immunodeficient mice after seeding to an atelocollagen matrix. Transplantations of atelocollagen matrixes with and without micronized dermis were employed as experimental controls. The results indicated that MGCTs markedly promote the vascularization and epithelialization of the defect area 14 days after transplantation compared to the experimental controls. After 21 days, complete wound closure with low contraction was obtained only in the MGCT grafts. Tracking analysis of transplanted MGCTs revealed that some mesenchymal cells derived from MGCTs can survive during healing and may function to assist in wound healing. We propose here that micro-grafting with MGCTs represents an alternative strategy for keratinized tissue reconstruction that is characterized by low morbidity and ready availability. © 2017 Wiley Periodicals, Inc.

  16. 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

  17. 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

  18. 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

  19. [Primary soft tissue tumors of the epididymis, paratesticular tissue and spermatic cord].

    PubMed

    Kosmehl, H; Katenkamp, D

    1985-01-01

    The present study comprises 23 primary soft tissue tumors of the epididymis, paratesticular tissue and of the spermatic cord. These tumors were reclassified according to the diagnostic criteria of the WHO. The most common tumor of the paratesticular tissue is the adenomatoid tumor (65%), followed by the leiomyoma (17%). Other recognized tumors are: two typical lipomas, one lipo- and one leiomyosarcoma. Because of its relatively high frequency the adenomatoid tumor is reviewed more in detail with regard to its morphology and histogenesis. Some problems of the clinical pathology of paratesticular soft tissue tumors are briefly discussed.

  20. 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

  1. 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

  2. Functional attachment of soft tissues to bone: development, healing, and tissue engineering.

    PubMed

    Lu, Helen H; Thomopoulos, Stavros

    2013-01-01

    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.

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

    PubMed

    Burillo, Almudena; Moreno, Antonio; Salas, Carlos

    2007-11-01

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

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

    PubMed

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

    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.

  5. Photoacoustic tomography of foreign bodies in soft biological tissue

    NASA Astrophysics Data System (ADS)

    Cai, Xin; Kim, Chulhong; Pramanik, Manojit; Wang, Lihong V.

    2010-02-01

    Ultrasound imaging suffers from poor sensitivity (~50%) and specificity in detecting small foreign bodies in tissue. Hence, alternative imaging methods are needed. Photoacoustic (PA) imaging takes advantage of strong optical absorption contrast and high ultrasonic resolution. This work employed a PA imaging system to detect foreign bodies in biological tissues. To achieve deep penetration, we used near-infrared light and a 5-MHz spherically focused ultrasonic transducer. PA images were obtained from objects (glass, wood, cloth, plastic, and metal) embedded in chicken tissue. The location and size of the targets from the PA images agreed well with those of the actual samples. Objects were imaged more than 1 cm deep. Spectroscopic PA imaging was also performed on the objects. These results suggest PA imaging can potentially be a useful intraoperative imaging tool to identify foreign bodies and discriminate viable tissues in wounded patients.

  6. 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

  7. Treatment of soft tissue sarcoma: a focus on earlier stages.

    PubMed

    Gronchi, Alessandro; Maki, Robert G; Jones, Robin L

    2017-01-01

    Surgery, with or without radiation therapy, is the standard of care for primary soft tissue sarcoma, with adjuvant/neodjuvant chemotherapy playing a role only in high-risk patients. Chemotherapy is generally the principal treatment modality for locally advanced or metastatic disease. Within this context, newer techniques and promising new treatments are challenging traditional treatment paradigms. For example, identification of histology-specific treatments is leading the field toward individualized care, with better outcomes. Patients over 65 years represent a sizable and largely undertreated sector of the soft tissue sarcoma population, with many being unsuited to receive anthracycline- or ifosfamide-based chemotherapy. First-line treatment options in this population are discussed.

  8. Maffucci syndrome and soft tissue sarcoma: a case report

    PubMed Central

    Lissa, Fernando César Toniazzi; Argente, Juliana Sonego; Antunes, Geórgia Nunes; Basso, Franciani de Oliveira; Furtado, Janara

    2009-01-01

    Background Maffucci syndrome, a congenital mesodermal dysplasia characterized by multiple enchondromas and hemangiomas, was first described in 1881, and 200 cases have been reported in the literature since then. Its etiology is unknown, there is no predilection for race or sex, and the development of lesions usually occurs in puberty. The risk of sarcomatous transformation is about 25%. Case presentation The initial investigation of the case reported here focused on the diagnosis and treatment of malignancy, and the first diagnostic hypothesis was thrombosed hemangioma. After histopathologic confirmation of soft tissue sarcoma, examinations were performed to stage the tumor and enchondromas were found in ribs. The final diagnosis was Maffucci syndrome with malignant transformation. Conclusion Treatment should aim at symptom relief and early detection of malignancies; no therapy is indicated for asymptomatic patients. As in the case reported here, bone or soft tissue lesions that grow or become painful should be biopsied. PMID:19144147

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

    PubMed

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

    2011-05-01

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

  10. Photoacoustic imaging in both soft and hard biological tissue

    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.

  11. Soft-tissue osteoma of the thenar eminence.

    PubMed

    Ersoy, Burak

    2017-01-01

    The development of osteoma in soft tissues without a direct contact with the adjacent osseous and articular structures is a very rare event. The involvement of the hand is even rarer, with only two previous cases reported so far. A 25-year-old man presented with a painless solid mass in the thenar region of his right palm, which appeared almost 2 years ago and showed a progressive enlargement in the last months. Under regional anesthesia an excisional biopsy was performed and the histopathological evaluation of the lesion confirmed the diagnosis of soft tissue osteoma. The postoperative follow-up period was uneventful without any complication or recurrence. Following a brief period of hand physiotherapy the patient has returned to normal daily activities.

  12. 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.

  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.

  14. 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

  15. Morphometry of the orbital region soft tissues in Down syndrome.

    PubMed

    Sforza, Chiarella; Elamin, Fadil; Dellavia, Claudia; Rosati, Riccardo; Lodetti, Gianluigi; Mapelli, Andrea; Ferrario, Virgilio Ferruccio

    2012-01-01

    The orbital region of subjects with Down syndrome (DS) has been scanty described so far. We wanted to detail the morphologic characteristics of the soft tissue orbital region in Italian and North Sudanese subjects with DS. The three-dimensional coordinates of 10 landmarks on the orbital soft tissues were obtained using computerized anthropometry in 53 Italian and 64 North Sudanese subjects with DS aged 4 to 52 years, and in 461 (Italian) and 682 (North Sudanese) sex- and age-matched controls. From the landmarks, linear distances, ratios, areas, and angles were calculated, z scores computed, and compared by t-tests and analyses of covariance. In North Sudanese DS subjects, intercanthal width and height-to-length ratio were increased; biorbital width, eye height, length, and area were reduced. Eye fissure and orbital inclinations relative to Frankfort plane were reduced, whereas orbital inclinations versus the true horizontal were increased. In Italian DS men, orbital height and height-to-length ratio were increased, eye length was decreased; orbital inclination versus the true horizontal was increased. For almost all measurements, a significant effect of age was found. No effects of sex were found. Ethnic group influenced orbital height, area, and orbital inclination versus Frankfort plane. All paired measurements had similar discrepancies on both sides. The orbital soft tissues of North Sudanese DS subjects differed from those of their reference subjects, but this was only partially true for Italian subjects. The 2 ethnic groups had different alterations in their soft tissue orbital regions that were influenced by age, but not by sex.

  16. 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.

  17. Pediatric Benign Soft Tissue Oral and Maxillofacial Pathology.

    PubMed

    Glickman, Alexandra; Karlis, Vasiliki

    2016-02-01

    Despite the many types of oral pathologic lesions found in infants and children, the most commonly encountered are benign soft tissue lesions. The clinical features, diagnostic criteria, and treatment algorithms of pathologies in the age group from birth to 18 years of age are summarized based on their prevalence in each given age distribution. Treatment modalities include both medical and surgical management. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Biofabricated soft network composites for cartilage tissue engineering.

    PubMed

    Bas, Onur; De-Juan-Pardo, Elena; Meinert, Christoph; D'Angella, Davide; Baldwin, Jeremy; Bray, Laura; Wellard, R; Kollmannsberger, Stefan; Rank, Ernst; Werner, Carsten; Klein, Travis; Catelas, Isabelle; Hutmacher, Dietmar Werner

    2017-04-04

    Articular cartilage from a material science point of view is a soft network composite that plays a critical role in load-bearing joints during dynamic loading. Its composite structure, consisting of a collagen fiber network and a hydrated proteoglycan matrix, gives rise to the complex mechanical properties of the tissue including viscoelasticity and stress relaxation. Melt Electrospinning Writing (MEW) allows the design and fabrication of medical grade polycaprolactone (mPCL) fibrous networks for the reinforcement of soft hydrogel matrices for cartilage tissue engineering. However, these fiber-reinforced constructs underperformed under dynamic and prolonged loading conditions, suggesting that more targeted design approaches and material selection are required to fully exploit the potential of fibers as reinforcing agents for cartilage tissue engineering. In this study, we emulate the proteoglycan matrix of articular cartilage by using highly negatively charged star-shaped poly(ethylene glycol)/heparin hydrogel (sPEG/Hep) as the soft matrix. These soft hydrogels combined with mPCL melt electrospun fibrous networks exhibit mechanical anisotropy, nonlinearity, viscoelasticity and morphology analogous to those of their native counterpart, and provide suitable microenvironment for in vitro human chondrocyte culture and neocartilage formation. In addition, a high-order finite element methods (p-FEM) was developed in order to gain further insights concerning the deformation mechanisms of the constructs in silico as well as to predict compressive moduli. To our knowledge, this is the first study presenting cartilage tissue-engineered constructs that capture the overall transient, equilibrium and dynamic biomechanical properties of human articular cartilage.

  19. 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.

  20. Assessing fundamental 2-dimensional understanding of basic soft tissue techniques.

    PubMed

    Jabbour, Noel; Dobratz, Eric J; Dresner, Harley S; Hilger, Peter A

    2011-01-01

    To develop a written practical examination and scoring system for assessing trainee skills in basic soft-tissue techniques. A brief written practical examination was developed to assess the ability of trainees to sketch preoperative plans and postoperative results for common soft-tissue techniques: simple-excision, M-plasty, geometric broken line closure, Z-plasty, V-to-Y flap, and rhombic flap. A scoring system was developed to assign 0 to 5 points to each of 10 items on the examination for a total score of 0-50. The 15-minute examination was administered as a pretest, posttest, and 3-month posttest assessment as part of a soft-tissue course at our institution. University of Minnesota, Otolaryngology Department. Three raters reviewed all examination answer sheets independently. The pretest scores of examinees correlated strongly with their level of training; the average pretest for junior residents (PGY 1-2) compared with senior residents (PGY 4-5) was 17.3 (of 50) versus 26.0 (p < 0.01). The scoring system showed a high intrarater reliability and high interrater reliability with correlation coefficients of r = 0.99 and r = 0.95, respectively and agreement coefficients of κ = 0.82 and κ = 0.77, respectively. This written practical examination and scoring system may be used to assess the skills of trainees accurately in basic soft tissue techniques and to expose areas of deficiency that can be addressed in future training sessions. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

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

    PubMed

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

    2001-06-01

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

  2. Current status and perspectives of mucogingival soft tissue measurement methods.

    PubMed

    Ronay, Valerie; Sahrmann, Philipp; Bindl, Andreas; Attin, Thomas; Schmidlin, Patrick R

    2011-06-01

    The morphologic and metric assessment of mucogingival soft tissue dimensions is of great multidisciplinary clinical and academic interest, in order to quantify and monitor gingival changes while in treatment, e.g., during periodontal, restorative, prosthetic, orthodontic, or implant therapy. Pink esthetics play an increasingly important role in the overall treatment success, and therefore have to be monitored throughout therapy. The purpose of this article was to identify and summarize methods, which aim at quantifying gingival dimensions in terms of morphology, thickness, and volume, with respect to their accuracy and practicability. The introduced measurement methods should further facilitate personalized treatment planning and monitoring. Mucogingival esthetics play an increasingly important role whenever treatment results are evaluated. Several qualitative and (semi)quantitative methods for measuring soft tissue dimensions are available. New methods like CAD/CAM (computer-aided design and computer-aided manufacturing) technologies are emerging and allow practitioners to reliably monitor their patient's soft tissues throughout therapy. Future improvements may help to develop better treatment strategies in terms of optimized preservation and creation of gingival morphology, especially in the esthetic zone. © 2011 Wiley Periodicals, Inc.

  3. 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

  4. 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

    2016-06-07

    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.

  5. Palliation of Soft Tissue Cancer Pain With Radiofrequency Ablation

    PubMed Central

    Locklin, Julia K.; Mannes, Andrew; Berger, Ann; Wood, Bradford J.

    2008-01-01

    The purpose of this study was to analyze the feasibility, safety, and efficacy of radiofrequency ablation (RFA) to treat pain from soft tissue neoplasms. RFA was performed on 15 painful soft tissue tumors in 14 patients. Tumors varied in histology and location and ranged in size from 2 to 20 cm. Patient pain was assessed using the Brief Pain Inventory (BPI) at baseline and 1 day, 1 week, 1 month, and 3 months post RFA. All patients had unresectable tumors or were poor operative candidates whose pain was poorly controlled by conventional treatment methods. BPI scores were divided into two categories: pain severity and interference of pain. Although not all scores were statistically significant, all mean scores trended down with increased time post ablation. Based on these outcomes, RFA appears to be a low-risk and well-tolerated procedure for pain palliation in patients with unresectable, painful soft tissue neoplasms. RFA is effective for short-term local pain control and may provide another option for failed chemotherapy or radiation therapy in patients with cancer. However, pain may transiently worsen, and relief is often temporary. PMID:15524075

  6. 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

  7. Soft tissue tumors induced by monomeric {sup 239}Pu

    SciTech Connect

    Lloyd, R.D.; Angus, W.; Taylor, G.N.; Miller, S.C.

    1995-10-01

    Individual records of soft tissue tumor occurrence (lifetime incidence) among 236 beagles injected with {sup 239}Pu citrate as young adults and 131 comparable control beagles given no radioactivity enabled us to analyze the possible effects on soft tissue tumor induction resulting from internal exposure to {sup 239}Pu. A significant trend was identified in the proportion of animals having malignant liver tumors with increasing radiation dose from {sup 239}. There was also a significant difference in the relative numbers of both malignant liver tumors (18.1 expected, 66 observed). Malignant tumors of the mouth, pancreas, and skin were more frequent among controls than among the dogs given {sup 239}Pu as well as tumors (malignant plus benign) of the mouth, pancreas, testis, and vagina. For all other tumor sites or types, there was no significant difference for both malignant and all (malignant plus benign) tumors. Mammary tumor occurrence appeared not to be associated with {sup 239}Pu incorporation. We conclude that the only soft-tissue neoplasia induced by the intake of {sup 239}Pu directly into blood is probably a liver tumor. 20 refs., 6 tabs.

  8. Soft Tissue Surgical Procedures for Optimizing Anterior Implant Esthetics.

    PubMed

    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.

  9. A biomechanical liver model for intraoperative soft tissue registration

    NASA Astrophysics Data System (ADS)

    Suwelack, Stefan; Talbot, Hugo; Röhl, Sebastian; Dillmann, Rüdiger; Speidel, Stefanie

    2011-03-01

    Organ motion due to respiration and contact with surgical instruments can significantly degrade the accuracy of image guided surgery. In most applications the ensuing soft tissue deformations have to be compensated in order to register preoperative planning data to the patient. Biomechanical models can be used to perform an accurate registration based on sparse intraoperative sensor data. Using elasticity theory, the approach can be formulated as a boundary value problem with displacement boundary conditions. In this paper, several models of the liver from the literature and a new simplified model are evaluated with regards to their application to intraoperative soft tissue registration. We construct finite element models of a liver phantom using the different material laws. Thereafter, typical deformation pattern that occur during surgery are imposed by applying displacement boundary conditions. A comparative numerical study shows that the maximal registration error of all non-linear models stays below 1.1mm, while the linear model produces errors up to 3.9mm. It can be concluded that linear elastic models are not suitable for the registration of the liver and that a geometrically non-linear formulation has to be used. Although the stiffness parameters of the non-linear materials differ considerably, the calculated displacement fields are very similar. This suggests that a difficult patient-specific parameterization of the model might not be necessary for intraoperative soft tissue registration. We also demonstrate that the new simplified model achieves nearly the same registration accuracy as complex quasi-linear viscoelastic models.

  10. Outcome of Incus Interposition after Preservation in Soft Tissue

    PubMed Central

    Faramarzi, Mohammad; Roosta, Sareh; Dianat, Mahboobe

    2017-01-01

    Introduction: The lenticular process of the incus succumbs to necrosis in chronic otitis media. Few researchers have addressed the issue of autograft incus preservation in the soft tissue of the tragus or mastoid cavity. Nonetheless, preservation of the incus in this method during the second stage of ossiculoplasty is a subject that is still up for debate. This study was carried out to demonstrate the hearing outcome after a modification of the incus interposition technique, which involved preserving it in the periauricular soft tissue. Materials and Methods: In the primary operations, tympanoplasty was performed with a postauricular incision. At the end of the surgery, a small pocket was created to preserve the incus beneath the temporalis fascia. The second stage of ossiculoplasty was performed 6 to 18 months after the primary operation. Post-operative pure tone audiometry was analyzed after at least 12 months and was considered successful after achieving an air-bone gap (ABG) within 20 dB. Results: In this paper, we analyzed 199 ears. The mean duration of follow up was 2.5 years. We achieved post-operative ABG within 20 dB in 157 patients (78.9% of patients). Conclusion: This study indicates the efficacy and safety of incus interposition when it is preserved in the postauricular soft tissue. PMID:28393055

  11. 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.

  12. 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

  13. Developments in the management of extremity soft tissue sarcomas.

    PubMed

    Palesty, J Alexander; Kraybill, William G

    2005-01-01

    Soft tissue sarcomas, a rare and extremely low prevalence tumor, has no uniform treatment recommendation because there have been few randomized prospective trials to guide management. Recently, there have been surgical, medical, biologic, and genetic advances toward improved treatment. A multidisciplinary approach at specialized treatment centers should be sought because the skill set necessary to implement these advances can be provided and outcomes improved. Centralized care will be crucial to improving survival and functional outcome because it will allow for patients to be effectively entered into prospective randomized trials and create regional and national tissue banks to generate meaningful data.

  14. Soft tissue deformation tracking for robotic assisted minimally invasive surgery.

    PubMed

    Stoyanov, Danail; Yang, Guang-Zhong

    2009-01-01

    This paper presents a new framework for tracking soft tissue deformation in robotic assisted minimally invasive surgery. The method combines optical feature tracking based on stereo-laparoscope images and a constrained geometrical surface model that deforms with feature motion. This has the advantage of relying on reliable salient feature tracking while embedding underlying constraints on the tissue surface for deriving consistent temporal deformation. The proposed framework is resilient to occlusions and specular highlights. The accuracy and robustness of the proposed method are validated using a phantom heart model with known ground truth. To demonstrate the practical value of the method, example in vivo results are also provided.

  15. Alarm symptoms of soft-tissue and bone sarcoma in patients referred to a specialist center

    PubMed Central

    Dyrop, Heidi B; Vedsted, Peter; Safwat, Akmal; Maretty-Nielsen, Katja; Hansen, Bjarne H; Jørgensen, Peter H; Baad-Hansen, Thomas; Keller, Johnny

    2014-01-01

    Background and purpose — The Danish Cancer Patient Pathway for sarcoma defines a set of alarm symptoms as criteria for referral to a sarcoma center. This may exclude cancer patients without alarm symptoms, so we investigated the presence of alarm symptoms (defined as being indicative of a sarcoma) in patients who had been referred to the Aarhus Sarcoma Center. Patients and methods — We reviewed the medical records of all 1,126 patients who had been referred, with suspected sarcoma, from other hospitals in the period 2007–2010 for information on symptoms, clinical findings, and diagnosis. Alarm symptoms were analyzed for predictive values in diagnosing sarcoma. Results — 179 (69%) of 258 sarcoma patients were referred with alarm symptoms (soft-tissue tumor > 5 cm or deep-seated, fast-growing soft-tissue tumor, palpable bone tumor, or deep persisting bone pain). The remaining 79 sarcomas were found accidentally. “Size over 5 cm” for soft-tissue tumors, and “deep persisting bone pain” for bone tumors had the highest sensitivity and positive predictive value. Of the 79 sarcoma patients who were referred without alarm symptoms, 7 were found accidentally on imaging, 5 were referred with suspected recurrence of a sarcoma, 64 were referred with a confirmed histological diagnosis, and 3 were referred for other reasons. Interpretation — Defined alarm symptoms are predictive of sarcoma, but one-third of the patients were found accidentally. Further studies on presenting symptoms in primary care are needed to assess the true value of alarm symptoms. PMID:25175662

  16. 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;…

  17. AZD0530 in Treating Patients With Recurrent Locally Advanced or Metastatic Soft Tissue Sarcoma

    ClinicalTrials.gov

    2015-07-02

    Adult Fibrosarcoma; Adult Leiomyosarcoma; Adult Liposarcoma; Adult Malignant Fibrous Histiocytoma; Adult Rhabdomyosarcoma; Dermatofibrosarcoma Protuberans; Endometrial Stromal Sarcoma; Recurrent Adult Soft Tissue Sarcoma; Recurrent Uterine Sarcoma; Stage III Adult Soft Tissue Sarcoma; Stage III Uterine Sarcoma; Stage IV Adult Soft Tissue Sarcoma; Stage IV Uterine Sarcoma; Uterine Carcinosarcoma; Uterine Leiomyosarcoma

  18. 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.

  19. 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

  20. A progressive rupture model of soft tissue stress relaxation.

    PubMed

    Bates, Jason H T; Ma, Baoshun

    2013-06-01

    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.

  1. 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.

  2. 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.

  3. 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

  4. Orthopaedic Interface Tissue Engineering for the Biological Fixation of Soft Tissue Grafts

    PubMed Central

    Moffat, Kristen L .; Wang, I-Ning Elaine; Rodeo, Scott A.; Lu, Helen H.

    2012-01-01

    Interface tissue engineering is a promising new strategy aimed at the regeneration of tissue interfaces and ultimately enabling the biological fixation of soft tissue grafts utilized in orthopaedic repair and sports medicine. Many ligaments and tendons with direct insertions into subchondral bone exhibit a complex enthesis consisting of several distinct yet continuous regions of soft tissue, noncalcified fibrocartilage, calcified fibrocartilage and bone. Regeneration of this multi-tissue interface will be critical for functional graft integration and improving long term clinical outcome. This review will highlight current knowledge of the structure-function relationship at the interface, the mechanism of interface regeneration, and the strategic biomimicry implemented in stratified scaffold design for interface tissue engineering and multi-tissue regeneration. Potential challenges and future directions in this emerging field will also be discussed. It is anticipated that interface tissue engineering will lead to the design of a new generation of integrative fixation devices for soft tissue repair, and it will be instrumental for the development of integrated musculoskeletal tissue systems with biomimetic complexity and functionality. PMID:19064172

  5. Bordetella trematum sepsis with shock in a diabetic patient with rapidly developing soft tissue infection.

    PubMed

    Majewski, Lorrance L; Nogi, Masayuki; Bankowski, Matthew J; Chung, Heath H

    2016-09-01

    Bordetella is a gram-negative, glucose non-fermenting bacillus, consisting of many host-associated species. B. trematum has previously been identified in wound infections, but rarely known to be a source of bacteremia. Currently, 16S rRNA sequencing represents the reference standard method by which identification is made. Herein, we present a case of fatal B. trematum bacteremia with septic shock. The presumed primary site of the infection was a rapidly developing left leg deep soft tissue infection without necrotizing fasciitis. B. trematum should now be considered as a significant pathogen in sepsis.

  6. Ultrasonographically locating the mental foramen and its soft tissue relations

    PubMed Central

    Wells, Mike

    2016-01-01

    Objectives: This ultrasound-based cross-sectional study aimed to visualize, locate and compare the position of the mental foramen with regard to its relationship to various soft tissue landmarks. Methods: 100 Black and Caucasian subjects were included. An ultrasound transducer was used to locate the mental foramina. Distances to various landmarks were measured and compared. Results: All mental foramina were visualized. The mean soft tissue distance of the entire group from the mental foramen on the right and left sides, respectively, were as follows: (a) 3.4 mm [standard deviation (SD) 1.7 mm] and 3.4 mm (SD 1.5 mm) lateral to a vertical line passing through the chelion; (b) 20.1 mm (SD 2.6 mm) and 20.1 mm (SD 2.6 mm) distal to a horizontal line bisecting the chelions; (c) 15.1 mm (SD 2.4 mm) and 15.0 mm (SD 2.4 mm) proximal to the inferior border of the mandible. We found no statistically significant differences between race groups, between gender group and between age categories with regard to the horizontal soft tissue distance from a vertical line passing through the chelion to the mental foramen on the right or left sides. There were statistically significant (but not clinically significant) differences between race groups and between gender groups but not between age groups with regard to the vertical soft tissue distance from a horizontal line bisecting the chelions to the mental foramen as well as from the inferior border of the mandible to the mental foramen on both the right and left sides. Conclusions: This study suggests that ultrasound is a feasible imaging modality that can be utilized to locate the mental foramen. Differences in the position of the mental foramen with regard to various soft tissue landmarks are minor and clinically insignificant. PMID:27506296

  7. [Research of pressure of skin soft tissue expander].

