Hip joint injection

MedlinePlus

... medicine into the joint. The provider uses a real-time x-ray (fluoroscopy) to see where to place ... Wakefield RJ. Arthrocentesis and injection of joints and soft tissue. In: Firestein GS, Budd RC, Gabriel SE, ...

Intralesional copper wire retention and pingyangmycin injection: an effective combinational therapy for complex venous malformation in soft tissue.

PubMed

Yuan, S-M; Hong, Z-J; Jiang, H-Q; Wang, J; Hu, X-B

2014-04-01

Complex venous malformations (VMs) may extensively involve the soft tissue. The treatment remains a challenge till now. Here we introduce a combinational therapy of copper wires and pingyangmycin (bleomycin A5,PYM). Copper wires were retained in VMs by repeated penetration with a straight needle. Subsequently, PYM solution was injected into the lesion. Eight to 10 days later, copper wires were removed. The dressing was changed every day until the puncture pores healed. Magnetic resonance imaging scanning was performed to observe the change of VMs. From January 2001 to December 2011, 56 patients were treated. During the follow-up period, most of the VMs shrunk obviously. The symptoms were relieved or disappeared. The complications included local pain, temporary paraesthesia and moderate fever, which disappeared quickly after the removal of copper wires. This combinational therapy is a safe and effective approach for the complex VMs in soft tissue.

Hyaluronic acid gel distribution pattern in periocular area with high-resolution ultrasound imaging.

PubMed

Goh, Alice S; Kohn, Jocelyne C; Rootman, Daniel B; Lin, Joseph L; Goldberg, Robert A

2014-05-01

High-resolution ultrasound (HRUS) is a useful tool in defining anatomic and dynamic soft tissue relationships in the periocular area. It also allows visualization of hyaluronic acid (HA) gel within the soft tissue. The authors investigate the difference in the distribution pattern between 2 HA fillers in the periocular tissue using HRUS. The charts of 10 patients who underwent periocular injection using HA gel filler and were subsequently examined with HRUS were reviewed. Half of the patients (n = 5) were treated with Restylane-L (Medicis Aesthetics, Inc, Scottsdale, Arizona) and the remaining 5 with Belotero Balance (Merz Aesthetics, Inc, San Mateo, California). Ultrasonographic evaluation (Logiq p6; GE Healthcare, Waukesha, Washington) was performed before and immediately after HA filler injection. The HA appears as a hypoechoic image within the soft tissue plane on HRUS. Restylane-L filler formed a localized hypoechoic image within the tissue, with some spread into bubbles or pearl-like configuration. Belotero Balance spread more widely into the tissue plane and diffused into an elongated or spindle-shaped hypoechoic image. Our preliminary data suggest that HA gel fillers with differing production technologies show distinct spread and distribution patterns in the periocular tissues on HRUS examination.

Liquid injectable silicone: a review of its history, immunology, technical considerations, complications, and potential.

PubMed

Narins, Rhoda S; Beer, Kenneth

2006-09-01

For over five decades, liquid injectable silicone has been used for soft-tissue augmentation. Its use has engendered polarized reactions from the public and from physicians. Adherents of this product tout its inert chemical structure, ease of use, and low cost. Opponents of silicone cite the many reports of complications, including granulomas, pneumonitis, and disfiguring nodules that are usually the result of large-volume injection and/or industrial grade or adulterated material. Unfortunately, as recently as 2006, reports in The New England Journal of Medicine and The New York Times failed to distinguish between the use of medical grade silicone injected by physicians trained in the microdroplet technique and the use of large volumes of industrial grade products injected by unlicensed or unskilled practitioners. This review separates these two markedly different procedures. In addition, it provides an overview of the chemical structure of liquid injectable silicone, the immunology of silicone reactions within the body, treatment for cosmetic improvement including human immunodeficiency virus lipoatrophy, technical considerations for its injection, complications seen following injections, and some considerations of the future for silicone soft-tissue augmentation.

Injectable alginate-O-carboxymethyl chitosan/nano fibrin composite hydrogels for adipose tissue engineering.

PubMed

Jaikumar, Dhanya; Sajesh, K M; Soumya, S; Nimal, T R; Chennazhi, K P; Nair, Shantikumar V; Jayakumar, R

2015-03-01

Injectable, biodegradable scaffolds are required for soft tissue reconstruction owing to its minimally invasive approach. Such a scaffold can mimic the native extracellular matrix (ECM), provide uniform distribution of cells and overcome limitations like donor site morbidity, volume loss, etc. So, here we report two classes of biocompatible and biodegradable hydrogel blend systems namely, Alginate/O-carboxymethyl chitosan (O-CMC) and Alginate/poly (vinyl alcohol) (PVA) with the inclusion of fibrin nanoparticles in each. The hydrogels were prepared by ionic cross-linking method. The developed hydrogels were compared in terms of its swelling ratio, degradation profile, compressive strength and elastic moduli. From these preliminary findings, it was concluded that Alginate/O-CMC formed a better blend for tissue engineering applications. The potential of the formed hydrogel as an injectable scaffold was revealed by the survival of adipose derived stem cells (ADSCs) on the scaffold by its adhesion, proliferation and differentiation into adipocytes. Cell differentiation studies of fibrin incorporated hydrogel scaffolds showed better differentiation was confirmed by Oil Red O staining technique. These injectable gels have potential in soft tissue regeneration. Copyright © 2014 Elsevier B.V. All rights reserved.

Development of crosslinked methylcellulose hydrogels for soft tissue augmentation using an ammonium persulfate-ascorbic acid redox system.

PubMed

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

2015-12-10

Hydrogels composed of methylcellulose are candidate materials for soft tissue reconstruction. Although photocrosslinked methylcellulose hydrogels have shown promise for such applications, gels crosslinked using reduction-oxidation (redox) initiators may be more clinically viable. In this study, methylcellulose modified with functional methacrylate groups was polymerized using an ammonium persulfate (APS)-ascorbic acid (AA) redox initiation system to produce injectable hydrogels with tunable properties. By varying macromer concentration from 2% to 4% (w/v), the equilibrium moduli of the hydrogels ranged from 1.47 ± 0.33 to 5.31 ± 0.71 kPa, on par with human adipose tissue. Gelation time was found to conform to the ISO standard for injectable materials. Cellulase treatment resulted in complete degradation of the hydrogels within 24h, providing a reversible corrective feature. Co-culture with human dermal fibroblasts confirmed the cytocompatibility of the gels based on DNA measurements and Live/Dead imaging. Taken together, this evidence indicates that APS-AA redox-polymerized methylcellulose hydrogels possess properties beneficial for use as soft tissue fillers. Copyright © 2015 Elsevier Ltd. All rights reserved.

Interventional articular and para-articular knee procedures

PubMed Central

Lalam, Radhesh K; Winn, Naomi

2016-01-01

The knee is a common area of the body to undergo interventional procedures. This article discusses image-guided interventional issues specific to the knee area. The soft tissues in and around the knee are frequently affected by sport-related injuries and often need image-guided intervention. This article details the specific technical issues related to intervention in these soft tissues, including the iliotibial tract, fat pads, patellar tendon and other tendons, bursae and the meniscus. Most often, simple procedures such as injection and aspiration are performed without image guidance. Rarely image-guided diagnostic arthrography and therapeutic joint injections are necessary. The technique, indications and diagnostic considerations for arthrography are discussed in this article. Primary bone and soft-tissue tumours may involve the knee and adjacent soft tissues. Image-guided biopsies are frequently necessary for these lesions; this article details the technical issues related to image-guided biopsy around the knee. A number of newer ablation treatments are now available, including cryoablation, high-frequency ultrasound and microwave ablation. Radiofrequency ablation, however, still remains the most commonly employed ablation technique. The indications, technical and therapeutic considerations related to the application of this technique around the knee are discussed here. Finally, we briefly discuss some newer, but as of yet, unproven image-guided interventions for osteochondral lesions and Brodie's abscess. PMID:26682669

Mechanically robust cryogels with injectability and bioprinting supportability for adipose tissue engineering.

PubMed

Qi, Dianjun; Wu, Shaohua; Kuss, Mitchell A; Shi, Wen; Chung, Soonkyu; Deegan, Paul T; Kamenskiy, Alexey; He, Yini; Duan, Bin

2018-05-26

Bioengineered adipose tissues have gained increased interest as a promising alternative to autologous tissue flaps and synthetic adipose fillers for soft tissue augmentation and defect reconstruction in clinic. Although many scaffolding materials and biofabrication methods have been investigated for adipose tissue engineering in the last decades, there are still challenges to recapitulate the appropriate adipose tissue microenvironment, maintain volume stability, and induce vascularization to achieve long-term function and integration. In the present research, we fabricated cryogels consisting of methacrylated gelatin, methacrylated hyaluronic acid, and 4arm poly(ethylene glycol) acrylate (PEG-4A) by using cryopolymerization. The cryogels were repeatedly injectable and stretchable, and the addition of PEG-4A improved the robustness and mechanical properties. The cryogels supported human adipose progenitor cell (HWA) and adipose derived mesenchymal stromal cell adhesion, proliferation, and adipogenic differentiation and maturation, regardless of the addition of PEG-4A. The HWA laden cryogels facilitated the co-culture of human umbilical vein endothelial cells (HUVEC) and capillary-like network formation, which in return also promoted adipogenesis. We further combined cryogels with 3D bioprinting to generate handleable adipose constructs with clinically relevant size. 3D bioprinting enabled the deposition of multiple bioinks onto the cryogels. The bioprinted flap-like constructs had an integrated structure without delamination and supported vascularization. Adipose tissue engineering is promising for reconstruction of soft tissue defects, and also challenging for restoring and maintaining soft tissue volume and shape, and achieving vascularization and integration. In this study, we fabricated cryogels with mechanical robustness, injectability, and stretchability by using cryopolymerization. The cryogels promoted cell adhesion, proliferation, and adipogenic differentiation and maturation of human adipose progenitor cells and adipose derived mesenchymal stromal cells. Moreover, the cryogels also supported 3D bioprinting on top, forming vascularized adipose constructs. This study demonstrates the potential of the implementation of cryogels for generating volume-stable adipose tissue constructs and provides a strategy to fabricate vascularized flap-like constructs for complex soft tissue regeneration. Copyright © 2018. Published by Elsevier Ltd.

Improvement in the repair of defects in maxillofacial soft tissue in irradiated minipigs by a mixture of adipose-derived stem cells and platelet-rich fibrin.

PubMed

Chen, Yuanzheng; Niu, Zhanguo; Xue, Yan; Yuan, Fukang; Fu, Yanjie; Bai, Nan

2014-10-01

To find out if adipose-derived stem cells (ASC) and platelet-rich fibrin (PRF), alone or combined, had any effect on the repair of maxillofacial soft tissue defects in irradiated minipigs, ASC were isolated, characterised, and expanded. Twenty female minipigs, the right parotid glands of which had been irradiated, were randomly divided into 4 groups of 5 each: those in the first group were injected with both ASC and PRF (combined group), the second group was injected with ASC alone (ASC group), the third group with PRF alone (PRF group), and the fourth group with phosphate buffer saline (PBS) (control group). Six months after the last injection, the size and depth of each defect were assessed, and subcutaneous tissues were harvested, stained with haematoxylin and eosin, and examined immunohistologically and for apoptosis. Expanded cells were successfully isolated and identified. Six months after injection the defects in the 3 treated groups were significantly smaller (p<0.001) and shallower (p<0.001) than those in the control group. Those in the combined group were the smallest and shallowest. Haematoxylin and eosin showed that the 3 treated groups contained more subcutaneous adipose tissue than the control group, and also had significantly greater vascular density (p<0.001) and fewer apoptotic cells (p<0.001). Both ASC and PRF facilitate the repair of defects in maxillofacial soft tissue in irradiated minipigs, and their combined use is more effective than their use as single agents. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Postanesthetic ulceration of palate: A rare complication.

PubMed

Gupta, Ramesh; Garg, Meenu; Pawah, Salil; Gupta, Ajay

2016-01-01

The routine dental practice involves various dental procedures which needs the application of local anesthetics. Generally, there are very few complications associated with these procedures. Complications such as tissue necrosis can occur following the rapid injection of local anesthetic solutions. Palate is a favorable site for soft tissue lesions, various factors such as direct effects of the drug, blanching of the tissues during injection, a relatively poor blood supply, and reactivation of the latent forms of herpes can all promote to tissue ischemia and a lesion in the palate.

Postanesthetic ulceration of palate: A rare complication

PubMed Central

Gupta, Ramesh; Garg, Meenu; Pawah, Salil; Gupta, Ajay

2016-01-01

The routine dental practice involves various dental procedures which needs the application of local anesthetics. Generally, there are very few complications associated with these procedures. Complications such as tissue necrosis can occur following the rapid injection of local anesthetic solutions. Palate is a favorable site for soft tissue lesions, various factors such as direct effects of the drug, blanching of the tissues during injection, a relatively poor blood supply, and reactivation of the latent forms of herpes can all promote to tissue ischemia and a lesion in the palate. PMID:28163486

Soft-tissue abscess involving Actinomyces odontolyticus and two Prevotella species in an intravenous drug abuser.

PubMed

Sofianou, D; Avgoustinakis, E; Dilopoulou, A; Pournaras, S; Tsirakidis, G; Tsakris, A

2004-03-01

Skin and soft-tissue infections in intravenous users comprise a variety of microorganisms and anaerobic bacteria are frequently involved in these suppurative infections. A case of subcutaneous abscess into anterior femoral muscles involving Actinomyces odontolyticus and two Prevotella species (Prevotella buccae and Prevotella melaninogenica) in an intravenous drug abuser is presented. This combination of microorganisms has not previously been described in soft-tissue infections. The patient volunteering that he licked his hypodermic needle prior to cocaine injection supports that the implicating bacteria originated from the oral cavity. Eventually, the patient recovered and at a 6-month follow-up a gradual improvement of his subcutaneous infection was noticed.

Cannula Versus Sharp Needle for Placement of Soft Tissue Fillers: An Observational Cadaver Study.

PubMed

van Loghem, Jani A J; Humzah, Dalvi; Kerscher, Martina

2017-12-13

Soft-tissue fillers have become important products for facial rejuvenation. Deep fat compartments and facial bones lose volume during the natural aging process. For the most natural-looking results, deep volumetric injections at strategic sites are therefore preferred. Supraperiosteal placement is performed with a sharp needle or a non-traumatic cannula. The primary objective was to determine whether there is a difference in precision between supraperiosteal placement with a sharp needle compared with a non-traumatic cannula in cadaver specimens. A secondary objective was to analyze the safety profiles of both injection techniques. Cadaver heads were injected with dye material and soft-tissue fillers at multiple aesthetic facial sites on the supraperiosteum and subsequently dissected for observation of dye and filler placement. The non-traumatic cannula technique resulted in product being confined to the deep anatomic layers. In contrast, with the sharp needle technique, material was placed in multiple anatomic layers, from the periosteum to more superficial skin layers. For both techniques results were consistent for all facial sites. Although direct extrapolation from cadavers to the in vivo situation cannot be made, cannulae showed more precision in placement of product. With the sharp needle, the material was injected on the periosteum, and then migrated in a retrograde direction along the trajectory of the needle path, ending up in multiple anatomic layers. The sharp needle technique also showed a higher complication risk with intra-arterial injection occurring, even though the needle tip was positioned on the periosteum and the product was injected with the needle in constant contact with the periosteum. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

Palatal mucosa necrosis because of accidental sodium hypochlorite injection instead of anaesthetic solution.

PubMed

Gursoy, U K; Bostanci, V; Kosger, H H

2006-02-01

A case is reported in which sodium hypochlorite (NaOCl) was inadvertently injected into the palatal mucosa instead of local anaesthetic solution. An adult male was referred to the University clinic 15 days after an inadvertent NaOCl injection into the palatal mucosa. Soft tissue necrosis was evident, without obvious bony involvement. Tissues healed without scarring within 30 days. No surgical intervention was required. NaOCl is highly irritant when extruded into vital tissues.--Dentists should be careful to avoid the misuse of NaOCl, and should check the nature of any agent before injecting it into patients.--NaOCl should not be dispensed in a way that could allow it to be mistaken for local anaesthetic solutions.--The well-perfused tissues of the oral cavity have considerable healing ability.

Soft-tissue tumor differentiation using 3D power Doppler ultrasonography with echo-contrast medium injection.

PubMed

Chiou, Hong-Jen; Chou, Yi-Hong; Chen, Wei-Ming; Chen, Winby; Wang, Hsin-Kai; Chang, Cheng-Yen

2010-12-01

We aimed to evaluate the ability of 3-dimensional power Doppler ultrasonography to differentiate soft-tissue masses from blood flow and vascularization with contrast medium. Twenty-five patients (mean age, 44.1 years; range, 12-77 years) with a palpable mass were enrolled in this study. Volume data were acquired using linear and convex 3-dimensional probes and contrast medium injected manually by bolus. Data were stored and traced slice by slice for 12 slices. All patients were scanned by the same senior sonologist. The vascular index (VI), flow index (FI), and vascular-flow index (VFI) were automatically calculated after the tumor was completely traced. All tumors were later confirmed by pathology. The study included 8 benign (mean, 36.5 mL; range, 2.4-124 mL) and 17 malignant (mean, 319.4 mL; range, 9.9-1,179.6 mL) tumors. Before contrast medium injection, mean VI, FI and VFI were, respectively, 3.22, 32.26 and 1.07 in benign tumors, and 1.97, 29.33 and 0.67 in malignant tumors. After contrast medium injection, they were, respectively, 20.85, 37.33 and 8.52 in benign tumors, and 40.12, 41.21 and 17.77 in malignant tumors. The mean differences between with and without contrast injection for VI, FI and VFI were, respectively, 17.63, 5.07 and 7.45 in benign tumors, and 38.15, 11.88 and 16.55 in malignant tumors. Tumor volume, VI, FI and VFI were not significantly different between benign and malignant tumors before and after echo-contrast medium injection. However, VI, FI and VFI under self-differentiation (differences between with and without contrast injection) were significantly different between malignant and benign tumors. Three-dimensional power Doppler ultrasound is a valuable tool for differential diagnosis of soft-tissue tumors, especially with the injection of an echo-contrast medium. Copyright © 2010 Elsevier. Published by Elsevier B.V. All rights reserved.

Safety of radiofrequency treatment over human skin previously injected with medium-term injectable soft-tissue augmentation materials: a controlled pilot trial.

PubMed

Alam, Murad; Levy, Ross; Pajvani, Urvi; Pavjani, Urvi; Ramierez, James A; Guitart, Joan; Veen, Heather; Gladstone, Hayes B

2006-03-01

Several soft-tissue augmentation materials are now available for reduction of nasolabial fold creases and perioral rhytides. Nasolabial folds and perioral rhytides can also be improved by skin tightening delivered by non-ablative radiofrequency (RF) treatment. The purpose of this study was to assess the safety of RF treatment over skin areas recently injected with medium-term injectable soft-tissue augmentation materials. Five subjects were assigned to the experimental arm (augmentation materials plus RF) and one to the control arm (augmentation materials alone). Each subject received injections of 0.3 mL of hyaluronic acid derivative (Restylane) and calcium hydroxylapatite (Radiesse) 3 cm apart on the upper inner arm. Two weeks later, two non-overlapping passes of RF (Thermage ThermaCool TC) were delivered at 63.5 setting with medium-fast 1.5 cm2 tip over injected sites in all of the experimental subjects. Punch skin biopsies were obtained 3 days later from each of the two injection sites on each subject. Light microscopy and digital photomicrographs obtained at low, medium, and high power showed no difference between filler materials in experimental and control subjects. In both cases filler was evident at the deep dermal-subcutaneous junction. Nodule formation, foreign body extravasation, or hemorrhage/clot was not observed grossly or histologically. Subjects and physicians did not report any difference in signs and symptoms between the experimental and control arms. Slightly increased transitory pain was noted when RF was delivered over filler versus over normal skin. Applying RF treatment over the same area 2 weeks after deep dermal injection with hyaluronic acid derivatives or calcium hydroxylapatite does not appear to cause gross morphological changes in the filler material or surrounding skin. Further studies with different parameters are necessary to confirm these findings. 2006 Wiley-Liss, Inc.

Hazards of Improper Dispensary: Literature Review and Report of an Accidental Chloroform Injection.

PubMed

Verma, Prashant; Tordik, Patricia; Nosrat, Ali

2018-06-01

Several clear, transparent solutions are used in endodontics. Inappropriate dispensing methods can lead to accidental injection or accidental irrigation. These accidents can cause permanent tissue damage including damage to the bone, periodontium, nerves, and vasculature. This article reports on the consequences of an accidental chloroform injection. Nonsurgical retreatment of tooth #8 was planned as part of a restorative treatment plan in a 69-year-old woman. The dentist accidentally injected chloroform instead of local anesthesia because chloroform was loaded into the anesthetic syringe. The patient experienced severe pain and swelling and soft tissue necrosis and suffered permanent sensory and motor nerve damage. A review of the literature was performed on accidents caused by improper dispensary, namely accidental injections and accidental irrigations. The data were extracted and summarized. Sodium hypochlorite, chlorhexidine, formalin, formocresol, 1:1000 adrenaline, benzalkonium chloride, and lighter fuel were accidentally injected as an intraoral nerve block or as infiltration injections. Bone and soft tissue necrosis, tooth loss, and sensory nerve damage (anesthesia and paresthesia) were the most common consequences reported. Such disastrous events can be prevented by appropriate labeling and separate dispensing methods for each solution. There is a need for disseminating information on toxicity and biocompatibility of materials/solutions used in endodontics. The authors recommend training dental students and endodontic residents on immediate and long-term therapeutic management of patients when an accidental injection or accidental irrigation occurs. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

[Follow-up on an outbreak in Venezuela of soft-tissue infection due to Mycobacterium abscessus associated with Mesotherapy].

PubMed

Da Mata Jardín, Omaira; Hernández-Pérez, Rolando; Corrales, Haideé; Cardoso-Leao, Sylvia; de Waard, Jacobus H

2010-11-01

Skin and soft tissue infections caused by nontuberculous mycobacteria (NMT) are reported to be associated with injections, liposuction, plastic surgery, and acupuncture. Herein, we describe an outbreak of soft tissue infection due to NMT following mesotherapy, a cosmetic procedure involving injection of poorly defined mixtures alleged to reduce local adiposity. Patients with skin lesions and a history of mesotherapy treatment, who visited the dermatology department of the public hospital in Barinas, Venezuela, from November 2004 to February 2005 were interviewed. Clinical and environmental samples were taken for mycobacteria isolation. The interviews revealed that 68 patients who had been treated for cosmetic purposes at the same clinic by the same therapist had received injections with the same product and were infected with NMT. Clinical specimens from 5 patients grew Mycobacterium abscessus. No mesotherapy solution was available for analysis but M. abscessus was isolated from an environmental sample in the clinic. PCR-based strain typing techniques (ERIC-PCR, BOXA1R and RAPD) showed that the patient's isolates were undistinguishable from each other but different from the environmental isolate. This outbreak was likely caused by a contaminated injectable mesotherapy product and not by mycobacteria from the clinic environment. We emphasize the importance of better microbiological control of these products. To our knowledge, this outbreak, which affected at least 68 patients, appears to be the largest ever associated with mesotherapy and described in the literature. Copyright © 2009 Elsevier España, S.L. All rights reserved.

Flexible-Device Injector with a Microflap Array for Subcutaneously Implanting Flexible Medical Electronics.

PubMed

Song, Kwangsun; Kim, Juho; Cho, Sungbum; Kim, Namyun; Jung, Dongwuk; Choo, Hyuck; Lee, Jongho

2018-06-25

Implantable electronics in soft and flexible forms can reduce undesired outcomes such as irritations and chronic damages to surrounding biological tissues due to the improved mechanical compatibility with soft tissues. However, the same mechanical flexibility also makes it difficult to insert such implants through the skin because of reduced stiffness. In this paper, a flexible-device injector that enables the subcutaneous implantation of flexible medical electronics is reported. The injector consists of a customized blade at the tip and a microflap array which holds the flexible implant while the injector penetrates through soft tissues. The microflap array eliminates the need of additional materials such as adhesives that require an extended period to release a flexible medical electronic implant from an injector inside the skin. The mechanical properties of the injection system during the insertion process are experimentally characterized, and the injection of a flexible optical pulse sensor and electrocardiogram sensor is successfully demonstrated in vivo in live pig animal models to establish the practical feasibility of the concept. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Suicide attempt by intravenous injection of gasoline: a case report.