    PubMed

    Xu, Kunming; Li, Hongmian; Luo, Zhijun; Li, Qingfeng

    2013-03-01

    To investigate the change law of the intracapsular pressure in vitro without outside force and the pressure of the expander upon the skin soft tissue in vivo during clinical routine expansion so as to provide some references for the safe application of the expander. The rectangle expanders of 50, 80, 100, 150, 200, 250, 300, and 400 mL were used for in vitro expansion at room temperature to 400% volume of the expander capacity. The pressures before and after saline injection were recorded. Twelve patients who needed scar plastic surgery were enrolled; 17 rectangle expanders were implanted in 5 areas (cheek, trunk, forehead and temporal, limb, and head) and expanded routinely. The pressures before and after saline injection were recorded. The pressure of the expander upon the skin soft tissue was calculated and the values of the pressure at 50%, 100%, 150%, and 200% volume of 5 areas were chosen and analyzed statistically. The intracapsular pressure of the expanders at different volumes in vitro without outside force during routine expansion before and after saline injection was beyond 0 mm Hg (1 mm Hg=0.133 kPa) at around 100% volume, increased rapidly from 100% to 250% volume, and kept stable from 250% to 400% volume. In vivo, 16 expanders within 200% volume had the maximum pressure before saline injection, 15 had the maximum pressure after saline injection. Before saline injection, the pressure of the expander upon the skin soft tissue was lowest in the cheek, showing significant difference when compared with those of the forehead and temporal and head (P < 0.05); the pressure in the trunk was significantly lower than that in the head (P < 0.05); and there was no significant difference between the other body sites (P > 0.05). After saline injection, the pressure of the expander upon the skin soft tissue was lowest in the cheek, and showed an increasing trend in the trunk, the limb, the forehead and temporal, and the head; no significant difference was found

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

    PubMed

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

    2013-01-01

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

  9. Multimodal noninvasive monitoring of soft tissue wound healing.

    PubMed

    Bodo, Michael; Settle, Timothy; Royal, Joseph; Lombardini, Eric; Sawyer, Evelyn; Rothwell, Stephen W

    2013-12-01

    Here we report results of non-invasive measurements of indirect markers of soft tissue healing of traumatic wounds in an observational swine study and describe the quantification of analog physiological signals. The primary purpose of the study was to measure bone healing of fractures with four different wound treatments. A second purpose was to quantify soft tissue wound healing by measuring the following indirect markers: (1) tissue oxygenation, (2) fluid content, and (3) blood flow, which were all measured by non-invasive modalities, measured with available devices. Tissue oxygenation was measured by near infrared spectroscopy; fluid content was measured by bipolar bio-impedance; and blood flow was measured by Doppler ultrasound. Immediately after comminuted femur fractures were produced in the right hind legs of thirty anesthetized female Yorkshire swine, one of four wound treatments was instilled into each wound. The four wound treatments were as follows: salmon fibrinogen/thrombin-n = 8; commercial bone filler matrix-n = 7; bovine collagen-n = 8; porcine fibrinogen/thrombin-n = 7. Fractures were stabilized with an external fixation device. Immediately following wound treatments, measurements were made of tissue oxygenation, fluid content and blood flow; these measurements were repeated weekly for 3 weeks after surgery. Analog signals of each modality were recorded on both the wounded (right) hind leg and the healthy (left) hind leg, for comparison purposes. Data were processed off-line. The mean values of 10-s periods were calculated for right-left leg comparison. ANOVA was applied for statistical analysis. Results of the bone healing studies are published separately (Rothwell et al. in J Spec Oper Med 13:7-18, 2013). For soft tissue wounds, healing did not differ significantly among the four wound treatments; however, regional oxygenation of wounds treated with salmon fibrinogen/thrombin showed slightly different time trends. Further studies are

  10. Genetic profiling identifies two classes of soft-tissue leiomyosarcomas with distinct clinical characteristics.

    PubMed

    Italiano, Antoine; Lagarde, Pauline; Brulard, Céline; Terrier, Philippe; Laë, Marick; Marques, Bernard; Ranchere-Vince, Dominique; Michels, Jean-Jacques; Trassard, Martine; Cioffi, Angela; Piperno-Neumann, Sophie; Chevreau, Christine; Blay, Jean-Yves; Delcambre, Corinne; Isambert, Nicolas; Penel, Nicolas; Bay, Jacques-Olivier; Bonvalot, Sylvie; Le Cesne, Axel; Coindre, Jean-Michel; Chibon, Frédéric

    2013-03-01

    Data about the prognostic factors of soft-tissue leiomyosarcomas and their correlation with molecular profile are limited. From 1990 to 2010, 586 adult patients with a primary soft-tissue leiomyosarcoma were included in the French Sarcoma Group (GSF) database after surgery of the primary tumor. Multivariate analyses were conducted by Cox regression model in a backward stepwise procedure. Genetic profiling was conducted for 73 cases. Median age was 59 years (range, 21-98 years). The median follow-up of patients alive was 46 months. The 5-year metastasis-free survival (MFS) rate was 51% (95% location and grade > I were independent adverse prognostic factors for MFS). The 5-year overall survival (OS) rate was 63% [95% confidence interval (CI), 59-67]. On multivariate analysis, age ≥ 60 years old, tumor size > 5 cm, deep location, and grade > I were independent adverse prognostic factors for OS. Molecular profiling identified specific clusters with activation of different biologic pathways: retroperitoneal leiomyosarcomas are characterized by overexpression of genes involved in muscle differentiation and nonretroperitoneal leiomyosarcomas characterized by overexpression of genes mainly involved in extracellular matrix, wounding, and adhesion pathways. The CINSARC signature but not comparative genomic hybridization (CGH) profiling was predictive of outcome. Soft-tissue leiomyosarcomas represent a heterogeneous group of tumors with at least two categories, retroperitoneal and extremities leiomyosarcomas, having specific clinical outcome and molecular features. Future clinical trials should consider this heterogeneity for a better stratification of patients. ©2013 AACR.

  11. Local recurrence of soft tissue sarcoma following brachytherapy.

    PubMed

    Gemer, L S; Trowbridge, D R; Neff, J; Lin, F; Reddy, E; Evans, R G; Hassanein, R

    1991-03-01

    Twenty-five patients with soft tissue sarcomas were treated with Ir192 implants following wide local excision at our institution between 1982 and 1987. External beam radiotherapy was given in addition to the implant in a majority of patients. The median follow-up in these 25 patients is 36 months (12 to 75 months). Twenty patients have had no evidence of local recurrence following their primary treatment (FFR = 80%). A multivariate analysis using stepwise logistic regression was used to predict failure in 3 years or less. Potential predictors examined included age, sex, tumor location, primary versus recurrent disease, grade, histology, surgical margins, implant only versus implant plus external beam, and a ratio of the volume of tissue which received 65 Gy (TV65) to the tumor volume (TV), that is (TV65/TV). The single variable which was significantly associated with local failure by 3 years was a TV65/TV of less than one. Once this variable was entered into the analysis, no other factor proved statistically significant. Our data suggest that when attempting local control of soft tissue sarcomas with brachytherapy, the volume of tissue receiving 65 Gy (TV65) from both implant and external beam must exceed the volume of the excised lesion (TV). Since the volume of a tumor can be readily determined prior to surgical excision either by CT or MRI scanning, pre-planning of the implant volume could potentially reduce the rate of local failure.

  12. 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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. 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.

  14. Clinicopathology of soft tissue lesions associated with extracted teeth.

    PubMed

    Gbolahan, Olalere; Fatusi, Olawunmi; Owotade, Foluso; Akinwande, Jelili; Adebiyi, Kehinde

    2008-11-01

    The study assessed the prevalence and the clinical and histologic pattern of soft tissue lesions associated with extracted teeth and determined the validity of clinical diagnoses in comparison with histologic diagnosis. Soft tissue from the apices of 100 teeth extracted by the intra-alveolar approach and from the follicle of 50 teeth extracted by the transalveolar approach was examined histologically subsequent to clinical diagnosis. The subjects were seen within a 2-year period at the Oral Surgery unit of a Nigerian teaching hospital. Association between age, gender, and the histopathologic diagnosis was assessed, and the clinical presumptive diagnoses were compared with the histopathologic diagnoses using the epidemiologic parameters of sensitivity, specificity, and positive and negative predictive values. There were 76 (50.7%) males and 74 (49.3%) females, with age range of 17 to 77 years (33 +/- 14 years). Although clinical diagnosis indicated that all the cases were inflammatory in origin, histopathologic diagnosis reported 84% to be of inflammatory origin, 10% to be normal tissue, and 6% to be noninflammatory in nature. The noninflammatory lesions included dentigerous cyst (4%), central giant cell granuloma (1.3%), and ameloblastoma (0.7%). Gender and age were not associated statistically with type and frequency of pathology. Inflammatory conditions showed the highest sensitivity (98%). The study showed that the probability of clinical misdiagnosis of pathologically significant lesions associated with extracted teeth is lowest with inflammation and highest with cysts and neoplasms. Thus, routine histopathologic examination of all recoverable soft tissues associated with extracted teeth would contribute to improve management of cases although the cost and related implications of this need to be investigated further.

  15. Numerical Simulation of Temperature Elevation in Soft Tissue by High Intensity Focused Ultrasound

    NASA Astrophysics Data System (ADS)

    Lee, Kang Il; Sim, Imbo; Kang, Gwan Suk; Choi, Min Joo

    In focused ultrasound surgery, high intensity focused ultrasound (HIFU) can be used to destroy pathological tissue deep inside the body without any damage to the surrounding normal tissue. This noninvasive technique has been used to treat malignant tumors of the liver, prostate, kidney, and benign breast tumors via a percutaneous or transrectal approach without the need for general anaesthesia. In the present study, a finite element method was used for the simulation of temperature elevation in soft tissue by HIFU. First, the HIFU field was modeled using the Westervelt equation for the propagation of finite-amplitude sound in a thermoviscous fluid in order to account for the effects of diffraction, absorption, and nonlinearity. Second, the Pennes bioheat transfer equation was used to predict the temperature elevation in soft tissue by HIFU. In order to verify the numerical simulation, the simulated temperature elevation at the focus in a tissue-mimicking phantom was compared with the measurements, using a concave focused transducer with a focal length of 62.6 mm, a radius of 35.0 mm, and a center frequency of 1.1 MHz.

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

    ClinicalTrials.gov

    2016-11-14

    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

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

    ClinicalTrials.gov

    2016-11-03

    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

  18. 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.

  19. Livers, guts and gills: mapping the decay profiles of soft tissues to understand authigenic mineral replacement.

    NASA Astrophysics Data System (ADS)

    Clements, Thomas; Purnell, Mark; Gabbott, Sarah

    2016-04-01

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

  20. 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.

  1. Images of Soft-bodied Animals with External Hard Shell: 3D Visualization of the Embedded Soft Tissue

    SciTech Connect

    Rao, Donepudi V.; Akatsuka, Takao; Tromba, Giuliana

    2004-05-12

    Images of soft-bodied animals (snails) of various types with external hard shell are obtained for 25, 27 and 29 keV synchrotron X-rays. The SYRMEP facility at Elettra,Trieste, Italy and the associated detection system has been used for the image acquisition. The interior properties of the embedded soft tissue are analysed utilizing the software. From the reconstructed images, the soft tissue distribution, void spaces associated with the soft tissue and external hard shell are identified. 3D images are reconstructed at these energies and optimum energy is chosen based on the quality of the image for further analysis. The optimum energy allowed us to visualize the visibility of low absorbing details and interior microstructure of the embedded soft tissue.

  2. Mechanistic micro-structural theory of soft tissues growth and remodeling: tissues with unidirectional fibers.

    PubMed

    Lanir, Yoram

    2015-04-01

    A new mechanistic theory was developed for soft tissues growth and remodeling (G&R). The theory considers tissues with unidirectional fibers. It is based on the loading-dependent local turnover events of each constituent and on the resulting evolution of the tissue micro-structure, the tissue dimensions and its mechanical properties. The theory incorporates the specific mechanical properties and turnover kinetics of each constituent, thereby establishing a general framework which can serve for future integration of additional mechanisms involved in G&R. The feasibility of the theory was examined by considering a specific realization of tissues with one fibrous constituent (collagen fibers), assuming a specific loading-dependent first-order fiber's turnover kinetics and the fiber's deposition characteristics. The tissue was subjected to a continuous constant rate growth. Model parameters were adopted from available data. The resulting predictions show qualitative agreement with a number of well-known features of tissues including the fibers' non-uniform recruitment density distribution, the associated tissue convex nonlinear stress-stretch relationship, and the development of tissue pre-stretch and pre-stress states. These results show that mechanistic micro-structural modeling of soft tissue G&R based on first principles can successfully capture the evolution of observed tissues' structure and size, and of their associated mechanical properties.

  3. 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.

  4. Pitfalls in soft tissue sarcoma imaging: chronic expanding hematomas.

    PubMed

    Jahed, Kiarash; Khazai, Behnaz; Umpierrez, Monica; Subhawong, Ty K; Singer, Adam D

    2017-09-08

    Solid or nodular enhancement is typical of soft tissue sarcomas although high grade soft tissue sarcomas and those with internal hemorrhage often appear heterogeneous with areas of nonenhancement and solid or nodular enhancement. These MRI findings often prompt an orthopedic oncology referral, a biopsy or surgery. However, not all masses with these imaging findings are malignant. We report the multimodality imaging findings of two surgically proven chronic expanding hematomas (CEH) with imaging features that mimicked sarcomas. A third case of nonenhancing CEH of the lower extremity is also presented as a comparison. It is important that in the correct clinical scenario with typical imaging findings, the differential diagnosis of a chronic expanding hematoma be included in the workup of these patients. An image-guided biopsy of nodular tissue within such masses that proves to be negative for malignancy should not necessarily be considered discordant. A correct diagnosis may prevent a morbid unnecessary surgery and may indicate the need for a conservative noninvasive follow-up with imaging.

  5. Influence of electroacupuncture on the soft tissue healing process.

    PubMed

    Parmen, Valentin; Taulescu, Marian; Ober, Ciprian; Pestean, Cosmin; Oana, Liviu

    2014-10-01

    The aim of this study was to determine the effect of bipolar electroacupuncture (EA) on a soft tissue defect in rabbits. Ten clinically healthy New Zealand white rabbits were divided into two groups: the control group (Group C, n = 5) and the experimental (EA) group (Group T, n = 5). During neuroleptanalgesia, defects of soft tissue (skin and muscle) were made at the dorsum site on the rabbits in both groups, and those defects were stimulated using EA. The biopsy samples were collected on Day 2, Day 4, and Day 6, prepared for histology, and examined microscopically. On the 2(nd) day, in Group C, the inflammatory degree was higher than it was in Group T; on subsequent days, low or identical degrees of inflammation were observed in both groups. Proliferative fibrous activity was increased on Day 4 for Group T and identical for both groups on Day 6. The dynamics of the epidermal thickness were characterized by a high rate on Day 2, Day 4, and Day 6 for Group T. EA facilitates a low tissue mechanical stress and has a positive effect on the healing of muscular defects. EA enhances the healing process, with no side effects. Copyright © 2014. Published by Elsevier B.V.

  6. Differential accumulation of lead by soft tissues of rabbit

    SciTech Connect

    Villarreal-Trevino, C.M.; Villegas-Navarro, A.

    1987-08-01

    In studies on retention of lead by soft tissues, it is reported that, in acute and chronic intoxications, the concentration of Pb decrease in the following order: liver, kidney, heart and brain. The liver contains more lead than the other soft tissues; this might be due to the volume of blood that stays within the organ. Several parameters like age, temperature, perfusion, vascularity and residual blood volume could be important factors in the movement and differential accumulation of lead in blood and tissues. However, these parameters do not completely explain the quantitative differences in the retention of Pb between organs, and it is possible that other factors like the dose and the time between the administration of lead and the killing (exposure time), would have considerable importance in this process that so far has not been satisfactorily explained. The relationships between the size of a dose of lead given intravenously and the retention of this metal by some organs, as well as the effect of the duration of exposure of an intravenously administered dose of lead on accumulation were studied in this work. The possible relationships between accumulation and the values reported for perfusion and residual blood volumes were also studied.

  7. 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.

  8. Noncontact diffuse correlation spectroscopy for noninvasive deep tissue blood flow measurement

    NASA Astrophysics Data System (ADS)

    Lin, Yu; He, Lian; Shang, Yu; Yu, Guoqiang

    2012-01-01

    A noncontact diffuse correlation spectroscopy (DCS) probe has been developed using two separated optical paths for the source and detector. This unique design avoids the interference between the source and detector and allows large source-detector separations for deep tissue blood flow measurements. The noncontact probe has been calibrated against a contact probe in a tissue-like phantom solution and human muscle tissues; flow changes concurrently measured by the two probes are highly correlated in both phantom (R2=0.89, p<10-5) and real-tissue (R2=0.77, p<10-5, n=9) tests. The noncontact DCS holds promise for measuring blood flow in vulnerable (e.g., pressure ulcer) and soft (e.g., breast) tissues without distorting tissue hemodynamic properties.

  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. 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.

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

    NASA Astrophysics Data System (ADS)

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

    2017-04-01

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

  12. 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

  13. Primary and secondary management of pediatric soft tissue injuries.

    PubMed

    Hogg, Nicholas J V

    2012-08-01

    Injury is the most common cause of death in pediatric patients, with a large proportion related to head injury. The craniofacial region in children develops rapidly and at an early age, making the area more prominent compared with the remainder of the body, increasing the likelihood of injury. This article reviews the primary management of pediatric soft tissue injuries, including assessment, cleansing, surgical technique, anesthesia, and considerations for special wounds. The secondary management of pediatric facial injury is also discussed, including scar revision, management of scar hypertrophy/keloids, and staged surgical correction.

  14. Body weight and risk of soft-tissue sarcoma

    PubMed Central

    Tavani, A; Soler, M; Vecchia, C La; Negri, E; Gallus, S; Franceschi, S

    1999-01-01

    The relation between body mass (BMI) and soft-tissue sarcoma (STS) risk was evaluated in a case–control study from Northern Italy based on 217 incident STS and 1297 hospital controls. The risk of STS rose with BMI, with multivariate odds ratios of 3.49 (95% confidence interval (CI) 1.06–11.55) among men and 3.26 (95% CI 1.27–8.35) among women with a BMI >30 kg m–2 compared to those with BMI ≤ 20 kg m–2. © 1999 Cancer Research Campaign PMID:10555763

  15. 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

  16. Soft Tissue Reconstruction Pyramid for the Diabetic Charcot Foot.

    PubMed

    Capobianco, Claire M; Zgonis, Thomas

    2017-01-01

    Foot and ankle ulcerations in patients with diabetic Charcot neuroarthropathy (DCN) occur frequently and can be challenging to address surgically when conservative care fails. Patients with acute or chronic diabetic foot ulcers (DFU) are at continued risk for development of osteomyelitis, septic arthritis, gas gangrene, and potential lower extremity amputation. Concurrent vasculopathy and peripheral neuropathy as well as uncontrolled medical comorbidities complicate the treatment approach. In addition, pathomechanical forces left untreated may contribute to DFU recurrence in this patient population. This article outlines in detail the stepwise approach and options available for durable soft tissue coverage in the DCN patient.

  17. Electrospun nanofibrous scaffolds for engineering soft connective tissues.

    PubMed

    James, Roshan; Toti, Udaya S; Laurencin, Cato T; Kumbar, Sangamesh G

    2011-01-01

    Tissue-engineered medical implants, such as polymeric nanofiber scaffolds, are potential alternatives to autografts and allografts, which are short in supply and carry risks of disease transmission. These scaffolds have been used to engineer various soft connective tissues such as skin, ligament, muscle, and tendon, as well as vascular and neural tissue. Bioactive versions of these materials have been produced by encapsulating molecules such as drugs and growth factors during fabrication. The fibers comprising these scaffolds can be designed to match the structure of the native extracellular matrix (ECM) closely by mimicking the dimensions of the collagen fiber bundles evident in soft connective tissues. These nanostructured implants show improved biological performance over the bulk materials in aspects of cellular infiltration and in vivo integration, and the topography of such scaffolds has been shown to dictate cellular attachment, migration, proliferation, and differentiation, which are critical steps in engineering complex functional tissues and crucial to improved biocompatibility and functional performance. Nanofiber matrices can be fabricated using a variety of techniques, including drawing, molecular self-assembly, freeze-drying, phase separation, and electrospinning. Among these processes, electrospinning has emerged as a simple, elegant, scalable, continuous, and reproducible technique to produce polymeric nanofiber matrices from solutions and their melts. We have shown the ability of this technique to be used to fabricate matrices composed of fibers from a few hundred nanometers to several microns in diameter by simply altering the polymer solution concentration. This chapter will discuss the use of the electrospinning technique in the fabrication of ECM-mimicking scaffolds. Furthermore, selected scaffolds will be seeded with primary adipose-derived stromal cells, imaged using scanning electron microscopy and confocal microscopy, and evaluated in terms

  18. A novel advancement flap for reconstruction of massive forehead and temple soft-tissue defects.

    PubMed

    Huang, Andrew Tsao; Tarasidis, George; Yelverton, Joshua Calvin; Burke, Alan

    2012-08-01

    To describe the authors' experience with an extended deep-plane cervicofacial (EDPCF) advancement flap, a modification of the deep-plane cervicofacial flap, for reconstruction of large forehead and temple soft-tissue defects. Case series at a tertiary referral medical center. The charts of 11 consecutive patients who underwent EDPCF flap surgery for reconstruction of forehead and temple skin cancer defects were reviewed for demographics, smoking status, defect size, length of surgery and hospitalization, American Society of Anesthesiologists Physical Status Classification (ASA) grade, and postoperative complications. All patients had reconstruction of large forehead and temple defects following either primary resection or Mohs micrographic surgery for skin cancer. No skin grafting was required for secondary defects. The average defect size was 52.2 cm(2) . Patient ages averaged 74 years with a median ASA grade of 3. Thirty-six percent of patients admitted to smoking. Average operative time was 100 minutes, with 82% of patients treated on an outpatient basis. There were no complications of ectropion or facial nerve injury encountered. Partial distal flap necrosis occurred in one patient who admitted to smoking and resolved with conservative management. The EDCPF flap is a robust flap with a dual arterial supply and both rotation and advancement components. It is ideal in frail patients with good soft-tissue laxity and provides an immediate one-stage reconstruction with ideal skin color, texture, and thickness matches for large forehead and temple defects. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  19. Soft-tissue changes after head and neck radiation: CT findings.

    PubMed

    Bronstein, A D; Nyberg, D A; Schwartz, A N; Shuman, W P; Griffin, B R

    1989-01-01

    To identify possible soft-tissue changes of the head and neck after radiation therapy, 102 CT scans from 78 patients with head and neck tumors were reviewed to assess (1) skin thickening, (2) epiglottic thickening, (3) stranding of subcutaneous fat, and (4) stranding of deep cervical fat. Scans were obtained after radiation therapy alone (10 cases), after radiation and surgery (27 cases), after surgery alone (24 cases), or before either surgery or radiation (41 cases). Skin thickening, epiglottic thickening, and stranding of subcutaneous fat were seen more frequently after radiation therapy than before such treatment. However, skin thickening and stranding of subcutaneous fat were sometimes also associated with tumor involvement and/or previous surgery, while epiglottic thickening was only occasionally associated with tumor involvement. Stranding of deep cervical fat was noted with increased frequency after radiation or surgery, but postradiation effects could not be reliably distinguished from postsurgical or tumor effects. We conclude that soft-tissue changes of the head and neck on CT may commonly be associated with previous radiation therapy, but these postradiation effects are not always distinguishable from postsurgical effects or tumor.

  20. Chitin-based Materials in Tissue Engineering: Applications in Soft Tissue and Epithelial Organ

    PubMed Central

    Yang, Tsung-Lin

    2011-01-01

    Chitin-based materials and their derivatives are receiving increased attention in tissue engineering because of their unique and appealing biological properties. In this review, we summarize the biomedical potential of chitin-based materials, specifically focusing on chitosan, in tissue engineering approaches for epithelial and soft tissues. Both types of tissues play an important role in supporting anatomical structures and physiological functions. Because of the attractive features of chitin-based materials, many characteristics beneficial to tissue regeneration including the preservation of cellular phenotype, binding and enhancement of bioactive factors, control of gene expression, and synthesis and deposition of tissue-specific extracellular matrix are well-regulated by chitin-based scaffolds. These scaffolds can be used in repairing body surface linings, reconstructing tissue structures, regenerating connective tissue, and supporting nerve and vascular growth and connection. The novel use of these scaffolds in promoting the regeneration of various tissues originating from the epithelium and soft tissue demonstrates that these chitin-based materials have versatile properties and functionality and serve as promising substrates for a great number of future applications. PMID:21673932

  1. Chitin-based materials in tissue engineering: applications in soft tissue and epithelial organ.

    PubMed

    Yang, Tsung-Lin

    2011-01-01

    Chitin-based materials and their derivatives are receiving increased attention in tissue engineering because of their unique and appealing biological properties. In this review, we summarize the biomedical potential of chitin-based materials, specifically focusing on chitosan, in tissue engineering approaches for epithelial and soft tissues. Both types of tissues play an important role in supporting anatomical structures and physiological functions. Because of the attractive features of chitin-based materials, many characteristics beneficial to tissue regeneration including the preservation of cellular phenotype, binding and enhancement of bioactive factors, control of gene expression, and synthesis and deposition of tissue-specific extracellular matrix are well-regulated by chitin-based scaffolds. These scaffolds can be used in repairing body surface linings, reconstructing tissue structures, regenerating connective tissue, and supporting nerve and vascular growth and connection. The novel use of these scaffolds in promoting the regeneration of various tissues originating from the epithelium and soft tissue demonstrates that these chitin-based materials have versatile properties and functionality and serve as promising substrates for a great number of future applications.