PubMed

Fink, Katrin; Kuehnemund, Alexander; Schwab, Tilmann; Geibel-Zehender, Annette; Bley, Thorsten; Bode, Christoph; Busch, Hans-Joerg

2010-11-01

There is much experience with intoxication by aspiration of volatile hydrocarbon products, whereas intravenous injection of these distillates is rare. There are only few reports that describe a wide variety of associated pathological changes, predominantly in the pulmonary system. We report the case of an intravenous self-injection of gasoline by a young man in a suicide attempt. Immediately after injecting gasoline, the 22-year-old man developed bradycardia, hypotension, and increasing dyspnea. Computed tomography scan of the chest showed signs consistent with diffuse alveolar-toxic damage to the lung. These symptoms and radiological findings are similar to those commonly observed after inhalation of this type of substance. This may have been due to diffusion of gasoline into the alveoli, where its presence leads to this characteristic damage. In this patient, gasoline entered the intramuscular tissue, and the patient developed a soft-tissue phlegmon at the forearm. At operation, gas emanation and superficial necrosis were noted. Nevertheless, the patient's outcome was good, with full recovery within 3 weeks. The major changes in this patient after intravenous injection of gasoline were in the pulmonary system, including hypoxemia and radiological findings that could be related to an exhalation of the volatile substance. In addition, gas in the musculature of the injection area caused a soft-tissue phlegmon. Copyright © 2010 Elsevier Inc. All rights reserved.

Soft tissue fillers for adipose tissue regeneration: From hydrogel development toward clinical applications.

PubMed

Van Nieuwenhove, I; Tytgat, L; Ryx, M; Blondeel, P; Stillaert, F; Thienpont, H; Ottevaere, H; Dubruel, P; Van Vlierberghe, S

2017-11-01

There is a clear and urgent clinical need to develop soft tissue fillers that outperform the materials currently used for adipose tissue reconstruction. Recently, extensive research has been performed within this field of adipose tissue engineering as the commercially available products and the currently existing techniques are concomitant with several disadvantages. Commercial products are highly expensive and associated with an imposing need for repeated injections. Lipofilling or free fat transfer has an unpredictable outcome with respect to cell survival and potential resorption of the fat grafts. Therefore, researchers are predominantly investigating two challenging adipose tissue engineering strategies: in situ injectable materials and porous 3D printed scaffolds. The present work provides an overview of current research encompassing synthetic, biopolymer-based and extracellular matrix-derived materials with a clear focus on emerging fabrication technologies and developments realized throughout the last decade. Moreover, clinical relevance of the most promising materials will be discussed, together with potential concerns associated with their application in the clinic. Copyright © 2017 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Phase 1/2 study of immunotherapy with dendritic cells pulsed with autologous tumor lysate in patients with refractory bone and soft tissue sarcoma.

PubMed

Miwa, Shinji; Nishida, Hideji; Tanzawa, Yoshikazu; Takeuchi, Akihiko; Hayashi, Katsuhiro; Yamamoto, Norio; Mizukoshi, Eishiro; Nakamoto, Yasunari; Kaneko, Shuichi; Tsuchiya, Hiroyuki

2017-05-01

There are limited options for the curative treatment of refractory bone and soft tissue sarcomas. The purpose of this phase 1/2 study was to assess the immunological and clinical effects of dendritic cells (DCs) pulsed with autologous tumor lysate (TL) in patients with advanced bone and soft tissue sarcomas. Thirty-seven patients with metastatic or recurrent sarcomas were enrolled in this study. Peripheral blood mononuclear cells obtained from the patients were suspended in media containing interleukin 4 (IL-4) and granulocyte-macrophage colony-stimulating factor. Subsequently, these cells were treated with TL, tumor necrosis factor α, and OK-432. The DCs were injected into the inguinal or axillary region. One treatment course comprised 6 weekly DC injections. The toxicity, clinical response (tumor volume, serum interferon-γ [IFN-γ], and serum IL-12), and oncological outcomes were observed. In total, 47 courses of DC therapy were performed in 37 patients. No severe adverse events or deaths associated with the DC injections were observed in the study patients. Increased serum IFN-γ and IL-12 levels were observed 1 month after the DC injection. Among the 37 patients, 35 patients were assessed for clinical responses: 28 patients showed tumor progression, 6 patients had stable disease, and 1 patient showed a partial response 8 weeks after the DC injection. The 3-year overall and progression-free survival rates of the patients were 42.3% and 2.9%, respectively. Although DC therapy appears safe and resulted in an immunological response in patients with refractory sarcoma, it resulted in an improvement of the clinical outcome in only a small number of patients. Cancer 2017;123:1576-1584. © 2017 American Cancer Society. © 2017 American Cancer Society.

Injectable Hydrogel Scaffold from Decellularized Human Lipoaspirate

PubMed Central

Young, D. Adam; Ibrahim, Dina O.; Hu, Diane; Christman, Karen L.

2010-01-01

Soft tissue fillers are rapidly gaining popularity for aesthetic improvements or repair of adipose tissue deficits. Several injectable biopolymers have been investigated for this purpose but often face rapid resorption or limited adipogenesis, and do not mimic the native adipose extracellular matrix (ECM). We have generated an injectable adipose matrix scaffold by efficiently removing both the cellular and lipid contents of human lipoaspirate. The decellularized material retained a complex composition of peptides and glycosaminoglycans found in native adipose ECM. This matrix can be further processed by solubilizing the extracted ECM to generate a thermally-responsive hydrogel that self-assembles upon subcutaneous injection. This hydrogel also supports the growth and survival of patient matched adipose - derived stem cells in vitro. The development of an injectable hydrogel from human lipoaspirate represents a minimally-invasive option for adipose tissue engineering in terms of both the collection of source material and delivery of the scaffold. PMID:20932943

Evaluation of injection augmentation treatment of hyaluronic acid based materials on rabbit vocal folds viscoelasticity.

PubMed

Borzacchiello, A; Mayol, L; Gärskog, O; Dahlqvist, A; Ambrosio, L

2005-06-01

The viscoelastic properties of vocal folds after injection of hyaluronic acid (hyaluronan, HA) based materials have been studied in an animal model (rabbit) six months after injection. The results indicate that the viscoelastic properties of the vocal folds injected with the HA based materials are similar to the healthy vocal folds (non-injected samples) used as control. Histological analysis has been also performed to investigate on the fate of the injected materials after six months from the implant. The HA based materials remain up to six months and they recruited fibroblasts that induce the ingrowth of new connective tissue resulting in an endogenous soft tissue augmentation. The HA based compounds are good candidate for further studies aimed at restoring/preserving the vibratory capacity of the vocal folds with injection treatment in glottal insufficiency.

Validation of a Radiography-Based Quantification Designed to Longitudinally Monitor Soft Tissue Calcification in Skeletal Muscle.

PubMed

Moore, Stephanie N; Hawley, Gregory D; Smith, Emily N; Mignemi, Nicholas A; Ihejirika, Rivka C; Yuasa, Masato; Cates, Justin M M; Liu, Xulei; Schoenecker, Jonathan G

2016-01-01

Soft tissue calcification, including both dystrophic calcification and heterotopic ossification, may occur following injury. These lesions have variable fates as they are either resorbed or persist. Persistent soft tissue calcification may result in chronic inflammation and/or loss of function of that soft tissue. The molecular mechanisms that result in the development and maturation of calcifications are uncertain. As a result, directed therapies that prevent or resorb soft tissue calcifications remain largely unsuccessful. Animal models of post-traumatic soft tissue calcification that allow for cost-effective, serial analysis of an individual animal over time are necessary to derive and test novel therapies. We have determined that a cardiotoxin-induced injury of the muscles in the posterior compartment of the lower extremity represents a useful model in which soft tissue calcification develops remote from adjacent bones, thereby allowing for serial analysis by plain radiography. The purpose of the study was to design and validate a method for quantifying soft tissue calcifications in mice longitudinally using plain radiographic techniques and an ordinal scoring system. Muscle injury was induced by injecting cardiotoxin into the posterior compartment of the lower extremity in mice susceptible to developing soft tissue calcification. Seven days following injury, radiographs were obtained under anesthesia. Multiple researchers applied methods designed to standardize post-image processing of digital radiographs (N = 4) and quantify soft tissue calcification (N = 6) in these images using an ordinal scoring system. Inter- and intra-observer agreement for both post-image processing and the scoring system used was assessed using weighted kappa statistics. Soft tissue calcification quantifications by the ordinal scale were compared to mineral volume measurements (threshold 450.7mgHA/cm3) determined by μCT. Finally, sample-size calculations necessary to discriminate between a 25%, 50%, 75%, and 100% difference in STiCSS score 7 days following burn/CTX induced muscle injury were determined. Precision analysis demonstrated substantial to good agreement for both post-image processing (κ = 0.73 to 0.90) and scoring (κ = 0.88 to 0.93), with low inter- and intra-observer variability. Additionally, there was a strong correlation in quantification of soft tissue calcification between the ordinal system and by mineral volume quantification by μCT (Spearman r = 0.83 to 0.89). The ordinal scoring system reliably quantified soft tissue calcification in a burn/CTX-induced soft tissue calcification model compared to non-injured controls (Mann-Whitney rank test: P = 0.0002, ***). Sample size calculations revealed that 6 mice per group would be required to detect a 50% difference in STiCSS score with a power of 0.8. Finally, the STiCSS was demonstrated to reliably quantify soft tissue calcification [dystrophic calcification and heterotopic ossification] by radiographic analysis, independent of the histopathological state of the mineralization. Radiographic analysis can discriminate muscle injury-induced soft tissue calcification from adjacent bone and follow its clinical course over time without requiring the sacrifice of the animal. While the STiCSS cannot identify the specific type of soft tissue calcification present, it is still a useful and valid method by which to quantify the degree of soft tissue calcification. This methodology allows for longitudinal measurements of soft tissue calcification in a single animal, which is relatively less expensive, less time-consuming, and exposes the animal to less radiation than in vivo μCT. Therefore, this high-throughput, longitudinal analytic method for quantifying soft tissue calcification is a viable alternative for the study of soft tissue calcification.

Validation of a Radiography-Based Quantification Designed to Longitudinally Monitor Soft Tissue Calcification in Skeletal Muscle

PubMed Central

Moore, Stephanie N.; Hawley, Gregory D.; Smith, Emily N.; Mignemi, Nicholas A.; Ihejirika, Rivka C.; Yuasa, Masato; Cates, Justin M. M.; Liu, Xulei; Schoenecker, Jonathan G.

2016-01-01

Introduction Soft tissue calcification, including both dystrophic calcification and heterotopic ossification, may occur following injury. These lesions have variable fates as they are either resorbed or persist. Persistent soft tissue calcification may result in chronic inflammation and/or loss of function of that soft tissue. The molecular mechanisms that result in the development and maturation of calcifications are uncertain. As a result, directed therapies that prevent or resorb soft tissue calcifications remain largely unsuccessful. Animal models of post-traumatic soft tissue calcification that allow for cost-effective, serial analysis of an individual animal over time are necessary to derive and test novel therapies. We have determined that a cardiotoxin-induced injury of the muscles in the posterior compartment of the lower extremity represents a useful model in which soft tissue calcification develops remote from adjacent bones, thereby allowing for serial analysis by plain radiography. The purpose of the study was to design and validate a method for quantifying soft tissue calcifications in mice longitudinally using plain radiographic techniques and an ordinal scoring system. Methods Muscle injury was induced by injecting cardiotoxin into the posterior compartment of the lower extremity in mice susceptible to developing soft tissue calcification. Seven days following injury, radiographs were obtained under anesthesia. Multiple researchers applied methods designed to standardize post-image processing of digital radiographs (N = 4) and quantify soft tissue calcification (N = 6) in these images using an ordinal scoring system. Inter- and intra-observer agreement for both post-image processing and the scoring system used was assessed using weighted kappa statistics. Soft tissue calcification quantifications by the ordinal scale were compared to mineral volume measurements (threshold 450.7mgHA/cm3) determined by μCT. Finally, sample-size calculations necessary to discriminate between a 25%, 50%, 75%, and 100% difference in STiCSS score 7 days following burn/CTX induced muscle injury were determined. Results Precision analysis demonstrated substantial to good agreement for both post-image processing (κ = 0.73 to 0.90) and scoring (κ = 0.88 to 0.93), with low inter- and intra-observer variability. Additionally, there was a strong correlation in quantification of soft tissue calcification between the ordinal system and by mineral volume quantification by μCT (Spearman r = 0.83 to 0.89). The ordinal scoring system reliably quantified soft tissue calcification in a burn/CTX-induced soft tissue calcification model compared to non-injured controls (Mann-Whitney rank test: P = 0.0002, ***). Sample size calculations revealed that 6 mice per group would be required to detect a 50% difference in STiCSS score with a power of 0.8. Finally, the STiCSS was demonstrated to reliably quantify soft tissue calcification [dystrophic calcification and heterotopic ossification] by radiographic analysis, independent of the histopathological state of the mineralization. Conclusions Radiographic analysis can discriminate muscle injury-induced soft tissue calcification from adjacent bone and follow its clinical course over time without requiring the sacrifice of the animal. While the STiCSS cannot identify the specific type of soft tissue calcification present, it is still a useful and valid method by which to quantify the degree of soft tissue calcification. This methodology allows for longitudinal measurements of soft tissue calcification in a single animal, which is relatively less expensive, less time-consuming, and exposes the animal to less radiation than in vivo μCT. Therefore, this high-throughput, longitudinal analytic method for quantifying soft tissue calcification is a viable alternative for the study of soft tissue calcification. PMID:27438007

21 CFR 522.56 - Amikacin sulfate injection.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) caused by susceptible strains of Escherichia coli and Proteus spp. and skin and soft tissue infections caused by susceptible strains of Pseudomonas spp. and E. coli. (3) Limitations. The drug is administered...

Hydrogel derived from decellularized porcine adipose tissue as a promising biomaterial for soft tissue augmentation.

PubMed

Tan, Qiu-Wen; Zhang, Yi; Luo, Jing-Cong; Zhang, Di; Xiong, Bin-Jun; Yang, Ji-Qiao; Xie, Hui-Qi; Lv, Qing

2017-06-01

Decellularized extracellular matrix (ECM) scaffolds from human adipose tissue, characterized by impressive adipogenic induction ability, are promising for soft tissue augmentation. However, scaffolds from autologous human adipose tissue are limited by the availability of tissue resources and the time necessary for scaffold fabrication. The objective of the current study was to investigate the adipogenic properties of hydrogels of decellularized porcine adipose tissue (HDPA). HDPA induced the adipogenic differentiation of human adipose-derived stem cells (ADSCs) in vitro, with significantly increased expression of adipogenic genes. Subcutaneous injection of HDPA in immunocompetent mice induced host-derived adipogenesis without cell seeding, and adipogenesis was significantly enhanced with ADSCs seeding. The newly formed adipocytes were frequently located on the basal side in the non-seeding group, but this trend was not observed in the ADSCs seeding group. Our results indicated that, similar to human adipose tissue, the ECM scaffold derived from porcine adipose tissue could provide an adipogenic microenvironment for adipose tissue regeneration and is a promising biomaterial for soft tissue augmentation. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 1756-1764, 2017. © 2017 Wiley Periodicals, Inc.

Sodium hypochlorite accident with evaluation by cone beam computed tomography.

PubMed

Behrents, K T; Speer, M L; Noujeim, M

2012-05-01

To show the radiographic manifestation of sodium hypochlorite after accidental injection past the apical foramen and into the soft tissues. A female patient was seen for an emergency visit after suffering a sodium hypochlorite accident at her general dentist's office. The patient was seen within 1 h of the accident and was in pain associated with facial swelling. Radiographs, including a Cone Beam Computed Tomography (CBCT), and photographs were taken. Endodontic emergency treatment was initiated. The patient was reassured and given pain medication and antibiotics. Follow-up visits were scheduled over 6 days when the swelling had resolved. • Importance of multiple radiographic images during preoperative endodontic evaluation when undertaking endodontic retreatment. • Knowledge of apical anatomy as related to surrounding structures. • Effect of sodium hypochlorite when injected in the soft tissues. © 2012 International Endodontic Journal.

Histopathology of Lyme arthritis in LSH hamsters

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hejka, A.; Schmitz, J.L.; England, D.M.

1989-05-01

The authors studied the histopathologic evolution of arthritis in nonirradiated and irradiated hamsters infected with Borrelia burgdorferi. Nonirradiated hamsters injected in the hind paws with B. burgdorferi developed an acute inflammatory reaction involving the synovium, periarticular soft tissues, and dermis. This acute inflammatory reaction was short-lived and was replaced by a mild chronic synovitis as the number of detectable spirochetes in the synovium, periarticular soft tissues, and perineurovascular areas diminished. Exposing hamsters to radiation before inoculation with B. burgdorferi exacerbated and prolonged the acute inflammatory phase. Spirochetes also persisted longer in the periarticular soft tissues. A major histopathologic finding wasmore » destructive and erosive bone changes of the hind paws, which resulted in deformation of the joints. These studies should be helpful in defining the immune mechanism participating in the onset, progression, and resolution of Lyme arthritis.« less

Needle-less local anesthesia: clinical evaluation of the effectiveness of the jet anesthesia Injex in local anesthesia in dentistry.

PubMed

Dabarakis, Nikolaos N; Alexander, Veis; Tsirlis, Anastasios T; Parissis, Nikolaos A; Nikolaos, Maroufidis

2007-01-01

To clinically evaluate the jet injection Injex (Rösch AG Medizintechnik) using 2 different anesthetic solutions, and to compare the jet injection and the standard needle injection techniques. Of the 32 patients in the study, 10 received mepivacaine 3% anesthetic solution by means of the jet injection technique, while the remaining 22 patients received lidocaine 2% with epinephrine 1:80,000 by the same method. The 14 patients in whom pulp anesthesia was achieved were selected for an additional evaluation of the pulp reaction using standard needle injection anesthesia. The differences between the 2 compounds with Injex were statistically evaluated by means of independent-samples t test analysis. The differences between subgroups receiving both jet injection and needle injection anesthesia were evaluated by means of paired t test analysis. The administration of mepivacaine 3% using Injex did not achieve pulp anesthesia in any of the 10 patients, although the soft tissue anesthesia was successful. The administration of lidocaine with epinephrine using Injex resulted in pulp anesthesia in only 14 patients; soft tissue anesthesia was observed in all patients of this group. There was no statistically significant difference between Injex and the needle injection technique in onset of anesthesia. However, the duration of anesthesia was significantly longer for the needle infiltration group than for the Injex injection group. The anesthetic solution should be combined with a vasoconstriction agent when the Injex technique is implemented.

Optimizing injectable poly-L-lactic acid administration for soft tissue augmentation: The rationale for three treatment sessions

PubMed Central

Bauer, Ute; Graivier, Miles H

2011-01-01

BACKGROUND: The availability and variety of different injectable modalities has led to a dramatic increase in soft tissue augmentation procedures in recent years. Injectable poly-L-lactic acid (PLLA) is a synthetic, biodegradable polymer device approved in the United States for use in immunocompetent patients as a single regimen of up to four treatment sessions for correction of shallow to deep nasolabial fold contour deficiencies and other facial wrinkles. Injectable PLLA is also approved for restoration and/or correction of signs of facial fat loss (lipoatrophy) in individuals with HIV. METHODS: The present article provides an overview of previous studies with injectable PLLA, and specifically focuses on the number of recommended treatment sessions and intervals between treatment sessions. The authors also provide two case studies to support their recommendations for an average of three treatment sessions. RESULTS: Although the specific mechanisms remain hypothetical, injections of PLLA are believed to cause a cascade of cellular events that lead to collagen repair and subsequent restoration of facial volume. Because the development of a response to injectable PLLA is gradual and its duration of effect is long lasting, sufficient time between treatment sessions should be allocated to avoid overcorrection. CONCLUSION: Studies of injectable PLLA support the hypothesized mode of operation, and the experience and clinical recommendations of the authors that suggest that three treatment sessions are an optimal regimen for use of injectable PLLA in the majority of patients. PMID:22942665

Soft tissue augmentation in skin of color: market growth, available fillers, and successful techniques.

PubMed

Burgess, Cheryl M

2007-01-01

In recent years, people of color have become an increasingly important market force for the cosmetics industry. Product lines have been expanded to accommodate a broader spectrum of skin colors and marketing strategies have been specialized in order to target specific ethnic populations. In addition, it is predicted that people with pigmented skin will eventually comprise a majority of the domestic and international population during the 21st century. Not surprisingly, people of color are increasingly seeking out products and procedures to fight the effects of aging, including an increase in surgical and nonsurgical cosmetic procedures. Among nonsurgical procedures, soft tissue augmentation has experienced dramatic growth. Today, clinicians are performing more and more of these procedures in people of color. As a result of these shifts in the cosmetics industry, clinicians performing soft tissue augmentation require increased expertise in the treatment of ethnic skin. This article reviews the important differences that exist between the appearance of the aging faces of Caucasians and people of color. In addition, soft tissue augmentation strategies and injection techniques that are specific to skin of color are discussed.

A five-patient satisfaction pilot study of calcium hydroxylapatite injection for treatment of aging hands.

PubMed

Marmur, Ellen S; Al Quran, Hanadi; De Sa Earp, Ana Paula; Yoo, Jane Y

2009-12-01

The process of skin aging is not limited to the face but involves every part of the body, including the hands. A common manifestation of aging of the hands is the loss of volume, which occurs as the skin loses its subcutaneous fat. Injectable dermal fillers have surfaced as a popular method to address such deficiencies. To report the use of calcium hydroxylapatite (CaHA) to address lost volume. Five female subjects with soft tissue deficiency of the dorsa of the hands were enrolled at Mount Sinai Medical Center. A solution of CaHA with 2% lidocaine in amounts of 0.3 to 1.0 mL was injected interdigitally at each of three to five insertion sites; the sites were massaged and molded up to three times to ensure an optimal cosmetic end point. Subjects were seen for a follow-up visit after 1, 4, 16, and 24 weeks. With a single injection, all subjects reached their correction goals without requiring any touch-ups. At the 24-week visit, the subjects retained the filling effect, with no adverse events and high patient satisfaction. CaHA, a new, easily injectable, safe dermal filler, has emerged as an excellent option for soft tissue augmentation in aging hands.

Regeneration of the periodontium using enamel matrix derivative in combination with an injectable bone cement.

PubMed

Oortgiesen, Daniël A W; Meijer, Gert J; Bronckers, Antonius L J J; Walboomers, X Frank; Jansen, John A

2013-03-01

Enamel matrix derivative (EMD) has proven to enhance periodontal regeneration; however, its effect is mainly restricted to the soft periodontal tissues. Therefore, to stimulate not only the soft tissues, but also the hard tissues, in this study EMD is combined with an injectable calcium phosphate cement (CaP; bone graft material). The aim was to evaluate histologically the healing of a macroporous CaP in combination with EMD. Intrabony, three-wall periodontal defects (2 × 2 × 1.7 mm) were created mesial of the first upper molar in 15 rats (30 defects). Defects were randomly treated according to one of the three following strategies: EMD, calcium phosphate cement and EMD, or left empty. The animals were killed after 12 weeks, and retrieved samples were processed for histology and histomorphometry. Empty defects showed a reparative type of healing without periodontal ligament or bone regeneration. As measured with on a histological grading scale for periodontal regeneration, the experimental groups (EMD and CaP/EMD) scored equally, both threefold higher compared with empty defects. However, most bone formation was measured in the CaP/EMD group; addition of CAP to EMD significantly enhanced bone formation with 50 % compared with EMD alone. Within the limits of this animal study, the adjunctive use of EMD in combination with an injectable cement, although it did not affect epithelial downgrowth, appeared to be a promising treatment modality for regeneration of bone and ligament tissues in the periodontium. The adjunctive use of EMD in combination with an injectable cement appears to be a promising treatment modality for regeneration of the bone and ligament tissues in the periodontium.

Wnt10b and Dkk-1 gene therapy differentially influenced trabecular bone architecture, soft tissue integrity, and osteophytosis in a skeletally mature rat model of osteoarthritis.

PubMed

Mason, Jeffrey B; Gurda, Brittney L; Hankenson, Kurt D; Harper, Lindsey R; Carlson, Cathy S; Wilson, James M; Richardson, Dean W

2017-11-01

Our goals in the current experiments were to determine if (a) upregulation of Wnt signaling would induce osteoarthritis changes in stable stifle joints and (b) if downregulation of Wnt signaling in destabilized joints would influence the progression of OA. At 37 weeks of age, rats were injected in the stifle joint with a recombinant adeno-associated viral vector containing the Wnt-inhibitor Dkk-1 or a Wnt10b transgene. At 40 weeks of age, rats underwent surgical destabilization of the joint. At 50 weeks of age, stifle joints were submitted for micro-computed tomography and histopathological analysis. Injection of either Wnt10b or Dkk-1 transgenes in stable joints improved bone architectural parameters, but worsened soft tissue integrity. Osteophytosis was decreased by Dkk-1, but unchanged by Wnt10b. Destabilization negatively influenced bone architecture, increased osteophytosis, and decreased soft tissue integrity. Dkk-1 exacerbated the negative effects of destabilization, whereas Wnt10b had little effect on these parameters. Osteophytosis was improved, whereas soft tissue integrity was worsened by both transgenes in destabilized joints. The Wnt-inhibitor Dkk-1 does not appear to completely inhibit the effects of Wnt signaling on bone remodeling. In vivo upregulation of Wnt10b and its inhibitor, Dkk-1, can produce both parallel or contrasting phenotypic responses depending on the specific parameter measured and the fidelity of the examined joint. These observations elucidate different roles for Wnt signaling in stable versus destabilized joints and may help to explain the conflicting results previously reported for the role of Dkk-1 in joint disease.

Percutaneous Soft Tissue Release for Treating Chronic Recurrent Myofascial Pain Associated with Lateral Epicondylitis: 6 Case Studies

PubMed Central

Lin, Ming-Ta; Chou, Li-Wei; Chen, Hsin-Shui; Kao, Mu-Jung

2012-01-01

Objective. The purpose of this pilot study is to investigate the effectiveness of the percutaneous soft tissue release for the treatment of recurrent myofascial pain in the forearm due to recurrent lateral epicondylitis. Methods. Six patients with chronic recurrent pain in the forearm with myofascial trigger points (MTrPs) due to chronic lateral epicondylitis were treated with percutaneous soft tissue release of Lin's technique. Pain intensity (measured with a numerical pain rating scale), pressure pain threshold (measured with a pressure algometer), and grasping strength (measured with a hand dynamometer) were assessed before, immediately after, and 3 months and 12 months after the treatment. Results. For every individual case, the pain intensity was significantly reduced (P < 0.01) and the pressure pain threshold and the grasping strength were significantly increased (P < 0.01) immediately after the treatment. This significant effectiveness lasts for at least one year. Conclusions. It is suggested that percutaneous soft tissue release can be used for treating chronic recurrent lateral epicondylitis to avoid recurrence, if other treatment, such as oral anti-inflammatory medicine, physical therapy, or local steroid injection, cannot control the recurrent pain. PMID:23243428

Soft tissue tumors induced by monomeric {sup 239}Pu

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lloyd, R.D.; Angus, W.; Taylor, G.N.

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 controlsmore » 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.« less

Joint and Soft Tissue Injections

MedlinePlus

... TestingRead Article >>Plasma Viral Load TestingInsulin TherapyRead Article >>Insulin Therapy Visit our interactive symptom checker Visit our interactive symptom checker Get Started Related ArticlesPlasma Viral Load TestingRead ... TherapyRead Article >>Drugs, Procedures & DevicesInsulin TherapyThe goal of ...

Early intervention reduces morbidity in extravasation injuries from 'lighter fuel' injection.

PubMed

Thaha, M A; McKinnell, T H; Graham, K E; Naasan, A N

2007-01-01

Injection of 'lighter fuel' with suicidal intent is rare. Extravasation of the chemical may rarely cause systemic toxicity, but usually it results in extensive soft tissue damage. Such injuries when managed by the traditional expectant policy are associated with considerable morbidity. Early aggressive surgical management using 'saline flush out' limits the tissue damage by stopping the natural progression of the chemical mediated injury and the subsequent inflammatory response, thereby allowing better skin preservation and functional outcome in these cases. We report a case of 'lighter fuel' subcutaneous extravasation injury managed by 'saline flush out' technique soon after presentation.

Ultrasound-guided injection for plantar fasciitis: A brief review

PubMed Central

Nair, AS; Sahoo, RK

2016-01-01

Plantar fasciitis (PF) is a distressing condition experienced by many patients. Although self-limiting, it tends to become a chronic ailment if the precipitating factors are not addressed. One of the modality of treating PF is intra-lesional corticosteroid injection. This was done using palpation technique earlier but nowadays many specialists use ultrasound (US) imaging as a guide to give injection accurately instead of inadvertently damaging the plantar fascia or injecting into surrounding soft tissue, both of which can have serious implications. We did a literature search in Medline, Scopus, and Embase databases to find out articles describing US-guided corticosteroid injection for treating PF and whether guided injection was effective than injection given by palpation. PMID:27833490

Fillers: from the past to the future.

PubMed

Glogau, Richard G

2012-06-01

Modern medical use of injectable soft-tissue augmentation fillers has evolved from the introduction of bovine collage implants to an array of synthesized materials in the current domestic and foreign markets. The concept of augmentation has moved from simple lines, scars, and wrinkles to revolumizing the aging face. A brief overview of the past, present, and future injectable fillers is presented. Copyright © 2012 Elsevier Inc. All rights reserved.

Multicenter case-control study of risk factors associated with development of vaccine-associated sarcomas in cats.

PubMed

Kass, Philip H; Spangler, William L; Hendrick, Mattie J; McGill, Lawrence D; Esplin, D Glen; Lester, Sally; Slater, Margaret; Meyer, E Kathryn; Boucher, Faith; Peters, Erika M; Gobar, Glenna G; Htoo, Thurein; Decile, Kendra

2003-11-01

To determine whether particular vaccine brands, other injectable medications, customary vaccination practices, or various host factors were associated with the formation of vaccine-associated sarcomas in cats. Prospective multicenter case-control study. Cats in the United States and Canada with soft tissue sarcomas or basal cell tumors. Veterinarians submitting biopsy specimens from cats with a confirmed diagnosis of soft tissue sarcoma or basal cell tumor were contacted for patient medical history. Time window statistical analyses were used in conjunction with various assumptions about case definitions. No single vaccine brand or manufacturer within antigen class was found to be associated with sarcoma formation. Factors related to vaccine administration were also not associated with sarcoma development, with the possible exception of vaccine temperature prior to injection. Two injectable medications (long-acting penicillin and methyl prednisolone acetate) were administered to case cats more frequently than to control cats. Findings do not support the hypotheses that specific brands or types of vaccine within antigen class, vaccine practices such as reuse of syringes, concomitant viral infection, history of trauma, or residence either increase or decrease the risk of vaccine-associated sarcoma formation in cats. There was evidence to suggest that certain long-acting injectable medications may also be associated with sarcoma formation.

Blood Glucose Levels After Local Musculoskeletal Steroid Injections in Patients With Diabetes Mellitus: A Clinical Review.

PubMed

Waterbrook, Anna L; Balcik, Brenden J; Goshinska, Aaron John

Diabetes mellitus (DM) has become an epidemic in the United States and is associated with increased risk of multiple comorbidities, including painful musculoskeletal conditions. A common treatment for many of these painful musculoskeletal conditions is local soft tissue and intra-articular corticosteroid injection (CSI). These local injections have the potential to cause elevated blood glucose levels (BGLs) and cause complications in patients with DM. Therefore, it was the objective of this investigation to review the currently available evidence that directly addresses the effects of local CSIs used for painful musculoskeletal conditions on BGL in patients with DM. PubMed, Google Scholar, EMBASE, CINAHL, and Cochrane Review databases were searched with a combination of the terms corticosteroid, glucocorticoid, steroid, injection, musculoskeletal, and diabetes. Search limits included the English language. Bibliographic references from these articles were also examined to identify pertinent literature. Clinical review. Level 3. Ten studies that met the inclusion criteria were reviewed. All these studies showed significant but transient increases in postinjection BGL after a single local CSI in patients with DM. There were no adverse reactions or complications reported. Single, local soft tissue and intra-articular musculoskeletal CSIs are most likely safe in patients with well-controlled DM.

Complications of Minimally Invasive Cosmetic Procedures: Prevention and Management

PubMed Central

Levy, Lauren L; Emer, Jason J

2012-01-01

Over the past decade, facial rejuvenation procedures to circumvent traditional surgery have become increasingly popular. Office-based, minimally invasive procedures can promote a youthful appearance with minimal downtime and low risk of complications. Injectable botulinum toxin (BoNT), soft-tissue fillers, and chemical peels are among the most popular non-invasive rejuvenation procedures, and each has unique applications for improving facial aesthetics. Despite the simplicity and reliability of office-based procedures, complications can occur even with an astute and experienced injector. The goal of any procedure is to perform it properly and safely; thus, early recognition of complications when they do occur is paramount in dictating prevention of long-term sequelae. The most common complications from BoNT and soft-tissue filler injection are bruising, erythema and pain. With chemical peels, it is not uncommon to have erythema, irritation and burning. Fortunately, these side effects are normally transient and have simple remedies. More serious complications include muscle paralysis from BoNT, granuloma formation from soft-tissue filler placement and scarring from chemical peels. Thankfully, these complications are rare and can be avoided with excellent procedure technique, knowledge of facial anatomy, proper patient selection, and appropriate pre- and post-skin care. This article reviews complications of office-based, minimally invasive procedures, with emphasis on prevention and management. Practitioners providing these treatments should be well versed in this subject matter in order to deliver the highest quality care. PMID:23060707

21 CFR 522.56 - Amikacin.

Code of Federal Regulations, 2014 CFR

2014-04-01

... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS IMPLANTATION OR INJECTABLE DOSAGE FORM NEW ANIMAL DRUGS § 522.56 Amikacin. (a... Escherichia coli and Proteus spp. and skin and soft tissue infections caused by susceptible strains of...

21 CFR 522.56 - Amikacin.

Code of Federal Regulations, 2012 CFR

2012-04-01

... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS IMPLANTATION OR INJECTABLE DOSAGE FORM NEW ANIMAL DRUGS § 522.56 Amikacin. (a... of Escherichia coli and Proteus spp. and skin and soft tissue infections caused by susceptible...

21 CFR 522.90b - Ampicillin trihydrate.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS IMPLANTATION OR INJECTABLE DOSAGE FORM NEW ANIMAL DRUGS § 522.90b..., gastrointestinal infections, skin infections, soft tissue infections, and postsurgical infections. (iii...

21 CFR 522.90b - Ampicillin trihydrate.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS IMPLANTATION OR INJECTABLE DOSAGE FORM NEW ANIMAL DRUGS § 522.90b..., gastrointestinal infections, skin infections, soft tissue infections, and postsurgical infections. (iii...

21 CFR 522.56 - Amikacin.

Code of Federal Regulations, 2013 CFR

2013-04-01

... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS IMPLANTATION OR INJECTABLE DOSAGE FORM NEW ANIMAL DRUGS § 522.56 Amikacin. (a... of Escherichia coli and Proteus spp. and skin and soft tissue infections caused by susceptible...

What's new with phentolamine mesylate: a reversal agent for local anaesthesia?

PubMed

Yagiela, John A

2011-01-01

Phentolamine mesylate (OraVerse), a nonselective a-adrenergic blocking drug, is the first therapeutic agent marketed for the reversal of soft-tissue anaesthesia and the associated functional deficits resulting from an intraoral submucosal injection of a local anaesthetic containing a vasoconstrictor. In clinical trials, phentolamine injected in doses of 0.2 to 0.8 mg (0.5 to 2 cartridges), as determined by patient age and volume of local anaesthetic administered, significantly hastened the return of normal soft-tissue sensation in adults and children 6 years of age and older. Median lip recovery times were reduced by 75 to 85 minutes. Functional deficits, such as drooling and difficulty in drinking, smiling, or talking--and subjects' perception of altered function or appearance--were consistently resolved by the time sensation to touch had returned to normal. Adverse effects of phentolamine injected in approved doses for reversal of local anaesthesia in patients ranging in age from 4 to 92 years were similar in incidence to those of sham injections, and no serious adverse events caused by such use were reported. The clinical use of phentolamine is viewed favorably by dentists who have administered the drug and by patients who have received it. Optimal use may require some modifications of the technique described in the package insert; cost of the agent may be influencing its widespread adoption into clinical practice. Phentolamine mesylate, in the form of OraVerse (Novalar Pharmaceuticals, San Diego, USA) represents a new therapeutic class of drugs in dentistry intended to reverse soft-tissue anaesthesia after nonsurgical dental procedures (e.g., restorative or deep scaling/root planing procedures). As shown in Figure 1, OraVerse is manufactured in 1.7 mL dental cartridges, each of which contains 0.4 mg active drug. This review describes the development of phentolamine as a dental drug, its pharmacologic characteristics, and how it may be used in clinical practice to improve patient care.

Ocular Pain and Impending Blindness During Facial Cosmetic Injections: Is Your Office Prepared?

PubMed

Prado, Giselle; Rodríguez-Feliz, Jose

2017-02-01

Soft tissue filler injections are the second most common non-surgical procedure performed by the plastic surgeon. Embolization of intravascular material after facial injection is a rare but terrifying outcome due to the high likelihood of long-term sequela such as blindness and cerebrovascular accident. The literature is replete with examples of permanent blindness caused by injection with autologous fat, soft tissue fillers such as hyaluronic acid, PLLA, calcium hydroxyl-apatite, and even corticosteroid suspensions. However, missing from the discussion is an effective treatment algorithm that can be quickly and safely followed by injecting physicians in the case of an intravascular injection with impending blindness. In this report, we present the case of a 64-year-old woman who suffered from blindness and hemiparesis after facial cosmetic injections performed by a family physician. We use this case to create awareness that this complication has become more common as the number of injectors and patients seeking these treatments have increased exponentially over the past few years. We share in this study our experience with the incorporation of a "blindness safety kit" in each of our offices to promptly initiate treatment in someone with embolization and impending blindness. The kit contains a step-by-step protocol to follow in the event of arterial embolization of filler material associated with ocular pain and impending loss of vision. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Injectable Biodegradable Polyurethane Scaffolds with Release of Platelet-derived Growth Factor for Tissue Repair and Regeneration

PubMed Central

Hafeman, Andrea E.; Li, Bing; Yoshii, Toshitaka; Zienkiewicz, Katarzyna; Davidson, Jeffrey M.; Guelcher, Scott A.

2013-01-01

Purpose The purpose of this work was to investigate the effects of triisocyanate composition on the biological and mechanical properties of biodegradable, injectable polyurethane scaffolds for bone and soft tissue engineering. Methods Scaffolds were synthesized using reactive liquid molding techniques, and were characterized in vivo in a rat subcutaneous model. Porosity, dynamic mechanical properties, degradation rate, and release of growth factors were also measured. Results Polyurethane scaffolds were elastomers with tunable damping properties and degradation rates, and they supported cellular infiltration and generation of new tissue. The scaffolds showed a two-stage release profile of platelet-derived growth factor, characterized by a 75% burst release within the first 24 h and slower release thereafter. Conclusions Biodegradable polyurethanes synthesized from triisocyanates exhibited tunable and superior mechanical properties compared to materials synthesized from lysine diisocyanates. Due to their injectability, biocompatibility, tunable degradation, and potential for release of growth factors, these materials are potentially promising therapies for tissue engineering. PMID:18516665

Computer modeling of the combined effects of perfusion, electrical conductivity, and thermal conductivity on tissue heating patterns in radiofrequency tumor ablation.

PubMed

Ahmed, Muneeb; Liu, Zhengjun; Humphries, Stanley; Goldberg, S Nahum

2008-11-01

To use an established computer simulation model of radiofrequency (RF) ablation to characterize the combined effects of varying perfusion, and electrical and thermal conductivity on RF heating. Two-compartment computer simulation of RF heating using 2-D and 3-D finite element analysis (ETherm) was performed in three phases (n = 88 matrices, 144 data points each). In each phase, RF application was systematically modeled on a clinically relevant template of application parameters (i.e., varying tumor and surrounding tissue perfusion: 0-5 kg/m(3)-s) for internally cooled 3 cm single and 2.5 cm cluster electrodes for tumor diameters ranging from 2-5 cm, and RF application times (6-20 min). In the first phase, outer thermal conductivity was changed to reflect three common clinical scenarios: soft tissue, fat, and ascites (0.5, 0.23, and 0.7 W/m- degrees C, respectively). In the second phase, electrical conductivity was changed to reflect different tumor electrical conductivities (0.5 and 4.0 S/m, representing soft tissue and adjuvant saline injection, respectively) and background electrical conductivity representing soft tissue, lung, and kidney (0.5, 0.1, and 3.3 S/m, respectively). In the third phase, the best and worst combinations of electrical and thermal conductivity characteristics were modeled in combination. Tissue heating patterns and the time required to heat the entire tumor +/-a 5 mm margin to >50 degrees C were assessed. Increasing background tissue thermal conductivity increases the time required to achieve a 50 degrees C isotherm for all tumor sizes and electrode types, but enabled ablation of a given tumor size at higher tissue perfusions. An inner thermal conductivity equivalent to soft tissue (0.5 W/m- degrees C) surrounded by fat (0.23 W/m- degrees C) permitted the greatest degree of tumor heating in the shortest time, while soft tissue surrounded by ascites (0.7 W/m- degrees C) took longer to achieve the 50 degrees C isotherm, and complete ablation could not be achieved at higher inner/outer perfusions (>4 kg/m(3)-s). For varied electrical conductivities in the setting of varied perfusion, greatest RF heating occurred for inner electrical conductivities simulating injection of saline around the electrode with an outer electrical conductivity of soft tissue, and the least amount of heating occurring while simulating renal cell carcinoma in normal kidney. Characterization of these scenarios demonstrated the role of electrical and thermal conductivity interactions, with the greatest differences in effect seen in the 3-4 cm tumor range, as almost all 2 cm tumors and almost no 5 cm tumors could be treated. Optimal combinations of thermal and electrical conductivity can partially negate the effect of perfusion. For clinically relevant tumor sizes, thermal and electrical conductivity impact which tumors can be successfully ablated even in the setting of almost non-existent perfusion.

Soft shell clams Mya arenaria with disseminated neoplasia demonstrate reverse transcriptase activity

USGS Publications Warehouse

House, M.L.; Kim, C.H.; Reno, P.W.

1998-01-01

Disseminated neoplasia (DN), a proliferative cell disorder of the circulatory system of bivalves, was first reported in oysters in 1969. Since that time, the disease has been determined to be transmissible through water-borne exposure, but the etiological agent has not been unequivocally identified. In order to determine if a viral agent, possibly a retrovirus, could be the causative agent of DN, transmission experiments were performed, using both a cell-free filtrate and a sucrose gradient-purified preparation of a cell-free filtrate of DN positive materials. Additionally, a PCR-enhanced reverse transcriptase assay was used to determine if reverse transcriptase was present in tissues or hemolymph from DN positive soft shell clams Mya arenaria. DN was transmitted to healthy clams by injection with whole DN cells, but not with cell-free flitrates prepared from either tissues from DN positive clams, or DN cells. The cell-free preparations from DN-positive tissues and hemolymph having high levels of DN cells in circulation exhibited positive reactions in the PCR-enhanced reverse transcriptase assay. Cell-free preparations of hemolymph from clams having low levels of DN (<0.1% of cells abnormal), hemocytes from normal soft shell clams, and normal soft shell clam tissues did not produce a positive reaction in the PCR enhanced reverse transcriptase assay.

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

PubMed Central

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

2016-01-01

Background. Facial aging is a dynamic process involving both soft tissue and bony structures. Skin atrophy, with loss of tone, elasticity, and distribution of facial fat, coupled with gravity and muscle activity, leads to wrinkling and folds. Purpose. The aim of the study was to evaluate microporous tricalcium phosphate (β-TCP) and autologous platelet gel (APG) mix in mice for oral and maxillofacial soft tissue augmentation. The hypothesis was that β-TCP added with APG was able to increase the biostimulating effect on fibroblasts and quicken resorption. Materials and Methods. Ten female, 6–8-week-old black-haired mice were selected. β-TCP/APG gel was injected into one cheek; the other was used as control. The animals were sacrificed at 8 weeks and histologically evaluated. Results. The new fibroblast was intensively stained with acid fuchsin and presented in contact with β-TCP. At higher magnification, actively secreting fibroblasts were observed at the periphery of β-TCP with a well differentiated fibroblast cell line and blood vessels. Acid fuchsin stained cutaneous structures in pink: no epidermal/dermal alterations or pathological inflammatory infiltrates were detected. The margins of β-TCP granules were clear and not diffused near tissues. Conclusion. APG with β-TCP preserves skin morphology, without immune response, with an excellent tolerability and is a promising scaffold for cells and biomaterial for soft tissue augmentation. PMID:27478828

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

PubMed

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

2016-01-01

Background. Facial aging is a dynamic process involving both soft tissue and bony structures. Skin atrophy, with loss of tone, elasticity, and distribution of facial fat, coupled with gravity and muscle activity, leads to wrinkling and folds. Purpose. The aim of the study was to evaluate microporous tricalcium phosphate (β-TCP) and autologous platelet gel (APG) mix in mice for oral and maxillofacial soft tissue augmentation. The hypothesis was that β-TCP added with APG was able to increase the biostimulating effect on fibroblasts and quicken resorption. Materials and Methods. Ten female, 6-8-week-old black-haired mice were selected. β-TCP/APG gel was injected into one cheek; the other was used as control. The animals were sacrificed at 8 weeks and histologically evaluated. Results. The new fibroblast was intensively stained with acid fuchsin and presented in contact with β-TCP. At higher magnification, actively secreting fibroblasts were observed at the periphery of β-TCP with a well differentiated fibroblast cell line and blood vessels. Acid fuchsin stained cutaneous structures in pink: no epidermal/dermal alterations or pathological inflammatory infiltrates were detected. The margins of β-TCP granules were clear and not diffused near tissues. Conclusion. APG with β-TCP preserves skin morphology, without immune response, with an excellent tolerability and is a promising scaffold for cells and biomaterial for soft tissue augmentation.

[Sclerotization of orbital lymphangioma with OK-432].

PubMed

Lagrèze, W; Metzger, M; Rössler, J

2014-05-01

Orbital lymphangiomas are mostly congenital, apparent vascular space-occupying lesions, which can lead to disfiguring swelling of the periorbital soft tissues, ocular motility disorders, optic nerve compression and keratopathy. The treatment is challenging because the disease is principally incurable. Lymphangiomatous tissue can be surgically partially reduced or treated by intralesional injection of various sclerosants. In this review we report the successful use of OK-432 for destruction of a macrocystic orbital lymphangioma.

The role of nonsteroidal anti-inflammatory drugs intramuscular injection in the development and severity of deep soft tissue infection in mice.