  2. Decellularized skin/adipose tissue flap matrix for engineering vascularized composite soft tissue flaps.

    PubMed

    Zhang, Qixu; Johnson, Joshua A; Dunne, Lina W; Chen, Youbai; Iyyanki, Tejaswi; Wu, Yewen; Chang, Edward I; Branch-Brooks, Cynthia D; Robb, Geoffrey L; Butler, Charles E

    2016-04-15

    Using a perfusion decellularization protocol, we developed a decellularized skin/adipose tissue flap (DSAF) comprising extracellular matrix (ECM) and intact vasculature. Our DSAF had a dominant vascular pedicle, microcirculatory vascularity, and a sensory nerve network and retained three-dimensional (3D) nanofibrous structures well. DSAF, which was composed of collagen and laminin with well-preserved growth factors (e.g., vascular endothelial growth factor, basic fibroblast growth factor), was successfully repopulated with human adipose-derived stem cells (hASCs) and human umbilical vein endothelial cells (HUVECs), which integrated with DSAF and formed 3D aggregates and vessel-like structures in vitro. We used microsurgery techniques to re-anastomose the recellularized DSAF into nude rats. In vivo, the engineered flap construct underwent neovascularization and constructive remodeling, which was characterized by the predominant infiltration of M2 macrophages and significant adipose tissue formation at 3months postoperatively. Our results indicate that DSAF co-cultured with hASCs and HUVECs is a promising platform for vascularized soft tissue flap engineering. This platform is not limited by the flap size, as the entire construct can be immediately perfused by the recellularized vascular network following simple re-integration into the host using conventional microsurgical techniques. Significant soft tissue loss resulting from traumatic injury or tumor resection often requires surgical reconstruction using autologous soft tissue flaps. However, the limited availability of qualitative autologous flaps as well as the donor site morbidity significantly limits this approach. Engineered soft tissue flap grafts may offer a clinically relevant alternative to the autologous flap tissue. In this study, we engineered vascularized soft tissue free flap by using skin/adipose flap extracellular matrix scaffold (DSAF) in combination with multiple types of human cells. Following

  3. Comparative soft and hard tissue responses to titanium and polymer healing abutments.

    PubMed

    Koutouzis, Theofilos; Richardson, Joseph; Lundgren, Tord

    2011-03-01

    Limited information exists regarding soft tissue and hard tissue responses to abutments with different material composition. The aim of this study is to evaluate soft and hard tissue responses to titanium and polymer healing abutments over a 3-month period. Sixteen patients were included in this prospective trial. Implants were provisionalized with either titanium or polymer healing abutments. Changes of marginal bone level and soft tissue dimensions were recorded at implant installation and at 3 months.

  4. Pyrintegrin Induces Soft Tissue Formation by Transplanted or Endogenous Cells

    PubMed Central

    Shah, Bhranti S.; Chen, Mo; Suzuki, Takahiro; Embree, Mildred; Kong, Kimi; Lee, Chang H.; He, Ling; Xiang, Lusai; Ahn, Jeffrey A.; Ding, Sheng; Mao, Jeremy J.

    2017-01-01

    Focal adipose deficiency, such as lipoatrophy, lumpectomy or facial trauma, is a formidable challenge in reconstructive medicine, and yet scarcely investigated in experimental studies. Here, we report that Pyrintegrin (Ptn), a 2,4-disubstituted pyrimidine known to promote embryonic stem cells survival, is robustly adipogenic and induces postnatal adipose tissue formation in vivo of transplanted adipose stem/progenitor cells (ASCs) and recruited endogenous cells. In vitro, Ptn stimulated human adipose tissue derived ASCs to differentiate into lipid-laden adipocytes by upregulating peroxisome proliferator-activated receptor (PPARγ) and CCAAT/enhancer-binding protein-α (C/EBPα), with differentiated cells increasingly secreting adiponectin, leptin, glycerol and total triglycerides. Ptn-primed human ASCs seeded in 3D-bioprinted biomaterial scaffolds yielded newly formed adipose tissue that expressed human PPARγ, when transplanted into the dorsum of athymic mice. Remarkably, Ptn-adsorbed 3D scaffolds implanted in the inguinal fat pad had enhanced adipose tissue formation, suggesting Ptn’s ability to induce in situ adipogenesis of endogenous cells. Ptn promoted adipogenesis by upregulating PPARγ and C/EBPα not only in adipogenesis induction medium, but also in chemically defined medium specifically for osteogenesis, and concurrently attenuated Runx2 and Osx via BMP-mediated SMAD1/5 phosphorylation. These findings suggest Ptn’s novel role as an adipogenesis inducer with a therapeutic potential in soft tissue reconstruction and augmentation. PMID:28128224

  5. Management of soft tissue wounds of the face.

    PubMed

    Bhattacharya, V

    2012-09-01

    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.

  6. 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

  7. 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

  8. 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.

  9. 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.

  10. Diagnosis of necrotizing soft tissue infections by computed tomography.

    PubMed

    Zacharias, Nikos; Velmahos, George C; Salama, Ahmed; Alam, Hasan B; de Moya, Marc; King, David R; Novelline, Robert A

    2010-05-01

    In contrast to previous beliefs, we hypothesize that computed tomography (CT) scanning is sensitive and specific for the diagnosis of necrotizing soft tissue infections (NSTIs). Retrospective and prospective case series. Academic medical center. Patients who were clinically suspected of having NSTIs from January 1, 2003, through April 30, 2009, and who underwent imaging with a 16- or 64-section helical CT scanner were studied. The CT result was considered positive if inflamed and necrotic tissue with or without gas or fluid collections across tissue planes was found. The disease (NSTI) was considered present if surgical exploration revealed elements of infection and necrosis of the soft tissues and pathological analysis confirmed the findings. The disease was considered absent if surgical exploration and pathological analysis failed to identify any of these findings or the patient was successfully treated without surgical exploration. Sensitivity and specificity of CT for diagnosing NSTI. Of 67 patients with study inclusion criteria, 58 underwent surgical exploration, and NSTI was confirmed in 25 (43%). The remaining 42 patients had either nonnecrotizing infections during surgical exploration (n = 33) or were treated nonoperatively with successful resolution of the symptoms (n = 9). The sensitivity of CT to identify NSTI was 100%, specificity was 81%, positive predictive value was 76%, and negative predictive value was 100%. No differences were found in demographics, white blood cell count on admission, symptoms, or site of infection between those with a false- or true-positive CT result. A negative CT result reliably excludes the diagnosis of NSTI. A positive CT result correctly identifies the disease with a high likelihood.

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

    PubMed

    Theuwissen, Elke; Smit, Egbert; Vermeer, Cees

    2012-03-01

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

  12. Epirubicin and DTIC (EDIC) for advanced soft-tissue sarcomas.

    PubMed

    Lopez, M; Carpano, S; Di Lauro, L; Vici, P; Conti, E M

    1991-01-01

    Fifty-six patients with measurable advanced soft-tissue sarcomas were treated with epirubicin, 90 mg/m2 intravenously on day 1, and DTIC, 250 mg/m2 intravenously on days 1-5, with the entire regimen repeated every 3 weeks. The overall response rate in 52 evaluable patients was 48% with 9 complete remissions. Noncardiac toxicity was limited predominantly to vomiting, alopecia and myelosuppression. Laboratory evidence of cardiotoxicity [greater than or equal to 20% decrease in left-ventricular ejection fraction (LVEF) from the baseline value] was observed in 4 out of 39 patients who had at least two determinations of LVEF, at a median dose of 1,305 mg/m2. Two patients had clinical congestive heart failure at cumulative dose of 1,440 and 1,620 mg/m2. These findings suggest that the combination of epirubicin and DTIC is an active regimen in soft-tissue sarcomas, and provide further evidence that epirubicin is a doxorubicin analogue with reduced cardiac toxicity, but preserved efficacy in this disease.

  13. 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.

  14. Analysis of results of soft tissue sarcoma margins revision surgery.

    PubMed

    García-Jiménez, A; Trullols-Tarragó, L; Peiró-Ibáñez, A; Gracia-Alegría, I

    Patients from other centres where they have had an unplanned surgical resection of a soft tissue sarcoma are often referred to hospitals specialised in sarcomas. A study was conducted on 35 patients who required this type of surgery were referred to our center between November 2001 and July 2013. Surgery had been performed on 29% of the patients without any complementary tests being done. In 75% of cases, the sarcoma diagnosis was discovered in the post-surgical histological study. Synovial sarcoma was the most common, affecting 38% of the patients. A surgical revision of the margins was performed on all of them, and adjuvant treatment was performed on 86% of them. The histopathology study found that 69% of the patients had residual disease. At the end of follow-up, 12% had a local recurrence, another 12% distant metastases, and 3% had died. Given the results, it is concluded that any tumour of the soft tissues in which malignancy is suspected has to be resected in a reference centre. If an unplanned esection was performed in another centre, it should be referred immediately in order to perform an imaging study, revision surgery, and if required, adjuvant treatment. Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. [Bone lengthening and soft tissue correction using the Ilizarov technique].

    PubMed

    Schiessel, A; Windhager, R; Fellinger, E; Kotz, R

    1998-05-22

    From March 1989 to September 1995 at the Department of Orthopedic Surgery at the Vienna General Hospital 31 limb-lengthenings or corrections of the soft-tissue (contractions of joints, clubfeet) using the Ilizarov method were performed. 15 patients have already finished growth. All complications were analysed according to Paley's classification. The tibia-group (n=13) reached an average lengthening of 3.5 cm (2-5.7 cm) [16% (6-35%) of the initial length] with a healing index of 1.7 mo/cm and a complication rate of 42%. In the femur-group (n=8) a mean lengthening of 5.4 cm (2.5-9.4 cm) [21% (7-34%) of the initial length] could be achieved with a healing rate of 1.3 mo/cm and a complication rate of 40%. The ulna-group (n=3) reached an average lengthening of 2.6 cm (2.2-3.4 cm) [21% (17-24%) or the initial length] with a healing index of 1.4 mo/cm and a complication rate of 17%. The knee contracture group (n=2) was free of complications. The Ilizarov technique has been performed successfully in a high percentage although extensive elongations reported by Ilizarov could not be achieved neither by us nor by other authors. The above-mentioned method has been proved to be efficient and successful to correct deformities of the soft-tissue.

  16. Soft tissue strain measurement using an optical method

    NASA Astrophysics Data System (ADS)

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

    2008-11-01

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

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

    PubMed

    Morel, Mélanie; Taïeb, Sophie; Penel, Nicolas; Mortier, Laurent; Vanseymortier, Luc; Robin, Y Marie; Gosset, Pierre; Cotten, Anne; Ceugnart, Luc

    2011-03-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-11-01

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

  19. Massive osteoradionecrosis of facial bones and soft tissues.

    PubMed

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

    2009-01-01

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

  20. 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

  1. A rate insensitive linear viscoelastic model for soft tissues

    PubMed Central

    Zhang, Wei; Chen, Henry Y.; Kassab, Ghassan S.

    2012-01-01

    It is well known that many biological soft tissues behave as viscoelastic materials with hysteresis curves being nearly independent of strain rate when loading frequency is varied over a large range. In this work, the rate insensitive feature of biological materials is taken into account by a generalized Maxwell model. To minimize the number of model parameters, it is assumed that the characteristic frequencies of Maxwell elements form a geometric series. As a result, the model is characterized by five material constants: μ0, τ, m, ρ and β, where μ0 is the relaxed elastic modulus, τ the characteristic relaxation time, m the number of Maxwell elements, ρ the gap between characteristic frequencies, and β = μ1/μ0 with μ1 being the elastic modulus of the Maxwell body that has relaxation time τ. The physical basis of the model is motivated by the microstructural architecture of typical soft tissues. The novel model shows excellent fit of relaxation data on the canine aorta and captures the salient features of vascular viscoelasticity with significantly fewer model parameters. PMID:17512585

  2. 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

  3. Soft tissue reconstruction for calcaneal fractures or osteomyelitis.

    PubMed

    Attinger, C; Cooper, P

    2001-01-01

    A systematic approach of the surgical management of a calcaneal fracture can minimize the potential of soft tissue complications. When reducing a closed calcaneal fracture, the incision used affects the postoperative complications. The L-shaped incision with the horizontal limb lying on the lateral glabrous junction ensures maximum blood flow to either side of the incision. Whether or not the wound can be closed primarily depends on the preexisting edema, the lost calcaneal height, and the delay between the fracture and reduction (Fig. 20). The wrinkle test is a good indicator that the incision can be closed primarily if the amount of height restored is minimal. If the edema is too great, steps should be taken to reduce it sufficiently to allow successful wound closure. If the wound, after reduction, is too wide to allow primary closure, an ADM flap laterally or an AHM flap medially should be used. For larger defects, a free flap should be considered. The three important steps to reconstruction of soft tissue defects around the calcaneus include good blood supply, a infection-free wound, and the simplest soft tissue reconstructive option that covers the wound successfully. Adequate blood supply can be determined by the use of Doppler. If the supply is inadequate, revascularization is necessary before proceeding. Achieving a clean wound requires aggressive debridement, intravenous antibiotics, and good wound care. Adjuncts that can help in achieving a clean wound include topical antibiotics (silver sulfadiazine), the VAC, and hyperbaric oxygen. Osteomyelitis has to be treated aggressively. Any suspicious bone has to be removed. Only clean, healthy, bleeding bone is left behind. Antibiotic beads can be useful when there is doubt as to whether the cancellous bone is infection-free. The beads are not a substitute for good debridement, however. Soft tissue reconstruction ranges from delayed primary closure to the use of microsurgical free flaps (Fig. 21). When bone or

  4. Repair of Craniomaxillofacial Traumatic Soft Tissue Defects With Tissue Expansion in the Early Stage.

    PubMed

    Han, Yan; Zhao, Jianhui; Tao, Ran; Guo, Lingli; Yang, Hongyan; Zeng, Wei; Song, Baoqiang; Xia, Wensen

    2017-09-01

    Craniomaxillofacial traumatic soft tissue defects severely affect the function and appearance of the patients. The traditional skin grafting or free flap transplantation can only close the defects in the early stage of operation but cannot ensure similar color, texture, and relative aesthetic contour. In the present study, the authors have explored a novel strategy to repair craniomaxillofacial traumatic soft tissue defects by tissue expansion in the early stage and have obtained satisfactory results. Eighteen patients suffering large craniomaxillofacial traumatic soft tissue defects were treated by thorough debridement leaving the wounds unclosed or simply closed with thin split-thickness scalp grafts, adjacent expander implantation in the first stage, and expanded flap transposition in the second stage. There were 11 male patients and 7 female patients ranging in age from 3.5 to 40 years (mean, 19.4 ± 12.2 years), with average 15 months follow-up (range, 3-67 months). The average expansion time was 74.3 days (range, 53-96 days). The 18 patients with a total of 22 expanders were treated with satisfactory results. All the flaps survived and the skin color, texture, and contour well matched those of the peripheral tissue. Only 1 complication of infection happened in the 18 cases (5.56%) and the 22 expanders (4.55%), which was similar to the rate reported in the literature. No other complications related to the expanders occurred. Debridement and tissue expansion in the early stage has been proved to be a more effective strategy to repair craniomaxillofacial traumatic soft tissue defects. This strategy can not only achieve satisfactory color, unbulky and well-matched texture similar to normal, but also avoid unnecessary donor site injuries.

  5. Reverse sural flap for ankle and heel soft tissues reconstruction

    PubMed Central

    Ciofu, RN; Zamfirescu, DG; Popescu, SA; Lascar, I

    2017-01-01

    Introduction: The potential of the medial calf integument, as donor site for a free flap based on musculocutaneous branches of the medial sural artery, was first identified by Taylor and Daniel, following cadaver investigation. In 1981, Pontén described the fasciocutaneous sural flap as a reconstructive option for soft tissue loss of the lower extremity, particularly around the knee. Two years later, Donski and Fogdestram presented the distally based fasciocutaneous flap from the sural region followed by Montegut and Allen who considered the sural artery perforator flap as a viable alternative for the gastrocnemius myocutaneous flap. The sural flap proved a considerable versatility at the level of the lower leg (from the knee to the ankle and heel) as well as for other anatomical regions. The most common usage of the flap is for the distal-third defects of the leg. Materials and method: A group of 10 patients with soft tissue losses at the ankle or heal due to a various etiopathogeny represented by cancer excision, trauma, unstable scars, chronic osteomyelitis, in which a microsurgical free transfer had no indication or was not wanted, was presented. Our group reported a 30% complication rate in a high-risk patient population, including patients with diabetes mellitus, peripheral vascular disease, and venous insufficiency. Results: All the defects were covered successfully, without major complications. Usually, only a minor margin of the tip of the flap was lost, which was easily solved with a guided secondary healing. Most flaps showed a slight venous congestion, which cleared in a few days. The functional result was very good in all the patients, while the aesthetic appearance was acceptable even in female patients. Discussion: An ideal indication of a reverse sural flap may be a defect over an intact but partially exposed Achilles tendon. Conclusions: The sural reverse flap is useful in the ankle and foot soft tissues reconstruction whenever we have reasons not

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

    PubMed

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

    2014-12-01

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

  7. Light-Mediated Deep-Tissue Theranostics

    PubMed Central

    Han, Gang; Xie, Jin

    2016-01-01

    This theme issue provides an overview on recent developments of light-mediated imaging and therapy approaches, with an emphasis on those that transcend the shallow tissue penetration dogma. PMID:27877234

  8. Biofilm in group A streptococcal necrotizing soft tissue infections

    PubMed Central

    Siemens, Nikolai; Chakrakodi, Bhavya; Shambat, Srikanth Mairpady; Morgan, Marina; Bergsten, Helena; Skrede, Steinar; Madsen, Martin B.; Johansson, Linda; Juarez, Julius; Bosnjak, Lidija; Mörgelin, Matthias; Svensson, Mattias

    2016-01-01

    Necrotizing fasciitis caused by group A streptococcus (GAS) is a life-threatening, rapidly progressing infection. At present, biofilm is not recognized as a potential problem in GAS necrotizing soft tissue infections (NSTI), as it is typically linked to chronic infections or associated with foreign devices. Here, we present a case of a previously healthy male presenting with NSTI caused by GAS. The infection persisted over 24 days, and the surgeon documented the presence of a “thick layer biofilm” in the fascia. Subsequent analysis of NSTI patient tissue biopsies prospectively included in a multicenter study revealed multiple areas of biofilm in 32% of the patients studied. Biopsies associated with biofilm formation were characterized by massive bacterial load, a pronounced inflammatory response, and clinical signs of more severe tissue involvement. In vitro infections of a human skin tissue model with GAS NSTI isolates also revealed multilayered fibrous biofilm structures, which were found to be under the control of the global Nra gene regulator. The finding of GAS biofilm formation in NSTIs emphasizes the urgent need for biofilm to be considered as a potential complicating microbiological feature of GAS NSTI and, consequently, emphasizes reconsideration of antibiotic treatment protocols. PMID:27699220

  9. Biofilm in group A streptococcal necrotizing soft tissue infections.

    PubMed

    Siemens, Nikolai; Chakrakodi, Bhavya; Shambat, Srikanth Mairpady; Morgan, Marina; Bergsten, Helena; Hyldegaard, Ole; Skrede, Steinar; Arnell, Per; Madsen, Martin B; Johansson, Linda; Juarez, Julius; Bosnjak, Lidija; Mörgelin, Matthias; Svensson, Mattias; Norrby-Teglund, Anna

    2016-07-07

    Necrotizing fasciitis caused by group A streptococcus (GAS) is a life-threatening, rapidly progressing infection. At present, biofilm is not recognized as a potential problem in GAS necrotizing soft tissue infections (NSTI), as it is typically linked to chronic infections or associated with foreign devices. Here, we present a case of a previously healthy male presenting with NSTI caused by GAS. The infection persisted over 24 days, and the surgeon documented the presence of a "thick layer biofilm" in the fascia. Subsequent analysis of NSTI patient tissue biopsies prospectively included in a multicenter study revealed multiple areas of biofilm in 32% of the patients studied. Biopsies associated with biofilm formation were characterized by massive bacterial load, a pronounced inflammatory response, and clinical signs of more severe tissue involvement. In vitro infections of a human skin tissue model with GAS NSTI isolates also revealed multilayered fibrous biofilm structures, which were found to be under the control of the global Nra gene regulator. The finding of GAS biofilm formation in NSTIs emphasizes the urgent need for biofilm to be considered as a potential complicating microbiological feature of GAS NSTI and, consequently, emphasizes reconsideration of antibiotic treatment protocols.

  10. 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.

  11. Slow light for deep tissue imaging with ultrasound modulation

    NASA Astrophysics Data System (ADS)

    Zhang, Huiliang; Sabooni, Mahmood; Rippe, Lars; Kim, Chulhong; Kröll, Stefan; Wang, Lihong V.; Hemmer, Philip R.

    2012-03-01

    Slow light has been extensively studied for applications ranging from optical delay lines to single photon quantum storage. Here, we show that the time delay of slow-light significantly improves the performance of the narrowband spectral filters needed to optically detect ultrasound from deep inside highly scattering tissue. We demonstrate this capability with a 9 cm thick tissue phantom, having 10 cm-1 reduced scattering coefficient, and achieve an unprecedented background-free signal. Based on the data, we project real time imaging at video rates in even thicker phantoms and possibly deep enough into real tissue for clinical applications like early cancer detection.

  12. Compatibility of elastomeric impression materials for use as soft tissue casts.

    PubMed

    Beyak, B L; Chee, W W

    1996-11-01

    The communication of soft tissue contours from the clinical situation to the laboratory technician through the laboratory phases of the dental implant restoration is enhanced with the use of soft tissue casts. Modern elastomeric impression materials can function well as both the master impression and soft tissue cast materials. The purpose of this study was to test the compatibility of a variety of elastomeric impression materials and commercially available soft tissue cast materials with various matrix impression materials. Chemical interaction between the materials may result in adhesion or inhibition of the set of the soft tissue cast material. The results of this study indicated that consideration must be given to material compatibility if predictably successful results are to be achieved in soft tissue cast fabrication.

  13. Melorheostosis with recurrent soft-tissue components: a histologically confirmed case.

    PubMed

    Hasegawa, Shoichi; Kanda, Shotaro; Imada, Hiroki; Yamaguchi, Takehiko; Akiyama, Toru

    2017-03-01

    Melorheostosis is a very rare disorder characterized by irregular cortical thickening seen on radiographs. In this paper, we present a case of melorheostosis with microscopically confirmed soft-tissue components. The patient was a 51-year-old man who complained of severe pain in the lateral aspect of his right knee. The excision of an ossified soft-tissue lesion relieved intractable pain that had lasted 20 years. Microscopically, the cortex of the affected fibula was composed of thick compact bone and the soft-tissue component consisted of dense compact bone without endochondral ossification. The presence of soft-tissue osseous nodules around the joints is one of the specific conditions for melorheostosis and should be differentiated from synovial chondromatosis. The ossified soft-tissue lesion in our patient is to our knowledge the first reported case of the histologically confirmed soft-tissue component of melorheostosis, which differs from that of synovial chondromatosis.

  14. Current update on the diagnosis and management of head and neck soft tissue sarcomas.

    PubMed

    Tudor-Green, Ben; Gomez, Ricardo; Brennan, Peter A

    2017-10-01

    Head and neck soft tissue sarcomas are a group of rare heterogeneous tumours arising from embryonic mesoderm. They comprise <1% of all head and neck malignancies and 5-15% of all sarcomas with most head and neck sarcomas arising from soft tissues. Although rare, they are associated with both high recurrence and mortality rates. We review the current management of head and neck soft tissue sarcomas. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. 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

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

    PubMed

    Weickenmeier, J; Jabareen, M; Mazza, E

    2015-12-16

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

  17. 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

  18. [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.

  19. 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

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

    PubMed

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

    2007-01-01

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

  1. 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.

  2. Facial soft tissue thicknesses: Noise, signal, and P.

    PubMed

    Stephan, Carl N; Munn, Lachlan; Caple, Jodi

    2015-12-01

    Facial soft tissue thicknesses (FSTTs) hold an important role in craniofacial identification, forming the underlying quantitative basis of craniofacial superimposition and facial approximation methods. It is, therefore, important that patterns in FSTTs be correctly described and interpreted. In prior FSTT literature, small statistically significant differences have almost universally been overemphasized and misinterpreted to reflect sex and ancestry effects when they instead largely encode nuisance statistical noise. Here we examine FSTT data and give an overview of why P-values do not mean everything. Scientific inference, not mechanical evaluation of P, should be awarded higher priority and should form the basis of FSTT analysis. This hinges upon tempered consideration of many factors in addition to P, e.g., study design, sampling, measurement errors, repeatability, reproducibility, and effect size. While there are multiple lessons to be had, the underlying message is foundational: know enough statistics to avoid misinterpreting background noise for real biological effects.

  3. Soft Tissue Myoepithelial Carcinoma of the Neck with Spinal Invasion.

    PubMed

    Moussaly, Elias; Nazha, Bassel; Kedia, Shiksha; Chang, Qing; Forte, Frank

    2016-09-05

    Soft tissue myoepithelial neoplasms are a rare yet diverse group of tumors, ranging from benign to malignant lesions. Their presentation in the head and neck region is uncommon and represents a challenging diagnosis. Early identification of myoepithelial carcinoma is crucial given its more aggressive course compared to its benign counterpart, although the histopathological distinction between the two can be difficult. EWSR1 gene rearrangement is found in half the cases and has a speculative role in pathogenesis. Complete excision remains the treatment of choice. The roles of chemotherapy and radiation are unclear. We report the hospital course of a 33-year-old female who presented to our institution with a posterior neck mass with spinal invasion, diagnosed as myoepithelial cancer. A literature review of these rare tumors is discussed here.

  4. Orthodontic tooth extrusion to enhance soft tissue implant esthetics.

    PubMed

    Brindis, Marco A; Block, Michael S

    2009-11-01

    The purpose of this report was to review the published data on orthodontic extrusion and make recommendations for its use according to the evidence presented, including the technique for use by clinicians. A MEDLINE search was performed to identify reports in referenced journals in English. These studies were collated and reviewed for clinical and animal data on orthodontic extrusion. In addition, the experiences of our team using orthodontic extrusion was added to the evidence used to make the recommendations. From this background information, orthodontic tooth extrusion is able to move the soft tissues when the sulcular attachment apparatus is intact. Bone formation as the tooth is extruded is dependent on the vector of the movement of the tooth. The rate of tooth extrusion is effected by the bone-tooth attachment. When used as we have described, extrusion can effectively move the facial gingival margin to allow for esthetic restoration of implants placed in the extruded tooth position.

  5. Radical soft-tissue release of the arthrogrypotic clubfoot.

    PubMed

    Widmann, Roger F; Do, Twee T; Burke, Stephen W

    2005-03-01

    The purpose of this study was to evaluate the results of primary radical soft-tissue release of arthrogrypotic clubfeet in children less than 1 year of age. We performed a retrospective review of six patients (12 feet) who underwent radical release of clubfoot deformity. Primary surgery was performed at an average of 7.4 months and the average follow-up was 4.3 years. We graded our results using a modified functional clubfoot rating system. We had two excellent, four good, three fair and three poor results. Revision surgery was performed on one foot for residual equinus. All patients ambulated independently with orthoses. Our short-term results with primary radical release of clubfoot deformity in arthrogryposis in infants under 1 year of age have been very encouraging. Correction of hindfoot equinus is excellent, and the recurrence rate remains low. Salvage talectomy has not been necessary in this population of children.