PubMed

Ture, Zeynep; Demiraslan, Hayati; Kontas, Olgun; Alp, Emine; Doganay, Mehmet

2018-04-01

The aim of this study was to determine the role of nonsteroidal anti-inflammatory drugs (NSAID) injection on the severity of local infection and the effect on the progression of soft tissue infection (STI).The mouse model of STI with Group A streptococcus (GAS) was developed and treated with diclofenac sodium (DS) intramuscularly. Mice were divided into five groups: administered DS for 48 h before GAS (Group 1), GAS-DS and maintained DS for 48 h (Group 2), DS for 48 h (Group 3), GAS on zero time (Group 4), and control (Group 5). In vitro, a high concentration (40 mg/L) of DS inhibited GAS growth, whereas a lower concentration (0.4 mg/L) was not effective. Sepsis was observed in animals with DS and GAS inoculation (group 1 and 2). Group 4 had statistically significant higher bacterial load than groups 1 and 2. All groups had a higher inflammation rate than the control group. The median of TNF-alpha and mean IL-6 in the groups 1, 2, and 4 was significantly higher than those in the control group. Even if the animals that were treated with DS injection prior to the GAS inoculation had similar inflammation score, similar cytokine levels and low bacterial load in the tissue, they had a rather high rate of sepsis. In conclusion, DS injection prior to bacterial inoculation might predispose to bacteremia and sepsis. © 2017 Société Française de Pharmacologie et de Thérapeutique.

Obtention of injectable platelets rich-fibrin (i-PRF) and its polymerization with bone graft: technical note.

PubMed

Mourão, Carlos Fernando de Almeida Barros; Valiense, Helder; Melo, Elias Rodrigues; Mourão, Natália Belmock Mascarenhas Freitas; Maia, Mônica Diuana-Calasans

2015-01-01

The use of autologous platelet concentrates, represent a promising and innovator tools in the medicine and dentistry today. The goal is to accelerate hard and soft tissue healing. Among them, the platelet-rich plasma (PRP) is the main alternative for use in liquid form (injectable). These injectable form of platelet concentrates are often used in regenerative procedures and demonstrate good results. The aim of this study is to present an alternative to these platelet concentrates using the platelet-rich fibrin in liquid form (injectable) and its use with particulated bone graft materials in the polymerized form.

Desire for penile girth enhancement and the effects of the self-injection of hyaluronic Acid gel.

PubMed

Coskuner, Enis Rauf; Canter, Halil Ibrahim

2012-07-01

Penile girth enhancement is a controversial subject but demands for enhancement are increasing steadily. Although various fillers have been widely used for soft tissue augmentation, there is no reliable material for this particular situation. Here we report a case of an acute hypersensitivity reaction in a man after his first self-injection of a filler material, which, he claimed, was hyaluronic acid gel for penile girth enhancement and glans penis augmentation.

Heroin-associated anthrax with minimal morbidity.

PubMed

Black, Heather; Chapman, Ann; Inverarity, Donald; Sinha, Satyajit

2017-03-08

In 2010, during an outbreak of anthrax affecting people who inject drugs, a heroin user aged 37 years presented with soft tissue infection. He subsequently was found to have anthrax. We describe his management and the difficulty in distinguishing anthrax from non-anthrax lesions. His full recovery, despite an overall mortality of 30% for injectional anthrax, demonstrates that some heroin-related anthrax cases can be managed predominately with oral antibiotics and minimal surgical intervention. 2017 BMJ Publishing Group Ltd.

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

PubMed

Cohen, Joel L; Gold, Michael H

2014-10-01

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

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

PubMed Central

Gold, Michael H.

2014-01-01

Injection of dermal fillers for soft tissue augmentation is a minimally invasive cosmetic procedure with growing popularity. However, patients often express concern about pain with such procedures. A topical anesthetic cream formulated with lidocaine/tetracaine 7%7% was approved by the United States Food and Drug Administration in 2006 and recently reintroduced to the market for use during superficial dermatological procedures. A Phase 3 study was conducted to assess the efficacy and safety of lidocaine/tetracaine 7%7% cream versus placebo cream when used to induce local dermal anesthesia during injections with hyaluronic acid. Mean visual analog scale scores significantly favored lidocaine/tetracaine 7%7% cream. A significant percent of subjects also indicated that lidocaine/tetracaine 7%7% cream provided adequate pain relief and that they would use lidocaine/tetracaine 7%7% cream again. Investigators also rated lidocaine/tetracaine 7%7% cream significantly better than placebo cream for providing adequate pain relief and on the assessment of pain scale. Lidocaine/tetracaine 7%7% cream was safe and well tolerated with most subjects reporting no erythema, edema, or blanching. No related adverse events were reported with lidocaine/tetracaine 7%7% cream; one related adverse event of erythema was reported with placebo cream. The results of this study indicate that lidocaine/tetracaine 7%7% cream is efficacious and safe at providing pain relief for soft tissue augmentation with hyaluronic acid. PMID:25371769

21 CFR 522.1620 - Orgotein for injection.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Horses. (i) It is used in the treatment of soft tissue inflammation associated with the musculoskeletal... other day for 2 weeks and twice weekly for 2 to 3 more weeks. Severe cases, both acute and chronic, may... the relief of inflammation associated with ankylosing spondylitis, spondylosis, and disc disease. When...

21 CFR 522.1620 - Orgotein for injection.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) Horses. (i) It is used in the treatment of soft tissue inflammation associated with the musculoskeletal... other day for 2 weeks and twice weekly for 2 to 3 more weeks. Severe cases, both acute and chronic, may... the relief of inflammation associated with ankylosing spondylitis, spondylosis, and disc disease. When...

21 CFR 522.1620 - Orgotein for injection.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Horses. (i) It is used in the treatment of soft tissue inflammation associated with the musculoskeletal... other day for 2 weeks and twice weekly for 2 to 3 more weeks. Severe cases, both acute and chronic, may... the relief of inflammation associated with ankylosing spondylitis, spondylosis, and disc disease. When...

21 CFR 522.1620 - Orgotein for injection.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) Horses. (i) It is used in the treatment of soft tissue inflammation associated with the musculoskeletal... other day for 2 weeks and twice weekly for 2 to 3 more weeks. Severe cases, both acute and chronic, may... the relief of inflammation associated with ankylosing spondylitis, spondylosis, and disc disease. When...

Studies in fat grafting: Part I. Effects of injection technique on in vitro fat viability and in vivo volume retention.

PubMed

Chung, Michael T; Paik, Kevin J; Atashroo, David A; Hyun, Jeong S; McArdle, Adrian; Senarath-Yapa, Kshemendra; Zielins, Elizabeth R; Tevlin, Ruth; Duldulao, Chris; Hu, Michael S; Walmsley, Graham G; Parisi-Amon, Andreina; Momeni, Arash; Rimsa, Joe R; Commons, George W; Gurtner, Geoffrey C; Wan, Derrick C; Longaker, Michael T

2014-07-01

Fat grafting has become increasingly popular for the correction of soft-tissue deficits at many sites throughout the body. Long-term outcomes, however, depend on delivery of fat in the least traumatic fashion to optimize viability of the transplanted tissue. In this study, the authors compare the biological properties of fat following injection using two methods. Lipoaspiration samples were obtained from five female donors, and cellular viability, proliferation, and lipolysis were evaluated following injection using either a modified Coleman technique or an automated, low-shear device. Comparisons were made to minimally processed, uninjected fat. Volume retention was also measured over 12 weeks after injection of fat under the scalp of immunodeficient mice using either the modified Coleman technique or the Adipose Tissue Injector. Finally, fat grafts were analyzed histologically. Fat viability and cellular proliferation were both significantly greater with the Adipose Tissue Injector relative to injection with the modified Coleman technique. In contrast, significantly less lipolysis was noted using the automated device. In vivo fat volume retention was significantly greater than with the modified Coleman technique at the 4-, 6-, 8-, and 12-week time points. This corresponded to significantly greater histologic scores for healthy fat and lower scores for injury following injection with the device. Biological properties of injected tissues reflect how disruptive and harmful techniques for placement of fat may be, and the authors' in vitro and in vivo data both support the use of the automated, low-shear devices compared with the modified Coleman technique.

Studies in Fat Grafting: Part I. Effects of Injection Technique on in vitro Fat Viability and in vivo Volume Retention

PubMed Central

Chung, Michael T.; Paik, Kevin J.; Atashroo, David A.; Hyun, Jeong S.; McArdle, Adrian; Senarath-Yapa, Kshemendra; Zielins, Elizabeth R.; Tevlin, Ruth; Duldulao, Chris; Hu, Michael S.; Walmsley, Graham G.; Parisi-Amon, Andreina; Momeni, Arash; Rimsa, Joe R.; Commons, George W.; Gurtner, Geoffrey C.; Wan, Derrick C.; Longaker, Michael T.

2014-01-01

Background Fat grafting has become increasingly popular for the correction of soft tissue deficits at many sites throughout the body. Long-term outcomes, however, depend on delivery of fat in the least traumatic fashion to optimize viability of the transplanted tissue. In this study, we compare the biologic properties of fat following injection using two methods. Methods Lipoaspiration samples were obtained from five female donors and cellular viability, proliferation, and lipolysis were evaluated following injection using either a modified Coleman technique or an automated, low shear device. Comparisons were made to minimally processed, uninjected fat. Volume retention was also measured over twelve weeks following injection of fat under the scalp of immunodeficient mice using either the modified Coleman technique or the Adipose Tissue Injector. Finally, fat grafts were analyzed histologically. Results Fat viability and cellular proliferation were both significantly greater with the Adipose Tissue Injector relative to injection with the modified Coleman technique. In contrast, significantly less lipolysis was noted using the automated device. In vivo fat volume retention was significantly greater than with the modified Coleman technique at 4, 6, 8, and 12 week time points. This corresponded with significantly greater histological scores for healthy fat and lower scores for injury following injection with the device. Conclusions Biological properties of injected tissues reflect how disruptive and harmful techniques for placement of fat may be, and our in vitro and in vivo data both support the use of the automated, low shear devices compared to the modified Coleman technique. PMID:24622574

Pharmacokinetic properties of new antitumor radiopharmaceutical on the basis of diamond nanoporous composites labeled with rhenium-188

NASA Astrophysics Data System (ADS)

Petriev, V. M.; Tishchenko, V. K.; Kuril'chik, A. A.; Skvortsov, V. G.

2017-01-01

Today the development of address therapeutic radionuclide delivery systems directly to tumor tissue is of current interest. It can be achieved by the design of drug containers of specific sizes and shapes from carbon-based composite materials. It will be allowed to enhance the efficacy of anticancer therapy and avoid serious side effects. In this work we studied the pharmacokinetic properties of nanodiamond nanoporous composite labeled with rhenium-188 in rats with hepatocholangioma PC-1 after intratumoral injection. It was established that substantial part of injected radioactivity remained in tumor tissue. Within three hours after 188Re-nanoporous composites injection activity in tumor constituted 79.1-91.3% of injected dose (ID). Then activity level declined to 45.9% ID at 120 hours. No more than 1.34% ID entered the bloodstream. In soft organs and tissues, except thyroid gland, the content of compound didn’t exceed 0.3% ID/g. The highest activity in thyroid gland was 6.95% ID/g. In conclusion, received results suggest 188Re-nanoporous composites can be promising radionuclide delivery systems for cancer treatment.

Filler migration and extensive lesions after lip augmentation: Adverse effects of polydimethylsiloxane filler.

PubMed

Abtahi-Naeini, Bahareh; Faghihi, Gita; Shahmoradi, Zabihollah; Saffaei, Ali

2018-01-07

Polydimethylsiloxane (PDMS), also called liquid silicone, belongs to a group of polymeric compounds that are commonly referred to as silicones. These filling agents have been used as injectable filler for soft tissue augmentation. There are limited experiences about management of the severe complications related to filler migration associated with PDMS injection. We present a 35-year-old female with severe erythema, edema over her cheeks and neck, and multiple irregularities following cosmetic lip augmentation with PDMS. Further studies are required for management of this complicated case of PDMS injection. © 2018 Wiley Periodicals, Inc.

Outcome of Conventional Adipose Tissue Grafting for Contour Deformities of Face and Role of Ex Vivo Expanded Adipose Tissue-Derived Stem Cells in Treatment of Such Deformities.

PubMed

Bashir, Muhammad Mustehsan; Sohail, Muhammad; Bashir, Afzaal; Khan, Farid Ahmad; Jan, Sadia Nosheen; Imran, Muhammad; Ahmad, Fridoon Jawad; Choudhery, Mahmood S

2018-02-23

To evaluate the outcomes of conventional fat grafting for facial contour deformities and to describe clinical outcome of a patient with contour deformity of face treated with ex vivo expanded adipose tissue-derived mesenchymal stem cells (ASCs) enriched fat graft. The Department of Plastic Surgery and Tissue Engineering and Regenerative Medicine Laboratory, King Edward Medical University/Mayo Hospital, Lahore, from September 2015 to September 2017. Patients with contour deformities of face requiring soft tissue augmentation were included. Fat was harvested, processed, and injected following a standard protocol. Both subjective and objective assessments were performed and complications were also noted. Twenty-five patients underwent 51 fat-grafting sessions over a period of 24 months. Eighteen (72%) patients underwent multiple fat-grafting sessions. Mean (standard deviation) soft tissue thickness after 72 hours and 6 months of first fat graft session was 18.62 (7.2) and 12.88 (6.21) mm, respectively, which corresponds to 30.77 (13)% reduction of transplanted fat. Physician and patient assessment scores were 3.42 (0.92) and 4 (1.04), respectively. Few minor complications were observed. In the patient undergoing ex vivo expanded ASCs enriched fat graft, there was minimal decrease in soft tissue thickness of treated area (44 mm vs 42 mm) 6 months postoperatively and patient was highly satisfied with the outcome after the single session. Conventional fat grafting is safe for correction of facial contour deformities. However, procedure needs to be repeated multiple times to produce satisfactory results. Beneficial effects of ex vivo expanded ASCs enriched fat grafting have a potential to alter the current treatment paradigm of fat grafting for soft tissue reconstruction.

Percutaneous Treatment of Iatrogenic Pseudoaneurysms by Cyanoacrylate-Based Wall-Gluing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Del Corso, Andrea, E-mail: adelcorso2000@hotmail.com; Vergaro, Giuseppe

Purpose. Although the majority of iatrogenic pseudoaneurysms (PSAs) are amenable to ultrasound (US)-guided thrombin injection, patients with those causing neuropathy, claudication, significant venous compression, or soft tissue necrosis are considered poor candidates for this option and referred to surgery. We aimed to test the effectiveness and feasibility of a novel percutaneous cyanoacrylate glue (NBCA-MS)-based technique for treatment of symptomatic and asymptomatic iatrogenic PSA. Material and Methods. During a 3-year period, we prospectively enrolled 91 patients with iatrogenic PSA [total n = 94 (femoral n = 76; brachial n = 11; radial n = 6; axillary n = 1)]. PSA weremore » asymptomatic in 66 % of cases, and 34 % presented with symptoms due to neuropathy, venous compression, and/or soft tissue necrosis. All patients signed informed consent. All patients received NBCA-MS-based percutaneous treatment. PSA chamber emptying was first obtained by US-guided compression; superior and inferior walls of the PSA chamber were then stuck together using NBCA-MS microinjections. Successfulness of the procedure was assessed immediately and at 1-day and 1-, 3-, and 12-month US follow-up. Results. PSA occlusion rate was 99 % (93 of 94 cases). After treatment, mean PSA antero-posterior diameter decrease was 67 {+-} 22 %. Neuropathy and vein compression immediately disappeared in 91 % (29 of 32) of cases. Patients with tissue necrosis (n = 6) underwent subsequent outpatient necrosectomy. No distal embolization occurred, nor was conversion to surgery necessary. Conclusion. PSA treatment by way of NBCA-MS glue injection proved to be safe and effective in asymptomatic patients as well as those with neuropathy, venous compression, or soft-tissue necrosis (currently candidates for surgery). Larger series are needed to confirm these findings.« less

Desire for Penile Girth Enhancement and the Effects of the Self-Injection of Hyaluronic Acid Gel

PubMed Central

Coskuner, Enis Rauf; Canter, Halil Ibrahim

2012-01-01

Penile girth enhancement is a controversial subject but demands for enhancement are increasing steadily. Although various fillers have been widely used for soft tissue augmentation, there is no reliable material for this particular situation. Here we report a case of an acute hypersensitivity reaction in a man after his first self-injection of a filler material, which, he claimed, was hyaluronic acid gel for penile girth enhancement and glans penis augmentation. PMID:23112518

Detection and volume estimation of artificial hematomas in the subcutaneous fatty tissue: comparison of different MR sequences at 3.0 T.

PubMed

Ogris, Kathrin; Petrovic, Andreas; Scheicher, Sylvia; Sprenger, Hanna; Urschler, Martin; Hassler, Eva Maria; Yen, Kathrin; Scheurer, Eva

2017-06-01

In legal medicine, reliable localization and analysis of hematomas in subcutaneous fatty tissue is required for forensic reconstruction. Due to the absence of ionizing radiation, magnetic resonance imaging (MRI) is particularly suited to examining living persons with forensically relevant injuries. However, there is limited experience regarding MRI signal properties of hemorrhage in soft tissue. The aim of this study was to evaluate MR sequences with respect to their ability to show high contrast between hematomas and subcutaneous fatty tissue as well as to reliably determine the volume of artificial hematomas. Porcine tissue models were prepared by injecting blood into the subcutaneous fatty tissue to create artificial hematomas. MR images were acquired at 3T and four blinded observers conducted manual segmentation of the hematomas. To assess segmentability, the agreement of measured volume with the known volume of injected blood was statistically analyzed. A physically motivated normalization taking into account partial volume effect was applied to the data to ensure comparable results among differently sized hematomas. The inversion recovery sequence exhibited the best segmentability rate, whereas the T1T2w turbo spin echo sequence showed the most accurate results regarding volume estimation. Both sequences led to reproducible volume estimations. This study demonstrates that MRI is a promising forensic tool to assess and visualize even very small amounts of blood in soft tissue. The presented results enable the improvement of protocols for detection and volume determination of hemorrhage in forensically relevant cases and also provide fundamental knowledge for future in-vivo examinations.

Nitroglycerin: a review of its use in the treatment of vascular occlusion after soft tissue augmentation.

PubMed

Kleydman, Kate; Cohen, Joel L; Marmur, Ellen

2012-12-01

Skin necrosis after soft tissue augmentation with dermal fillers is a rare but potentially severe complication. Nitroglycerin paste may be an important treatment option for dermal and epidermal ischemia in cosmetic surgery. To summarize the knowledge about nitroglycerin paste in cosmetic surgery and to understand its current use in the treatment of vascular compromise after soft tissue augmentation. To review the mechanism of action of nitroglycerin, examine its utility in the dermal vasculature in the setting of dermal filler-induced ischemia, and describe the facial anatomy danger zones in order to avoid vascular injury. A literature review was conducted to examine the mechanism of action of nitroglycerin, and a treatment algorithm was proposed from clinical observations to define strategies for impending facial necrosis after filler injection. Our experience with nitroglycerin paste and our review of the medical literature supports the use of nitroglycerin paste on the skin to help improve flow in the dermal vasculature because of its vasodilatory effect on small-caliber arterioles. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Providing specialist clinical skills in soft tissue and intra-articular injection through a postgraduate masters module.

PubMed

Stevenson, Kay; Waterfield, Jackie

2005-01-01

Current philosophy and policy changes in the National Health Service are encouraging healthcare practitioners to extend their clinical skills to create a more patient-centred approach thus allowing patients to be seen in a timely and more appropriate manner. This often requires further development of the practitioners' skills and knowledge. One approach to achieve this is through collaboration between employers and educational providers to ensure that educational experience is not only evidence based but also responsive to the needs of the current and future workforce. A postgraduate module was developed to raise critical and evaluative skills, as well as the technical skills of practitioners using injections in the management of joint and soft tissue pathology, while developing a professional responsibility towards injection practice. The module emphasized learning though experience by contextualizing the theoretical aspects of the module and by its student centred assessments. Further strengths of this module are that it has utilized academic and clinical expertise and knowledge to enable clinicians to gain additional skills and the multidisciplinary approach engendered good working practice Overall the module was evaluated positively by both tutors and students and not only met its aims but also addressed the current professional and policy issues around continuing professional development. Copyright (c) 2005 John Wiley & Sons, Ltd.

Foreign body granuloma formation secondary to silicone injection.

PubMed

Schwartzfarb, Elissa M; Hametti, Juan Martin; Romanelli, Paolo; Ricotti, Carlos

2008-07-15

Injectable silicone has been used extensively over the last 40 years for soft tissue augmentation. Although considered biologically inert, this material has been implicated in a variety of adverse reactions including granulomas, disfiguring nodules, and lymphedema, sometimes with latent periods of decades. Often these complications are a result of the use of industrial grade products injected by unlicensed or unskilled practitioners. Here we report a case of foreign body granuloma in the thigh secondary to silicone injection in the buttocks. Initially the patient did not disclose a cosmetic contouring procedure administered by a nonprofessional nine months earlier, making diagnosis difficult. We remind clinicians to include foreign body granulomas in the differential diagnosis of apparent cellulitis and to question patients about the use of injectable fillers.

Two anthrax cases with soft tissue infection, severe oedema and sepsis in Danish heroin users

PubMed Central

2013-01-01

Background Anthrax had become extremely rare in Europe, but in 2010 an outbreak of anthrax among heroin users in Scotland increased awareness of contaminated heroin as a source of anthrax. We present the first two Danish cases of injectional anthrax and discuss the clinical presentations, which included both typical and more unusual manifestations. Case presentations The first patient, a 55-year old man with HIV and hepatitis C virus co-infection, presented with severe pain in the right thigh and lower abdomen after injecting heroin into the right groin. Computed tomography and ultrasonographic examination of the abdomen and right thigh showed oedematous thickened peritoneum, distended oedematous mesentery and subcutaneous oedema of the right thigh. At admission the patient was afebrile but within 24 hours he progressed to severe septic shock and abdominal compartment syndrome. Cultures of blood and intraperitoneal fluid grew Bacillus anthracis. The patient was treated with meropenem, clindamycin, ciprofloxacin and metronidazole. Despite maximum supportive care including mechanical ventilation, vasopressor treatment and continuous veno-venous hemodiafiltration the patient died on day four. The second patient, a 39-year old man with chronic hepatitis C virus infection, presented with fever and a swollen right arm after injecting heroin into his right arm. The arm was swollen from the axilla to the wrist with tense and discoloured skin. He was initially septic with low blood pressure but responded to crystalloids. During the first week, swelling progressed and the patient developed massive generalised oedema with a weight gain of 40 kg. When blood cultures grew Bacillus anthracis antibiotic treatment was changed to meropenem, moxifloxacin and metronidazole, and on day 7 hydroxycloroquin was added. The patient responded to treatment and was discharged after 29 days. Conclusions These two heroin-associated anthrax cases from Denmark corroborate that heroin contaminated with anthrax spores may be a continuous source of injectional anthrax across Europe. Clinicians and clinical microbiologists need to stay vigilant and suspect anthrax in patients with a history of heroin use who present with soft tissue or generalised infection. Marked swelling of affected soft tissue or unusual intra-abdominal oedema should strengthen clinical suspicion. PMID:24004900

Two anthrax cases with soft tissue infection, severe oedema and sepsis in Danish heroin users.

PubMed

Russell, Lene; Pedersen, Michael; Jensen, Andreas V; Søes, Lillian Marie; Hansen, Ann-Brit Eg

2013-09-03

Anthrax had become extremely rare in Europe, but in 2010 an outbreak of anthrax among heroin users in Scotland increased awareness of contaminated heroin as a source of anthrax. We present the first two Danish cases of injectional anthrax and discuss the clinical presentations, which included both typical and more unusual manifestations. The first patient, a 55-year old man with HIV and hepatitis C virus co-infection, presented with severe pain in the right thigh and lower abdomen after injecting heroin into the right groin. Computed tomography and ultrasonographic examination of the abdomen and right thigh showed oedematous thickened peritoneum, distended oedematous mesentery and subcutaneous oedema of the right thigh. At admission the patient was afebrile but within 24 hours he progressed to severe septic shock and abdominal compartment syndrome. Cultures of blood and intraperitoneal fluid grew Bacillus anthracis. The patient was treated with meropenem, clindamycin, ciprofloxacin and metronidazole. Despite maximum supportive care including mechanical ventilation, vasopressor treatment and continuous veno-venous hemodiafiltration the patient died on day four.The second patient, a 39-year old man with chronic hepatitis C virus infection, presented with fever and a swollen right arm after injecting heroin into his right arm. The arm was swollen from the axilla to the wrist with tense and discoloured skin. He was initially septic with low blood pressure but responded to crystalloids. During the first week, swelling progressed and the patient developed massive generalised oedema with a weight gain of 40 kg. When blood cultures grew Bacillus anthracis antibiotic treatment was changed to meropenem, moxifloxacin and metronidazole, and on day 7 hydroxycloroquin was added. The patient responded to treatment and was discharged after 29 days. These two heroin-associated anthrax cases from Denmark corroborate that heroin contaminated with anthrax spores may be a continuous source of injectional anthrax across Europe. Clinicians and clinical microbiologists need to stay vigilant and suspect anthrax in patients with a history of heroin use who present with soft tissue or generalised infection. Marked swelling of affected soft tissue or unusual intra-abdominal oedema should strengthen clinical suspicion.

Preventing, identifying, and managing cosmetic procedure complications, part 2: lasers and chemical peels.

PubMed

Brown, Megan

2016-08-01

Part 1 of this series highlighted some of the potential complications that have been associated with soft tissue augmentation and botulinum toxin injections. In part 2, tips for how dermatology residents may prevent, identify, and manage complications from lasers and chemical peels for optimal patient outcomes are provided.

Cytocompatible in situ forming chitosan/hyaluronan hydrogels via a metal-free click chemistry for soft tissue engineering.

PubMed

Fan, Ming; Ma, Ye; Mao, Jiahui; Zhang, Ziwei; Tan, Huaping

2015-07-01

Injectable hydrogels are important cell scaffolding materials for tissue engineering and regenerative medicine. Here, we report a new class of biocompatible and biodegradable polysaccharide hydrogels derived from chitosan and hyaluronan via a metal-free click chemistry, without the addition of copper catalyst. For the metal-free click reaction, chitosan and hyaluronan were modified with oxanorbornadiene (OB) and 11-azido-3,6,9-trioxaundecan-1-amine (AA), respectively. The gelation is attributed to the triazole ring formation between OB and azido groups of polysaccharide derivatives. The molecular structures were verified by FT-IR spectroscopy and elemental analysis, giving substitution degrees of 58% and 47% for chitosan-OB and hyaluronan-AA, respectively. The in vitro gelation, morphologies, equilibrium swelling, compressive modulus and degradation of the composite hydrogels were examined. The potential of the metal-free hydrogel as a cell scaffold was demonstrated by encapsulation of human adipose-derived stem cells (ASCs) within the gel matrix in vitro. Cell culture showed that this metal-free hydrogel could support survival and proliferation of ASCs. A preliminary in vivo study demonstrated the usefulness of the hydrogel as an injectable scaffold for adipose tissue engineering. These characteristics provide a potential opportunity to use the metal-free click chemistry in preparation of biocompatible hydrogels for soft tissue engineering applications. Copyright © 2015 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Alopecia with foreign body granulomas induced by Radiesse injection: A case report.

PubMed

Liu, Ren-Feng; Kuo, Tseng-Tong; Chao, Yen-Yu; Huang, Yu-Huei

2018-02-26

Radiesse is a soft tissue filler which has been widely used for cosmetic enhancement. The safety of Radiesse has been thoroughly investigated via numerous studies. A late-onset complication of Radiesse injection consists of foreign body granulomas, with only three case reports in over 10 years of clinical use. Herein, we describe the case of a patient who experienced alopecia with foreign body granulomas at the injection region one month after receiving a Radiesse injection. To our knowledge, this is the first report in the English literature of alopecia as an adverse event associated with Radiesse injection. The present case reminded physicians to evaluate more cautiously the necessity of injecting filler into hair-bearing area for lifting purpose. This procedure may cause foreign body granulomatous reaction, which may result in hair loss at the injection region.

Technical Considerations for Filler and Neuromodulator Refinements

PubMed Central

Wilson, Anthony J.; Chang, Brian L.; Percec, Ivona

2016-01-01

Background: The toolbox for cosmetic practitioners is growing at an unprecedented rate. There are novel products every year and expanding off-label indications for neurotoxin and soft-tissue filler applications. Consequently, aesthetic physicians are increasingly challenged by the task of selecting the most appropriate products and techniques to achieve optimal patient outcomes. Methods: We employed a PubMed literature search of facial injectables from the past 10 years (2005–2015), with emphasis on those articles embracing evidence-based medicine. We evaluated the scientific background of every product and the physicochemical properties that make each one ideal for specific indications. The 2 senior authors provide commentary regarding their clinical experience with specific technical refinements of neuromodulators and soft-tissue fillers. Results: Neurotoxins and fillers are characterized by unique physical characteristics that distinguish each product. This results in subtle but important differences in their clinical applications. Specific indications and recommendations for the use of the various neurotoxins and soft-tissue fillers are reviewed. The discussion highlights refinements in combination treatments and product physical modifications, according to specific treatment zones. Conclusions: The field of facial aesthetics has evolved dramatically, mostly secondary to our increased understanding of 3-dimensional structural volume restoration. Our work reviews Food and Drug Administration–approved injectables. In addition, we describe how to modify products to fulfill specific indications such as treatment of the mid face, décolletage, hands, and periorbital regions. Although we cannot directly evaluate the duration or exact physical properties of blended products, we argue that “product customization” is safe and provides natural results with excellent patient outcomes. PMID:28018778

Acute tissue injury activates satellite cells and promotes sarcoma formation via the HGF/c-MET signaling pathway.

PubMed

Van Mater, David; Añó, Leonor; Blum, Jordan M; Webster, Micah T; Huang, WeiQiao; Williams, Nerissa; Ma, Yan; Cardona, Diana M; Fan, Chen-Ming; Kirsch, David G

2015-02-01

Some patients with soft-tissue sarcoma (STS) report a history of injury at the site of their tumor. Although this phenomenon is widely reported, there are relatively few experimental systems that have directly assessed the role of injury in sarcoma formation. We recently described a mouse model of STS whereby p53 is deleted and oncogenic Kras is activated in muscle satellite cells via a Pax7(CreER) driver following intraperitoneal injection with tamoxifen. Here, we report that after systemic injection of tamoxifen, the vast majority of Pax7-expressing cells remain quiescent despite mutation of p53 and Kras. The fate of these muscle progenitors is dramatically altered by tissue injury, which leads to faster kinetics of sarcoma formation. In adult muscle, quiescent satellite cells will transition into an active state in response to hepatocyte growth factor (HGF). We show that modulating satellite cell quiescence via intramuscular injection of HGF increases the penetrance of sarcoma formation at the site of injection, which is dependent on its cognate receptor c-MET. Unexpectedly, the tumor-promoting effect of tissue injury also requires c-Met. These results reveal a mechanism by which HGF/c-MET signaling promotes tumor formation after tissue injury in a mouse model of primary STS, and they may explain why some patients develop a STS at the site of injury. ©2014 American Association for Cancer Research.

Endoscopic debridement and fibrin glue injection of a chronic Morel-Lavallée lesion of the knee in a professional soccer player: A case report and literature review.

PubMed

Koc, Baris B; Somorjai, Nicolaas; P M Kiesouw, Egid; Vanderdood, Kurt; Meesters-Caberg, Marleen; Draijer, Frits W; Jansen, Edwin J P

2017-01-01

A Morel-Lavallée lesion is a post-traumatic closed degloving injury of soft tissue. The lesion is due to a shearing trauma with separation of subcutaneous tissue from underlying fascia. When conservative treatment fails, surgical treatment is imperative. Commonly, open drainage and debridement is performed. This case report describes a Morel-Lavallée lesion of the knee in a professional soccer player who was successfully treated with endoscopic debridement and fibrin glue injection after failure of conservative management. This method achieves the goal of an open surgical debridement without exposing patients to an increased morbidity. Copyright © 2016. Published by Elsevier B.V.

Drug injection into fat tissue with a laser based microjet injector

NASA Astrophysics Data System (ADS)

Han, Tae-hee; Hah, Jung-moo; Yoh, Jack J.

2011-05-01

We have investigated a new micro drug jet injector using laser pulse energy. An infrared laser beam of high energy (˜3 J/pulse) is focused inside a driving fluid in a small chamber. The pulse then induces various energy releasing processes, and generates fast microjets through a micronozzle. The elastic membrane of this system plays an important role in transferring mechanical pressure and protecting drug from heat release. In this paper, we offer the sequential images of microjet generation taken by a high speed camera as an evidence of the multiple injections via single pulse. Furthermore, we test the proposed system to penetrate soft animal tissues in order to evaluate its feasibility as an advanced transdermal drug delivery method.

Relation between the location of elements in the periodic table and various organ-uptake rates.

PubMed

Ando, A; Ando, I; Hiraki, T; Hisada, K

1989-01-01

Fifty four elements and 65 radioactive compounds were examined to determine the organ uptake rates for rats 3, 24 and 48 h after i.v. injection of these compounds. They were prepared as carrier free nuclides, or containing a small amount of stable nuclide. Generally speaking, behaviors of K, Rb, Cs and Tl in all the organs were very similar to one another, but they differed from that of Na. Bivalent hard acids were avidly taken up into bone; therefore, uptake rates in soft tissues were very small. Hard acids of tri-, quadri- and pentavalence which were taken up into the soft tissue organs decreased more slowly from these organs than other ions. Soft acids such as Hg2+ were bound very firmly to the component in the kidney. Anions (with few exceptions), GeCl4 and SbCl3 were rapidly excreted in urine, so that the uptake rates in organs were low.

The use of polymethyl-methacrylate (Artecoll) as an adjunct to facial reconstruction

PubMed Central

Mok, David; Schwarz, Jorge

2004-01-01

BACKGROUND: Injectable polymethyl-methacrylate (PMMA) microspheres, or Artecoll, has been used for the last few years in aesthetic surgery as long-term tissue filler for the correction of wrinkles and for lip augmentation. This paper presents three cases of the use of PMMA microsphere injection for reconstructive patients with defects of varying etiologies. These cases provide examples of a novel adjunct to the repertoire of the reconstructive surgeon. OBJECTIVES: To evaluate the effectiveness (short- and long-term) of PMMA injection for the correction of small soft tissue defects of the face. METHODS: Three case histories are presented. They include the origin of the defect; previous reconstructions of the defect; and area, volume, timing and technical particularities of PMMA administration. RESULTS: All three cases showed improvement of the defect with the PMMA injection with respect to both objective evidence and patient satisfaction. The improvements can still be seen after several years. CONCLUSIONS: PMMA microsphere injection can be effectively used to correct selected small facial defects in reconstructive cases and the results are long lasting. PMID:24115873

Physiotherapy for patients with soft tissue shoulder disorders: a systematic review of randomised clinical trials.

PubMed Central

van der Heijden, G. J.; van der Windt, D. A.; de Winter, A. F.

1997-01-01

OBJECTIVE: To assess the effectiveness of physiotherapy for patients with soft tissue shoulder disorders. DESIGN: A systematic computerised literature search of Medline and Embase, supplemented with citation tracking, for relevant trials with random allocation published before 1996. SUBJECTS: Patients treated with physiotherapy for disorders of soft tissue of the shoulder. MAIN OUTCOME MEASURES: Success rates, mobility, pain, functional status. RESULTS: Six of the 20 assessed trials satisfied at least five of eight validity criteria. Assessment of methods was often hampered by insufficient information on various validity criteria, and trials were often flawed by lack of blinding, high proportions of withdrawals from treatment, and high proportions of missing values. Trial sizes were small: only six trials included intervention groups of more than 25 patients. Ultrasound therapy, evaluated in six trials, was not shown to be effective. Four other trials favoured physiotherapy (laser therapy or manipulation), but the validity of their methods was unsatisfactory. CONCLUSIONS: There is evidence that ultrasound therapy is ineffective in the treatment of soft tissue shoulder disorders. Due to small trial sizes and unsatisfactory methods, evidence for the effectiveness of other methods of physiotherapy is inconclusive. For all methods of treatment, trials were too heterogeneous with respect to included patients, index and reference treatments, and follow up to merit valid statistical pooling. Future studies should show whether physiotherapy is superior to treatment with drugs, steroid injections, or a wait and see policy. PMID:9233322

Inadvertent injection of formalin mistaken for local anesthetic agent: report of a case.

PubMed

Arakeri, Gururaj; Brennan, Peter A

2012-05-01

Chemical facial cellulitis, while commonly seen in domestic accidents or attempted suicide, is uncommon in the dental office and hence rarely addressed in the dental literature. We present an unusual case of chemical facial cellulitis caused by inadvertent injection of formalin into the soft tissues of the oral cavity, which was mistaken for local anesthesia solution. This report comprises the immediate symptoms, possible root cause, and management of the difficult situation. We also provide some guidelines to avoid such unfortunate events. Copyright © 2012 Elsevier Inc. All rights reserved.

Expansion and delivery of adipose-derived mesenchymal stem cells on three microcarriers for soft tissue regeneration.

PubMed

Zhou, Yalei; Yan, Zhiwei; Zhang, Hongmei; Lu, Wei; Liu, Shiyu; Huang, Xinhui; Luo, Hailang; Jin, Yan

2011-12-01

Cell/microcarrier combinations can be injected to repair tissue defects, but whether currently available microcarriers can be utilized to repair different tissue defects remains unknown. Here, we compared the suitability of fabricated micronized acellular dermal matrix (MADM), micronized small intestinal submucosa (MSIS), and gelatin microspheres as expansion and delivery scaffolds for adipose-derived mesenchymal stem cells (ADSCs). The results of MTS assay, scanning electron microscopy (SEM), and flow cytometry suggested that the three microcarriers all have good biocompatibility. Quantitative polymerase chain reaction revealed enhanced epidermal growth factor, vascular endothelial growth factor, basal fibroblast growth factor, and transforming growth factor-β expression levels after ADSCs had been cultured on MADM or MSIS for 5 days. After culturing ADSCs on microcarriers in osteogenic medium for 7 days, the expression levels of bone formation-related genes were enhanced. ADSC/microcarrier treatment accelerated wound closure. The ADSC/MADM and ADSC/MSIS combinations retained more of the original implant volume at 1 month postimplantation than ADSC/gelatin microspheres combination in soft-tissue augmentation studies. All implants displayed fibroblast and capillary vessel infiltrations; but ectopic bone formation did not occur, and the calvarial defect repair results were unfavorable. Our study demonstrates the potential utility of these microcarriers not only as a cell-culture substrate but also as a cell-transplantation vehicle for skin regeneration and soft-tissue reconstruction.

Platelet-Rich Plasma

PubMed Central

Cole, Brian J.; Seroyer, Shane T.; Filardo, Giuseppe; Bajaj, Sarvottam; Fortier, Lisa A.

2010-01-01

Context: Platelet-rich plasma (PRP) may affect soft tissue healing via growth factors released after platelet degranulation. Because of this potential benefit, clinicians have begun to inject PRP for the treatment of tendon, ligament, muscle, and cartilage injuries and early osteoarthritis. Evidence Acquisition: A PubMed search was performed for studies relating to PRP, growth factors, and soft tissue injuries from 1990 to 2010. Relevant references from these studies were also retrieved. Results: Soft tissue injury is a major source of disability that may often be complicated by prolonged and incomplete recovery. Numerous growth factors may potentiate the healing and regeneration of tendons and ligaments. The potential benefits of biologically enhanced healing processes have led to a recent interest in the use of PRP in orthopaedic sports medicine. There has been widespread anecdotal use of PRP for muscle strains, tendinopathy, and ligament injuries and as a surgical adjuvant to rotator cuff repair, anterior cruciate ligament reconstruction, and meniscal or labral repairs. Although the fascination with this emerging technology has led to a dramatic increase in its use, scientific data supporting this use are still in their infancy. Conclusions: The literature is replete with studies on the basic science of growth factors and their relation to the maintenance, proliferation, and regeneration of various tissues and tissue-derived cells. Despite the promising results of several animal studies, well-controlled human studies are lacking. PMID:23015939

Soft tissue tumors among beagles injected with 90Sr, 228Ra, OR 228Th.

PubMed

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

1995-08-01

The occurrence of soft-tissue tumors in beagles given 90Sr (88 dogs), 228Ra (76 dogs), or 228Th (81 dogs) as young adults and followed throughout their lifespans was compared with that of 133 control beagles given no radioactivity. For animals injected with 228Ra, tumors of the eye were more prominent (p < 0.05) than in the controls, and soft-tissue tumors of cavities in the head (excluding the brain, mouth, and eye) were more prominent in dogs given 90Sr than in the controls (p < 0.05). There was some indication that eye tumors in animals given about 0.56 kBq 228Th kg-1 were associated with their radionuclide exposure. For tumors at a few other locations, the relative occurrence was greater (p < 0.05) in the controls. These included malignant tumors of the testis and malignant plus benign tumors of the mammae and vagina in 228Th dogs; both malignant and malignant plus benign tumors of the mouth and testis, and malignant plus benign tumors of the mammae and vagina in 228Ra dogs; and malignant plus benign tumors of the mammae in 90Sr dogs (p > 0.05 by Odds Ratio Chi Square analysis but p < 0.05 by Fisher's Exact Test). Differences in relative occurrence between radioactive dogs and controls of all other tumor types that appeared in any of the animals (notably lymphosarcoma, lymph node tumors, leukemia, mast cell tumors, liver tumors, etc.) were not statistically significant (p > 0.05). Intercurrent mortality, mainly from bone cancer, was higher in the radioactive dogs than in the controls. Mean survival was reduced in the dogs given 90Sr, 228Ra, or 228Th (13.17 +/- 2.64 y in controls, 10.95 +/- 4.06 y in 90Sr dogs, 9.07 +/- 3.61 y in 228Ra dogs, and 9.20 +/- 4.15 y in 228Th dogs). Attenuated lifespans could account, at least in part, for the relative paucity of soft-tissue tumors not induced by radiation among the groups of dogs given radioactivity and occurring near the end of life for control animals.

A new injectable biphasic hydrogel based on partially hydrolyzed polyacrylamide and nano hydroxyapatite, crosslinked with chromium acetate, as scaffold for cartilage regeneration

NASA Astrophysics Data System (ADS)

Koushki, N.; Tavassoli, H.; Katbab, A. A.; Katbab, P.; Bonakdar, S.

2015-05-01

Polymer scaffolds are applied in the field of tissue engineering as three dimensional structures to organize cells and present stimuli to direct generation of a desired damaged tissue. In situ gelling scaffolds have attracted great attentions, as they are structurally similar to the extra cellular matrix (ECM). In the present work, attempts have been made to design and fabricate a new injectable and crosslinkable biphasic hydrogel based on partially hydrolyzed polyacrylamide (HPAM), chromium acetate as crosslink agent and nanocrystalline hydroxyapatite (nHAp) as reinforcing and bioactive agent for repair and regeneration of damaged cartilage. The distinct characteristic of HPAM is the presence of carboxylate anion groups on its backbone which allows to engineer the structure of the hydrogel for the desired bioactivity with appropriate cells differentiation towards both soft and hard (bone) tissues. The synthesized hydrogel exhibited bifunctional behavior which was derived by its biphasic structure in which one phase was loaded with nano hydroxyapatite to provide integration capability by subchondral bones and fix the hydrogel at cartilage defect without a need for suturing. The other phase differentiates the rabbit adipogenic mesenchymal stem cells (MSCs) towards soft tissue. Rheomechanical spectrometry (RMS) was employed to study the kinetic of the gelation including induction time and rate, as well as to measure the ultimate elastic modulus of the optimum crosslinked hydrogel. Surface tension measurement was also performed to tailor the surface characteristics of the gels. In vitro culturing of the cells inside the crosslinked hydrogel revealed high viability and high differentiation of the encapsulated rabbit stem cells, providing that the chromium acetate level was kept below 0.2 wt%. Based on the obtained results, the designed and fabricated biphasic hydrogel exhibited high potential as carrier for the stem cells for cartilage tissue engineering application with excellent injectability.

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

ClinicalTrials.gov

2017-12-11

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

Intra-articular and soft tissue injections, a systematic review of relative efficacy of various corticosteroids.

PubMed

Garg, Neha; Perry, Lisa; Deodhar, Atul

2014-12-01

The comparative efficacy of various Corticosteroid (CS) injections commonly used to treat musculoskeletal conditions has not been systematically studied. Our objective is to synthesize data about comparative efficacy of various CS used for intra-articular and periarticular soft tissue injections. Online databases were searched including MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Database of Abstracts of Reviews of Effectiveness, and bibliographies of studies till November 2013. We included all randomized controlled trials comparing two CS for intra-articular and periarticular injections, selected according to Preferred Reporting Items for Systematic reviews and Meta-Analyses methodology. Seven good quality trials were selected for qualitative data synthesis. Two trials comparing triamcinolone hexacetonide (TH) and methylprednisolone (MP) for knee arthritis suggested faster pain relief with TH for rheumatoid arthritis (RA) at day 7 (p < 0.05) and osteoarthritis (OA) at week 3 (visual analogue scale, 33 mm vs 14 mm, p < 0.01) but a similar long-term efficacy. One trial suggested faster pain relief with MP compared to triamcinolone acetonide (TA) for rotator cuff tendonitis at 2 weeks (percentage of patients improving 92 % vs. 50 %; p = 0.02) but similar long-term efficacy, while another trial suggested no difference between TA and MP for knee OA. Two trials for knee arthritis suggested a substantially better efficacy for TH than TA (response rate at 24 months 77 % vs 39 %; p = 0.001) and betamethasone (BM) at day 42 (p < 0.01). There is paucity of data regarding comparative efficacy of various CS injections. Limited number of studies favored TH over other CS (TA, MP, BM).

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.

Interventional Pain Management in Rheumatological Diseases - A Three Years Physiatric Experience in a Tertiary Medical College Hospital in Bangladesh

PubMed Central

Hasan, Suzon Al; Das, Gautam; Khan, Amin Uddin A

2011-01-01

Background Interventional pain management (IPM) is a branch of medical science that deals with management of painful medical conditions using specially equipped X-ray machines and anatomical landmarks. Interventional physiatry is a branch of physical medicine and rehabilitation that treats painful conditions through intervention in peripheral joints, the spine, and soft tissues. Methods A cross-sectional study was conducted using three years of hospital records (2006 to 2008) from the Physical Medicine and Rehabilitation Department at Chittagong Medical College Hospital in Bangladesh, with a view toward highlighting current interventional pain practice in a tertiary medical college hospital. Results The maximum amount of intervention was done in degenerative peripheral joint disorders (600, 46.0%), followed by inflammatory joint diseases (300, 23.0%), soft tissue rheumatism (300, 23.0%), and radicular or referred lower back conditions (100, 8.0%). Of the peripheral joints, the knee was the most common site of intervention. Motor stimulation-guided intralesional injection of methylprednisolone into the piriformis muscle was given in 10 cases of piriformis syndrome refractory to both oral medications and therapeutic exercises. Soft tissue rheumatism of unknown etiology was most common in the form of adhesive capsulitis (90, 64.3%), and is discussed separately. Epidural steroid injection was practiced for various causes of lumbar radiculopathy, with the exception of infective discitis. Conclusions All procedures were performed using anatomical landmarks, as there were no facilities for the C-arm/diagnostic ultrasound required for accurate and safe intervention. A dedicated IPM setup should be a requirement in all PMR departments, to provide better pain management and to reduce the burden on other specialties. PMID:22220242

Arteriovenous Patterns in Beaked Whales

DTIC Science & Technology

2015-09-30

flushing of blood clots from the vascular system and injection of casting compound followed by corrosion of soft tissue. Resulting vascular casts were...extensive blood clotting of pulmonary vasculature. These pulmonary pathologies rendered all fresh specimens obtained unusable. Due to these complications...The objective was to describe and better understand the gross morphology of the blood vessels in the heads of beaked whales. Gross anatomical

Implanted depleted uranium fragments cause soft tissue sarcomas in the muscles of rats.