  6. 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

  7. The modelling of fibre reorientation in soft tissue.

    PubMed

    Karsaj, Igor; Sansour, Carlo; Sorić, Jurica

    2009-10-01

    In this paper, a hyperelastic and thermodynamically consistent model for soft tissue is developed that is able to describe the change of the initial orientation of the collagen fibres. Full numerical implementation is considered as well. The collagen architecture is assumed to reorient driven by a specific thermodynamical force. The anisotropy is described by a strain energy function, which is decomposed into a part related to the matrix and a part related to the fibres. The initial fibre orientation is defined by a structural tensor, while the current orientation is described by a time-dependent structural tensor, which results from the initial one by a rotational transformation. The rotation tensor is obtained via an integration process of a rate tensor, which depends on an adequately defined thermodynamical force. The integration is achieved via an exponential map algorithm, where it is shown that the rotation is necessarily a two-parametric one. Efficiency of the proposed formulation is demonstrated using some numerical examples.

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

    PubMed

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

    2017-01-01

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

  9. Soft Tissue Myoepithelial Carcinoma of the Neck with Spinal Invasion

    PubMed Central

    Moussaly, Elias; Nazha, Bassel; Kedia, Shiksha; Chang, Qing; Forte, Frank

    2016-01-01

    Soft tissue myoepithelial neoplasms are a rare yet diverse group of tumors, ranging from benign to malignant lesions. Their presentation in the head and neck region is uncommon and represents a challenging diagnosis. Early identification of myoepithelial carcinoma is crucial given its more aggressive course compared to its benign counterpart, although the histopathological distinction between the two can be difficult. EWSR1 gene rearrangement is found in half the cases and has a speculative role in pathogenesis. Complete excision remains the treatment of choice. The roles of chemotherapy and radiation are unclear. We report the hospital course of a 33-year-old female who presented to our institution with a posterior neck mass with spinal invasion, diagnosed as myoepithelial cancer. A literature review of these rare tumors is discussed here. PMID:27746887

  10. 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.

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

    PubMed

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

    2016-10-31

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

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

    PubMed

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

    1999-03-01

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

  13. 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.

  14. [What role does soft tissue play in callus distraction? An animal experiment].

    PubMed

    Schmidt, J; Schmidt, I; Winker, H; Merk, H; Ekkernkamp, A

    2008-01-01

    Extremity conserving treatment in hospitals of maximum care involves a combination of soft tissue replacement and segment transfer. In contrast some other countries favour the segment transfer without soft tissue replacement and can demonstrate good results. Thus, we posed the question of the effects of soft tissue defects in callus distraction. In an experimental study with two groups of sheep, a standardized fracture model in one group with bone and soft tissue defects and in the other group without soft tissue defects was compared. At specific dates the animals were euthanized and the bone quality combined with different soft tissue conditions were quantified. At the outset of callus maturation, animals without soft tissue defects have a lead over animals with soft tissue defects. At the end of the experimental study both groups show the same bone quality results compared to a healthy comparison group. At the terminal phase of the animal experiment the results of open segment transfer show no differences between the groups with or without soft tissue defects. This supports the experience of other countries. Because of the experimental set-up we cannot make any prediction regarding the biomechanical stability of the callus.

  15. Ang-2 but not Ang-1 expression in perivascular soft tissue tumors.

    PubMed

    Shrestha, Swati; Shen, Jia; Giacomelli, Paulina; Scott, Michelle A; Soo, Chia; Ting, Kang; Péault, Bruno; Dry, Sarah M; James, Aaron W

    2017-03-01

    Perivascular soft tissue tumors are relatively uncommon neoplasms of unclear line of differentiation, although most are presumed to originate from pericytes. Previously, we reported a shared immunophenotype across these related tumor types. Here, we extend these findings to examine the expression of the pericyte markers angiopoietin-1 and -2 (Ang-1 and -2) among perivascular soft tissue tumors. Results showed consistent Ang-2 but not Ang-1 expression across tumor types. In summary, the absence of Ang-1 expression distinguishes perivascular from vascular soft tissue tumors. Ang-2 expression is present across perivascular soft tissue tumors, with some variation between histologic subtypes.

  16. Free anterolateral thigh flaps for upper extremity soft tissue reconstruction

    PubMed Central

    Spindler, Nick; Al-Benna, Sammy; Ring, Andrej; Homann, Heinz; Steinsträsser, Lars; Steinau, Hans-Ulrich; Langer, Stefan

    2015-01-01

    Introduction: Limb-threatening wounds of the upper extremity pose a challenge to the micro vascular surgeon. The aim of this study is to analyze the outcome of free anterolateral thigh flaps for upper extremity soft tissue reconstruction. Methods: A retrospective review of patients undergoing this procedure from 2005 to 2012 was performed. Case note analysis was performed to determine demographic and perioperative factors, and complications and outcomes. Results: Thirty-two patients with a mean age of 53 years (9–84 yrs) underwent upper extremity reconstruction with an anterolateral thigh (ALT) flap. There were 24 (75%) males and 8 (25%) females. The etiology of the soft tissue defects was: infection (44.6%); post-tumor ablation (40%); and trauma (15.6%). The defect site was most commonly in the forearm (53.1%), followed by the elbow (12.5 %), arm (12.5%) and hand (21.9%). The mean timing of free flap transfer was 6.8 days after admission to our institution (minimum 1 days, maximum 9 days). Mean operative time of surgery was 4 h 39 min (minimum 3 h 2 min, maximum 6 h 20 min). The mean hospitalization was 24.8 days (minimum 5, maximum 85). The ALT success rate was at 92.3%. Partial flap necrosis was documented in five cases (15.6%). Complete flap loss occurred in two post-traumatic cases who both lost their limbs. Discussion: This flap, in the hands of experienced surgeons, provides reliable coverage of upper extremity defects. PMID:26504734

  17. Systemic aspects of soft tissue rheumatic disorders (STRDs).

    PubMed

    Owlia, Mohammad Bagher; Mehrpoor, Golbarg

    2014-06-01

    To determine the markers of systemic inflammation in soft tissue rheumatic disorders (STRDs). Case series. Rheumatology Clinic, Yazd, Iran, from November 2010 to December 2011. Patients aged 20 years or above with known diagnosis of STRD according to clinical criteria and/ or paraclinical investigations for at least 3 weeks duration were longitudinally followed. Patients with diagnosis of rheumatoid arthritis, hypothyroidism, or any other known systemic conditions (other than diabetes mellitus) were excluded. After careful and detailed history taking, laboratory tests indicating systemic inflammation including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and routine screening rheumatologic tests were assessed. Of the 90 patients, 75% were female and 25% were male and 28 (31.1%) of patients had diabetes mellitus. Fifty six (62%) and 49 (54%) of all studies cases had some degrees of morning stiffness and remarkable fatigue respectively. Twenty two (24%) had elevated CRP and 5 (5.5%) had abnormal ESR. Rheumatoid factor (RF) and anti-CCP was positive in 5 (5.5%) and 12 (13.3%) of patients accordingly. Three (3.3%) patients suffered from anemia of chronic disease. Mean ESR was 48 ± 7.34 (hl) and mean CRP was 10.06 ± 1.96 mg/dl. Mean RF was 10.8 ± 1.64 U/ml and mean anti- CCP was 18.5 ± 2.71 U/ml. Mean hemoglobin was between 10.4 ± 1.01 g/dl. Features of subtle systemic inflammation are positive in some cases of soft tissue rheumatism.

  18. Sex differences and hormonal modulation of deep tissue pain

    PubMed Central

    Traub, Richard J.; Ji, Yaping

    2013-01-01

    Women disproportionately suffer from many deep tissue pain conditions. Experimental studies show that women have lower pain thresholds, higher pain ratings and less tolerance to a range of painful stimuli. Most clinical and epidemiological reports suggest female gonadal hormones modulate pain for some, but not all, conditions. Similarly, animal studies support greater nociceptive sensitivity in females in many deep tissue pain models. Gonadal hormones modulate responses in primary afferents, dorsal horn neurons and supraspinal sites, but the direction of modulation is variable. This review will examine sex differences in deep tissue pain in humans and animals focusing on the role of gonadal hormones (mainly estradiol) as an underlying component of the modulation of pain sensitivity. PMID:23872333

  19. 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. © 2015 Wiley Periodicals, Inc.

  20. Factitial soft tissue pseudotumor due to injection of anabolic steroids: a report of 3 cases in 2 patients.

    PubMed

    Weinreb, Ilan; Goldblum, John R; Rubin, Brian P

    2010-03-01

    Traumatically induced inflammation or reactive processes are a relatively well-known phenomenon in both skin and soft tissue. These include panniculitides, fat necrosis, nodular fasciitis, and nonspecific fibrosis. Occasionally, traumatic reactions can be associated with factitial injury due to self-induced blunt trauma or injection of chemical agents. Factitial pseudotumors of soft tissue mimicking neoplasms and occurring in deep-seated locations are rare and not well recognized. We have had the opportunity to review a handful of cases over the years of soft tissue pseudotumors caused by self injection of steroids for the purposes of bodybuilding. Three of these cases in 2 patients are presented here. One patient developed a deep lateral thigh mass that was radiologically suspicious for sarcoma but upon core biopsy was found to be a lipogranulomatous reaction. The second patient had 2 masses occurring in the upper and lower extremity with an interval of 1 year between the two. This patient had both masses resected. The first had the appearance of a giant cell tumor with no immediately discernible foreign material. The second mass was initially presumed to be a metastasis from the upper extremity tumor and showed similar areas to the first specimen; however, it also had areas of obvious reactive features with foreign material. These features were found in the first tumor as well upon retrospective review. Both patients admitted to self injection of anabolic steroids after further history was sought by the clinicians. Deep soft tissue pseudosarcomas caused by injection of steroids are not well documented, and patient's reluctance to provide this information leads to difficulty in arriving at a correct diagnosis. Recognition of this possibility is important in avoiding incorrect diagnoses and unnecessary treatments.

  1. Deep reflection-mode photoacoustic imaging of biological tissue.

    PubMed

    Song, Kwang Hyun; Wang, Lihong V

    2007-01-01

    A reflection-mode photoacoustic (PA) imaging system was designed and built to image deep structures in biological tissues. We chose near-infrared laser pulses of 804-nm wavelength for PA excitation to achieve deep penetration. To minimize unwanted surface signals, we adopted dark-field ring-shaped illumination. This imaging system employing a 5-MHz spherically focused ultrasonic transducer provides penetration up to 38 mm in chicken breast tissue. At the 19-mm depth, the axial resolution is 144 microm and the transverse resolution is 560 microm. Internal organs of small animals were imaged clearly.

  2. Tissue preservation strategies for fostering long-term soft and hard tissue stability.

    PubMed

    Romanos, Georgios E

    2015-01-01

    As placement of functionally stable dental implants has become routine, concerns have shifted to maintenance of crestal bone and soft tissue stability. This article proposes the development of a tissue preservation philosophy to avoid crestal bone loss and gingival recession and thus foster long-term esthetics around implants. Pillars of this philosophy must include avoidance or minimization of an implant-abutment microgap and micromovement, use of platform switching, appropriate implant positioning relative to the bone crest, and preservation of the papillae when placing both single and multiple implants.

  3. Soft tissue coverage of war extremity injuries: the use of pedicle flap transfers in a combat support hospital.

    PubMed

    Mathieu, Laurent; Gaillard, Christophe; Pellet, Nicolas; Bertani, Antoine; Rigal, Sylvain; Rongiéras, Frédéric

    2014-10-01

    Definitive management of extremity injuries including soft tissue coverage is seldom achieved in battlefield medical treatment facilities due to limited resources and operational constraints. The purpose of this study was to analyse the French Army Medical Service experience performing such reconstructive surgery in a Combat Support Hospital (CSH) in Afghanistan. A clinical study was performed in the KaIA (Kabul International Airport) CSH from July 2012 to January 2013. During this period 23 Afghan patients treated for soft tissue coverage of combat-related extremity injuries were included. They totalled 28 extremity injuries including 18 blast trauma (BT) and ten non blast trauma (NBT). Overall, 35 extremity pedicled flaps were performed. There were 26 fasciocutaneous flaps, eight muscle flaps and one composite flap. Soft tissue coverage was achieved on all patients reviewed with a mean follow-up of 59 days. Five postoperative complications occurred including two deep infections, one partial flap necrosis and two flap failures, without difference according to injury mechanism. Reconstruction of traumatic soft tissue defect can be achieved in CSHs for local nationals. Pedicle flap transfers provide simple and safe coverage for war extremity injuries in this challenging environment whatever the injury mechanism.

  4. Pharmacological Regulation of In Situ Tissue Stem Cells Differentiation for Soft Tissue Calcification Treatment.

    PubMed

    Hu, Jia-Jie; Yin, Zi; Shen, Wei-Liang; Xie, Yu-Bin; Zhu, Ting; Lu, Ping; Cai, You-Zhi; Kong, Min-Jian; Heng, Boon Chin; Zhou, Yi-Ting; Chen, Wei-Shan; Chen, Xiao; Ouyang, Hong-Wei

    2016-04-01

    Calcification of soft tissues, such as heart valves and tendons, is a common clinical problem with limited therapeutics. Tissue specific stem/progenitor cells proliferate to repopulate injured tissues. But some of them become divergent to the direction of ossification in the local pathological microenvironment, thereby representing a cellular target for pharmacological approach. We observed that HIF-2alpha (encoded by EPAS1 inclined form) signaling is markedly activated within stem/progenitor cells recruited at calcified sites of diseased human tendons and heart valves. Proinflammatory microenvironment, rather than hypoxia, is correlated with HIF-2alpha activation and promoted osteochondrogenic differentiation of tendon stem/progenitor cells (TSPCs). Abnormal upregulation of HIF-2alpha served as a key switch to direct TSPCs differentiation into osteochondral-lineage rather than teno-lineage. Notably, Scleraxis (Scx), an essential tendon specific transcription factor, was suppressed on constitutive activation of HIF-2alpha and mediated the effect of HIF-2alpha on TSPCs fate decision. Moreover, pharmacological inhibition of HIF-2alpha with digoxin, which is a widely utilized drug, can efficiently inhibit calcification and enhance tenogenesis in vitro and in the Achilles's tendinopathy model. Taken together, these findings reveal the significant role of the tissue stem/progenitor cells fate decision and suggest that pharmacological regulation of HIF-2alpha function is a promising approach for soft tissue calcification treatment.

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

    NASA Astrophysics Data System (ADS)

    Bartels, Kenneth E.

    1991-05-01

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

  6. Scaling model for laser-produced bubbles in soft tissue

    SciTech Connect

    London, R. A., LLNL

    1998-03-12

    The generation of vapor-driven bubbles is common in many emerging laser-medical therapies involving soft tissues. To successfully apply such bubbles to processes such as tissue break-up and removal, it is critical to understand their physical characteristics. To complement previous experimental and computational studies, an analytic mathematical model for bubble creation and evolution is presented. In this model, the bubble is assumed to be spherically symmetric, and the laser pulse length is taken to be either very short or very long compared to the bubble expansion timescale. The model is based on the Rayleigh cavitation bubble model. In this description, the exterior medium is assumed to be an infinite incompressible fluid, while the bubble interior consists of a mixed liquid-gas medium which is initially heated by the laser. The heated interior provides the driving pressure which expands the bubble. The interior region is assumed to be adiabatic and is described by the standard water equation-of-state, available in either tabular, or analytic forms. Specifically, we use adiabats from the equation-of-state to describe the evolution of the interior pressure with bubble volume. Analytic scaling laws are presented for the maximum size, the duration, and the energy of bubbles as functions of the laser energy and initially heated volume. Of particular interest, is the efficiency of converting laser energy into bubble motion.

  7. Scaling model for laser-produced bubbles in soft tissue

    NASA Astrophysics Data System (ADS)

    London, Richard A.; Bailey, David S.; Amendt, Peter A.; Visuri, Steven R.; Esch, Victor C.

    1998-05-01

    The generation of vapor-driven bubbles is common in many emerging laser-medical therapies involving soft tissues. To successfully apply such bubbles to processes such as tissue break-up and removal, it is critical to understand their physical characteristics. To complement previous experimental and computational studies, an analytic mathematical model for bubble creation and evolution is presented. In this model, the bubble is assumed to be spherically symmetric, and the laser pulse length is taken to be either very short or very long compared to the bubble expansion timescale. The model is based on the Rayleigh cavitation bubble model. In this description, the exterior medium is assumed to be an infinite incompressible fluid, while the bubble interior consists of a mixed liquid-gas medium which is initially heated by the laser. The heated interior provides the driving pressure which expands the bubble. The interior region is assumed to be adiabatic and is described by the standard water equation-of- state, available in either tabular, or analytic forms. Specifically, we use adiabats from the equation-of-state to describe the evolution of the interior pressure with bubble volume. Analytic scaling laws are presented for the maximum size and duration of bubbles as functions of the laser energy and initially heated volume.

  8. Serious soft tissue infections of the head and neck

    SciTech Connect

    Herr, R.D.; Murdock, R.T.; Davis, R.K. )

    1991-09-01

    The head and neck contain a number of spaces that can be invaded by organisms of the mouth or by spread of cervical osteomyelitis. Infection in these spaces may progress from superficial infection to cellulitis to the formation of an abscess requiring immediate drainage. Spread of infection between spaces depends on anatomic location. Most patients require hospitalization and intravenous antibiotic therapy. Because a deep space infection may be occult, a high index of suspicion is required for diagnosis. Early recognition is necessary to avoid tissue damage, bacteremia or airway compromise. The possibility of deep space infection should be considered in any patient who does not respond to the usual treatment of an abscessed tooth or tonsillitis. This type of infection also should be considered in a toxic patient who has a fever of unknown origin, with or without blood cultures that show anaerobic organisms. Computed tomography or magnetic resonance imaging is usually necessary to locate the infection and to detect suppuration that will be amenable to surgical exploration and drainage. 25 references.

  9. Platelet-rich therapies for musculoskeletal soft tissue injuries.

    PubMed

    Moraes, Vinícius Y; Lenza, Mário; Tamaoki, Marcel Jun; Faloppa, Flávio; Belloti, João Carlos

    2014-04-29

    Platelet-rich therapies are being used increasingly in the treatment of musculoskeletal soft tissue injuries such as ligament, muscle and tendon tears and tendinopathies. These therapies can be used as the principal treatment or as an augmentation procedure (application after surgical repair or reconstruction). Platelet-rich therapies are produced by centrifuging a quantity of the patient's own blood and extracting the active, platelet-rich, fraction. The platelet-rich fraction is applied to the injured tissue; for example, by injection. Platelets have the ability to produce several growth factors, so these therapies should enhance tissue healing. There is a need to assess whether this translates into clinical benefit. To assess the effects (benefits and harms) of platelet-rich therapies for treating musculoskeletal soft tissue injuries. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (25 March 2013), the Cochrane Central Register of Controlled Trials (CENTRAL 2013 Issue 2), MEDLINE (1946 to March 2013), EMBASE (1980 to 2013 Week 12) and LILACS (1982 to March 2012). We also searched trial registers (to Week 2 2013) and conference abstracts (2005 to March 2012). No language or publication restrictions were applied. We included randomised and quasi-randomised controlled trials that compared platelet-rich therapy with either placebo, autologous whole blood, dry needling or no platelet-rich therapy for people with acute or chronic musculoskeletal soft tissue injuries. Primary outcomes were functional status, pain and adverse effects. Two review authors independently extracted data and assessed each study's risk of bias. Disagreement was resolved by discussion or by arbitration by a third author. We contacted trial authors for clarification of methods or missing data. Treatment effects were assessed using risk ratios for dichotomous data and mean differences (MD) or standardised mean differences (SMD) for continuous data, together with

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

    PubMed Central

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

    2009-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Semenov, Serguei; Kellam, James; Althausen, Peter; Williams, Thomas; Abubakar, Aria; Bulyshev, Alexander; Sizov, Yuri

    2007-09-01

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

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

    PubMed Central

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

    2014-01-01

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

  13. Effects of energy drinks on soft tissue healing.

    PubMed

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

    2014-11-01

    The aim of the present study was to investigate the effects of an energy drink (ED) on soft tissue wound healing in the rat model. Thirty-six male Wistar albino rats were randomly divided into 2 groups. A full-thickness paravertebral linear incision wound model was created. The experimental group (EG) received an ED (Red Bull), and the control group (CG) received water. Red Bull (3.57 mL/kg/d) was administered to the rats by the oral gavage method on the day before the skin incision and continued for 14 days. The rats were sacrificed (n = 6 in each group) on the 3rd, 7th, and 14th day of the study. Sections were obtained from excised linear wound healing site and stained with hematoxylin-eosin and Masson trichrome for morphological analysis. To assess angiogenesis on the sections, immunohistochemical studies were carried out using vascular endothelial growth factor antibody and alpha smooth muscle actin Ab-1. The breaking strength of the wound healing site was measured in Newtons using a tensiometer. Morphological analysis showed that collagen deposition in the wound areas was statistically higher in the EG compared with that of the CG at both the third and seventh days (P < 0.05). Re-epithelialization on healing sites in the EG was statistically higher than in the CG on the seventh day (P < 0.05). The results of the immunohistochemical studies indicated that the numbers of new blood vessels in the wound healing sites of the EG were significantly higher at the 7th and 14th days when compared with the CG (P < 0.05). The breaking strength of the wound healing sites was also significantly higher on the 7th and 14th days in the EG (P < 0.05). The results demonstrate that ED accelerates soft tissue wound healing and that its effect may be due to increased collagen deposition, re-epithelialization, and new blood vessel formation in the wound.

  14. Deep-tissue optical imaging of decubitus ulcers

    NASA Astrophysics Data System (ADS)

    Moza, Rohin; DiMaio, J. Michael; Melendez, Jose

    2011-03-01

    Decubitus ulcers are a costly and widespread issue in healthcare today, that result from impaired blood flow in skin and underlying muscle and tissue. To address this need, a point of care multi-wavelength diagnostic imaging system has been developed to monitor hemodynamic processes via use of optical imaging of deep tissue. The resulting measurements demonstrate changes in light-tissue interaction to differentiate healthy and pathologic tissue without disturbing patients in a hospital setting. The identification of light source-detector illumination patterns uniquely map to spatial depths of tissue. The additional time dependent component, allows a novel four-dimensional analysis of tissue. The portable, noninvasive, and non-contact features provide quantitative in-situ measurements.

  15. Cixutumumab and Doxorubicin Hydrochloride in Treating Patients With Unresectable, Locally Advanced, or Metastatic Soft Tissue Sarcoma

    ClinicalTrials.gov

    2016-05-16

    Adult Angiosarcoma; Adult Desmoplastic Small Round Cell Tumor; 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 High Grade Pleomorphic Sarcoma of Bone; Childhood Angiosarcoma; Childhood Desmoplastic Small Round Cell Tumor; Childhood Epithelioid Sarcoma; Childhood Fibrosarcoma; Childhood Leiomyosarcoma; Childhood Liposarcoma; Childhood Malignant Mesenchymoma; Childhood Malignant Peripheral Nerve Sheath Tumor; Childhood Pleomorphic Rhabdomyosarcoma; Childhood Rhabdomyosarcoma With Mixed Embryonal and Alveolar Features; Childhood Synovial Sarcoma; Dermatofibrosarcoma Protuberans; Malignant Adult Hemangiopericytoma; Malignant Childhood Hemangiopericytoma; Metastatic Childhood Soft Tissue Sarcoma; Previously Treated Childhood Rhabdomyosarcoma; Recurrent Adult Soft Tissue Sarcoma; Recurrent Childhood Rhabdomyosarcoma; Recurrent Childhood Soft Tissue Sarcoma; Stage III Adult Soft Tissue Sarcoma; Stage IV Adult Soft Tissue Sarcoma; Untreated Childhood Rhabdomyosarcoma

  16. Thermal-mechanical deformation modelling of soft tissues for thermal ablation.

    PubMed

    Li, Xin; Zhong, Yongmin; Jazar, Reza; Subic, Aleksandar

    2014-01-01

    Modeling of thermal-induced mechanical behaviors of soft tissues is of great importance for thermal ablation. This paper presents a method by integrating the heating process with thermal-induced mechanical deformations of soft tissues for simulation and analysis of the thermal ablation process. This method combines bio-heat transfer theories, constitutive elastic material law under thermal loads as well as non-rigid motion dynamics to predict and analyze thermal-mechanical deformations of soft tissues. The 3D governing equations of thermal-mechanical soft tissue deformation are discretized by using the finite difference scheme and are subsequently solved by numerical algorithms. Experimental results show that the proposed method can effectively predict the thermal-induced mechanical behaviors of soft tissues, and can be used for the thermal ablation therapy to effectively control the delivered heat energy for cancer treatment.

  17. 3-D finite element modelling of facial soft tissue and preliminary application in orthodontics.

    PubMed

    Chen, Si; Lou, Hangdi; Guo, Liang; Rong, Qiguo; Liu, Yi; Xu, Tian-Min

    2012-01-01

    Prediction of soft tissue aesthetics is important for achieving an optimal outcome in orthodontic treatment planning. Previously, applicable procedures were mainly restricted to 2-D profile prediction. In this study, a generic 3-D finite element (FE) model of the craniofacial soft and hard tissue was constructed, and individualisation of the generic model based on cone beam CT data and mathematical transformation was investigated. The result indicated that patient-specific 3-D facial FE model including different layers of soft tissue could be obtained through mathematical model transformation. Average deviation between the transformed model and the real reconstructed one was 0.47 ± 0.77 mm and 0.75 ± 0.84 mm in soft and hard tissue, respectively. With boundary condition defined according to treatment plan, such FE model could be used to predict the result of orthodontic treatment on facial soft tissue.

  18. Dehydration effect on the mechanical behaviour of biological soft tissues: observations on kidney tissues.

    PubMed

    Nicolle, S; Palierne, J-F

    2010-11-01

    This paper deals with the effects of dehydration on the mechanical properties of biological soft tissues and with the validity of methods used in previous works such as a coat of petroleum jelly or silicon oil to minimise the drying of the tissue during mechanical testing. We find that the samples get stiffer as they dry but that this phenomenon is wholly reversible upon re-hydrating the samples. A bath of saline solution is the best hydration method but a coat of low-viscosity silicon oil around the free edge of the sample also proves to be a good anti-drying method. However, using petroleum jelly to prevent tissue dehydration should be banned because the jelly largely contributes to the measured mechanical moduli. (c) 2010 Elsevier Ltd. All rights reserved.