PubMed Central

Hahn, Fletcher F; Guilmette, Raymond A; Hoover, Mark D

2002-01-01

In this study, we determined the carcinogenicity of depleted uranium (DU) metal fragments containing 0.75% titanium in muscle tissues of rats. The results have important implications for the medical management of Gulf War veterans who were wounded with DU fragments and who retain fragments in their soft tissues. We compared the tissue reactions in rats to the carcinogenicity of a tantalum metal (Ta), as a negative foreign-body control, and to a colloidal suspension of radioactive thorium dioxide ((232)Th), Thorotrast, as a positive radioactive control. DU was surgically implanted in the thigh muscles of male Wistar rats as four squares (2.5 x 2.5 x 1.5 mm or 5.0 x 5.0 x 1.5 mm) or four pellets (2.0 x 1.0 mm diameter) per rat. Ta was similarly implanted as four squares (5.0 x 5.0 x 1.1 mm) per rat. Thorotrast was injected at two sites in the thigh muscles of each rat. Control rats had only a surgical implantation procedure. Each treatment group included 50 rats. A connective tissue capsule formed around the metal implants, but not around the Thorotrast. Radiographs demonstrated corrosion of the DU implants shortly after implantation. At later times, rarifactions in the radiographic profiles correlated with proliferative tissue responses. After lifetime observation, the incidence of soft tissue sarcomas increased significantly around the 5.0 x 5.0 mm squares of DU and the positive control, Thorotrast. A slightly increased incidence occurred in rats implanted with the 2.5 x 2.5 mm DU squares and with 5.0 x 5.0 mm squares of Ta. No tumors were seen in rats with 2.0 x 1.0 mm diameter DU pellets or in the surgical controls. These results indicate that DU fragments of sufficient size cause localized proliferative reactions and soft tissue sarcomas that can be detected with radiography in the muscles of rats. PMID:11781165

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

ClinicalTrials.gov

2012-03-14

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

PubMed Central

MAZZOLA, R.F.; CANTARELLA, G.; TORRETTA, S.; SBARBATI, A.; LAZZARI, L.; PIGNATARO, L.

2011-01-01

SUMMARY Minimally-invasive autologous fat injection of the head and neck region can be considered a valid alternative to major invasive surgical procedures both for aesthetic and functional purposes. The favourable outcomes of autologous fat injection in otolaryngological practice are due to the filling of soft tissue and, mainly, to the potential regenerative effect of adipose-derived mesenchymal stem cells. Herewith, some important biological preliminary remarks are described underlying the potential of autologous fat injection in regenerative medicine, and personal experience in using it for both consolidated clinical applications, such as fat grafting to the face and vocal fold augmentation in the treatment of glottic incompetence, and more recent applications including the treatment of post-parotidectomy Frey syndrome and velopharyngeal insufficiency. PMID:22058586

A comparative study of vascular injection fluids in fresh-frozen and embalmed human cadaver forearms.

PubMed

Doomernik, D E; Kruse, R R; Reijnen, M M P J; Kozicz, T L; Kooloos, J G M

2016-10-01

Over the years, various vascular injection products have been developed to facilitate anatomical dissections. This study aimed to compare the most commonly used vascular injection products in fresh-frozen and formalin-embalmed cadaver specimens. An overview of the properties, advantages and limitations of each substance was given, and a comparison of vascular infusion procedures in both preservation methods was made. A literature search was performed in order to identify the most commonly used vascular injection products. Acrylic paint, latex, gelatin, silicone, Araldite F and Batson's No. 17 were selected for the study. One fresh-frozen and one embalmed cadaver forearm were infused with each injection product according to a uniform protocol. The curing time, skin- and subcutaneous tissue penetration, degree of filling of the arterial tree, extravasations, consistency of the injected vessels during dissection, and the costs of each injection fluid were noted. There was a large variation between the injection fluids in processing- and curing time, colour intensity, flexibility, fragility, elasticity, strength, toxicity and costs. All fluids were suitable for infusion. The penetration of injection fluid into the skin and subcutaneous tissue was significantly better in fresh-frozen specimens (P = 0.002 and P = 0.009, respectively), with significantly smaller branches casted (P = 0.004). Vascular infusion of fresh-frozen cadaver specimens results in a significantly better filled coloured arterial tree, enabling more detail to be achieved and smaller branches casted. The biomechanical properties of fresh-frozen soft tissues are less affected compared with formalin fixation. All the injection fluids studied are suitable for vascular infusion, but their different properties ensure that certain products and procedures are more suitable for specific study purposes. © 2016 Anatomical Society.

Mechanotransductive cascade of Myo-II-dependent mesoderm and endoderm invaginations in embryo gastrulation

PubMed Central

Mitrossilis, Démosthène; Röper, Jens-Christian; Le Roy, Damien; Driquez, Benjamin; Michel, Aude; Ménager, Christine; Shaw, Gorky; Le Denmat, Simon; Ranno, Laurent; Dumas-Bouchiat, Frédéric; Dempsey, Nora M.; Farge, Emmanuel

2017-01-01

Animal development consists of a cascade of tissue differentiation and shape change. Associated mechanical signals regulate tissue differentiation. Here we demonstrate that endogenous mechanical cues also trigger biochemical pathways, generating the active morphogenetic movements shaping animal development through a mechanotransductive cascade of Myo-II medio-apical stabilization. To mimic physiological tissue deformation with a cell scale resolution, liposomes containing magnetic nanoparticles are injected into embryonic epithelia and submitted to time-variable forces generated by a linear array of micrometric soft magnets. Periodic magnetically induced deformations quantitatively phenocopy the soft mechanical endogenous snail-dependent apex pulsations, rescue the medio-apical accumulation of Rok, Myo-II and subsequent mesoderm invagination lacking in sna mutants, in a Fog-dependent mechanotransductive process. Mesoderm invagination then activates Myo-II apical accumulation, in a similar Fog-dependent mechanotransductive process, which in turn initiates endoderm invagination. This reveals the existence of a highly dynamic self-inductive cascade of mesoderm and endoderm invaginations, regulated by mechano-induced medio-apical stabilization of Myo-II. PMID:28112149

Mechanotransductive cascade of Myo-II-dependent mesoderm and endoderm invaginations in embryo gastrulation

NASA Astrophysics Data System (ADS)

Mitrossilis, Démosthène; Röper, Jens-Christian; Le Roy, Damien; Driquez, Benjamin; Michel, Aude; Ménager, Christine; Shaw, Gorky; Le Denmat, Simon; Ranno, Laurent; Dumas-Bouchiat, Frédéric; Dempsey, Nora M.; Farge, Emmanuel

2017-01-01

Animal development consists of a cascade of tissue differentiation and shape change. Associated mechanical signals regulate tissue differentiation. Here we demonstrate that endogenous mechanical cues also trigger biochemical pathways, generating the active morphogenetic movements shaping animal development through a mechanotransductive cascade of Myo-II medio-apical stabilization. To mimic physiological tissue deformation with a cell scale resolution, liposomes containing magnetic nanoparticles are injected into embryonic epithelia and submitted to time-variable forces generated by a linear array of micrometric soft magnets. Periodic magnetically induced deformations quantitatively phenocopy the soft mechanical endogenous snail-dependent apex pulsations, rescue the medio-apical accumulation of Rok, Myo-II and subsequent mesoderm invagination lacking in sna mutants, in a Fog-dependent mechanotransductive process. Mesoderm invagination then activates Myo-II apical accumulation, in a similar Fog-dependent mechanotransductive process, which in turn initiates endoderm invagination. This reveals the existence of a highly dynamic self-inductive cascade of mesoderm and endoderm invaginations, regulated by mechano-induced medio-apical stabilization of Myo-II.

Necrotizing soft tissue infection masquerading as cutaneous abcess following illicit drug injection.

PubMed

Callahan, T E; Schecter, W P; Horn, J K

1998-08-01

To assess factors that might predict serious necrotizing soft tissue infections following illicit drug injection. A retrospective review of a consecutive case series. An urban municipal hospital. Thirty patients presenting with cutaneous abscesses resulting from illicit drug injections during a 5-year period. All cases presented clinically with fluctuance, erythema, or induration but required extensive debridement at the time of incision and drainage. Operative treatment employed wide incision, routine subfascial examination, and aggressive debridement. Clinical management included broad-spectrum antibiotics, critical care support, and reconstructive procedures. Mortality, extent of debridement, preoperative vital signs and laboratory values, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, bacteriologic and pathologic test results. Postoperatively, all patients were housed in the intensive care unit for 8.4 +/- 14.5 days. Six patients died (20%). On arrival at the intensive care unit, systolic blood pressure was 80 mm Hg or less in 2 patients, 1 of whom died. White blood cell count on hospital admission was elevated in 27 of 30 patients (mean, 27.2 +/- 15.3 x 10(9)/L) and 2 patients were identified as having human immunodeficiency virus infection. All patients underwent initial surgery less than 24 hours after admission; following debridement, the average wound size was 276 +/- 238 cm2 (range, 15-783 cm2). Five patients required extremity amputation, and all other survivors underwent reconstruction with skin grafts and/or myocutaneous flaps. All but 1 patient were reexamined in the operating room within 12 hours and underwent an average of 3.1 +/- 1.6 operative procedures. Of those wound cultures obtained in the operating room, there was no pattern to the bacteriologic isolates. Seventeen patients had mixed isolates and 11 had single organisms. Pathologic findings in 20 patients included panniculitis (3 patients), necrotizing fasciitis (11 patients), myositis (6 patients), and osteomyelitis (1 patient). We failed to identify any clinical factor, including temperature, heart rate, systolic blood pressure, white blood cell count, base deficit, albumin level, PO2, or APACHE II score that could predict mortality or the requirement for extensive debridement. Parenteral injections of illicit drugs can produce infections that present with signs of simple cutaneous abscess and yet unpredictably become extensive necrotizing soft tissue infections. Treatment requires a high index of suspicion along with an inquisitive operative approach to avoid missing these potentially serious infections.

Targeted photodynamic therapy of established soft-tissue infections in mice

NASA Astrophysics Data System (ADS)

Gad, Faten; Zahra, Touqir; Hasan, Tayyaba; Hamblin, Michael R.

2004-06-01

The worldwide rise in antibiotic resistance necessitates the development of novel antimicrobial strategies. Although many workers have used photodynamic therapy (PDT) to kill bacteria in vitro, the use of this approach has seldom been reported in vivo in animal models of infection. We have previously described the first use of PDT to treat excisional wound infections by Gram-negative bacteria in living mice. However these infected wound models used a short time after infection (30 min) before PDT. We now report on the use of PDT to treat an established soft-tissue infection in mice. We used Staphylococcus aureus stably transformed with a Photorhabdus luminescens lux operon (luxABCDE) that was genetically modified to be functional in Gram-positive bacteria. These engineered bacteria emitted bioluminescence allowing the progress of the infection to be monitored in both space and time with a lowlight imaging charged couple device (CCD) camera. One million cells were injected into one or both thigh muscles of mice that had previously been rendered neutropenic by cyclophosphamide administration. Twenty-four hours later the bacteria had multiplied more than one hundred-fold, and poly-L-lysine chlorin(e6) conjugate or free chlorin(e6) was injected into one area of infected muscle and imaged with the CCD camera. Thirty-minutes later red light from a diode laser was delivered as a surface spot or by interstitial fiber into the infection. There was a lightdose dependent loss of bioluminescence (to < 5% of that seen in control infections) not seen in untreated or light alone treated infections, but in some cases the infection recurred. Conjugate alone led to a lesser reduction in bioluminescence. Infections treated with free chlorin(e6) responded less and the infection subsequently increased over the succeeding days, probably due to PDT-mediated tissue damage. PDT-treated infected legs healed better than legs with untreated infections. This data shows that PDT may have applications in drug-resistant soft-tissue infections.

Illicit Cosmetic Silicone Injection: A Recent Reiteration of History.

PubMed

Leonardi, Nicholas R; Compoginis, John M; Luce, Edward A

2016-10-01

The injection of liquid silicone for cosmetic augmentation has a history of both legal as well as illicit practice in the United States and worldwide. Recently, the American Society of Plastic Surgeons has launched a public awareness campaign through patient stories and various statements in response to the rise in deaths related to this illicit practice. A articular segment of the population that has become a target is the transgender patient group. A brief review is provided of the history of industrial liquid silicone injection, including the pathophysiology to fully describe and review silicone injection injury. Three cases of soft tissue cellulitis and wound necrosis treated at our institution are summarized and a treatment algorithm proposed based on literature review of treatment options and our own experience.

Xeroradiography and ultrasonography in the evaluation of a penile injury.

PubMed

Oesterling, J E; Bromberg, W D; Albertsen, P C

1986-04-01

A 34-year-old white man presented with severe penile cellulitis following injection of epoxy glue into the shaft of the penis. Preoperative xeroradiography and ultrasonography localized the hardened masses of glue to the left corpus cavernosum and subcutaneous tissues. Under the guidance of intraoperative ultrasonography this foreign material was removed surgically. Postoperatively, the cellulitis resolved promptly and xeroradiography demonstrated no residual fragments. Although various modalities, including computerized tomography and roentgenography, are available to detect foreign bodies in soft tissues, xeroradiography and ultrasonography are ideally suited for use in the male external genitalia.

Elastomeric and soft conducting microwires for implantable neural interfaces

PubMed Central

Kolarcik, Christi L.; Luebben, Silvia D.; Sapp, Shawn A.; Hanner, Jenna; Snyder, Noah; Kozai, Takashi D.Y.; Chang, Emily; Nabity, James A.; Nabity, Shawn T.; Lagenaur, Carl F.; Cui, X. Tracy

2015-01-01

Current designs for microelectrodes used for interfacing with the nervous system elicit a characteristic inflammatory response that leads to scar tissue encapsulation, electrical insulation of the electrode from the tissue and ultimately failure. Traditionally, relatively stiff materials like tungsten and silicon are employed which have mechanical properties several orders of magnitude different from neural tissue. This mechanical mismatch is thought to be a major cause of chronic inflammation and degeneration around the device. In an effort to minimize the disparity between neural interface devices and the brain, novel soft electrodes consisting of elastomers and intrinsically conducting polymers were fabricated. The physical, mechanical and electrochemical properties of these materials were extensively characterized to identify the formulations with the optimal combination of parameters including Young’s modulus, elongation at break, ultimate tensile strength, conductivity, impedance and surface charge injection. Our final electrode has a Young’s modulus of 974 kPa which is five orders of magnitude lower than tungsten and significantly lower than other polymer-based neural electrode materials. In vitro cell culture experiments demonstrated the favorable interaction between these soft materials and neurons, astrocytes and microglia, with higher neuronal attachment and a two-fold reduction in inflammatory microglia attachment on soft devices compared to stiff controls. Surface immobilization of neuronal adhesion proteins on these microwires further improved the cellular response. Finally, in vivo electrophysiology demonstrated the functionality of the elastomeric electrodes in recording single unit activity in the rodent visual cortex. The results presented provide initial evidence in support of the use of soft materials in neural interface applications. PMID:25993261

A Fluorescence-Guided Laser Ablation System for Removal of Residual Cancer in a Mouse Model of Soft Tissue Sarcoma.

PubMed

Lazarides, Alexander L; Whitley, Melodi J; Strasfeld, David B; Cardona, Diana M; Ferrer, Jorge M; Mueller, Jenna L; Fu, Henry L; Bartholf DeWitt, Suzanne; Brigman, Brian E; Ramanujam, Nimmi; Kirsch, David G; Eward, William C

2016-01-01

The treatment of soft tissue sarcoma (STS) generally involves tumor excision with a wide margin. Although advances in fluorescence imaging make real-time detection of cancer possible, removal is limited by the precision of the human eye and hand. Here, we describe a novel pulsed Nd:YAG laser ablation system that, when used in conjunction with a previously described molecular imaging system, can identify and ablate cancer in vivo. Mice with primary STS were injected with the protease-activatable probe LUM015 to label tumors. Resected tissues from the mice were then imaged and treated with the laser using the paired fluorescence-imaging/ laser ablation device, generating ablation clefts with sub-millimeter precision and minimal underlying tissue damage. Laser ablation was guided by fluorescence to target tumor tissues, avoiding normal structures. The selective ablation of tumor implants in vivo improved recurrence-free survival after tumor resection in a cohort of 14 mice compared to 12 mice that received no ablative therapy. This prototype system has the potential to be modified so that it can be used during surgery to improve recurrence-free survival in patients with cancer.

Periodontal regeneration in swine after cell injection and cell sheet transplantation of human dental pulp stem cells following good manufacturing practice.

PubMed

Hu, Jingchao; Cao, Yu; Xie, Yilin; Wang, Hua; Fan, Zhipeng; Wang, Jinsong; Zhang, Chunmei; Wang, Jinsong; Wu, Chu-Tse; Wang, Songlin

2016-09-09

Periodontitis, one of the most prevalent infectious diseases in humans, results in the destruction of tooth-supporting tissues. The purpose of the present study is to evaluate the effect of cell injection and cell sheet transplantation on periodontal regeneration in a swine model. In the present study, human dental pulp stem cells (hDPSCs) were transplanted into a swine model for periodontal regeneration. Twelve miniature pigs were used to generate periodontitis with bone defects of 5 mm in width, 7 mm in length, and 3 mm in depth. hDPSCs were obtained for bone regeneration using cell injection or cell sheet transplantation. After 12 weeks, clinical, radiological, and histological assessments of regenerated periodontal tissues were performed to compare periodontal regeneration treated with xenogeneic cell injection and cell sheet implantation. Our study showed that translating hDPSCs into this large animal model could significantly improve periodontal bone regeneration and soft tissue healing. After 12 weeks, both the hDPSC sheet treatment and hDPSC injection significantly improved periodontal tissue healing clinically in comparison with the control group. The volume of regenerative bone in the hDPSC sheet group (52.7 ± 4.1 mm(3)) was significantly larger than in the hDPSC injection group (32.4 ± 5.1 mm(3)) (P < 0.05). The percentage of bone in the periodontium in the hDPSC injection group was 12.8 ± 4.4 %, while it was 17.4 ± 5.3 % in the hDPSC sheet group (P < 0.05). Both hDPSC injection and cell sheet transplantation significantly regenerated periodontal bone in swine. The hDPSC sheet had more bone regeneration capacity compared with hDPSC injection.

Drawing attention to a neglected injecting-related harm: a systematic review of AA amyloidosis among people who inject drugs.

PubMed

Harris, Magdalena; Brathwaite, Rachel; Scott, Jenny; Gilchrist, Gail; Ciccarone, Dan; Hope, Vivian; McGowan, Catherine R

2018-04-26

Chronic skin and soft tissue infections (SSTI) among people who inject drugs (PWID) can lead to AA amyloidosis: a serious, yet neglected, multi-organ disease. We aim to synthesize findings on the epidemiology, risk factors, clinical outcomes, screening recommendations and challenges to treatment for AA amyloidosis among PWID. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We searched the following bibliographic databases in July 2017: CINAHL Plus, Embase, Global Health, MEDLINE, PsycEXTRA, PsycINFO and SCOPUS. Studies were included if they investigated AA amyloidosis in PWID. Studies were not restricted to location, study type, year or language of publication. Study heterogeneity precluded meta-analysis; we present a narrative review of the literature. Thirty-seven papers from eight countries met inclusion criteria. A total of 781 PWID are reported on, of whom 177 had AA amyloidosis. Where disease causality is established, it is attributed to chronic inflammation caused by injecting-related SSTIs. Most (88.7%) PWID with AA amyloidosis had SSTIs. The proportion of PWID with AA amyloidosis at post-mortem ranged from 1.6% (Germany) to 22.5% (Serbia). Biopsy studies reported from 5.26% (Portugal) to 50% (Germany) of AA amyloidosis in PWID with suspected or known kidney disease. Following diagnosis, the typical trajectory for PWID with AA amyloidosis was rapid deterioration of renal function requiring haemodialysis. Treatment difficulties, end-stage renal failure and premature death from sepsis were observed. Good outcomes, including reversibility of AA amyloidosis, are attributed to rapid treatment of the underlining inflammation and injecting cessation. Notably, given the population in question, no studies were published in addiction or harm reduction journals; most (92%) appeared in specialist nephrology and medical journals. There is strong evidence of an association between skin and soft tissue infections (SSTIs) and AA amyloidosis. Among people who inject drugs, injecting-related SSTIs are a significant cause of morbidity and premature mortality and there is evidence of increasing SSTI prevalence. Limitations in the literature make it difficult to estimate AA amyloidosis prevalence among people who inject drugs. © 2018 Society for the Study of Addiction.

Effects of Two Different Anesthetic Solutions on Injection Pain, Efficacy, and Duration of Soft-Tissue Anesthesia with Inferior Alveolar Nerve Block for Primary Molars.

PubMed

Elbay, Ülkü Şermet; Elbay, Mesut; Kaya, Emine; Yıldırım, Sinem

The purpose of the study was to compare the efficacy, injection pain, duration of soft tissue anesthesia, and postoperative complications of two different anesthetics (2% lidocaine with 1:80,000 epinephrine and 3% plain mepivacaine) in pediatric patients in inferior alveolar nerve block (IANB) administered by a computer-controlled delivery system (CCDS). The study was conducted as a randomized, controlled-crossover, double-blind clinical trial with 60 children requiring bilateral pulpotomy or extraction of primary mandibular molars. A CCDS was used to deliver 3% mepivacaine to 1 primary tooth and 2% lidocaine to the contralateral tooth with an IANB technique. Severity of pain and efficacy of anesthesia were evaluated using the Face, Legs, Activity, Cry, Consolability Scale, and comfort and side effects were assessed using a questionnaire. Data were analyzed using the Mann-Whitney U, Wilcoxon t, and Fisher exact tests. Patients receiving 2% lidocaine experienced significantly less pain during injection than those receiving 3% mepivacaine, and no significant differences were found in the pain scores during treatments or in postoperative complications between the two anesthetics. The mean durations of anesthesia for 3% mepivacaine and 2% lidocaine were 139.68 minutes and 149.10 minutes, respectively. Plain mepivacaine and 2% lidocaine were similarly effective in pulpotomy and the extraction of primary mandibular molars. Although the use of 3% mepivacaine provided a shorter duration of anesthesia than 2% lidocaine, both solutions showed similar results in terms of postoperative complications.

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

ClinicalTrials.gov

2018-05-23

FNCLCC Sarcoma Grade 2; FNCLCC Sarcoma Grade 3; Leiomyosarcoma; Liposarcoma; Stage I Soft Tissue Sarcoma AJCC v7; Stage IA Soft Tissue Sarcoma AJCC v7; Stage IB Soft Tissue Sarcoma AJCC v7; Stage II Soft Tissue Sarcoma AJCC v7; Stage IIA Soft Tissue Sarcoma AJCC v7; Stage IIB Soft Tissue Sarcoma AJCC v7; Undifferentiated Pleomorphic Sarcoma

Studies on the Induction of Bone and Soft Tissue Tumours in Rats by Gamma Irradiation and the Effect of Growth Hormone and Thyroxine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cater, D. B.; Baserga, R.; Lisco, H.

1959-06-01

A single dose of 3000 roentgen of gamma irradiation from a iridium-192 teletherapy source applied to both knee joints of growing female rats induced osteosarcomata in 34 out of 116 rats. Fifty rats developed sarcomata of soft tissues, 10 cancer of the skin, and 12 had mammary cancers. Eighty days after irradiation, ten-week courses of growth hormone, thyroxine, growth hormone followed by thyroxine, and saline were given to study the effect of hormone treatment on the incidence and induction period of radiationinduced bone sarcomata. Twelve out of 30 growthhormone-treated rats developed bone sarcomata compared with 7 out of 31 inmore » the saline injected group. Thyroxine treatment significantly reduced the mean latent period of radiation-induced osteosarcomata. The incidence of other types of malignant tumors was not affected by the hormone treatments.« less

Efficacy and Safety of Injectable Robenacoxib for the Treatment of Pain Associated With Soft Tissue Surgery in Dogs.

PubMed

Friton, G; Thompson, C; Karadzovska, D; King, S; King, J N

2017-05-01

Nonsteroidal anti-inflammatory drugs (NSAIDs) are used routinely to control pain and inflammation after surgery in dogs. Robenacoxib is a cyclooxygenase-2 selective NSAID. Assess the clinical efficacy and safety of an injectable formulation of robenacoxib in dogs undergoing surgery. Three hundred and seventeen client-owned dogs (N = 159 robenacoxib or N = 158 placebo). In this prospective, multicenter, randomized, masked, placebo-controlled, parallel-group study, dogs received a SC injection of either robenacoxib, at a target dose of 2.0 mg/kg, or placebo once prior to surgery and for 2 additional days postoperatively. Pain assessments were performed using the short form of the Glasgow Composite Measure Pain Scale (CMPS-SF). The primary efficacy variable was treatment success/failure, with failure defined as the need for rescue therapy to control pain or withdrawal of the dog from the study due to an adverse event. Significantly (P = .006) more dogs administered robenacoxib were considered treatment successes (108 of 151, 73.7%) compared to dogs given placebo (85 of 152, 58.1%). Total pain scores (P < .01), pain at the surgery sites (response to touch, P < .01), and posture/activity (P < .05) were significantly improved at 3, 5, and 8 hours postextubation in dogs receiving robenacoxib versus placebo. Robenacoxib administered by SC injection prior to surgery and for 2 additional days postoperatively was effective and well tolerated in the control of postoperative pain and inflammation associated with soft tissue surgery in dogs. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

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

Two-step impression/ injection, an alternative putty/ wash impression technique: case report.

PubMed

Caputi, S; Murmura, G; Sinjari, B; Varvara, G

2012-01-01

We here describe a new technique for making a definitive impression that we refer to as the two-step impression/injection technique. This technique initially follows the classical one-step putty/ light-body impression technique with the polymerization of the putty and the light-body compound. This is then followed by the second step: injection of extra-light-body compound into the preparation through a hole in the metal stock tray. The aim of this additional step is to control the wash bulk and minimize the changes that can produce unfavorable impression results. This new two-step impression/injection technique allows displacement of soft tissues, such as the tongue, during the first seating of the putty and wash materials, while in the second step, the extra-light-body compound records all of the finer details without being compressed.

The effects of prostaglandin E2 in growing rats - Increased metaphyseal hard tissue and cortico-endosteal bone formation

NASA Technical Reports Server (NTRS)

Jee, W. S. S.; Ueno, K.; Deng, Y. P.; Woodbury, D. M.

1985-01-01

The role of in vivo prostaglandin E2 (PGE2) in bone formation is investigated. Twenty-five male Sprague-Dawley rats weighing between 223-267 g were injected subcutaneously with 0.3, 1.0, 3.0, and 6.0 mg of PGE2-kg daily for 21 days. The processing of the tibiae for observation is described. Radiographs and histomorphometric analyses are also utilized to study bone formation. Body weight, weights of soft tissues and bones morphometry are evaluated. It is observed that PGE2 depressed longitudinal bone growth, increased growth cartilage thickness, decreased degenerative cartilage cell size and cartilage cell production, and significantly increased proximal tibial metaphyseal hard tissue mass. The data reveal that periosteal bone formation is slowed down at higher doses of PGE2 and endosteal bone formation is slightly depressed less than 10 days post injection; however, here is a late increase (10 days after post injection) in endosteal bone formation and in the formation of trabecular bone in the marrow cavity of the tibial shaft. It is noted that the effects of PGE2 on bone formation are similar to the responses of weaning rats to PGE2.

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

ClinicalTrials.gov

2017-09-07

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

An electromechanical based deformable model for soft tissue simulation.

PubMed

Zhong, Yongmin; Shirinzadeh, Bijan; Smith, Julian; Gu, Chengfan

2009-11-01

Soft tissue deformation is of great importance to surgery simulation. Although a significant amount of research efforts have been dedicated to simulating the behaviours of soft tissues, modelling of soft tissue deformation is still a challenging problem. This paper presents a new deformable model for simulation of soft tissue deformation from the electromechanical viewpoint of soft tissues. Soft tissue deformation is formulated as a reaction-diffusion process coupled with a mechanical load. The mechanical load applied to a soft tissue to cause a deformation is incorporated into the reaction-diffusion system, and consequently distributed among mass points of the soft tissue. Reaction-diffusion of mechanical load and non-rigid mechanics of motion are combined to govern the simulation dynamics of soft tissue deformation. An improved reaction-diffusion model is developed to describe the distribution of the mechanical load in soft tissues. A three-layer artificial cellular neural network is constructed to solve the reaction-diffusion model for real-time simulation of soft tissue deformation. A gradient based method is established to derive internal forces from the distribution of the mechanical load. Integration with a haptic device has also been achieved to simulate soft tissue deformation with haptic feedback. The proposed methodology does not only predict the typical behaviours of living tissues, but it also accepts both local and large-range deformations. It also accommodates isotropic, anisotropic and inhomogeneous deformations by simple modification of diffusion coefficients.

Soft tissue tumors among beagles injected with {sup 90}Sr, {sup 228}Ra, or {sup 228}Th

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lloyd, R.D.; Angus, W.; Taylor, G.N.

1995-08-01

The occurrence of soft-tissue tumors in beagles given {sup 90}Sr (88 dogs), {sup 228}Ra (76 dogs), or {sup 228}Th (81 dogs) as young adults and followed throughout their lifespans was compared with that of 133 control beagles given no radioactivity. For animals injected with {sup 228}Ra, tumors of the eye were more prominent (p<0.05) than in the controls, and soft-tissue tumors of cavities in the head (excluding the brain, mouth, and eye) were more prominent in dogs given {sup 90}Sr than in the controls (p<0.05). There was some indication that eye tumors in animals given about 0.56 kBq {sup 228}Thmore » kg{sup {minus}1} were associated with their radionuclide exposure. For tumors at a few other locations, the relative occurrence was greater (p<0.05) in the controls. These included malignant tumors of the testis, and malignant plus benign tumors of the mammae and vagina in {sup 228}Ra dogs; and malignant plus benign tumors of the mammae in {sup 90}Sr dogs (p>0.05 by Odds Ratio Chi Square analysis but p<0.05 by Fiosher`s Exact Test). Differences in relative occurrence between radioactive dogs and controls of all other tumor types that appeared in any of the animals (notably lymphosarcoma, lymph node tumors, leukemia, mast cell tumors, liver tumors, etc.) were not statistically significant (p > 0.05). Intercurrent mortality, mainly from bone cancer, was higher in the radioactive dogs than in the controls. Mean survival was reduced in the dogs given {sup 90}Sr, {sup 228}Ra, or {sup 228}Th(13.17 {plus_minus} 2.64 y in controls, 10.95 {plus_minus} 4.06 y in {sup 90}Sr dogs, 9.07 {plus_minus} 3.61 y in {sup 228}Ra dogs, and 9.20 {plus_minus}4.15 y in {sup 228}Th dogs). Attenuated lifespans could account, at least in part, for the relative paucity of soft-tissue tumors not induced by radiation among the groups of dogs given radioactivity and occurring near the end of life for control animals. 24 refs., 3 tabs.« less

[Construction of injectable tissue engineered adipose tissue with fibrin glue scaffold and human adipose-derived stem cells transfected by lentivirus vector expressing hepatocyte growth factor].

PubMed

Zhu, Yuanzheng; Yi, Yangyan; Yang, Shuifa; Zhang, Jing; Wu, Shu; Wang, Zhaohui

2017-09-01

To discuss the possibility of constructing injectable tissue engineered adipose tissue, and to provide a new approach for repairing soft tissue defects. Human adipose-derived stem cells (hADSCs) were extracted from the lipid part of human liposuction aspirate by enzymatic digestion and identified by morphological observation, flow cytometry, and adipogenic induction. The hADSCs underwent transfection by lentivirus vector expressing hepatocyte growth factor and green fluorescent protein (HGF-GFP-LVs) of different multiplicity of infection (MOI, 10, 30, 50, and 100), the transfection efficiency was calculated to determine the optimum MOI. The hADSCs transfected by HGF-GFP-LVs of optimal MOI and being adipogenic inducted were combined with injectable fibrin glue scaffold, and were injected subcutaneously into the right side of the low back of 10 T-cell deficiency BALB/c female nude mice (transfected group); non-HGF-GFP-LVs transfected hADSCs (being adipogenic inducted) combined with injectable fibrin glue scaffold were injected subcutaneously into the left side of the low back (untransfected group); and injectable fibrin glue scaffold were injected subcutaneously into the middle part of the neck (blank control group); 0.4 mL at each point. Twelve weeks later the mice were killed and the implants were taken out. Gross observation, wet weight measurement, HE staining, GFP fluorescence labeling, and immunofluorescence staining were performed to assess the in vivo adipogenic ability of the seed cells and the neovascularization of the grafts. The cultured cells were identified as hADSCs. Poor transfection efficiency was observed in MOI of 10 and 30, the transfection efficiency of MOI of 50 and 100 was more than 80%, so the optimum MOI was 50. Adipose tissue-like new-born tissues were found in the injection sites of the transfected and untransfected groups after 12 weeks of injection, and no new-born tissues was found in the blank control group. The wet-weight of new-born tissue in the transfected group [(32.30±4.06) mg] was significantly heavier than that of the untransfected group [(25.27±3.94) mg] ( t =3.929, P =0.001). The mature adipose cells in the transfected group [(126.93±5.36) cells/field] were significantly more than that in the untransfected group [(71.36±4.52) cells/field] ( t =30.700, P =0.000). Under fluorescence microscopy, some of the single cell adipocytes showed a network of green fluorescence, indicating the presence of GFP labeled exogenous hADSCs in the tissue. The vascular density of new-born tissue of the transfected group [(16.37±2.76)/field] was significantly higher than that of the untransfected group [(9.13±1.68)/field] ( t =8.678, P =0.000). The hADSCs extracted from the lipid part after liposuction can be used as seed cells. After HGF-GFP-LVs transfection and adipose induction, the hADSCs combined with injectable fibrin glue scaffold can construct mature adipose tissue in vivo , which may stimulate angiogenesis, and improve retention rate of new-born tissue.

Using methylene blue as a marker to find and remove tiny metallic foreign bodies embedded in the soft tissues of children: A randomised controlled trial.

PubMed

Su, Yuxi; Nan, Guoxin

2016-05-01

Embedment of metallic foreign bodies in the soft tissues is commonly encountered in the emergency room. Most foreign bodies are easily removed, but removal is difficult if the foreign body is very small or deeply embedded. To determine the usefulness of methylene blue staining in the surgical removal of tiny metallic foreign bodies embedded in the soft tissue. This prospective study involved 41 children treated between May 2007 and May 2012. The patients were randomly divided into a methylene blue group and a control group. In the control group, foreign bodies were located using a C-arm and removed via direct incision. In the methylene blue group, foreign bodies were located using a C-arm, marked with an injection of methylene blue and then removed surgically. The clinical outcomes, complications, operation time, surgical success rate, incision length, frequency of C-arm use, and length and depth of the foreign body were compared between the two groups. The surgical success rate was significantly higher in the methylene blue group. The average operation time was significantly shorter in the methylene blue group. The C-arm was used significantly less frequently in the methylene blue group than in the control group. The incision length was significantly shorter in the methylene blue group than in the control group. Methylene blue staining facilitated the location and removal of tiny metallic foreign bodies from the soft tissue, and significantly reduced operation time, incision length and radiation exposure compared to the conventional method. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

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.

A soft, transparent, freely accessible cranial window for chronic imaging and electrophysiology

PubMed Central

Heo, Chaejeong; Park, Hyejin; Kim, Yong-Tae; Baeg, Eunha; Kim, Yong Ho; Kim, Seong-Gi; Suh, Minah

2016-01-01

Chronic in vivo imaging and electrophysiology are important for better understanding of neural functions and circuits. We introduce the new cranial window using soft, penetrable, elastic, and transparent, silicone-based polydimethylsiloxane (PDMS) as a substitute for the skull and dura in both rats and mice. The PDMS can be readily tailored to any size and shape to cover large brain area. Clear and healthy cortical vasculatures were observed up to 15 weeks post-implantation. Real-time hemodynamic responses were successfully monitored during sensory stimulation. Furthermore, the PDMS window allowed for easy insertion of microelectrodes and micropipettes into the cortical tissue for electrophysiological recording and chemical injection at any location without causing any fluid leakage. Longitudinal two-photon microscopic imaging of Cx3Cr1+/− GFP transgenic mice was comparable with imaging via a conventional glass-type cranial window, even immediately following direct intracortical injection. This cranial window will facilitate direct probing and mapping for long-term brain studies. PMID:27283875

Design of an injectable synthetic and biodegradable surgical biomaterial

PubMed Central

Zawaneh, Peter N.; Singh, Sunil P.; Padera, Robert F.; Henderson, Peter W.; Spector, Jason A.; Putnam, David

2010-01-01

We report the design of an injectable synthetic and biodegradable polymeric biomaterial comprised of polyethylene glycol and a polycarbonate of dihydroxyacetone (MPEG-pDHA). MPEG-pDHA is a thixotropic physically cross-linked hydrogel, displays rapid chain relaxation, is easily extruded through narrow-gauge needles, biodegrades into inert products, and is well tolerated by soft tissues. We demonstrate the clinical utility of MPEG-pDHA in the prevention of seroma, a common postoperative complication following ablative and reconstructive surgeries, in an animal model of radical breast mastectomy. This polymer holds significant promise for clinical applicability in a host of surgical procedures ranging from cosmetic surgery to cancer resection. PMID:20534478

Descending necrotizing mediastinitis: report of a case following steroid neck injection.

PubMed

Harar, R P S; Cranston, C; Warwick-Brown, N

2002-10-01

Cervical necrotizing fasciitis is a rare, rapidly progressive, severe bacterial infection of the soft tissues of the neck. Uncommonly, it may descend into the mediastinum. We describe a case of descending necrotizing mediastinitis in a young man, where there was diagnostic confusion and delay, with an eventual fatal outcome. A steroid injection for neck pain is thought to be the source of infection. In this case, the signs of mediastinitis were initially masked, and the diagnosis delayed until cardiopulmonary arrest occurred. Early recognition with a low threshold for computed tomography (CT) scanning is essential. Aggressive multidisciplinary therapy with mediastinal drainage is mandatory.

Biology of soft tissue wound healing and regeneration--consensus report of Group 1 of the 10th European Workshop on Periodontology.

PubMed

Hämmerle, Christoph H F; Giannobile, William V

2014-04-01

The scope of this consensus was to review the biological processes of soft tissue wound healing in the oral cavity and to histologically evaluate soft tissue healing in clinical and pre-clinical models. To review the current knowledge regarding the biological processes of soft tissue wound healing at teeth, implants and on the edentulous ridge. Furthermore, to review soft tissue wound healing at these sites, when using barrier membranes, growth and differentiation factors and soft tissue substitutes. Searches of the literature with respect to recessions at teeth and soft tissue deficiencies at implants, augmentation of the area of keratinized tissue and soft tissue volume were conducted. The available evidence was collected, categorized and summarized. Oral mucosal and skin wound healing follow a similar pattern of the four phases of haemostasis, inflammation, proliferation and maturation/matrix remodelling. The soft connective tissue determines the characteristics of the overlaying oral epithelium. Within 7-14 days, epithelial healing of surgical wounds at teeth is completed. Soft tissue healing following surgery at implants requires 6-8 weeks for maturation. The resulting tissue resembles scar tissue. Well-designed pre-clinical studies providing histological data have been reported describing soft tissue wound healing, when using barrier membranes, growth and differentiation factors and soft tissue substitutes. Few controlled clinical studies with low numbers of patients are available for some of the treatments reviewed at teeth. Whereas, histological new attachment has been demonstrated in pre-clinical studies resulting from some of the treatments reviewed, human histological data commonly report a lack of new attachment but rather long junctional epithelial attachment and connective tissue adhesion. Regarding soft tissue healing at implants human data are very scarce. Oral soft tissue healing at teeth, implants and the edentulous ridge follows the same phases as skin wound healing. Histological studies in humans have not reported new attachment formation at teeth for the indications studied. Human histological data of soft tissue wound healing at implants are limited. The use of barriers membranes, growth and differentiation factors and soft tissue substitutes for the treatment of localized gingival/mucosal recessions, insufficient amount of keratinized tissue and insufficient soft tissue volume is at a developing stage. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Practice patterns for the use of iodinated i.v. contrast media for pediatric CT studies: a survey of the Society for Pediatric Radiology.

PubMed

Callahan, Michael J; Servaes, Sabah; Lee, Edward Y; Towbin, Alexander J; Westra, Sjirk J; Frush, Donald P

2014-04-01

There are limited data available on the use of i.v. contrast media for CT studies in the pediatric population. The purpose of this study is to determine the practice patterns of i.v. contrast media usage for pediatric CT by members of the Society for Pediatric Radiology (SPR). SPR members were surveyed regarding the use of i.v. contrast media for pediatric CT studies. Questions pertained to information required before administering i.v. contrast media, types of central catheters for injecting i.v. contrast media, injection rates based on angiocatheter size and study type, and management of i.v. contrast media extravasation. The response rate of 6% (88/1545) represented practice patterns of 26% (401/1545) of the SPR membership. Most respondents thought the following clinical information was mandatory before i.v. contrast media administration: allergy to i.v. contrast media (97%), renal insufficiency (97%), current metformin use (72%), significant allergies (61%), diabetes (54%), and asthma (52%). Most administered i.v. contrast media through nonimplanted central venous catheters (78%), implanted venous ports (78%), and peripherally inserted central catheters (72%). The most common maximum i.v. contrast media injection rates were 5.0 mL/s or greater for a 16-gauge angiocatheter, 4.0 mL/s for an 18-gauge angiocatheter, 3.0 mL/s for a 20-gauge angiocatheter, and 2.0 mL/s for a 22-gauge angiocatheter. For soft-tissue extravasation of i.v. contrast media, 95% elevate the affected extremity, 76% use ice, and 45% use heat. The results of this survey illustrate the collective opinion of a subset of SPR members relating to the use of i.v. contrast media in pediatric CT, providing guidelines for clinical histories needed before i.v. contrast media, maximum i.v. contrast injection rates for standard angiocatheters, contrast media injection rates for specific CT studies, and management of i.v. contrast media soft-tissue extravasation.

Evaluation of Efficacy of Intraligamentary Injection Technique for Extraction of Mandibular Teeth-A Prospective Study

PubMed Central

Pradhan, Raunak; Kulkarni, Deepak

2017-01-01

Introduction Fear of dental pain is one of the most common reasons for delaying dental treatment. Local Anaesthesia (LA) is the most commonly employed technique of achieving pain control in dentistry. Pterygomandibular Nerve Block (PNB), for achieving mandibular anaesthesia has been the traditional technique used and is associated with a few set of complications which include pain, nerve injury, trismus, and rarely facial nerve palsy, and sustained soft tissue anaesthesia. These complications have resulted in a rapid need for research on alternative local anaesthetic techniques. Aim This study was undertaken with the objective to determine pain, duration, profoundness and complications associated with administration of Intraligamentary Injection Technique (ILT). Materials and Methods This study was conducted on 194 patients (male=122, female=72) who reported for dental extractions in mandibular posteriors. The ILT was administered with ligajet intraligamentary jet injector using cartridge containing lignocaine hydrochloride 2% with adrenaline 1:80000 and a 30 gauge needle at buccal (mesiobuccal), lingual, mesial and distal aspect of the mandibular molars. The data was analyzed by using statistical computer software SPSS 11.0 (Statistical package for social sciences 11.O version of SPSS Inc.). Median was derived for Pain on Injection (PI) and Pain during Procedure (PP). Mean and standard deviation was derived for Duration of Anaesthesia (DA). Results Various advantages were seen such as, localized soft tissue anaesthesia, decreased PI (SD=0.83), and minimal PP (SD=0.94). The DA (SD=4.62) and mean value of 24.06 minutes. Conclusion This study is one of its kinds where intraligamentary injection has been used for extraction of mandibular molars. It was also successfully used in patients with exaggerated gag reflex and patients suffering from trismus due to oral submucous fibrosis. The intraligamentary injection technique can thus be used effectively to anaesthetize mandibular molars, as a primary technique for extraction of mandibular posterior teeth. PMID:28274058

Pain referral and regional deep tissue hyperalgesia in experimental human hip pain models.

PubMed

Izumi, Masashi; Petersen, Kristian Kjær; Arendt-Nielsen, Lars; Graven-Nielsen, Thomas

2014-04-01

Hip disorder patients typically present with extensive pain referral and hyperalgesia. To better understand underlying mechanisms, an experimental hip pain model was established in which pain referrals and hyperalgesia could be studied under standardized conditions. In 16 healthy subjects, pain was induced by hypertonic saline injection into the gluteus medius tendon (GMT), adductor longus tendon (ALT), or gluteus medius muscle (GMM). Isotonic saline was injected contralaterally as control. Pain intensity was assessed on a visual analogue scale (VAS), and subjects mapped the pain distribution. Before, during, and after injections, passive hip joint pain provocation tests were completed, together with quantitative sensory testing as follows: pressure pain thresholds (PPTs), cuff algometry pain thresholds (cuff PPTs), cutaneous pin-prick sensitivity, and thermal pain thresholds. Hypertonic saline injected into the GMT resulted in higher VAS scores than hypertonic injections into the ALT and GMM (P<.05). Referred pain areas spread to larger parts of the leg after GMT and GMM injections compared with more regionalized pain pattern after ALT injections (P<.05). PPTs at the injection site were decreased after hypertonic saline injections into GMT and GMM compared with baseline, ALT injections, and isotonic saline. Cuff PPTs from the thigh were decreased after hypertonic saline injections into the ALT compared with baseline, GMT injections, and isotonic saline (P<.05). More subjects had positive joint pain provocation tests after hypertonic compared with isotonic saline injections (P<.05), indicating that this provocation test also assessed hyperalgesia in extra-articular soft tissues. The experimental models may open for better understanding of pain mechanisms associated with painful hip disorders. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Intraosseous anesthesia using a computer-controlled system during non-surgical periodontal therapy (root planing): Two case reports.

PubMed

Han, Keumah; Kim, Jongbin

2018-02-01

Local anesthesia is administered to control pain, but it may induce fear and anxiety. Root planing is a non-surgical periodontal therapy; however, when it is performed in an extensive manner, some tissue removal is inevitable. Notably, this removal may be so painful that local anesthesia is required to be administered to the area scheduled for the treatment. Although patients tend to accept root planing easily, they frequently express a fear of local anesthesia. Intraosseous anesthesia (IA) is an intraosseous injection technique, whereby local anesthetic is injected into the cancellous bone supporting the teeth. A computer-controlled IA system (CIAS) exhibits multiple benefits, such as less painful anesthesia, reduced soft tissue numbness, and the provision of palatal or lingual, as well as buccal, anesthesia via single needle penetration. In this report, we present two cases of root planing that were performed under local anesthesia, using a CIAS.

Intraosseous anesthesia using a computer-controlled system during non-surgical periodontal therapy (root planing): Two case reports

PubMed Central

2018-01-01

Local anesthesia is administered to control pain, but it may induce fear and anxiety. Root planing is a non-surgical periodontal therapy; however, when it is performed in an extensive manner, some tissue removal is inevitable. Notably, this removal may be so painful that local anesthesia is required to be administered to the area scheduled for the treatment. Although patients tend to accept root planing easily, they frequently express a fear of local anesthesia. Intraosseous anesthesia (IA) is an intraosseous injection technique, whereby local anesthetic is injected into the cancellous bone supporting the teeth. A computer-controlled IA system (CIAS) exhibits multiple benefits, such as less painful anesthesia, reduced soft tissue numbness, and the provision of palatal or lingual, as well as buccal, anesthesia via single needle penetration. In this report, we present two cases of root planing that were performed under local anesthesia, using a CIAS. PMID:29556561

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

Soft tissue modelling with conical springs.

PubMed

Omar, Nadzeri; Zhong, Yongmin; Jazar, Reza N; Subic, Aleksandar; Smith, Julian; Shirinzadeh, Bijan

2015-01-01

This paper presents a new method for real-time modelling soft tissue deformation. It improves the traditional mass-spring model with conical springs to deal with nonlinear mechanical behaviours of soft tissues. A conical spring model is developed to predict soft tissue deformation with reference to deformation patterns. The model parameters are formulated according to tissue deformation patterns and the nonlinear behaviours of soft tissues are modelled with the stiffness variation of conical spring. Experimental results show that the proposed method can describe different tissue deformation patterns using one single equation and also exhibit the typical mechanical behaviours of soft tissues.