  19. Coherent X-ray diffraction from collagenous soft tissues

    PubMed Central

    Berenguer de la Cuesta, Felisa; Wenger, Marco P. E.; Bean, Richard J.; Bozec, Laurent; Horton, Michael A.; Robinson, Ian K.

    2009-01-01

    Coherent X-ray diffraction has been applied in the imaging of inorganic materials with great success. However, its application to biological specimens has been limited to some notable exceptions, due to the induced radiation damage and the extended nature of biological samples, the last limiting the application of most part of the phasing algorithms. X-ray ptychography, still under development, is a good candidate to overcome such difficulties and become a powerful imaging method for biology. We describe herein the feasibility of applying ptychography to the imaging of biological specimens, in particular collagen rich samples. We report here speckles in diffraction patterns from soft animal tissue, obtained with an optimized small angle X-ray setup that exploits the natural coherence of the beam. By phasing these patterns, dark field images of collagen within tendon, skin, bone, or cornea will eventually be obtained with a resolution of 60–70 nm. We present simulations of the contrast mechanism in collagen based on atomic force microscope images of the samples. Simulations confirmed the ‘speckled’ nature of the obtained diffraction patterns. Once inverted, the patterns will show the disposition and orientation of the fibers within the tissue, by enhancing the phase contrast between protein and no protein regions of the sample. Our work affords the application of the most innovative coherent X-ray diffraction tools to the study of biological specimens, and this approach will have a significant impact in biology and medicine because it overcomes many of the limits of current microscopy techniques. PMID:19706395

  20. Spectroscopic measurements and characterization of soft tissue phantoms

    NASA Astrophysics Data System (ADS)

    Solarte, Efrain; Ipus, Erick

    2013-02-01

    Tissue phantoms are important tools to calibrate and validate light propagation effects, measurements and diagnostic test in real biological soft tissue. We produce low cost phantoms using standard commercial jelly, distillated water, glycerol and a 20% lipid emulsion (Oliclinomel N7-1000 ®) was used in place of the usual Intralipid®. In a previous work we designed a protocol to elaborate high purity phantoms which can be used over months. We produced three different types of phantoms regarding the lipid emulsion - glycerol - gelatin - water composition: Pure gelatin phantoms, lipid in glycerol, and lipid in gelatin phantoms were produced and different concentrations of the lipid emulsion were used to study optical propagation properties of diffusive mixtures. Besides, 1.09 μm poly latex spheres in distilled water were used to produce reference phantoms. In order to use all the phantom sides, the phantoms were produced in disposable spectrometer cuvettes, designed for fluorescence studies. Measurements were performed using an OceanOptics 4000 channels spectrophotometer and integrating spheres. For the scattering measurements a homemade goniometer with a high resolution angular scale was used and the scattering detector was a linear array of optical fibers, with an angular collimator, connected to the spectrophotometer. White LED was used as light source, and the 6328.8 nm HeNe Laser was used for calibration. In this work we present characterization measurements for gelatin and microspheres phantoms using spectral reflectance, diffuse and direct spectral transmittance, and angle scattering measurements. The results of these measurements and their comparison are presented.

  1. Grasping soft tissue by means of vacuum technique.

    PubMed

    Vonck, D; Jakimowicz, J J; Lopuhaä, H P; Goossens, R H M

    2012-10-01

    A notable characteristic of bariatric surgery is the frequent manipulation of the bowel. The bowel is large, delicate, flexible, and has a natural lubricant on the tissue surface. Therefore the bowel is difficult to grasp and manipulate. Vacuum technique is commonly used in industry for all types of grasping and manipulation. Two types of nozzles that differed slightly in geometry (NT1 and NT2), were reviewed in an experimental set up for pull tests on pig bowels. An experimental set-up was used to conduct a series of pull tests on pig bowel tissue. The basic principle of the measurements was a Newton's force balance; F(Pmax)=Δp×A. Student t-tests, two-way ANOVA and Wilcoxon signed rank tests were conducted for the statistical analysis of NT1 and NT2 with regard to the maximum pull force (F(Pmax)). Concerning NT1 the Newton's force balance could not be confirmed. Concerning NT2 the Newton's force balance could partly be confirmed. For both nozzle types the effect of Δp on F(Pmax) was significant. F(Pmax) increases linear in proportion as Δp increases. This relation between F(Pmax) and Δp was confirmed by the Newton's force balance. The results confirm that vacuum technique can be used as a grasp technique for soft organs, particularly the bowels. By means of a clever design of the nozzle a firm grip can be obtained on the bowel segments. Therefore vacuum technique should be studied for further development of instruments, graspers and retractors, to be used in the abdominal area. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.

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

    PubMed

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

    2017-07-01

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

  3. Lymph node metastasis of soft tissue tumors: a cytomorphologic study.

    PubMed

    Loya, Anand C; Prayaga, Aruna K; Arora, Anu; Sundaram, C; Rao, I Satish; Uppin, Shantveer G; Raju, G Suryanarayana; Surath, Anjna; Rajappa, R Senthil

    2007-01-01

    To study the frequency of regional lymph node metastasis of soft tissue tumors (STT) and to evaluate the utility of fine needle aspiration cytology (FNAC) as an initial investigative modality. A prospective and retrospective study of over 6 years (1998-2004) was performed to look for frequency of STT metastasizing to lymph nodes. FNAC of enlarged nodes was performed as a routine outpatient procedure after obtaining complete clinical details. Histopathology and immunohistochemistry were correlated where available. Lymph node enlargement was seen in 23 of 241 patients with STTs, of which 19 cases showed involvement (7.88%), synchronous with primary in 12 cases and metachronous in 7 cases. The most common sites of primary tumor were the lower extremity and head and neck region with involved regional lymph nodes. STTs commonly involving lymph nodes were rhabdomyosarcoma and extraskeletal Ewing's/primitive neuroectodermal tumor (PNET); other rare tumors included malignant granular cell tumor, epithelioid hemangioendothelioma, mediastinal ganglioneuroblastoma, angiosarcoma and epithelioid sarcoma. Lymph node aspirates should be examined for alien cells, particularly smears that are paucicellular and demonstrate cystic change. Lymph node metastasis of STT is rare and influences staging, treatment and prognosis. Enlarged regional nodes should be examined with FNAC.

  4. Creating porous tubes by centrifugal forces for soft tissue application.

    PubMed

    Dalto, P D; Shoichet, M S

    2001-10-01

    Chemically crosslinked poly(2-hydroxyethyl methacrylate) (PHEMA) tubes were synthesized by applying centrifugal forces to propagating polymer chains in solution. Initiated monomer solutions, with a composition typical for PHEMA sponges, were placed into a cylindrical mold that was rotated about its long axis. As polymerization proceeded, phase separated PHEMA formed a sediment at the periphery under centrifugal action. The solvent remained in the center of the mold while the PHEMA phase gelled, resulting in a tube. By controlling the rotational speed and the formulation chemistry (i.e., monomer, initiator and crosslinking agent concentrations), the tube dimensions and wall morphology were manipulated. Tube manufacture was limited by a critical casting concentration [M]c, above which only rods formed. All tubes had an outer diameter of 2.4 mm, reflecting the internal diameter of the mold and a wall thickness of approximately 40-400 microm. Wall morphologies varied from interconnecting polymer and water phases to a closed cell, gel-like, structure. Concentric tubes were successfully prepared by using formulations that enhanced phase separation over gelation/network formation. This was achieved by using formulations with lower concentrations of monomer and crosslinking agent and higher concentrations of initiator. This technique offers a new approach to the synthesis of polymeric tubes for use in soft tissue applications, such as nerve guidance channels.

  5. Viscoelastic characterization of soft tissue from dynamic finite element models.

    PubMed

    Eskandari, Hani; Salcudean, Septimiu E; Rohling, Robert; Ohayon, Jacques

    2008-11-21

    An iterative solution to the inverse problem of elasticity and viscosity is proposed in this paper. A new dynamic finite element model that is consistent with known rheological models has been derived to account for the viscoelastic changes in soft tissue. The model assumes known lumped masses at the nodes, and comprises two vectors of elasticity and viscosity parameters that depend on the material elasticity and viscosity distribution, respectively. Using this deformation model and the observed dynamic data for harmonic excitation, the inverse problem is solved to reconstruct the viscosity and elasticity in the medium by using a Gauss-Newton-based approach. As in other inverse problems, previous knowledge of the parameters on the boundaries of the medium is necessary to assure uniqueness and convergence and to obtain an accurate map of the viscoelastic properties. The sensitivity of the solutions to noise, model and boundary conditions has been studied through numerical simulations. Experimental results are also presented. The viscosity and elasticity of a gelatin-based phantom with inclusion of known properties have been reconstructed and have been shown to be close to the values obtained using standard rheometry.

  6. Soft tissue sarcoma nomograms and their incorporation into practice.

    PubMed

    Callegaro, Dario; Miceli, Rosalba; Mariani, Luigi; Raut, Chandrajit P; Gronchi, Alessandro

    2017-08-01

    The accurate prediction of prognosis in patients with soft tissue sarcoma (STS) is a challenging issue. Extreme variability in the clinical and pathological characteristics of this family of tumors hinders the simple stratification of patients into meaningful prognostic cohorts. Precision medicine tools for the prediction of prognosis, such as nomograms, enable personalized computation of outcome based on clinical and pathological characteristics of both patient and tumor. The eighth edition of the American Joint Committee on Cancer staging manual moved from a "population-based" to a "personalized" approach endorsing high-quality nomograms to improve clinician prediction ability in definite patient subgroups. The first nomogram for STS was published in 2002, and this was followed by several prognostic predictors offered to clinicians. Focusing on a specific STS subgroup or site, nomograms can take into consideration highly specific factors relevant only in that particular scenario, thereby maximizing prognostic ability. The objective of this review was to critically evaluate available nomograms for patients with STS to provide clinicians and researchers with a choice of the most optimal tool for each specific patient. Cancer 2017;123:2802-20. © 2017 American Cancer Society. © 2017 American Cancer Society.

  7. Light ion irradiation for unfavorable soft tissue sarcoma

    SciTech Connect

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

    1990-09-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2017-09-01

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

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

    PubMed

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

    1996-01-01

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

  11. Giant cell tumor of soft tissue arising in breast.

    PubMed

    May, Steve A; Deavers, Michael T; Resetkova, Erika; Johnson, Deborah; Albarracin, Constance T

    2007-10-01

    Primary giant cell tumor of soft tissue (GCT-ST) arising in breast is exceedingly rare. We report a case of a 60-year-old woman with a primary breast giant cell tumor that appeared histologically identical to giant cell tumor of bone and had a clinically malignant course. The patient presented with a cystic mass of the breast, suspected on imaging to be an organizing hematoma, possibly related to previous injury. Histopathological evaluation revealed a neoplasm composed of mononuclear cells admixed with osteoclast-like giant cells resembling giant cell tumor of bone. Immunohistochemical staining was positive for CD68, smooth muscle actin, and vimentin, but was negative for a panel of epithelial and additional muscle markers. These features were most consistent with GCT-ST, an uncommon neoplasm of low malignant potential. Despite aggressive surgical treatment achieving clear surgical margins, the patient expired with pulmonary metastases within a year of her initial presentation. This case demonstrates the difficulty of predicting clinical behavior of GCT-ST of breast on the basis of histological features and depth of tumor alone. To our knowledge, this is the first case report of a GCT-ST arising in the breast associated with a fatal outcome. The distinction of this entity from other more common primary breast tumors with giant cell morphology is also emphasized.

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

    PubMed Central

    van Herk-Sukel, Myrthe P. P.; Shantakumar, Sumitra; Overbeek, Lucy I. H.; van Boven, Hester; Penning-van Beest, Fernie J. A.; Herings, Ron M. C.

    2012-01-01

    Background. Data is limited on the burden of common comorbidities, such as cardiovascular disease (CVD), respiratory disease and diabetes, or comorbidities related to cancer and its treatment, such as anemia and depression, in patients with soft tissue sarcoma (STS). Patients and Methods. From the Dutch Pathology Registry linked to the PHARMO database (including data on drug use and hospitalizations), 533 patients with STS were selected during 2000–2007 and matched 1 : 10 to cancer-free controls. The occurrences of comorbidities were assessed in the 12 months before and after STS diagnosis. Results. STS patients were 2–4 times more likely to have comorbidities at diagnosis compared with cancer-free controls. The incidence of CVD, anemia, and depression after STS diagnosis differed significantly from cancer-free controls and decreased during followup from 40–124 per 1,000 person-years (py) during the first six months to 11–38 per 1,000 py more than 12 months after diagnosis. The incidence of respiratory disease and diabetes among STS patients remained stable during followup (5–21 per 1,000 py) and did not differ significantly from cancer-free controls. Conclusions. STS patients were more likely to have comorbidities before cancer diagnosis and to develop CVD, anemia, and depression after diagnosis compared to cancer-free controls. PMID:22690132

  13. Soft tissue deformation using a Hierarchical Finite Element Model.

    PubMed

    Faraci, Alessandro; Bello, Fernando; Darzi, Ara

    2004-01-01

    Simulating soft tissue deformation in real-time has become increasingly important in order to provide a realistic virtual environment for training surgical skills. Several methods have been proposed with the aim of rendering in real-time the mechanical and physiological behaviour of human organs, one of the most popular being Finite Element Method (FEM). In this paper we present a new approach to the solution of the FEM problem introducing the concept of parent and child mesh within the development of a hierarchical FEM. The online selection of the child mesh is presented with the purpose to adapt the mesh hierarchy in real-time. This permits further refinement of the child mesh increasing the detail of the deformation without slowing down the simulation and giving the possibility of integrating force feedback. The results presented demonstrate the application of our proposed framework using a desktop virtual reality (VR) system that incorporates stereo vision with integrated haptics co-location via a desktop Phantom force feedback device.

  14. Quantification of pelvic soft tissue artifact in multiple static positions.

    PubMed

    Hara, Reiko; Sangeux, Morgan; Baker, Richard; McGinley, Jennifer

    2014-02-01

    Soft tissue artifact (STA) has been identified as the most critical source of error in clinical gait analysis. Multiple calibration is a technique to reduce the impact of STA on kinematic data, which involves several static calibrations through the range of motion of the joint of interest. This study investigated how skin markers at the pelvis were displaced in relation to anatomical body landmarks in multiple static calibration positions. The magnitude and direction of the pelvic marker displacement was assessed in nine different body positions including 90° and 45° hip flexion, maximum hip extension, and pelvic tilt in 20 healthy young adults. ASIS markers were found to be more susceptible to relative displacement than PSIS markers, with displacement particularly evident in positions where the hip was flexed (up to 17 mm). A strong correlation was found between the hip flexion angle and marker displacement (r(2) = 0.70). While the estimated impact of pelvic STA on gait kinematics was relatively small, the findings suggest that activities with large hip flexion would cause larger STA with a greater impact on pelvic kinematics. The skin surface located over the ASIS differed by a mean of 17 mm between standing and supine positions, which could affect the inter-ASIS distance and the location of hip joint center (HJC) by up to 20mm and 10mm, respectively.

  15. Prognostic significance of WT1 expression in soft tissue sarcoma

    PubMed Central

    2014-01-01

    Background Soft tissue sarcomas (STS) are rare. We evaluated the WT1 protein expression level in various types of STS and elucidated the value of WT1 as a prognostic factor and a possible therapeutic target. Methods Immunohistochemical staining for WT1 was performed in 87 cases of STS using formalin-fixed, paraffin-embedded blocks. The correlation between WT1 expression and clinicopathological factors was analyzed. Survival analysis was conducted in 67 patients. We assessed the validity of WT1 immunohistochemistry as an index of WT1 protein expression using Western blot analysis. Results WT1 expression was noted in 47 cases (54.0%). Most rhabdomyosarcomas and malignant peripheral nerve sheath tumors showed WT1 expression (91.7% and 71.4%, respectively; P = 0.005). WT1 expression was related to higher FNCLCC histologic grade and AJCC tumor stage. In the group with high grade STS, strong WT1 expression was correlated with better survival (P = 0.025). The immunohistochemical results were correlated quantitatively with the staining score and the concentration of the Western blot band. Conclusions This study demonstrates that various types of STS show positive immunostaining for WT1 and that WT1 expression has a prognostic significance. So STS should be considered candidates for WT1 peptide--based immunotherapy. PMID:25026998

  16. Nasal Soft Tissue Change Following Bimaxillary Orthognathic Surgery.

    PubMed

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

    2017-05-31

    The purpose of this study is to identify the correlation between maxillary movement and nasal soft tissue changes on three-dimensional reconstructed cone beam computed tomography (CBCT) images after Le Fort I osteotomy. The authors also investigate the long-term change of alar base width (ABW) to determine the effect of cinch suture. The authors retrospectively studied 52 subjects (14 males and 38 females) who were treated by bimaxillary orthognathic surgery including Le Fort I osteotomy and mandibular ramus surgery. The landmarks and planes were established on three-dimensional reconstructed CBCT images. The authors measured each parameters preoperatively, 1 month postoperatively, and 1 year postoperatively. There was no significant correlation between the horizontal movement of A-point and the widening of ABW (P < 0.038), nor was there a significant correlation between the vertical movement of A-point and the change of ABW (P < 0.61). There was no significant correlation between horizontal and vertical movement of anterior nasal spine and the widening of ABW, nor was there a significant correlation between the nasal tip length and the vector of maxillary movement. There was no significant correlation between the ABW widening and the vector of surgical maxillary movement. The effect and stability of the alar base cinch suture is difficult to determine and require further investigation.

  17. Neuroendocrine carcinoma of the pancreas with soft tissue metastasis.

    PubMed

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

    2012-12-07

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

  18. Expression of heparanase in soft tissue sarcomas of adults

    PubMed Central

    2014-01-01

    Background Heparanase is an endo-β-D-glucuronidase that cleaves heparan sulfate chains of proteoglycans, resulting in the disassembly of the extracellular matrix. Heparanase has a central role in the development of various tumors, and its expression has been associated with increased tumor growth, angiogenesis and metastasis, but there is insufficient information about the function of heparanase in sarcomas. Study aims 1) To evaluate heparanase levels in adult soft tissue sarcomas (STS); 2) To examine the correlation between heparanase levels and pathological and clinical parameters and treatment outcome. Methods Pathological specimens of primary or metastatic STS were subjected to immunohistochemical analysis applying an anti-heparanase antibody. The clinical and the pathological data, together with the data of heparanase levels, were evaluated in a logistic regression model for tumor recurrence and survival. Results One hundred and one samples were examined, 55 from primary tumors and 46 from metastatic sites. A high expression of heparanase was observed in 29 (52.7%) and 22 specimens (47.8%), respectively. There was no statistically significant difference between heparanase expressions in the primary vs. metastatic sites of tumors. Moreover, no correlation was observed between heparanase staining and tumor aggressiveness, tumor recurrence or patient survival in various groups of patients. Conclusion Expression of heparanase was observed in 50% of the STS, in various histological subtypes. A larger study with homogenous groups of specific sub-types of STS or stages of disease is required to validate over-expression of heparanase as a marker of disease aggressiveness. PMID:24887057

  19. Damping and energy dissipation in soft tissue vibrations during running.

    PubMed

    Khassetarash, Arash; Hassannejad, Reza; Enders, Hendrik; Ettefagh, Mir Mohammad

    2015-01-21

    It has been well accepted that the vibrations of soft tissue cannot be simulated by a single sinusoidal function. In fact, these vibrations are a combination of several vibration modes. In this study, these modes are extracted applying a recently developed method namely, partly ensemble empirical mode decomposition (PEEMD). Then, a methodology for estimating the damping properties and energy dissipation caused by damping for each mode is used. Applying this methodology on simulated signals demonstrates high accuracy. This methodology is applied to the acceleration signals of the gastrocnemius muscle during sprinting and the differences between the damping properties of different vibration modes were identified. The results were 1) the damping property of high-frequency mode was higher than that for low-frequency modes. 2) All identified modes were in under damped condition, therefore, the vibrations had an oscillatory nature. 3) The damping ratios of lower modes are about 100% increased compared to higher modes. 4) The energy dissipation occurred in lower modes were much more than that for higher mode; According to the power spectrum of the ground reaction force (GRF), which is the input force into the body, the recent finding supports the muscle tuning paradigm. It is suggested that the damping properties and energy dissipation can be used to distinguish between different running conditions (surface, fatigue, etc.).

  20. Diagnosis and Percutaneous Treatment of Soft-Tissue Hydatid Cysts

    SciTech Connect

    Akhan, Okan Gumus, Burcak; Akinci, Devrim; Karcaaltincaba, Musturay; Ozmen, Mustafa

    2007-06-15

    The purpose of this study is to demonstrate and discuss the radiological features of four patients with muscular hydatid disease and to evaluate the results of percutaneous treatment in these patients. Four patients (three female and one male) with six muscular hydatid cysts underwent percutaneous treatment and were followed up. The mean age of patients was 35 years (range: 12-60 years). Type I (n = 2), type II (n = 1), and type III (n = 3) hydatid cysts were observed in the thigh (n = 3) and gluteal (n = 1) region on radiologic examination. All interventions were performed under sonographic and fluoroscopic guidance. According to the type of the cyst, the procedure was carried out by either a 'catheterization technique with hypertonic saline and alcohol' or a 'modified catheterization technique.' The mean cathaterization time was 13.7 days, ranging from 1 to 54 days. The dimensions of the residual cavity were noted at every sonographic control, and an average of 96.1% volume reduction was obtained in six cysts of four patients. No sign of viability was observed during the follow-up period. Cavity infection and cellulitis were observed as complications, which resolved after medical therapy. Percutaneous treatment is a safe and effective procedure in patients with soft-tissue hydatid cysts and should be considered as a serious alternative to surgery.

  1. Skin and soft tissue necrosis from calcium chloride in a deicer.

    PubMed

    Kim, Min P; Raho, Vittorio J; Mak, John; Kaynar, A Murat

    2007-01-01

    Calcium chloride salt is the principle ingredient of many commercially available deicers. Calcium chloride melts snow and ice by its osmotic action. We present a case of skin and soft tissue necrosis associated with the use of a calcium chloride-containing deicer. Although calcium chloride is known to produce soft tissue necrosis if it extravasates during intravenous administration, necrosis and skin sloughing has rarely been described after topical exposure to this salt. Calcium chloride likely produces tissue injury from the heat liberated by mixing calcium chloride with water (exothermic reaction) and from direct calcium deposits in the skin (calcinosis cutis) and soft tissue.

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

    NASA Astrophysics Data System (ADS)

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

    2017-08-01

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

  3. Evaluation of reproducibility and reliability of 3D soft tissue analysis using 3D stereophotogrammetry.

    PubMed

    Plooij, J M; Swennen, G R J; Rangel, F A; Maal, T J J; Schutyser, F A C; Bronkhorst, E M; Kuijpers-Jagtman, A M; Bergé, S J

    2009-03-01

    In 3D photographs the bony structures are neither available nor palpable, therefore, the bone-related landmarks, such as the soft tissue gonion, need to be redefined. The purpose of this study was to determine the reproducibility and reliability of 49 soft tissue landmarks, including newly defined 3D bone-related soft tissue landmarks with the use of 3D stereophotogrammetric images. Two observers carried out soft-tissue analysis on 3D photographs twice for 20 patients. A reference frame and 49 landmarks were identified on each 3D photograph. Paired Student's t-test was used to test the reproducibility and Pearson's correlation coefficient to determine the reliability of the landmark identification. Intra- and interobserver reproducibility of the landmarks were high. The study showed a high reliability coefficient for intraobserver (0.97 (0.90 - 0.99)) and interobserver reliability (0.94 (0.69 - 0.99)). Identification of the landmarks in the midline was more precise than identification of the paired landmarks. In conclusion, the redefinition of bone-related soft tissue 3D landmarks in combination with the 3D photograph reference system resulted in an accurate and reliable 3D photograph based soft tissue analysis. This shows that hard tissue data are not needed to perform accurate soft tissue analysis.

  4. Bioabsorbable polymer optical waveguides for deep-tissue photomedicine

    PubMed Central

    Nizamoglu, Sedat; Gather, Malte C.; Humar, Matjaž; Choi, Myunghwan; Kim, Seonghoon; Kim, Ki Su; Hahn, Sei Kwang; Scarcelli, Giuliano; Randolph, Mark; Redmond, Robert W.; Yun, Seok Hyun

    2016-01-01

    Advances in photonics have stimulated significant progress in medicine, with many techniques now in routine clinical use. However, the finite depth of light penetration in tissue is a serious constraint to clinical utility. Here we show implantable light-delivery devices made of bio-derived or biocompatible, and biodegradable polymers. In contrast to conventional optical fibres, which must be removed from the body soon after use, the biodegradable and biocompatible waveguides may be used for long-term light delivery and need not be removed as they are gradually resorbed by the tissue. As proof of concept, we demonstrate this paradigm-shifting approach for photochemical tissue bonding (PTB). Using comb-shaped planar waveguides, we achieve a full thickness (>10 mm) wound closure of porcine skin, which represents ∼10-fold extension of the tissue area achieved with conventional PTB. The results point to a new direction in photomedicine for using light in deep tissues. PMID:26783091

  5. Bioabsorbable polymer optical waveguides for deep-tissue photomedicine

    NASA Astrophysics Data System (ADS)

    Nizamoglu, Sedat; Gather, Malte C.; Humar, Matjaž; Choi, Myunghwan; Kim, Seonghoon; Kim, Ki Su; Hahn, Sei Kwang; Scarcelli, Giuliano; Randolph, Mark; Redmond, Robert W.; Yun, Seok Hyun

    2016-01-01

    Advances in photonics have stimulated significant progress in medicine, with many techniques now in routine clinical use. However, the finite depth of light penetration in tissue is a serious constraint to clinical utility. Here we show implantable light-delivery devices made of bio-derived or biocompatible, and biodegradable polymers. In contrast to conventional optical fibres, which must be removed from the body soon after use, the biodegradable and biocompatible waveguides may be used for long-term light delivery and need not be removed as they are gradually resorbed by the tissue. As proof of concept, we demonstrate this paradigm-shifting approach for photochemical tissue bonding (PTB). Using comb-shaped planar waveguides, we achieve a full thickness (>10 mm) wound closure of porcine skin, which represents ~10-fold extension of the tissue area achieved with conventional PTB. The results point to a new direction in photomedicine for using light in deep tissues.

  6. Deep-tissue light delivery via optrode arrays.

    PubMed

    Abaya, Tanya V F; Diwekar, Mohit; Blair, Steve; Tathireddy, Prashant; Rieth, Loren; Solzbacher, Florian

    2014-01-01

    We establish performance characteristics of needle-type waveguides in three-dimensional array architectures as light delivery interfaces into deep tissue for applications, such as optogenetic and infrared (IR) neural stimulation. A single optrode waveguide achieves as high as 90% transmission efficiency, even at tissue depths >1  mm. Throughout the visible and near-IR spectrum, the effective light attenuation through the waveguide is ∼3 orders of magnitude smaller than attenuation in tissue/water, as confirmed by both simulation and experimental results. Light emission profiles from the optrode tips into tissue were also measured. Beam widths of 70 to 150 μm and full-angle divergence ranging from 13 to 40 deg in tissue can be achieved. These beam characteristics satisfy a wide range of requirements for targeted illumination in neural stimulation.

  7. Bioabsorbable polymer optical waveguides for deep-tissue photomedicine.

    PubMed

    Nizamoglu, Sedat; Gather, Malte C; Humar, Matjaž; Choi, Myunghwan; Kim, Seonghoon; Kim, Ki Su; Hahn, Sei Kwang; Scarcelli, Giuliano; Randolph, Mark; Redmond, Robert W; Yun, Seok Hyun

    2016-01-19

    Advances in photonics have stimulated significant progress in medicine, with many techniques now in routine clinical use. However, the finite depth of light penetration in tissue is a serious constraint to clinical utility. Here we show implantable light-delivery devices made of bio-derived or biocompatible, and biodegradable polymers. In contrast to conventional optical fibres, which must be removed from the body soon after use, the biodegradable and biocompatible waveguides may be used for long-term light delivery and need not be removed as they are gradually resorbed by the tissue. As proof of concept, we demonstrate this paradigm-shifting approach for photochemical tissue bonding (PTB). Using comb-shaped planar waveguides, we achieve a full thickness (>10 mm) wound closure of porcine skin, which represents ∼ 10-fold extension of the tissue area achieved with conventional PTB. The results point to a new direction in photomedicine for using light in deep tissues.

  8. Adaptive focus for deep tissue using diffuse backscatter

    NASA Astrophysics Data System (ADS)

    Kress, Jeremy; Pourrezaei, Kambiz

    2014-02-01

    A system integrating high density diffuse optical imaging with adaptive optics using MEMS for deep tissue interaction is presented. In this system, a laser source is scanned over a high density fiber bundle using Digital Micromirror Device (DMD) and channeled to a tissue phantom. Backscatter is then collected from the tissue phantom by a high density fiber array of different fiber type and channeled to CMOS sensor for image acquisition. Intensity focus is directly verified using a second CMOS sensor which measures intensity transmitted though the tissue phantom. A set of training patterns are displayed on the DMD and backscatter is numerically fit to the transmission intensity. After the training patterns are displayed, adaptive focus is performed using only the backscatter and fitting functions. Additionally, tissue reconstruction and prediction of interference focusing by photoacoustic and optical tomographic methods is discussed. Finally, potential NIR applications such as in-vivo adaptive neural photostimulation and cancer targeting are discussed.

  9. Platelet-rich therapies for musculoskeletal soft tissue injuries.

    PubMed

    Moraes, Vinícius Y; Lenza, Mário; Tamaoki, Marcel Jun; Faloppa, Flávio; Belloti, João Carlos

    2013-12-23

    Platelet-rich therapies are being used increasingly in the treatment of musculoskeletal soft tissue injuries such as ligament, muscle and tendon tears and tendinopathies. These therapies can be used as the principal treatment or as an augmentation procedure (application after surgical repair or reconstruction). Platelet-rich therapies are produced by centrifuging a quantity of the patient's own blood and extracting the active, platelet-rich, fraction. The platelet-rich fraction is applied to the injured tissue; for example, by injection. Platelets have the ability to produce several growth factors, so these therapies should enhance tissue healing. There is a need to assess whether this translates into clinical benefit. To assess the effects (benefits and harms) of platelet-rich therapies for treating musculoskeletal soft tissue injuries. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (25 March 2013), the Cochrane Central Register of Controlled Trials (CENTRAL 2013 Issue 2), MEDLINE (1946 to March 2013), EMBASE (1980 to 2013 Week 12) and LILACS (1982 to March 2012). We also searched trial registers (to Week 2 2013) and conference abstracts (2005 to March 2012). No language or publication restrictions were applied. We included randomised and quasi-randomised controlled trials that compared platelet-rich therapy with either placebo, autologous whole blood, dry needling or no platelet-rich therapy for people with acute or chronic musculoskeletal soft tissue injuries. Primary outcomes were functional status, pain and adverse effects. Two review authors independently extracted data and assessed each study's risk of bias. Disagreement was resolved by discussion or by arbitration by a third author. We contacted trial authors for clarification of methods or missing data. Treatment effects were assessed using risk ratios for dichotomous data and mean differences (MD) or standardised mean differences (SMD) for continuous data, together with

  10. Development of oral osteomucosal tissue constructs in vitro and localization of fluorescently-labeled bisphosphonates to hard and soft tissue.

    PubMed

    Bae, Susan; Sun, Shuting; Aghaloo, Tara; Oh, Ju-Eun; McKenna, Charles E; Kang, Mo K; Shin, Ki-Hyuk; Tetradis, Sotirios; Park, No-Hee; Kim, Reuben H

    2014-08-01

    Bisphosphonates (BPs) are anti-resorptive agents commonly used to treat bone-related diseases; however, soft tissue-related side-effects are frequently reported in some BP users, such as oral or gastrointestinal (GI) ulcerations. BPs are stable analogs of pyrophosphate and have high affinity to hydroxyapatite, allowing them to bind to the bone surfaces and exert suppressive effects on osteoclast functions. However, the underlying mechanisms as to how bone-seeking BPs also exert cytotoxic effects on soft tissue remain unknown. In the present study, we investigated the localization of nitrogen-containing BPs (N-BPs) in hard and soft tissue using fluorescently-labeled N-BPs in vitro. We developed osteomucosal tissue constructs in vitro to recapitulate the hard and soft tissue of the oral cavity. A histological examination of the osteomucosal tissue constructs revealed a differentiated epithelium over the bone containing osteocytes and the periosteum, similar to that observed in the rat palatal tissues. Following treatment with the fluorescently-labeled bisphosphonate, AF647-ZOL, the osteomucosal constructs exhibited fluorescent signals, not only in the bone, but also in the epithelium. No fluorescent signals were observed from the control- or ZOL-treated constructs, as expected. Collectively, the data from the present study suggest that N-BPs localize to epithelial tissue and that such a localization and subsequent toxicity of N-BPs may be associated, at least in part, with soft tissue-related side-effects.

  11. Development of oral osteomucosal tissue constructs in vitro and localization of fluorescently-labeled bisphosphonates to hard and soft tissue

    PubMed Central

    BAE, SUSAN; SUN, SHUTING; AGHALOO, TARA; OH, JU-EUN; McKENNA, CHARLES E.; KANG, MO K.; SHIN, KI-HYUK; TETRADIS, SOTIRIOS; PARK, NO-HEE; KIM, REUBEN H.

    2014-01-01

    Bisphosphonates (BPs) are anti-resorptive agents commonly used to treat bone-related diseases; however, soft tissue-related side-effects are frequently reported in some BP users, such as oral or gastrointestinal (GI) ulcerations. BPs are stable analogs of pyrophosphate and have high affinity to hydroxyapatite, allowing them to bind to the bone surfaces and exert suppressive effects on osteoclast functions. However, the underlying mechanisms as to how bone-seeking BPs also exert cytotoxic effects on soft tissue remain unknown. In the present study, we investigated the localization of nitrogen-containing BPs (N-BPs) in hard and soft tissue using fluorescently-labeled N-BPs in vitro. We developed osteomucosal tissue constructs in vitro to recapitulate the hard and soft tissue of the oral cavity. A histological examination of the osteomucosal tissue constructs revealed a differentiated epithelium over the bone containing osteocytes and the periosteum, similar to that observed in the rat palatal tissues. Following treatment with the fluorescently-labeled bisphosphonate, AF647-ZOL, the osteomucosal constructs exhibited fluorescent signals, not only in the bone, but also in the epithelium. No fluorescent signals were observed from the control- or ZOL-treated constructs, as expected. Collectively, the data from the present study suggest that N-BPs localize to epithelial tissue and that such a localization and subsequent toxicity of N-BPs may be associated, at least in part, with soft tissue-related side-effects. PMID:24920042

  12. Indentation Versus Tensile Measurements of Young's Modulus for Soft Biological Tissues

    PubMed Central

    McKee, Clayton T.; Last, Julie A.

    2011-01-01

    In this review, we compare the reported values of Young's modulus (YM) obtained from indentation and tensile deformations of soft biological tissues. When the method of deformation is ignored, YM values for any given tissue typically span several orders of magnitude. If the method of deformation is considered, then a consistent and less ambiguous result emerges. On average, YM values for soft tissues are consistently lower when obtained by indentation deformations. We discuss the implications and potential impact of this finding. PMID:21303220

  13. Bilateral iliopsoas haemophilic “soft tissue pseudotumours”: A case report

    PubMed Central

    Kamal, Achmad Fauzi; Pradana, Ananto Satya; Prabowo, Yogi

    2015-01-01

    Haemophilic soft tissue pseudotumour is one of the rarest complications of haemophilia that caused by repetitive bleeding resulting in an encapsulated mass of clotted blood and necrotic tissue. Soft tissue pseudotumour may not only cause flexion contracture but also chronic pain and femoral nerve compression that cause severe disability. Thus, surgical excision is the treatment of choice. It should only be carried out in a major haemophilic center by an integrated multidisciplinary surgical team. PMID:26083481

  14. Effects of Thread Depth in the Neck Area on Peri-Implant Hard and Soft Tissues: An Animal Study.

    PubMed

    Sun, Shan-Pao; Lee, Dong-Won; Yun, Jeong-Ho; Park, Kwang-Ho; Park, Kwang-Bum; Moon, Ik-Sang

    2016-11-01

    Implants with deep thread depth have been developed for the purpose of increasing total implant surface area. However, effects of implant thread depth remain controversial. The aim of this study is to examine effects of thread depth on peri-implant tissues in terms of bone-implant contact (BIC), bone-implant volume (BIV), and hard and soft tissue dimensions using comprehensive analyses, including microcomputed tomography (micro-CT). Five beagle dogs received experimental intramandibular implants 3 months after removal of their premolars and first molars (P2, P3, P4, and M1). Two different types of implants were installed in each animal: deep threaded (DT) and shallow threaded (ST). Resonance frequency testing was performed on the day of implantation as well as 4 and 8 weeks after implantation. Intraoral radiography, micro-CT, and histomorphometry were used to evaluate peri-implant tissues 4 and 8 weeks after implantation. There were no significant differences in resonance frequency test results between the two groups. Although radiographic analysis showed no group differences, micro-CT (P = 0.01) and histomorphometry (P = 0.003) revealed the DT group had significantly lower BIC values than the ST group at 4 weeks. However, by 8 weeks, BIC values of the two groups did not differ significantly. No significant differences in BIV or soft tissue height were observed between the two groups at either time point. DT implants showed no benefits over ST implants when inserted in dog mandibles.

  15. Is obesity a risk factor for deep tissue injury in patients with spinal cord injury?

    PubMed

    Elsner, Jonathan J; Gefen, Amit

    2008-12-05

    Deep tissue injury (DTI) is a severe form of pressure ulcers that occur in subcutaneous tissue under intact skin by the prolonged compression of soft tissues overlying bony prominences. Pressure ulcers and DTI in particular are common in patients with impaired motosensory capacities, such as those with a spinal cord injury (SCI). Obesity is also common among subjects with SCI, yet there are contradicting indications regarding its potential influence as a risk factor for DTI in conditions where these patients sit in a wheelchair without changing posture for prolonged times. It has been argued that high body mass may lead to a greater risk for DTI due to increase in compressive forces from the bones on overlying deep soft tissues, whereas conversely, it has been argued that the extra body fat associated with obesity may reduce the risk by providing enhanced subcutaneous cushioning that redistributes high interface pressures. No biomechanical evaluation of this situation has been reported to date. In order to elucidate whether obesity can be considered a risk factor for DTI, we developed computational finite element (FE) models of the seated buttocks with 4 degrees of obesity, quantified by body mass index (BMI) values of 25.5, 30, 35 and 40kg/m(2). We found that peak principal strains, strain energy densities (SED) and von Mises stresses in internal soft tissues (muscle, fat) overlying the ischial tuberosities (ITs) all increased with BMI. With a rise in BMI from 25.5 to 40kg/m(2), values of these parameters increased 1.5 times on average. Moreover, the FE simulations indicated that the bodyweight load transferred through the ITs has a greater effect in increasing internal tissue strains/stresses than the counteracting effect of thickening of the adipose layer which is concurrently associated with obesity. We saw that inducing some muscle atrophy (30% reduction in muscle volume, applied to the BMI=40kg/m(2) model) which is also characteristic of chronic SCI resulted

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

    ClinicalTrials.gov

    2017-04-10

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

  17. Thick soft tissue reconstruction on highly perfusive biodegradable scaffolds.

    PubMed

    Mandoli, Corrado; Mecheri, Barbara; Forte, Giancarlo; Pagliari, Francesca; Pagliari, Stefania; Carotenuto, Felicia; Fiaccavento, Roberta; Rinaldi, Antonio; Di Nardo, Paolo; Licoccia, Silvia; Traversa, Enrico

    2010-02-11

    The lack of a vascular network and poor perfusion is what mostly prevents three-dimensional (3D) scaffolds from being used in organ repair when reconstruction of thick tissues is needed. Highly-porous scaffolds made of poly(L-lactic acid) (PLLA) are prepared by directional thermally induced phase separation (dTIPS) starting from 1,4-dioxane/PLLA solutions. The influence of polymer concentration and temperature gradient, in terms of imposed intensity and direction, on pore size and distribution is studied by comparison with scaffolds prepared by isotropic TIPS. The processing parameters are optimized to achieve an overall porosity for the 3D scaffolds of about 93% with a degree of interconnectivity of 91%. The resulting pore network is characterized by the ordered repetition of closely packed dendrite-like cavities, each one showing stacks of 20 microm large side lamellar branches departing from 70 microm diameter vertical backbones, strongly resembling the vascular patterns. The in vitro biological responses after 1 and 2 weeks are evaluated from mesenchymal (bone marrow stromal) cells (MSC) static culturing. A novel vacuum-based deep-seeding method is set up to improve uniform cell penetration down to scaffold thicknesses of over 1 mm. Biological screenings show significant 3D scaffold colonization even after 18 h, while cellular retention is observed up to 14 d in vitro (DIV). Pore architecture-driven cellular growth is accompanied by cell tendency to preserve their multi-potency towards differentiation. Confluent tissues as thick as 1 mm were reconstructed taking advantage of the large perfusion enhanced by the highly porous microstructure of the engineered scaffolds, which could successfully serve for applications aimed at vascular nets and angiogenesis.

  18. Audit of diabetic soft tissue infection and foot disease in Accra.

    PubMed

    Asumanu, E; Ametepi, R; Koney, C T

    2010-01-01

    Soft tissue infection and foot disease are well known complications among diabetes mellitus patients. With an increasing prevalence of diabetes mellitus in Africa, management of these complications is expected to become a major problem. To audit the surgical management of diabetic soft tissue infection and foot disease over a two-year period in Accra, Ghana. A prospective study of all patients admitted to the General Surgical Unit of the 37 Military Hospital between May 2005 and April 2007 was conducted. Diabetic patients with soft tissue infections and foot disease were selected for study. Doppler studies using a monopolar 8 MHz Nicolet vascular probe was used in assessing the ankle to brachial pressure index (ABPI). Patients were managed based on admitting diagnosis and outcomes were noted. Eighty (8.3%) of 966 surgical patients had diabetes mellitus and soft tissue infection or foot disease. The peak age of presentation of diabetics with soft tissue infection or foot disease was 50-59 years. Diabetic foot disease (53.0%) was the commonest followed by cellulitis of the leg and other soft tissue infections. Overall amputation rate was 33.3% while mortality was 8.8%. Foot infections, cellulitis, abscesses and gangrene are the common surgical complications of diabetes mellitus patients in Ghana. Abscess of the hand is the commonest non-foot soft tissue surgical complication and had good outcomes. Overall, females presented earlier and had better outcomes than males.

  19. Improved Rubin-Bodner model for the prediction of soft tissue deformations.

    PubMed

    Zhang, Guangming; Xia, James J; Liebschner, Michael; Zhang, Xiaoyan; Kim, Daeseung; Zhou, Xiaobo

    2016-11-01

    In craniomaxillofacial (CMF) surgery, a reliable way of simulating the soft tissue deformation resulted from skeletal reconstruction is vitally important for preventing the risks of facial distortion postoperatively. However, it is difficult to simulate the soft tissue behaviors affected by different types of CMF surgery. This study presents an integrated bio-mechanical and statistical learning model to improve accuracy and reliability of predictions on soft facial tissue behavior. The Rubin-Bodner (RB) model is initially used to describe the biomechanical behavior of the soft facial tissue. Subsequently, a finite element model (FEM) computers the stress of each node in soft facial tissue mesh data resulted from bone displacement. Next, the Generalized Regression Neural Network (GRNN) method is implemented to obtain the relationship between the facial soft tissue deformation and the stress distribution corresponding to different CMF surgical types and to improve evaluation of elastic parameters included in the RB model. Therefore, the soft facial tissue deformation can be predicted by biomechanical properties and statistical model. Leave-one-out cross-validation is used on eleven patients. As a result, the average prediction error of our model (0.7035mm) is lower than those resulting from other approaches. It also demonstrates that the more accurate bio-mechanical information the model has, the better prediction performance it could achieve.

  20. Soft Tissue Tumor Immunohistochemistry Update: Illustrative Examples of Diagnostic Pearls to Avoid Pitfalls.

    PubMed

    Wei, Shi; Henderson-Jackson, Evita; Qian, Xiaohua; Bui, Marilyn M

    2017-08-01

    - Current 2013 World Health Organization classification of tumors of soft tissue arranges these tumors into 12 groups according to their histogenesis. Tumor behavior is classified as benign, intermediate (locally aggressive), intermediate (rarely metastasizing), and malignant. In our practice, a general approach to reaching a definitive diagnosis of soft tissue tumors is to first evaluate clinicoradiologic, histomorphologic, and cytomorphologic features of the tumor to generate some pertinent differential diagnoses. These include the potential line of histogenesis and whether the tumor is benign or malignant, and low or high grade. Although molecular/genetic testing is increasingly finding its applications in characterizing soft tissue tumors, currently immunohistochemistry still not only plays an indispensable role in defining tumor histogenesis, but also serves as a surrogate for underlining molecular/genetic alterations. Objective- To provide an overview focusing on the current concepts in the classification and diagnosis of soft tissue tumors, incorporating immunohistochemistry. This article uses examples to discuss how to use the traditional and new immunohistochemical markers for the diagnosis of soft tissue tumors. Practical diagnostic pearls, summary tables, and figures are used to show how to avoid diagnostic pitfalls. - Data were obtained from pertinent peer-reviewed English-language literature and the authors' first-hand experience as bone and soft tissue pathologists. - -The ultimate goal for a pathologist is to render a specific diagnosis that provides diagnostic, prognostic, and therapeutic information to guide patient care. Immunohistochemistry is integral to the diagnosis and management of soft tissue tumors.

  1. Prediction of Soft Tissue Deformations after CMF Surgery with Incremental Kernel Ridge Regression

    PubMed Central

    Pan, Binbin; Zhang, Guangming; Xia, James J.; Yuan, Peng; Ip, Horace H.S.; He, Qizhen; Lee, Philip K.M.; Chow, Ben; Zhou, Xiaobo

    2016-01-01

    Facial soft tissue deformation following osteotomy is associated with the corresponding biomechanical characteristics of bone and soft tissues. However, none of the methods devised to predict soft tissue deformation after osteotomy incorporates population-based statistical data. The aim of this study is to establish a statistical model to describe the relationship between biomechanical characteristics and soft tissue deformation after osteotomy. We proposed an incremental kernel ridge regression (IKRR) model to accomplish this goal. The input of the model is the biomechanical information computed by the Finite Element Method (FEM). The output is the soft tissue deformation generated from the paired pre-operative and post-operative 3D images. The model is adjusted incrementally with each new patient’s biomechanical information. Therefore, the IKRR model enables us to predict potential soft tissue deformations for new patient by using both biomechanical and statistical information. The integration of these two types of data is critically important for accurate simulations of soft-tissue changes after surgery. The proposed method was evaluated by leave-one-out cross-validation using data from 11 patients. The average prediction error of our model (0.9103 mm) was lower than some state-of-the-art algorithms. This model is promising as a reliable way to prevent the risk of facial distortion after craniomaxillofacial surgery. PMID:27213920

  2. Prediction of soft tissue deformations after CMF surgery with incremental kernel ridge regression.

    PubMed

    Pan, Binbin; Zhang, Guangming; Xia, James J; Yuan, Peng; Ip, Horace H S; He, Qizhen; Lee, Philip K M; Chow, Ben; Zhou, Xiaobo

    2016-08-01

    Facial soft tissue deformation following osteotomy is associated with the corresponding biomechanical characteristics of bone and soft tissues. However, none of the methods devised to predict soft tissue deformation after osteotomy incorporates population-based statistical data. The aim of this study is to establish a statistical model to describe the relationship between biomechanical characteristics and soft tissue deformation after osteotomy. We proposed an incremental kernel ridge regression (IKRR) model to accomplish this goal. The input of the model is the biomechanical information computed by the Finite Element Method (FEM). The output is the soft tissue deformation generated from the paired pre-operative and post-operative 3D images. The model is adjusted incrementally with each new patient's biomechanical information. Therefore, the IKRR model enables us to predict potential soft tissue deformations for new patient by using both biomechanical and statistical information. The integration of these two types of data is critically important for accurate simulations of soft-tissue changes after surgery. The proposed method was evaluated by leave-one-out cross-validation using data from 11 patients. The average prediction error of our model (0.9103mm) was lower than some state-of-the-art algorithms. This model is promising as a reliable way to prevent the risk of facial distortion after craniomaxillofacial surgery. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    PubMed

    Zhao, Xiaodong; Pelegri, Assimina A

    2014-09-01

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

  4. Trabectedin for the treatment of advanced metastatic soft tissue sarcoma.

    PubMed

    Simpson, E L; Rafia, R; Stevenson, M D; Papaioannou, D

    2010-05-01

    This paper presents a summary of the evidence review group (ERG) report into the clinical effectiveness and cost-effectiveness of trabectedin for the treatment of advanced metastatic soft tissue sarcoma, in accordance with the licensed indication, based on the evidence submission from the manufacturer to NICE as part of the single technology appraisal (STA) process. The outcomes stated in the manufacturer's definition of the decision problem were overall survival (OS), progression-free survival (PFS), response rates, adverse effects of treatment, health-related quality of life, and cost per quality-adjusted life-year (QALY) gained. The clinical evidence was derived from one randomised controlled trial (RCT), in which the licensed dose of trabectedin was compared with a different dose of trabectedin, and three phase II studies. In the RCT, the median OS was 13.9 months for the licensed dose of trabectedin, which was not significantly different from that for the comparator dose of trabectedin, which was 11.8 months. From the phase II uncontrolled trials, median OS was reported as 9.2 or 12.8 months. The RCT reported significantly superior PFS for the licensed dose of trabectedin (median 3.3 months) over the comparator trabectedin dose (median 2.3 months). One phase II uncontrolled trial reported median PFS as 1.9 months in the licensed dose of trabectedin. The RCT reported PFS rates at 6 months were 35.5% for the licensed dose of trabectedin, and 27.5% for the comparator dose of trabectedin. From the phase II uncontrolled trials, PFS rates at 6 months were 24.4% or 29%. For the RCT, deaths attributed to trabectedin occurred in 3.1% of the licensed dose, and 2.3% of the comparator group. The most common severe adverse events were neutropenia, although with a low rate of febrile neutropenia, thrombocytopenia, and aspartate aminotransferase and alanine aminotransferase elevation, although these were reported to be non-cumulative and reversible. Following dialogue

  5. Osteoclast-like cells in soft tissue leiomyosarcomas.

    PubMed

    Gibbons, C L M H; Sun, S G; Vlychou, M; Kliskey, K; Lau, Y S; Sabokbar, A; Athanasou, N A

    2010-03-01

    Giant cell-rich leiomyosarcoma of soft tissues is an unusual variant of malignant smooth muscle tumor characterized by the presence of numerous multinucleated giant cells (MNGCs). The nature of MNGCs and the cellular mechanisms underlying their accumulation in this tumor are poorly understood. Analysis of the expression of osteoclast, macrophage, and smooth muscle markers in two cases of giant cell-rich leiomyosarcoma revealed that the MNGCs in giant cell-rich leiomyosarcoma were negative for smooth muscle markers and that these cells expressed an osteoclast-like phenotype, being positive for CD45, CD68, tartrate-resistant acid phosphatase, and CD51 but negative for CD14 and HLA-DR. Scattered tumor-associated macrophages (TAMs) also expressed this phenotype. Leiomyosarcoma tumor cells strongly reacted for CD51 but were negative for CD14, CD45, and CD68. An analysis of 25 conventional (nongiant cell-containing) leiomyosarcomas found isolated CD68(+) MNGCs in three cases (12%), all of which were grade II/III leiomyosarcomas containing a prominent TAM infiltrate. Leiomyosarcoma-derived TAMs in the presence of receptor activator for nuclear factor kappa B ligand (RANKL) and macrophage colony-stimulating factor were capable of differentiating into osteoclast-like cells capable of resorbing bone. Reverse transcription polymerase chain reaction studies showed that RANKL, osteoprotegerin, and TNF-related apoptosis-inducing ligand were expressed by leiomyosarcoma cells. Our findings indicate that the giant cells found in leiomyosarcomas are osteoclast-like and that they are formed from TAMs by a RANKL-dependent mechanism.

  6. The Prediction Predicament: Rethinking Necrotizing Soft Tissue Infections Mortality

    PubMed Central

    Moore, Samantha A.; Levy, Brandon H.; Prematilake, Chalani

    2015-01-01

    Abstract Background: Our study sought to identify independent risk factors predisposing patients with necrotizing soft tissue infections (NSTIs) to mortality from among laboratory values, demographic data, and microbiologic findings in a small population. To this end, a retrospective review was conducted of the medical records of all patients with NSTI who had been treated at our institution from 2003 to 2012 (n=134). Methods: Baseline demographics and comorbidities, clinical and laboratory values, hospital course, and the microbiologic characteristics of surgical incision cultures were recorded. Each variable was tested for association with survival status and all associated variables with p<0.15 were included in a logistic regression model to seek factors associated independently with mortality. Results: Surprisingly, no demographic or pre-existing condition proved to be a predictor of mortality. Two laboratory values had an inverse correlation to mortality: High C-reactive protein (CRP) and highest recorded CRP. Of surgical incisions that grew bacteria in culture, 33.6% were polymicrobial. Mortality rates were highest with Enterococcus-containing polymicrobial infections (50%), followed by those containing Pseudomonas (40%), and Streptococcus spp. (27%). Understanding why so many studies across the literature, now including our own, find such disparate results for correlation of NSTI mortality with patient data may lie in the fundamentally dynamic nature of the organisms involved. Conclusions: This study suggests that no single factor present on admission is a robust predictor of outcome; it is likely that survival in NSTI is predicated upon a complex interaction of multiple host and microbial factors that do not lend themselves to reduction into a simple formula. It is also abundantly clear that the well-established principles of NSTI surgery should continue to be followed in all cases, with an emphasis on early debridement, irrespective of apparent severity of

  7. Soft tissue artefact assessment in humeral axial rotation.

    PubMed

    Cutti, Andrea Giovanni; Paolini, Gabriele; Troncossi, Marco; Cappello, Angelo; Davalli, Angelo

    2005-04-01

    The accuracy of upper-limb kinematic data acquired from optoelectronic systems with retro-reflective markers is poor, mainly due to soft tissue artefact (STA). For the upper-arm, humeral internal/external rotation (HIER) is the movement most affected by STA, which is measured as a percentile fraction (K) of the effective humeral axial rotation performed. The aim of this work was to quantify STA during HIERs, with independently varying attitude of the humerus and elbow flexion, and to test the possibility of estimating its mean value over the tested upper-limb orientations using one simple trial. Six able-bodied subjects performed a series of HIERs in combination with elbow flexion for different humeral planes and degrees of elevation. During the trials the instantaneous attitudes of two humeral anatomical frames were compared, one being affected by the STA to be measured, and the other assumed as the gold standard. K was found to range from 20% to 48% of the effective humeral axial rotation performed, depending on the subject, humeral attitude and elbow flexion. These last two factors comparably affect STA and resulted in mean K coefficients of variation among the subjects of about 9% and 7%, respectively. Common patterns of K with elbow flexion and humerus elevation are discussed. The data also show that the mean of K of a subject is very close to the value assessed in a specific upper-limb configuration consistent among the subjects. This result from this study could be used to build up a time-saving STA compensation procedure suitable for clinical applications.

  8. Does Cryotherapy Improve Outcomes With Soft Tissue Injury?

    PubMed

    Hubbard, Tricia J; Denegar, Craig R

    2004-09-01

    REFERENCE: Bleakley C, McDonough S, MacAuley D. The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials. Am J Sport Med. 2004; 32:251-261. CLINICAL QUESTION: What is the clinical evidence base for cryotherapy use? DATA SOURCES: Studies were identified by using a computer-based literature search on a total of 8 databases: MEDLINE, Proquest, ISI Web of Science, Cumulative Index to Nursing and Allied Health (CINAHL) on Ovid, Allied and Complementary Medicine Database (AMED) on Ovid, Cochrane Database of Systematic Reviews, Cochrane Database of Abstracts of Reviews of Effectiveness, and Cochrane Controlled Trials Register (Central). This was supplemented with citation tracking of relevant primary and review articles. Search terms included surgery,orthopaedics,sports injury,soft tissue injury,sprains and strains,contusions,athletic injury,acute,compression, cryotherapy,ice,RICE, andcold. STUDY SELECTION: To be included in the review, each study had to fulfill the following conditions: be a randomized, controlled trial of human subjects; be published in English as a full paper; include patients recovering from acute soft tissue or orthopaedic surgical interventions who received cryotherapy in inpatient, outpatient, or home-based treatment, in isolation or in combination with placebo or other therapies; provide comparisons with no treatment, placebo, a different mode or protocol of cryotherapy, or other physiotherapeutic interventions; and have outcome measures that included function (subjective or objective), pain, swelling, or range of motion. DATA EXTRACTION: The study population, interventions, outcomes, follow-up, and reported results of the assessed trials were extracted and tabulated. The primary outcome measures were pain, swelling, and range of motion. Only 2 groups reported adequate data for return to normal function. All eligible articles were rated for methodologic quality using the PEDro scale. The

  9. Biomedical application of commercial polymers and novel polyisobutylene-based thermoplastic elastomers for soft tissue replacement.

    PubMed

    Puskas, Judit E; Chen, Yaohong

    2004-01-01

    Novel polyisobutylene-based thermoplastic elastomers are introduced as prospective implant materials for soft tissue replacement and reconstruction. In comparison, poly(ethylene terephthalate) (PET), poly(tetrafluoroethylene) (PTFE), polypropylene (PP), polyurethanes (PU), and silicones are outlined from well-established implant history as being relatively inert and biocompatible biomaterials for soft tissue replacement, especially in vascular grafts and breast implants. Some general considerations for the design and development of polymers for soft tissue replacement are reviewed from the viewpoint of material science and engineering, with special attention to synthetic materials used in vascular grafts and breast implants.

  10. Soft tissue deformation simulation in virtual surgery using nonlinear finite element method.

    PubMed

    Yan, Zhennan; Gu, Lixu; Huang, Pengfei; Lv, Sizhe; Yu, Xiao; Kong, Xianming

    2007-01-01

    Simulation for soft tissue's realistic deformation is an important part in Virtual Surgery. For large global deformation of soft tissue, linear elastic models are inappropriate, such as Mass-Spring and linear Finite Element Method (FEM). In this paper we present a simulation for 3D soft tissue using nonlinear strain computation. To get a finer mesh for FEM, we consider meshing algorithm based on Improved Delaunay criterion. Besides, we would present Spatial Hashing Collision Detection method and some improvement for real-time computation.

  11. Simultaneous reconstruction of cervical soft tissue and esophagus with a gastro-omental free flap

    SciTech Connect

    Mixter, R.C.; Rao, V.K.; Katsaros, J.; Noon, J.; Tan, E. )

    1990-11-01

    A microvascular transfer of gastric tube and omentum was used to simultaneously reconstruct cervical soft-tissue and esophageal defects in five patients. All patients had previous high-dose radiation and multiple flap reconstructions. The largest esophageal and soft-tissue defects were 10 cm and 160 cm2, respectively. All wounds healed primarily except for one orocutaneous fistula. There was one death from an intraoperative stroke. The gastro-omental flap is useful in cases where the reconstructive surgeon is faced with both esophageal and soft-tissue defects--particularly in heavily irradiated patients who have few reconstructive options.

  12. EF5 to Evaluate Tumor Hypoxia in Patients With High-Grade Soft Tissue Sarcoma or Mouth Cancer

    ClinicalTrials.gov

    2013-01-15

    Stage I Adult Soft Tissue Sarcoma; Stage I Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage II Adult Soft Tissue Sarcoma; Stage II Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Adult Soft Tissue Sarcoma; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity

  13. Wound Hypoxia in Deep Tissue after Incision in the Rats

    PubMed Central

    Kang, Sinyoung; Lee, Dongchul; Theusch, Brett E.; Arpey, Christopher J.; Brennan, Timothy J.

    2013-01-01

    Our previous studies using rat models of incisional pain have demonstrated that tissue lactate levels increase and pH decreases for several days after incision, suggesting the presence of an ischemic-like condition. The purpose of this study was to evaluate the time course and the extent of tissue hypoxia that develops in incised muscle and skin. We directly measured oxygen tension at several time points after incisions of the gastrocnemius muscle, the paraspinal skin, and the plantar hindpaw in anesthetized rats using an oxygen-sensitive microelectrode. In vivo hypoxia of the incised tissues was also evaluated immunohistochemically using a hypoxia marker pimonidazole hydrochloride. To minimized inter-subject variability, unincised contralateral tissues were used as a control. Tissue oxygen tension was decreased in both skeletal muscle and skin compared to control, for several days after incision: when measured directly, oxygen tension decreased immediately and remained low for several days after incisions. Pimonidazole immunostaining revealed hypoxic areas in incised muscle and skin for several days. By postoperative day 10, tissue oxygen tension recovered to that of control tissue. These results support the evidence that a hypoxic condition is present in deep tissue after incisions and that an ischemic-like mechanism may contribute to postoperative pain. PMID:23926943

  14. Deep learning of the tissue-regulated splicing code

    PubMed Central

    Leung, Michael K. K.; Xiong, Hui Yuan; Lee, Leo J.; Frey, Brendan J.

    2014-01-01

    Motivation: Alternative splicing (AS) is a regulated process that directs the generation of different transcripts from single genes. A computational model that can accurately predict splicing patterns based on genomic features and cellular context is highly desirable, both in understanding this widespread phenomenon, and in exploring the effects of genetic variations on AS. Methods: Using a deep neural network, we developed a model inferred from mouse RNA-Seq data that can predict splicing patterns in individual tissues and differences in splicing patterns across tissues. Our architecture uses hidden variables that jointly represent features in genomic sequences and tissue types when making predictions. A graphics processing unit was used to greatly reduce the training time of our models with millions of parameters. Results: We show that the deep architecture surpasses the performance of the previous Bayesian method for predicting AS patterns. With the proper optimization procedure and selection of hyperparameters, we demonstrate that deep architectures can be beneficial, even with a moderately sparse dataset. An analysis of what the model has learned in terms of the genomic features is presented. Contact: frey@psi.toronto.edu Supplementary information: Supplementary data are available at Bioinformatics online. PMID:24931975

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2001-04-01

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

  17. Use of sol-gel-derived titania coating for direct soft tissue attachment.

    PubMed

    Areva, Sami; Paldan, Hannu; Peltola, Timo; Närhi, Timo; Jokinen, Mika; Lindén, Mika

    2004-08-01

    A firm bond between an implant and the surrounding soft tissue is important for the performance of many medical devices (e.g., stents, canyls, and dental implants). In this study, the performance of nonresorbable and reactive sol-gel-derived nano-porous titania (TiO(2)) coatings in a soft tissue environment was investigated. A direct attachment between the soft tissue and the sol-gel-derived titania coatings was found in vivo after 2 days of implantation, whereas the titanium control implants showed no evidence of soft tissue attachment. The coated implants were in immediate contact with the connective tissue, whereas the titanium controls formed a gap and a fibrous capsule on the implant-tissue interface. The good soft tissue attachment of titania coatings may result from their ability to initiate calcium phosphate nucleation and growth on their surfaces (although the formation of poorly crystalline bonelike apatite does not occur). Thus, the formation of a bonelike CaP layer is not crucial for their integration in soft tissue. The formation of bonelike apatite was hindered by the adsorption of proteins onto the initially formed amorphous calcium phosphate growth centers, thus preventing the dissolution/reprecipitation processes required for the formation of poorly crystalline bonelike apatite. These findings might open novel application areas for sol-gel-derived titania-based coatings.

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

    MedlinePlus

    ... health Organization permits use of MFH as an alternate name). Chemotherapy Active research in chemotherapy for soft ... world free from cancer. Help make it a reality. DONATE Cancer Information Cancer Prevention & Detection Cancer Basics ...

  19. A new method of optical biopsy: demonstration of mechanical contrast in deep tissue using an optical coherence elastography needle probe

    NASA Astrophysics Data System (ADS)

    Kennedy, Kelsey M.; Kennedy, Brendan F.; McLaughlin, Robert A.; Sampson, David D.

    2012-02-01

    We incorporate for the first time optical coherence elastography (OCE) into a needle probe and demonstrate its ability to provide depth-resolved information about the mechanical properties of soft tissues. This allows analysis of tissues located much deeper than has previously been possible with other forms of OCE. OCE exploits the microscopic resolution of optical coherence tomography (OCT) to produce high-resolution maps of tissue mechanical properties. While OCE has potential to delineate diseased and healthy tissues (e.g., stiff tumor in soft tissue), standard techniques are limited by the penetration depth of OCT in tissue (2-3 mm). Our OCE needle probe overcomes this limitation, as it may be inserted deep within the body to perform measurements. We tested needle-based OCE in tissue-mimicking phantoms and ex vivo porcine airway tissue comprising layers of varying stiffness. Results demonstrate mechanical differentiation of tissues and identification of tissue interfaces. The proof-of-principle results presented here pave the way for future measurements in human breast tissue that will aim to establish needle-based OCE as a viable technique for intraoperative guidance of breast cancer surgery.

  20. Infectious complications and soft tissue injury contribute to late amputation after severe lower extremity trauma.

    PubMed

    Huh, Jeannie; Stinner, Daniel J; Burns, Travis C; Hsu, Joseph R

    2011-07-01

    Although most combat-related amputations occur early for unsalvageable injuries, >15% occur late after reconstructive attempts. Predicting which patients will abandon limb salvage in favor of definitive amputation has not been explored. The purpose of this study was to identify factors contributing to late amputation for type III open tibia fractures sustained in combat. Operative databases were reviewed to identify all combat-related type III open diaphyseal tibia fractures from March 2003 to September 2007. Patients were categorized based on their definitive treatment: group I, limb salvage; group II, early amputation (<12 weeks postinjury); group III, late amputation (≥ 12 weeks postinjury). Injury, treatment, and complication data were extracted from medical records and compared across groups. We identified 213 consecutive fractures, including 166 (77.9%) treated definitively with limb salvage, 36 (16.9%) with early amputation, and 11 (5.2%) with late amputation. There was no difference in fracture severity among the three groups. Before amputation, group III was more likely to use autograft and bone morphogenic protein (27.3%), compared with group I (4.8%) and group II (0%), and was more likely to undergo rotational flap coverage (45.5%), compared with group II (0%). Group III patients had the highest average number of revision surgeries and rate of deep soft tissue infection and were more likely to have osteomyelitis (54.5%) before amputation compared with group I (13.9%) and group II (16.7%). Patients definitively managed with late amputation were more likely to have soft tissue injury requiring flap coverage and have their limb salvage course complicated by infection.

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

    PubMed

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

    2016-10-01

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

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

    PubMed

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

    2016-09-01

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

  3. Wireless power transfer to deep-tissue microimplants.

    PubMed

    Ho, John S; Yeh, Alexander J; Neofytou, Evgenios; Kim, Sanghoek; Tanabe, Yuji; Patlolla, Bhagat; Beygui, Ramin E; Poon, Ada S Y

    2014-06-03

    The ability to implant electronic systems in the human body has led to many medical advances. Progress in semiconductor technology paved the way for devices at the scale of a millimeter or less ("microimplants"), but the miniaturization of the power source remains challenging. Although wireless powering has been demonstrated, energy transfer beyond superficial depths in tissue has so far been limited by large coils (at least a centimeter in diameter) unsuitable for a microimplant. Here, we show that this limitation can be overcome by a method, termed midfield powering, to create a high-energy density region deep in tissue inside of which the power-harvesting structure can be made extremely small. Unlike conventional near-field (inductively coupled) coils, for which coupling is limited by exponential field decay, a patterned metal plate is used to induce spatially confined and adaptive energy transport through propagating modes in tissue. We use this method to power a microimplant (2 mm, 70 mg) capable of closed-chest wireless control of the heart that is orders of magnitude smaller than conventional pacemakers. With exposure levels below human safety thresholds, milliwatt levels of power can be transferred to a deep-tissue (>5 cm) microimplant for both complex electronic function and physiological stimulation. The approach developed here should enable new generations of implantable systems that can be integrated into the body at minimal cost and risk.

  4. Wireless power transfer to deep-tissue microimplants

    PubMed Central

    Yeh, Alexander J.; Neofytou, Evgenios; Kim, Sanghoek; Tanabe, Yuji; Patlolla, Bhagat; Beygui, Ramin E.; Poon, Ada S. Y.

    2014-01-01

    The ability to implant electronic systems in the human body has led to many medical advances. Progress in semiconductor technology paved the way for devices at the scale of a millimeter or less (“microimplants”), but the miniaturization of the power source remains challenging. Although wireless powering has been demonstrated, energy transfer beyond superficial depths in tissue has so far been limited by large coils (at least a centimeter in diameter) unsuitable for a microimplant. Here, we show that this limitation can be overcome by a method, termed midfield powering, to create a high-energy density region deep in tissue inside of which the power-harvesting structure can be made extremely small. Unlike conventional near-field (inductively coupled) coils, for which coupling is limited by exponential field decay, a patterned metal plate is used to induce spatially confined and adaptive energy transport through propagating modes in tissue. We use this method to power a microimplant (2 mm, 70 mg) capable of closed-chest wireless control of the heart that is orders of magnitude smaller than conventional pacemakers. With exposure levels below human safety thresholds, milliwatt levels of power can be transferred to a deep-tissue (>5 cm) microimplant for both complex electronic function and physiological stimulation. The approach developed here should enable new generations of implantable systems that can be integrated into the body at minimal cost and risk. PMID:24843161

  5. Comparison of violet diode laser with CO II laser in surgical performance of soft tissues

    NASA Astrophysics Data System (ADS)

    Hatayama, H.; Kato, J.; Inoue, A.; Akashi, G.; Hirai, Y.

    2007-02-01

    The violet diode laser (405nm) has recently begun to be studied for surgical use and authors reported the soft tissue could be effectively incised by irradiation power of even less than 1W. The wavelength of this laser is highly absorbed by hemoglobin, myoglobin or melanin pigment. Cutting or ablating soft tissues by lower irradiation power might be preferable for wound healing. The CO II laser is known to be preferable for low invasive treatment of soft tissues and widely used. The CO II laser light (10.6μm) is highly absorbed by water and proper for effective ablation of soft tissues. In this paper, we report the comparison of the violet diode laser with the CO II laser in surgical performance of soft tissues. Tuna tissue was used as an experimental sample. In the case of the violet diode laser, extensive vaporization of tissue was observed after the expansion of coagulation. Carbonization of tissue was observed after the explosion. On the other hand, consecutive vaporization and carbonization were observed immediately after irradiation in the case of CO II laser. The violet diode laser could ablate tissue equivalently with the CO II laser and coagulate larger area than the CO II laser. Therefore the violet diode laser might be expectable as a surgical tool which has excellent hemostatis.

  6. Thallium-201 chloride scintigraphy in soft tissue tumors.

    PubMed

    Otsuka, Hideki; Terazawa, Kaori; Morita, Naomi; Otomi, Yoichi; Takao, Shoichiro; Iwamoto, Seiji; Osaki, Kyosuke; Harada, Masafumi; Nishitani, Hiromu

    2009-08-01

    We report the findings of Thallium-201 chloride ((201)TlCl) scintigraphy and consider how to use this technique to evaluate the character of soft tissue lesions. We enrolled 91 consecutive patients (45 males and 46 females, age range 8-91-years-old). Nineteen patients were malignant and 72 were benign. Patients were scanned 15 minutes (early phase) and 3 hours (delayed phase) after (201)TlCl injection. More intense uptake in the lesion compared to the normal side was considered as 'high', the same degree of uptake was considered 'iso', and decreased uptake was 'low'. The retention index (RI) was calculated in 9 patients in the malignant group and in 16 patients in the benign group. In malignant tumors, 15 of 19 patients showed high uptake in both the early and delayed phases. One malignant fibrous histiocytoma patient was high only in the delayed phase and 1 liposarcoma patient was high only in the early phase. Two liposarcoma patients showed an iso uptake in both phases. One of these patients was pathologically diagnosed as a myxoid type. In benign lesions, no lipoma showed increased uptake. All neurogenic tumors except for 2 demonstrated high uptake. All 3 ganglions of the lower extremities showed iso uptake. Most inflammatory diseases showed increased uptake. Clinically-considered benign patients consisted of tumorous lesions or inflammatory disease. Only 2 patients were considered 'low', and these were diagnosed as intramuscular hematoma and cyst. RI was variable in both malignant and benign lesions and no statistically significant difference was seen between malignant and benign lesions by t-test (p=0.72). A high (201)TlCl uptake lesion is more frequently seen in malignant tumors, but regardless of whether the tumor is benign or malignant, according to the histopathological variety, the (201)TlCl uptake pattern can not be the only indicator to differentiate malignant from benign tumors. We ultimately need to evaluate the nature of tumors by a combination of

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

    NASA Astrophysics Data System (ADS)

    Bezares-Chavez, Jiddu

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

  8. Necrotising Soft Tissue Infection–Risk Factors for Mortality

    PubMed Central

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

    2013-01-01

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

  9. Multisegment Kinematics of the Spinal Column: Soft Tissue Artifacts Assessment.

    PubMed

    Mahallati, Sara; Rouhani, Hossein; Preuss, Richard; Masani, Kei; Popovic, Milos R

    2016-07-01

    A major challenge in the assessment of intersegmental spinal column angles during trunk motion is the inherent error in recording the movement of bony anatomical landmarks caused by soft tissue artifacts (STAs). This study aims to perform an uncertainty analysis and estimate the typical errors induced by STA into the intersegmental angles of a multisegment spinal column model during trunk bending in different directions by modeling the relative displacement between skin-mounted markers and actual bony landmarks during trunk bending. First, we modeled the maximum displacement of markers relative to the bony landmarks with a multivariate Gaussian distribution. In order to estimate the distribution parameters, we measured these relative displacements on five subjects at maximum trunk bending posture. Then, in order to model the error depending on trunk bending angle, we assumed that the error grows linearly as a function of the bending angle. Second, we applied our error model to the trunk motion measurement of 11 subjects to estimate the corrected trajectories of the bony landmarks and investigate the errors induced into the intersegmental angles of a multisegment spinal column model. For this purpose, the trunk was modeled as a seven-segment rigid-body system described using 23 reflective markers placed on various bony landmarks of the spinal column. Eleven seated subjects performed trunk bending in five directions and the three-dimensional (3D) intersegmental angles during trunk bending were calculated before and after error correction. While STA minimally affected the intersegmental angles in the sagittal plane (<16%), it considerably corrupted the intersegmental angles in the coronal (error ranged from 59% to 551%) and transverse (up to 161%) planes. Therefore, we recommend using the proposed error suppression technique for STA-induced error compensation as a tool to achieve more accurate spinal column kinematics measurements. Particularly, for intersegmental

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

    Cancer.gov

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

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

    PubMed

    Konior, R J

    1992-11-01

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

  12. Response of sarcomas of bone and of soft tissue to neutron beam therapy

    SciTech Connect

    Cohen, L.; Hendrickson, F.; Mansell, J.; Kurup, P.D.; Awschalom, M.; Rosenberg, I.; Ten Haken, R.K.

    1984-06-01

    A total of 51 patients were treated at Fermilab for sarcoma of bone (25 patients) and soft tissue (26 patients). Neutrons were delivered in twice weekly fractions over 6-7 weeks to total doses between 18 and 26 Gy. Long-term local control (greater than 2 years) was achieved in 24 patients (47%). Overall local control rates were 44% in the bone sarcomas and 50% in the soft tissue tumors. The overall survival rate was 40% in the entire series. These results are comparable with international experience in neutron therapy of sarcomas of bone and soft tissues. Out of 263 soft tissue sarcomas treated with neutrons only to full dosage throughout the world, 152 (58%) were locally controlled. Similarly out of 74 sarcomas of bone so treated 44 (60%) were controlled. Complications of the treatment are discussed.

  13. Soft tissue knee contracture of the knee due to melorheostosis, treated by total knee arthroplasty.

    PubMed

    Moulder, Elizabeth; Marsh, Clayton

    2006-10-01

    Melorheostosis is a rare condition which can cause soft tissue joint contractures. We present a case of melorheostosis causing disabling knee joint contracture, treated successfully by total knee arthroplasty.

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

    PubMed

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

    1997-12-01

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

  15. Soft-tissue cephalometric norms in Chinese adults with esthetic facial profiles.

    PubMed

    Lew, K K; Ho, K K; Keng, S B; Ho, K H

    1992-11-01

    Using a double selection process comprised of professional and lay judges, the cephalometric tracings on a final sample of 48 Chinese adults with esthetically pleasing profiles were analyzed. The soft-tissue cephalometric norms and standard deviations of two widely accepted soft-tissue analyses, the Legan and Burstone analysis and the Holdaway analysis, were determined. In comparison with white norms, the Chinese nose was less prominent (P < .01), the nasolabial angle was less obtuse (P < .01), both the upper and lower lips were more protrusive (P < .05), the upper lip curvature was greater (P < .01), and the soft-tissue chin thickness was less (P < .05). This variance between racial types emphasizes the need to recognize that soft-tissue lateral cephalometric norms are specific for the racial group and cannot always be applied across different racial types.

  16. Epithelial-connective tissue boundary in the oral part of the human soft palate

    PubMed Central

    PAULSEN, FRIEDRICH; THALE, ANDREAS

    1998-01-01

    The papillary layer of the oral part of the human soft palate was studied in 31 subjects of different age by means of histological, immunohistochemical and scanning electron microscopical methods. For scanning electron microscopy a new maceration method was introduced. Results determine epithelial thickness, height and density of connective tissue papillae and their 3-dimensional architecture inside the lining epithelium as well as the collagenous arrangement of the openings of the glandular ducts. The individual connective tissue papillae of the soft palate are compared with the connective tissue boundary on the other side of the oral cavity. The connective tissue plateaux carrying a variable number of connective tissue papillae were found to be the basic structural units of the papillary body. The function of the epithelial-connective tissue interface and the extracellular matrix arrangement in the lamina propria are discussed in order to promote the comparability of normal with pathologically altered human soft palates. PMID:9877301

  17. Air-cushion force-sensitive probe for soft tissue investigation during minimally invasive surgery.

    PubMed

    Zbyszewski, Dinusha; Challacombe, Benjamin; Liu, Hongbin; Seneviratne, Lakmal; Dasgupta, Prokar; Murphy, Declan; Althoefer, Kaspar

    2009-09-01

    We propose a novel air-cushion force-sensitive indentation probe for rapidly locating abnormalities within soft tissues during minimally invasive surgery (MIS). This system comprises a spherical-tipped optical-based force-sensing device that employs an air-cushion technique to conduct continuous rolling indentation over the surface of soft tissues. The device combines rapid acquisition of tissue resistance forces with high manoeuvrability. To determine the stiffness variation, the interaction forces acquired during rolling indentation can be integrated to generate spatio-mechanical stiffness images that can be used for tissue diagnosis. Rolling indentation tests on the probe were carried out on excised porcine liver. The results demonstrate that the probe can be used to acquire force signals for constructing mechanical images, reliably indicating areas of variable stiffness. This probe could be used to characterize the force tissue deflection profile of soft tissues during minimally invasive surgery providing surgeons with enhanced haptic feedback.

  18. Broadband acoustic trapping of a particle by a soft plate with a periodic deep grating

    NASA Astrophysics Data System (ADS)

    He, Hailong; Ouyang, Shiliang; He, Zhaojian; Deng, Ke; Zhao, Heping

    2015-04-01

    We investigated the acoustic radiation force (ARF) acting on a cylindrical brass particle near an acoustically soft plate patterned with a periodic deep grating. The existence of a negative ARF by which the particle can be pulled towards the sound source is confirmed. In addition, the bandwidth for negative ARF in this soft-plate system is found to be considerably broader than in the stiff-plate systems typically used in previous studies. It is further demonstrated by field distribution analysis that the negative ARF is caused by the gradient force induced by the gradient vortex velocity field near the surface, which stems from the collective resonance excitation of the antisymmetric coupling of Scholte surface waves in the thin plate. The effects of particle location and size on the ARF were also investigated in detail. The negative ARF has potential use in applications requiring particle manipulation using acoustic waves.

  19. Broadband acoustic trapping of a particle by a soft plate with a periodic deep grating

    SciTech Connect

    He, Hailong; Ouyang, Shiliang; He, Zhaojian E-mail: dengke@jsu.edu.cn; Deng, Ke E-mail: dengke@jsu.edu.cn; Zhao, Heping

    2015-04-28

    We investigated the acoustic radiation force (ARF) acting on a cylindrical brass particle near an acoustically soft plate patterned with a periodic deep grating. The existence of a negative ARF by which the particle can be pulled towards the sound source is confirmed. In addition, the bandwidth for negative ARF in this soft-plate system is found to be considerably broader than in the stiff-plate systems typically used in previous studies. It is further demonstrated by field distribution analysis that the negative ARF is caused by the gradient force induced by the gradient vortex velocity field near the surface, which stems from the collective resonance excitation of the antisymmetric coupling of Scholte surface waves in the thin plate. The effects of particle location and size on the ARF were also investigated in detail. The negative ARF has potential use in applications requiring particle manipulation using acoustic waves.

  20. An implant-retained auricular impression technique to minimize soft tissue distortion.

    PubMed

    Kubon, Todd M; Anderson, James D

    2003-01-01

    Achieving adaptation of an auricular prosthesis begins with an accurate impression. It is important to consider how the selection of the impression materials will affect the final outcome of the prosthesis. A procedure is presented to minimize the distortion of the soft tissues caused by the impression materials and procedure. The procedure consists of splinting the implant impression copings, then recording the soft tissue in silicone impression material, followed by the application of acrylic tray resin to provide rigidity.

  1. A modified impression technique for accurate registration of peri-implant soft tissues.

    PubMed

    Attard, Nikolai; Barzilay, Izchak

    2003-02-01

    Replacement of single missing teeth with an implant-supported restoration is recognized as a highly successful treatment. An impression technique for peri-implant soft-tissue replication in an anterior zone is described. The technique involves use of an interim restoration as an abutment for the final impression. This allows accurate duplication of the soft tissues and fabrication of a final restoration with the correct emergence profile.

  2. Modern surgical techniques for management of soft tissue sarcomas involving the spine: outcomes and complications.

    PubMed

    Mattei, Tobias A; Teles, Alisson R; Mendel, Ehud

    2015-04-01

    Several types of soft tissue sarcomas may locally extend to the spine. The best therapeutic strategy for such lesions strongly depends on the histological diagnosis. In this article the authors provide an up-to-date review of current guidelines regarding the management of soft tissue sarcomas involving the spine. Special attention is given to outcomes and complications of modern surgical series in order to highlight current challenges in the management of such lesions. © 2014 Wiley Periodicals, Inc.

  3. Neglected Thorn Injury Mimicking Soft Tissue Mass in a Child: A Case Report

    PubMed Central

    Gupta, Mayank; Kumar, Dharmendra; Naik, Ananta Kumar; Arya, Rajendera Kumar

    2015-01-01

    Thorn injuries are common especially in rural areas. The diagnosis of such in children is always missed. An untreated retained thorn may cause late soft tissue and osseous complications. Herein, we report a case of neglected thorn injury mimicking soft tissue mass in an 11-year-old male child. The presence of the thorn was confirmed with ultrasound scan and computerized tomography. The child was successfully managed with removal of thorn with excision of foreign body granuloma. PMID:26155524

  4. Soft-Tissue Masses and Masslike Conditions: What Does CT Add to Diagnosis and Management?

    PubMed Central

    Subhawong, Ty K.; Fishman, Elliot K.; Swart, Jennifer E.; Carrino, John A.; Attar, Samer; Fayad, Laura M.

    2010-01-01

    OBJECTIVE Although MRI is the technique of choice for evaluating most soft-tissue masses, CT often provides valuable complementary information. Specifically, there are distinguishing CT characteristics that can suggest a specific diagnosis, including the lesion’s mineralization pattern, density, pattern of adjacent bone involvement, and degree and pattern of vascularity. CONCLUSION This article provides an overview of the CT evaluation of soft-tissue masses, emphasizing a differential diagnosis based on these CT features. PMID:20489097

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

    PubMed Central

    Thompson, Joel C.; Woods, Gary M.; Arnold, Michael A.; Elmaraghy, Charles; Kahwash, Samir B.; Cripe, Timothy P.; Setty, Bhuvana A.

    2016-01-01

    Pediatric soft tissue sarcomas of the oral/maxillofacial region are rare neoplasms that present significant difficulty with respect to treatment and local control measures. We report four cases of pediatric oral/maxillofacial soft tissue sarcomas from our tertiary care pediatric hospital and emphasize the rarity of these malignancies and the challenges encountered in treating these lesions, and suggest areas for further research. We conclude that multimodal therapy and interdisciplinary cooperation are paramount to successful management of these lesions. PMID:27721766

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

    PubMed

    Thompson, Joel C; Woods, Gary M; Arnold, Michael A; Elmaraghy, Charles; Kahwash, Samir B; Cripe, Timothy P; Setty, Bhuvana A

    2016-01-01

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

  7. From morphological to molecular diagnosis of soft tissue tumors.

    PubMed

    Miettinen, Markku

    2006-01-01

    Cytogenetic discoveries of balanced translocations in soft tissue tumors have opened the way to molecular genetic definition of these translocations as gene fusions from the late 1980s. Many sarcomas are known to have such fusions, and the demonstration of the fusion transcripts in tumor tissue is of great value in specific diagnosis of synovial sarcoma (SYT-SSX), Ewing sarcoma (EWS-Fli1), clear cell sarcoma (EWS-ATF1), myxoid liposarcoma (FUS-CHOP), and other sarcomas. These translocations are believed to be disease-specific and pathogenetic forces, despite occasional observations to the contrary. Demonstration of SYT-SSX and EWS-ATF1 fusion assists in the diagnosis of synovial and clear cell sarcomas in unusual locations, such as the gastrointestinal tract, where these tumors occur with low frequency. Demonstration of sarcoma translocations and their fusion by different assays is well established; use of in situ hybridization is limited by availability of specific probes. In two exceptional instances, the same translocation and gene fusion occurs in two unrelated diseases: ETV6-NTRK fusion in infantile fibrosarcoma and secretory carcinoma of the breast, and ALK-TPM3 fusion in inflammatory myofibroblastic tumor and large cell anaplastic lymphoma. Thus, the target cell of the genetic change is an important factor to define the resulting disease. Activating mutations in two related receptor tyrosine kinases (RTKs), KIT, and platelet-derived growth factor receptor alpha (PDGFRA) is central to the pathogenesis of gastrointestinal stromal tumors (GISTs), and countering the mutational activation by specific tyrosine kinase inhibitors, such as Imatinib mesylate, is now standard treatment for metastatic GISTs. KIT exon 11 mutations (in frame deletions, point mutations, and duplications) occur in GISTs of all locations, whereas a characteristic exon 9 insertion-duplication AY502-503 is nearly specific for intestinal vs gastric tumors. In contrast, PDGFRA mutations are

  8. Implantation of preadipocyte-loaded hyaluronic acid-based scaffolds into nude mice to evaluate potential for soft tissue engineering.

    PubMed

    Hemmrich, Karsten; von Heimburg, Dennis; Rendchen, Raoul; Di Bartolo, Chiara; Milella, Eva; Pallua, Norbert

    2005-12-01

    The reconstruction of soft tissue defects following extensive deep burns or tumor resections remains an unresolved problem in plastic and reconstructive surgery since adequate implant materials are still not available. Preadipocytes, immature precursor cells found between mature adipocytes in adipose tissue, are a potential material for soft tissue engineering since they can proliferate and differentiate into adipose tissue after transplantation. In previous studies, we identified hyaluronan benzyl ester (HYAFF 11) sponges to be promising carrier matrices. This study now evaluates, in vitro and in vivo, a new sponge architecture with pores of 400 microm either made of plain HYAFF 11 or HYAFF 11 coated with the extracellular matrix glycosaminoglycan hyaluronic acid. Human preadipocytes were isolated, seeded onto carriers and implanted into nude athymic mice. Explants harvested after 3, 8, and 12 weeks were examined for macroscopical appearance, thickness, weight, pore structure, histology, and immunohistochemistry. Compared to previous studies, we found better penetration of cells into both types of scaffolds, with more extensive formation of new vessels throughout the construct but with only minor adipose tissue. Our encouraging results contribute towards a better seeded and vascularised scaffold but also show that the enhancement of adipogenic conversion of preadipocytes remains a major task for further in vivo experiments.

  9. Four different diode lasers comparison on soft tissues surgery: a preliminary ex vivo study

    PubMed Central

    Merigo, Elisabetta; Sozzi, Michele; Rocca, Jean-Paul; Poli, Federica; Selleri, Stefano; Cucinotta, Annamaria

    2016-01-01

    Objectives: The introduction of diode lasers in dentistry had several advantages, principally consisting on the reduced size, reduced cost and possibility to beam delivering by optical fibbers. Up today only the wavelengths around 810 and 980 nm were the most utilized in oral surgery but recently more different lasers had been proposed. The aim of this study was to compare the efficacy of four diode laser wavelengths (810, 980, 1470 and 1950 nm) for the ablation of soft tissues. Material and methods: Specimens were surgically collected from the dorsal surface of four bovine tongues and irradiated by four different diode wavelengths. Thermal increase was measured by two thermocouples, the first at a depth of 0.5 mm, and the second at a depth of 2 mm. Initial and final surface temperatures were recorded by IR thermometer. Epithelial changes, connective tissue modifications, presence of vascular modification and incision morphology were histologically evaluated by two blind pathologists. Results: The time necessary to perform the excision varied between 271 seconds (808 nm, 2W) and 112 seconds (1950 nm, 4W). Temperature increase superficial level varied from 16.3° (980 nm, 4W) and 9.2° (1950 nm, 2 W). The most significant deep temperature increase was recorded by 980 nm, 4 W (17.3°) and the lowest by 1950 nm, 2 W (9.7°). The width of epithelial tissue injuries varied between 74 pm from 1950 nm diode laser at 2 W to 540 pm for 1470 nm diode laser at 4 W. Conclusion: The quality of incision was better and the width of overall tissue injuries was minor in the specimens obtained with higher wavelength (1950 nm) at lower power (2W). PMID:27721562

  10. Wound Complications in Preoperatively Irradiated Soft-Tissue Sarcomas of the Extremities

    SciTech Connect

    Rosenberg, Lewis A.; Esther, Robert J.; Erfanian, Kamil; Green, Rebecca; Kim, Hong Jin; Sweeting, Raeshell; Tepper, Joel E.

    2013-02-01

    Purpose: To determine whether the involvement of plastic surgery and the use of vascularized tissue flaps reduces the frequency of major wound complications after radiation therapy for soft-tissue sarcomas (STS) of the extremities. Methods and Materials: This retrospective study evaluated patients with STS of the extremities who underwent radiation therapy before surgery. Major complications were defined as secondary operations with anesthesia, seroma/hematoma aspirations, readmission for wound complications, or persistent deep packing. Results: Between 1996 and 2010, 73 patients with extremity STS were preoperatively irradiated. Major wound complications occurred in 32% and secondary operations in 16% of patients. Plastic surgery closed 63% of the wounds, and vascularized tissue flaps were used in 22% of closures. When plastic surgery performed closure the frequency of secondary operations trended lower (11% vs 26%; P=.093), but the frequency of major wound complications was not different (28% vs 38%; P=.43). The use of a vascularized tissue flap seemed to have no effect on the frequency of complications. The occurrence of a major wound complication did not affect disease recurrence or survival. For all patients, 3-year local control was 94%, and overall survival was 72%. Conclusions: The rates of wound complications and secondary operations in this study were very similar to previously published results. We were not able to demonstrate a significant relationship between the involvement of plastic surgery and the rate of wound complications, although there was a trend toward reduced secondary operations when plastic surgery was involved in the initial operation. Wound complications were manageable and did not compromise outcomes.

  11. Four different diode lasers comparison on soft tissues surgery: a preliminary ex vivo study.

    PubMed

    Fornaini, Carlo; Merigo, Elisabetta; Sozzi, Michele; Rocca, Jean-Paul; Poli, Federica; Selleri, Stefano; Cucinotta, Annamaria

    2016-06-29

    Objectives: The introduction of diode lasers in dentistry had several advantages, principally consisting on the reduced size, reduced cost and possibility to beam delivering by optical fibbers. Up today only the wavelengths around 810 and 980 nm were the most utilized in oral surgery but recently more different lasers had been proposed. The aim of this study was to compare the efficacy of four diode laser wavelengths (810, 980, 1470 and 1950 nm) for the ablation of soft tissues. Material and methods: Specimens were surgically collected from the dorsal surface of four bovine tongues and irradiated by four different diode wavelengths. Thermal increase was measured by two thermocouples, the first at a depth of 0.5 mm, and the second at a depth of 2 mm. Initial and final surface temperatures were recorded by IR thermometer. Epithelial changes, connective tissue modifications, presence of vascular modification and incision morphology were histologically evaluated by two blind pathologists. Results: The time necessary to perform the excision varied between 271 seconds (808 nm, 2W) and 112 seconds (1950 nm, 4W). Temperature increase superficial level varied from 16.3° (980 nm, 4W) and 9.2° (1950 nm, 2 W). The most significant deep temperature increase was recorded by 980 nm, 4 W (17.3°) and the lowest by 1950 nm, 2 W (9.7°). The width of epithelial tissue injuries varied between 74 pm from 1950 nm diode laser at 2 W to 540 pm for 1470 nm diode laser at 4 W. Conclusion: The quality of incision was better and the width of overall tissue injuries was minor in the specimens obtained with higher wavelength (1950 nm) at lower power (2W).

  12. Photoactivation of Anticancer Ru Complexes in Deep Tissue: How Deep Can We Go?

    PubMed

    Sun, Wen; Thiramanas, Raweewan; Slep, Leonardo D; Zeng, Xiaolong; Mailänder, Volker; Wu, Si

    2017-08-10

    Activation of anticancer therapeutics such as ruthenium (Ru) complexes is currently a topic of intense investigation. The success of phototherapy relies on photoactivation of therapeutics after the light passes through skin and tissue. In this paper, the photoactivation of anticancer Ru complexes with 671-nm red light through tissue of different thicknesses was studied. Four photoactivatable Ru complexes with different absorption wavelengths were synthesized. Two of them (Ru3 and Ru4) were responsive to wavelengths in the "therapeutic window" (650-900 nm) and could be activated using 671-nm red light after passing through tissue up to 16-mm-thick. The other two (Ru1 and Ru2) could not be activated using red light. Additionally, activated Ru4 caused inhibition of cancer cells. These results suggest that photoactivatable Ru complexes are promising for applications in deep-tissue phototherapy. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

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

    PubMed

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

    2014-01-06

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

  14. Computational modelling and optimisation of soft tissue outcome in cranio-maxillofacial surgery planning.

    PubMed

    Gladilin, Evgeny; Ivanov, Alexander

    2009-06-01

    Cranio-maxillofacial (CMF) surgery operations are associated with rearrangement of facial hard and soft tissues, leading to dramatic changes in facial geometry. Often, correction of the aesthetical patient's appearance is the primary objective of the surgical intervention. Due to the complexity of the facial anatomy and the biomechanical behaviour of soft tissues, the result of the surgical impact cannot always be predicted on the basis of surgeon's intuition and experience alone. Computational modelling of soft tissue outcome using individual tomographic data and consistent numerical simulation of soft tissue mechanics can provide valuable information for surgeons during the planning stage. In this article, we present a general framework for computer-assisted planning of CMF surgery interventions that is based on the reconstruction of patient's anatomy from 3D computer tomography images and finite element analysis of soft tissue deformations. Examples from our clinical case studies that deal with the solution of direct and inverse surgical problems (i.e. soft tissue prediction, inverse implant shape design) demonstrate that the developed approach provides a useful tool for accurate prediction and optimisation of aesthetic surgery outcome.

  15. Can plantar soft tissue mechanics enhance prognosis of diabetic foot ulcer?

    PubMed

    Naemi, R; Chatzistergos, P; Suresh, S; Sundar, L; Chockalingam, N; Ramachandran, A

    2017-04-01

    To investigate if the assessment of the mechanical properties of plantar soft tissue can increase the accuracy of predicting Diabetic Foot Ulceration (DFU). 40 patients with diabetic neuropathy and no DFU were recruited. Commonly assessed clinical parameters along with plantar soft tissue stiffness and thickness were measured at baseline using ultrasound elastography technique. 7 patients developed foot ulceration during a 12months follow-up. Logistic regression was used to identify parameters that contribute to predicting the DFU incidence. The effect of using parameters related to the mechanical behaviour of plantar soft tissue on the specificity, sensitivity, prediction strength and accuracy of the predicting models for DFU was assessed. Patients with higher plantar soft tissue thickness and lower stiffness at the 1st Metatarsal head area showed an increased risk of DFU. Adding plantar soft tissue stiffness and thickness to the model improved its specificity (by 3%), sensitivity (by 14%), prediction accuracy (by 5%) and prognosis strength (by 1%). The model containing all predictors was able to effectively (χ(2) (8, N=40)=17.55, P<0.05) distinguish between the patients with and without DFU incidence. The mechanical properties of plantar soft tissue can be used to improve the predictability of DFU in moderate/high risk patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Biomechanical strain characteristics of soft tissue biceps tenodesis and bony tenodesis.

    PubMed

    Levin, Steven D; Wellman, David S; Liu, Charley; Li, Yue; Ren, Yupeng; Shah, Nirav A; Zhang, Li-Qun

    2013-09-01

    Biomechanical analysis of biceps tenodesis procedures has historically focused on load to failure models. Minimal data exists for the analysis of biomechanical strain properties of the biceps tendon in a sub-failure, physiologic cadaver model. Tendon strain characteristics are different between bony and soft tissue tenodesis surgery, and the soft tissue tenodesis procedure reproduces a strain pattern more similar to the native biceps tendon. Eight fresh frozen cadaver upper extremities were mounted onto a custom device that controls shoulder abduction and rotation. Strain on the tendon was measured using a differential variable reluctance transducer as the arm was moved through cycles of abduction and external rotation. Each arm was mounted once, and all 3 testing procedures were performed on each of the 8 specimens. Statistical analysis was completed using ANOVA, followed by multiple comparisons with Bonferroni correction. The bony tenodesis model placed higher strain on the biceps tendon than the soft tissue tenodesis (p = 0.025). Also, the bony tenodesis model increased the strain on the biceps tendon when compared to the native tendon (p = 0.031). In contrast, the soft tissue tenodesis did not significantly alter strain when compared to the native tendon (p = 0.089). The soft tissue tenodesis procedure better maintained the native strain environment when compared to the bony tenodesis using an interference screw. Due to this closer approximation of native biceps tendon biomechanics, the soft tissue procedure may be more preferable clinically than the bony tenodesis. 1, Controlled Laboratory Study.

  17. The application of diode laser in the treatment of oral soft tissues lesions. A literature review.

    PubMed

    Ortega-Concepción, Daniel; Cano-Durán, Jorge A; Peña-Cardelles, Juan-Francisco; Paredes-Rodríguez, Víctor-Manuel; González-Serrano, José; López-Quiles, Juan

    2017-07-01

    Since its appearance in the dental area, the laser has become a treatment of choice in the removal of lesions in the oral soft tissues, due to the numerous advantages they offer, being one of the most used currently the diode laser. The aim of this review was to determine the efficacy and predictability of diode laser as a treatment of soft tissue injuries compared to other surgical methods. A literature review of articles published in PubMed/MEDLINE, Scopus and the Cochrane Library databases between 2007 and 2017 was performed. "Diode laser", "soft tissue", "oral cavity" and "oral surgery" were employed for the search strategy. Only articles published English or Spanish were selected. The diode laser is a minimally invasive technology that offers great advantages, superior to those of the conventional scalpel, such as reduction of bleeding, inflammation and the lower probability of scars. Its effectiveness is comparable to that of other types of lasers, in addition to being an option of lower cost and greater ease of use. Its application in the soft tissues has been evaluated, being a safe and effective method for the excision of lesions like fibromas, epulis fissuratum and the accomplishment of frenectomies. The diode laser can be used with very good results for the removal of lesions in soft tissues, being used in small exophytic lesions due to their easy application, adequate coagulation, no need to suture and the slightest inflammation and pain. Key words:Diode laser, soft tissues, oral cavity, oral surgery.

  18. Facial soft tissue thickness in a sample of Sudanese adults with different occlusions.

    PubMed

    Hamid, Sama; Abuaffan, Amal H

    2016-09-01

    Facial soft tissue thickness is essential to orthodontists and plastic surgeons for treatment planning, and to forensic anthropologists for facial reconstruction, a process combining science and art to recreate a recognizable face from an unidentified skull. The facial profile, together with the age and sex of a person, is related to facial soft tissue thickness, which is required for accurate facial reconstruction and recognition. Skeletal occlusions in orthodontics are classified according to the basic human facial profiles: straight, convex, and concave or skeletal class I, II, and III, respectively. In the present study, the facial soft tissue thickness of 233 Sudanese subjects (105 men and 128 women), ranging in age from 18 to 35 years, with different facial profiles at 20 landmarks was measured (10 soft tissue and 10 dentoskeletal). Sexual dimorphism was noted, with males having thicker facial soft tissue at all measured points. The facial soft tissue thickness varied among different occlusions. Individuals with skeletal class II occlusion had the thickest lower lip, and class III individuals had the thickest upper lip. In general, the Sudanese sample had a unique spectrum of measurements, with thick upper and lower lips, compared with African and Caucasoid subjects, pointing to the need for ethnic-specific data.

  19. Measurement of guided mode wavenumbers in soft tissue-bone mimicking phantoms using ultrasonic axial transmission

    NASA Astrophysics Data System (ADS)

    Chen, Jiangang; Foiret, Josquin; Minonzio, Jean-Gabriel; Talmant, Maryline; Su, Zhongqing; Cheng, Li; Laugier, Pascal

    2012-05-01

    Human soft tissue is an important factor that influences the assessment of human long bones using quantitative ultrasound techniques. To investigate such influence, a series of soft tissue-bone phantoms (a bone-mimicking plate coated with a layer of water, glycerol or silicon rubber) were ultrasonically investigated using a probe with multi-emitter and multi-receiver arrays in an axial transmission configuration. A singular value decomposition signal processing technique was applied to extract the frequency-dependent wavenumbers of several guided modes. The results indicate that the presence of a soft tissue-mimicking layer introduces additional guided modes predicted by a fluid waveguide model. The modes propagating in the bone-mimicking plate covered by the soft-tissue phantom are only slightly modified compared to their counterparts in the free bone-mimicking plate, and they are still predicted by an elastic transverse isotropic two-dimensional waveguide. Altogether these observations suggest that the soft tissue-bone phantoms can be modeled as two independent waveguides. Even in the presence of the overlying soft tissue-mimicking layer, the modes propagating in the bone-mimicking plate can still be extracted and identified. These results suggest that our approach can be applied for the purpose of the characterization of the material and structural properties of cortical bone.

  20. Measurement of guided mode wavenumbers in soft tissue-bone mimicking phantoms using ultrasonic axial transmission.

    PubMed

    Chen, Jiangang; Foiret, Josquin; Minonzio, Jean-Gabriel; Talmant, Maryline; Su, Zhongqing; Cheng, Li; Laugier, Pascal

    2012-05-21

    Human soft tissue is an important factor that influences the assessment of human long bones using quantitative ultrasound techniques. To investigate such influence, a series of soft tissue-bone phantoms (a bone-mimicking plate coated with a layer of water, glycerol or silicon rubber) were ultrasonically investigated using a probe with multi-emitter and multi-receiver arrays in an axial transmission configuration. A singular value decomposition signal processing technique was applied to extract the frequency-dependent wavenumbers of several guided modes. The results indicate that the presence of a soft tissue-mimicking layer introduces additional guided modes predicted by a fluid waveguide model. The modes propagating in the bone-mimicking plate covered by the soft-tissue phantom are only slightly modified compared to their counterparts in the free bone-mimicking plate, and they are still predicted by an elastic transverse isotropic two-dimensional waveguide. Altogether these observations suggest that the soft tissue-bone phantoms can be modeled as two independent waveguides. Even in the presence of the overlying soft tissue-mimicking layer, the modes propagating in the bone-mimicking plate can still be extracted and identified. These results suggest that our approach can be applied for the purpose of the characterization of the material and structural properties of cortical bone.