Soft Tissue Sarcoma—Health Professional Version

Cancer.gov

Soft tissue sarcomas are malignant tumors that arise in any of the mesodermal tissues of the extremities, trunk and retroperitoneum, or head and neck. Soft tissue sarcomas may be heterogeneous. Find evidence-based information on soft tissue sarcoma treatment and research.

[Transforming gene in human esophageal carcinoma tissue].

PubMed

Jiang, W

1988-09-01

The transforming gene in human esophageal carcinoma (HEC) tissues collected from Lin-xian county, a high incidence area of esophageal cancer was studied. Eight primary HEC tissues were used as sources for the preparation of DNA. High molecular weight DNAs were separately added to NIH 3T3 cells by the calcium phosphate coprecipitation method. Of the 8 HEC tissues examined, 3 DNAs showed transforming activity and produced secondary transformants. The use of uncloned NIH 3T3 cells resulted in the appearances of non-transforming. The efficiency of primary transfection foci was low (0.025--0.05 focus per ug of DNA). In the secondary transfection, the efficiency was increased (0.30 focus per ug of DNA). The primary and secondary transformants were capable of forming colonies in soft agar (0.33%) in contrast to the control NIH 3T3 cells, which did not show any anchorage-independent growth. About 1 X 10(6) cells of the cloned secondary transformants were injected subcutaneously into athymic BALB/c nude mice. The mice developed large tumors (approximately 20-30 mm in diameter) within 5--15 days after injection. No tumor developed in mice injected with control NIH 3T3 cells even after 2 months. The transforming DNA had a linkage to the Alu sequence, indicating that a common human DNA fragment is conserved in the tumors. H-ras was found in the transforming DNA using Southern blot assay.

Large poroelastic deformation of a soft material

NASA Astrophysics Data System (ADS)

MacMinn, Christopher W.; Dufresne, Eric R.; Wettlaufer, John S.

2014-11-01

Flow through a porous material will drive mechanical deformation when the fluid pressure becomes comparable to the stiffness of the solid skeleton. This has applications ranging from hydraulic fracture for recovery of shale gas, where fluid is injected at high pressure, to the mechanics of biological cells and tissues, where the solid skeleton is very soft. The traditional linear theory of poroelasticity captures this fluid-solid coupling by combining Darcy's law with linear elasticity. However, linear elasticity is only volume-conservative to first order in the strain, which can become problematic when damage, plasticity, or extreme softness lead to large deformations. Here, we compare the predictions of linear poroelasticity with those of a large-deformation framework in the context of two model problems. We show that errors in volume conservation are compounded and amplified by coupling with the fluid flow, and can become important even when the deformation is small. We also illustrate these results with a laboratory experiment.

Primary extraskeletal myxoid chondrosarcoma of bone: Report of three cases and review of the literature.

PubMed

Finos, L; Righi, A; Frisoni, T; Gambarotti, M; Ghinelli, C; Benini, S; Vanel, D; Picci, P

2017-05-01

Extraskeletal myxoid chondrosarcoma is a rare neoplasm of soft tissue. The usual location is in deep parts of the proximal extremities and limb girdles in middle-aged adults. The bone location as primary location is extremely rare and few cases are reported. We present three cases arising in bone with molecular confirmation using both RT-PCR and FISH analysis. Patients include two men and one woman with an age of 62, 69 and 73 years old. The mean size of the lesion was 13cm (range 8-18cm). Tumors arose in the iliac bone in two cases and in the proximal humerus in the other case. At time of diagnosis the three cases show bone cortex and soft tissue involvement. On imaging, lesions have a lobular pattern, are purely lytic, but take up contrast medium after injection. Two patients are alive with disease (local recurrence and lung metastasis) after five years and five years and six months, respectively and one patient died of disease two years after the diagnosis. The primary extraskeletal myxoid chondrosarcoma of bone seems to have a more aggressive behavior than the soft tissue counterpart. The molecular confirmation of diagnosis using RT-PCR is necessary to do the differential diagnosis with other entities, in particular with myoepithelioma that shows similar morphological features and EWSR1 and FUS genes rearrangement. Copyright © 2017 Elsevier GmbH. All rights reserved.

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 ...

A comparative evaluation of pain and anxiety levels in 2 different anesthesia techniques: locoregional anesthesia using conventional syringe versus intraosseous anesthesia using a computer-controlled system (Quicksleeper).

PubMed

Özer, Senem; Yaltirik, Mehmet; Kirli, Irem; Yargic, Ilhan

2012-11-01

The aim of this study was to compare anxiety and pain levels during anesthesia and efficacy of Quicksleeper intraosseous (IO) injection system, which delivers computer-controlled IO anesthesia and conventional inferior alveolar nerve block (IANB) in impacted mandibular third molars. Forty subjects with bilateral impacted mandibular third molars randomly received IO injection or conventional IANB at 2 successive appointments. The subjects received 1.8 mL 2% articaine. IO injection has many advantages, such as enabling painless anesthesia with less soft tissue numbness and quick onset of anesthesia as well as lingual and palatal anesthesia with single needle penetration. Although IO injection is a useful technique commonly used during various treatments in dentistry, the duration of injection takes longer than conventional techniques, there is a possibility of obstruction at the needle tip, and, the duration of the anesthetic effect is inadequate for prolonged surgical procedures. Copyright © 2012 Elsevier Inc. All rights reserved.

Development and characterization of a novel hydrogel adhesive for soft tissue applications

NASA Astrophysics Data System (ADS)

Sanders, Lindsey Kennedy

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

SU-E-T-409: Evaluation of Tissue Composition Effect On Dose Distribution in Radiotherapy with 6 MV Photon Beam of a Medical Linac

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ghorbani, M; Tabatabaei, Z; Noghreiyan, A Vejdani

Purpose: The aim of this study is to evaluate soft tissue composition effect on dose distribution for various soft tissues and various depths in radiotherapy with 6 MV photon beam of a medical linac. Methods: A phantom and Siemens Primus linear accelerator were simulated using MCNPX Monte Carlo code. In a homogeneous cubic phantom, six types of soft tissue and three types of tissue-equivalent materials were defined separately. The soft tissues were muscle (skeletal), adipose tissue, blood (whole), breast tissue, soft tissue (9-component) and soft tissue (4-component). The tissue-equivalent materials included: water, A-150 tissue-equivalent plastic and perspex. Photon dose relativemore » to dose in 9-component soft tissue at various depths on the beam’s central axis was determined for the 6 MV photon beam. The relative dose was also calculated and compared for various MCNPX tallies including,F8, F6 and,F4. Results: The results of the relative photon dose in various materials relative to dose in 9-component soft tissue and using different tallies are reported in the form of tabulated data. Minor differences between dose distributions in various soft tissues and tissue-equivalent materials were observed. The results from F6 and F4 were practically the same but different with,F8 tally. Conclusion: Based on the calculations performed, the differences in dose distributions in various soft tissues and tissue-equivalent materials are minor but they could be corrected in radiotherapy calculations to upgrade the accuracy of the dosimetric calculations.« less

Soft tissue wound healing at teeth, dental implants and the edentulous ridge when using barrier membranes, growth and differentiation factors and soft tissue substitutes.

PubMed

Vignoletti, Fabio; Nunez, Javier; Sanz, Mariano

2014-04-01

To review the biological processes of wound healing following periodontal and periimplant plastic surgery when different technologies are used in a) the coverage of root and implant dehiscences, b) the augmentation of keratinized tissue (KT) and c) the augmentation of soft tissue volume. An electronic search from The National Library of Medicine (MEDLINE-PubMed) was performed: English articles with research focus in oral soft tissue regeneration, providing histological outcomes, either from animal experimental studies or human biopsy material were included. Barrier membranes, enamel matrix derivatives, growth factors, allogeneic and xenogeneic soft tissue substitutes have been used in soft tissue regeneration demonstrating different degrees of regeneration. In root coverage, these technologies were able to improve new attachment, although none has shown complete regeneration. In KT augmentation, tissue-engineered allogenic products and xenogeneic collagen matrixes demonstrated integration within the host connective tissue and promotion of keratinization. In soft tissue augmentation and peri-implant plastic surgery there are no histological data currently available. Soft tissue substitutes, growth differentiation factors demonstrated promising histological results in terms of soft tissue regeneration and keratinization, whereas there is a need for further studies to prove their added value in soft tissue augmentation. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A Novel Imaging System Distinguishes Neoplastic from Normal Tissue During Resection of Soft Tissue Sarcomas and Mast Cell Tumors in Dogs.

PubMed

Bartholf DeWitt, Suzanne; Eward, William C; Eward, Cindy A; Lazarides, Alexander L; Whitley, Melodi Javid; Ferrer, Jorge M; Brigman, Brian E; Kirsch, David G; Berg, John

2016-08-01

To assess the ability of a novel imaging system designed for intraoperative detection of residual cancer in tumor beds to distinguish neoplastic from normal tissue in dogs undergoing resection of soft tissue sarcoma (STS) and mast cell tumor (MCT). Non-randomized prospective clinical trial. 12 dogs with STS and 7 dogs with MCT. A fluorescent imaging agent that is activated by proteases in vivo was administered to the dogs 4-6 or 24-26 hours before tumor resection. During surgery, a handheld imaging device was used to measure fluorescence intensity within the cancerous portion of the resected specimen and determine an intensity threshold for subsequent identification of cancer. Selected areas within the resected specimen and tumor bed were then imaged, and biopsies (n=101) were obtained from areas that did or did not have a fluorescence intensity exceeding the threshold. Results of intraoperative fluorescence and histology were compared. The imaging system correctly distinguished cancer from normal tissue in 93/101 biopsies (92%). Using histology as the reference, the sensitivity and specificity of the imaging system for identification of cancer in biopsies were 92% and 92%, respectively. There were 10/19 (53%) dogs which exhibited transient facial erythema soon after injection of the imaging agent which responded to but was not consistently prevented by intravenous diphenhydramine. A fluorescence-based imaging system designed for intraoperative use can distinguish canine soft tissue sarcoma (STS) and mast cell tumor (MCT) tissue from normal tissue with a high degree of accuracy. The system has potential to assist surgeons in assessing the adequacy of tumor resections during surgery, potentially reducing the risk of local tumor recurrence. Although responsive to antihistamines, the risk of hypersensitivity needs to be considered in light of the potential benefits of this imaging system in dogs. © Copyright 2016 by The American College of Veterinary Surgeons.

Soft tissue deformation modelling through neural dynamics-based reaction-diffusion mechanics.

PubMed

Zhang, Jinao; Zhong, Yongmin; Gu, Chengfan

2018-05-30

Soft tissue deformation modelling forms the basis of development of surgical simulation, surgical planning and robotic-assisted minimally invasive surgery. This paper presents a new methodology for modelling of soft tissue deformation based on reaction-diffusion mechanics via neural dynamics. The potential energy stored in soft tissues due to a mechanical load to deform tissues away from their rest state is treated as the equivalent transmembrane potential energy, and it is distributed in the tissue masses in the manner of reaction-diffusion propagation of nonlinear electrical waves. The reaction-diffusion propagation of mechanical potential energy and nonrigid mechanics of motion are combined to model soft tissue deformation and its dynamics, both of which are further formulated as the dynamics of cellular neural networks to achieve real-time computational performance. The proposed methodology is implemented with a haptic device for interactive soft tissue deformation with force feedback. Experimental results demonstrate that the proposed methodology exhibits nonlinear force-displacement relationship for nonlinear soft tissue deformation. Homogeneous, anisotropic and heterogeneous soft tissue material properties can be modelled through the inherent physical properties of mass points. Graphical abstract Soft tissue deformation modelling with haptic feedback via neural dynamics-based reaction-diffusion mechanics.

Collagen-Based Biomaterials for Wound Healing

PubMed Central

Chattopadhyay, Sayani; Raines, Ronald T.

2014-01-01

With its wide distribution in soft and hard connective tissues, collagen is the most abundant of animal proteins. In vitro, natural collagen can be formed into highly organized, three-dimensional scaffolds that are intrinsically biocompatible, biodegradable, non-toxic upon exogenous application, and endowed with high tensile strength. These attributes make collagen the material of choice for wound healing and tissue engineering applications. In this article, we review the structure and molecular interactions of collagen in vivo; the recent use of natural collagen in sponges, injectables, films and membranes, dressings, and skin grafts; and the on-going development of synthetic collagen mimetic peptides as pylons to anchor cytoactive agents in wound beds. PMID:24633807

Enamel Matrix Derivative Promotes Healing of a Surgical Wound in the Rat Oral Mucosa.

PubMed

Maymon-Gil, Tal; Weinberg, Evgeny; Nemcovsky, Carlos; Weinreb, Miron

2016-05-01

Enamel matrix proteins (EMPs) play a role in enamel formation and the development of the periodontium. Sporadic clinical observations of periodontal regeneration treatments with enamel matrix derivative (EMD), a commercial formulation of EMPs, suggest that it also promotes post-surgical healing of soft tissues. In vitro studies showed that EMD stimulates various cellular effects, which could potentially enhance wound healing. This study examines the in vivo effects of EMD on healing of an oral mucosa surgical wound in rats. A bilateral oral mucosa wound was created via a crestal incision in the anterior edentulous maxilla of Sprague-Dawley rats. Full-thickness flaps were raised, and, after suturing, EMD was injected underneath the soft tissues on one side, whereas the EMD vehicle was injected in the contralateral side. Animals were sacrificed after 5 or 9 days, and the wound area was subjected to histologic and immunohistochemical analysis of the epithelial gap, number of macrophages, blood vessels, proliferating cells, and collagen content in the connective tissue (CT). Gene expression analysis was also conducted 2 days post-surgery. EMD had no effect on the epithelial gap of the wound. On both days 5 and 9, EMD treatment increased significantly the number of blood vessels and the collagen content. EMD also enhanced (by 20% to 40%) the expression of transforming growth factors β1 and β2, vascular endothelial growth factor, interleukin-1β, matrix metalloproteinase-1, versican, and fibronectin. EMD improves oral mucosa incisional wound healing by promoting formation of blood vessels and collagen fibers in CT.

Oxygen Generating Biomaterials Preserve Skeletal Muscle Homeostasis under Hypoxic and Ischemic Conditions

PubMed Central

Ward, Catherine L.; Corona, Benjamin T.; Yoo, James J.; Harrison, Benjamin S.; Christ, George J.

2013-01-01

Provision of supplemental oxygen to maintain soft tissue viability acutely following trauma in which vascularization has been compromised would be beneficial for limb and tissue salvage. For this application, an oxygen generating biomaterial that may be injected directly into the soft tissue could provide an unprecedented treatment in the acute trauma setting. The purpose of the current investigation was to determine if sodium percarbonate (SPO), an oxygen generating biomaterial, is capable of maintaining resting skeletal muscle homeostasis under otherwise hypoxic conditions. In the current studies, a biologically and physiologically compatible range of SPO (1–2 mg/mL) was shown to: 1) improve the maintenance of contractility and attenuate the accumulation of HIF1α, depletion of intramuscular glycogen, and oxidative stress (lipid peroxidation) that occurred following ∼30 minutes of hypoxia in primarily resting (duty cycle = 0.2 s train/120 s contraction interval <0.002) rat extensor digitorum longus (EDL) muscles in vitro (95% N2–5% CO2, 37°C); 2) attenuate elevations of rat EDL muscle resting tension that occurred during contractile fatigue testing (3 bouts of 25 100 Hz tetanic contractions; duty cycle = 0.2 s/2 s = 0.1) under oxygenated conditions in vitro (95% O2–5% CO2, 37°C); and 3) improve the maintenance of contractility (in vivo) and prevent glycogen depletion in rat tibialis anterior (TA) muscle in a hindlimb ischemia model (i.e., ligation of the iliac artery). Additionally, injection of a commercially available lipid oxygen-carrying compound or the components (sodium bicarbonate and hydrogen peroxide) of 1 mg/mL SPO did not improve EDL muscle contractility under hypoxic conditions in vitro. Collectively, these findings demonstrate that a biological and physiological concentration of SPO (1–2 mg/mL) injected directly into rat skeletal muscle (EDL or TA muscles) can partially preserve resting skeletal muscle homeostasis under hypoxic conditions. PMID:23991116

Efficacy and safety of 1alpha-hydroxyvitamin D3 for prevention of parturient paresis.

PubMed

Gast, D R; Marquardt, J P; Jorgensen, N A; Deluca, H F

1977-12-01

Four trials involved intravenous or intramuscular injections of 1alpha-hydroxyvitavin D3 to test efficacy in preventing parturient paresis. Use of .1 mg intravenously afforded total protection compared with an incidence of 33% (2/6) in controls. Intramuscular injections of .1 mg in 2 ml propylene glycol and .3, .5, and 1.0 mg in 5 ml corn oil resulted in 0, 15.7, 20, and 0% incidence of parturient paresis compared with 33, 16.7, 37.5, and 37.5% incidence of parturient paresis in the controls. There was a rapid increase in serum calcium (12 to 24 h) in response to intravenous treatment, whereas the response to intramuscular injections was gradual but was maintained longer. To evaluate the safety of 1alpha-hydroxyvitamin D3, eight cows, two per treatment, were given intramuscular doses of .5, 1.0, 1.5, or 3.0 mg (three 1.0 mg injections) in 5 ml corn oil. No clinical or pathological evidence of hypervitaminosis C or soft tissue calcification was found. Tissue taken from the injection site 15 days after last injection contained 3 to 38 IU vitamin D activity per 100 g wet tissue compared with control of 8 to 15 IU per 100 g. Total vitamin D activity of milk taken the 11th milking postpartum from cows receiving .5 or 1.0 mg had a mean of 13.4 and 22.6 IU vitamin D activity per liter compared to 19 IU per liter for control milk. Milk from the 5th milking postpartum in the cows receiving .5 mg had a mean activity of 14.5 IU per liter. Milk from animals slaughtered for retention studies had a mean activity of 22 IU per liter.

Bioactive Glass Nanoparticles: From Synthesis to Materials Design for Biomedical Applications

PubMed Central

Vichery, Charlotte; Nedelec, Jean-Marie

2016-01-01

Thanks to their high biocompatibility and bioactivity, bioactive glasses are very promising materials for soft and hard tissue repair and engineering. Because bioactivity and specific surface area intrinsically linked, the last decade has seen a focus on the development of highly porous and/or nano-sized materials. This review emphasizes the synthesis of bioactive glass nanoparticles and materials design strategies. The first part comprehensively covers mainly soft chemistry processes, which aim to obtain dispersible and monodispersed nanoparticles. The second part discusses the use of bioactive glass nanoparticles for medical applications, highlighting the design of materials. Mesoporous nanoparticles for drug delivery, injectable systems and scaffolds consisting of bioactive glass nanoparticles dispersed in a polymer, implant coatings and particle dispersions will be presented. PMID:28773412

Gait-related strategies for the prevention of plantar ulcer development in the high risk foot.

PubMed

Bowling, Frank L; Reeves, Neil D; Boulton, Andrew J

2011-05-01

High plantar pressures lead to ulceration in the diabetic foot, particularly in the forefoot region around the metatarsal heads. High plantar pressures persist during gait due to factors such as peripheral neuropathy, foot deformities, limited ankle dorsi flexion range of motion and reduced plantar tissue thickness. Strategies impinging upon gait such as the use of appropriate therapeutic footwear, custom-moulded insoles and injectable silicone can help to reduce plantar pressures and attenuate the risk for ulceration. Shoes adapted with external rocker profiles facilitate plantar flexion and restrict sagittal plane motion of the metatarsophalangeal joint, reducing pressures in the region of the metatarsal heads. Insoles custom-moulded to patient's feet help to reduce plantar pressures and minimise the risk of ulceration in the forefoot region. The loss of subcutaneous fat tissue in the diabetic foot enhances bony prominences and predisposes the foot to high-pressure areas. Silicone is a biocompatible material that can be safely injected into plantar soft tissue to augment tissue thickness and prevent the development of ulceration. This enhancement to the subcutaneous layer is remarkably well retained and is a generally well-adopted procedure in the clinical setting.

Three-dimensional Biomimetic Technology: Novel Biorubber Creates Defined Micro- and Macro-scale Architectures in Collagen Hydrogels

PubMed Central

Rodriguez-Rivera, Veronica; Weidner, John W.; Yost, Michael J.

2016-01-01

Tissue scaffolds play a crucial role in the tissue regeneration process. The ideal scaffold must fulfill several requirements such as having proper composition, targeted modulus, and well-defined architectural features. Biomaterials that recapitulate the intrinsic architecture of in vivo tissue are vital for studying diseases as well as to facilitate the regeneration of lost and malformed soft tissue. A novel biofabrication technique was developed which combines state of the art imaging, three-dimensional (3D) printing, and selective enzymatic activity to create a new generation of biomaterials for research and clinical application. The developed material, Bovine Serum Albumin rubber, is reaction injected into a mold that upholds specific geometrical features. This sacrificial material allows the adequate transfer of architectural features to a natural scaffold material. The prototype consists of a 3D collagen scaffold with 4 and 3 mm channels that represent a branched architecture. This paper emphasizes the use of this biofabrication technique for the generation of natural constructs. This protocol utilizes a computer-aided software (CAD) to manufacture a solid mold which will be reaction injected with BSA rubber followed by the enzymatic digestion of the rubber, leaving its architectural features within the scaffold material. PMID:26967145

Three-dimensional Biomimetic Technology: Novel Biorubber Creates Defined Micro- and Macro-scale Architectures in Collagen Hydrogels.

PubMed

Rodriguez-Rivera, Veronica; Weidner, John W; Yost, Michael J

2016-02-12

Tissue scaffolds play a crucial role in the tissue regeneration process. The ideal scaffold must fulfill several requirements such as having proper composition, targeted modulus, and well-defined architectural features. Biomaterials that recapitulate the intrinsic architecture of in vivo tissue are vital for studying diseases as well as to facilitate the regeneration of lost and malformed soft tissue. A novel biofabrication technique was developed which combines state of the art imaging, three-dimensional (3D) printing, and selective enzymatic activity to create a new generation of biomaterials for research and clinical application. The developed material, Bovine Serum Albumin rubber, is reaction injected into a mold that upholds specific geometrical features. This sacrificial material allows the adequate transfer of architectural features to a natural scaffold material. The prototype consists of a 3D collagen scaffold with 4 and 3 mm channels that represent a branched architecture. This paper emphasizes the use of this biofabrication technique for the generation of natural constructs. This protocol utilizes a computer-aided software (CAD) to manufacture a solid mold which will be reaction injected with BSA rubber followed by the enzymatic digestion of the rubber, leaving its architectural features within the scaffold material.

Soft Tissue Alterations in Esthetic Postextraction Sites: A 3-Dimensional Analysis.

PubMed

Chappuis, V; Engel, O; Shahim, K; Reyes, M; Katsaros, C; Buser, D

2015-09-01

Dimensional alterations of the facial soft and bone tissues following tooth extraction in the esthetic zone play an essential role to achieve successful outcomes in implant therapy. This prospective study is the first to investigate the interplay between the soft tissue dimensions and the underlying bone anatomy during an 8-wk healing period. The analysis is based on sequential 3-dimensional digital surface model superimpositions of the soft and bone tissues using digital impressions and cone beam computed tomography during an 8-wk healing period. Soft tissue thickness in thin and thick bone phenotypes at extraction was similar, averaging 0.7 mm and 0.8 mm, respectively. Interestingly, thin bone phenotypes revealed a 7-fold increase in soft tissue thickness after an 8-wk healing period, whereas in thick bone phenotypes, the soft tissue dimensions remained unchanged. The observed spontaneous soft tissue thickening in thin bone phenotypes resulted in a vertical soft tissue loss of only 1.6 mm, which concealed the underlying vertical bone resorption of 7.5 mm. Because of spontaneous soft tissue thickening, no significant differences were detected in the total tissue loss between thin and thick bone phenotypes at 2, 4, 6, and 8 wk. More than 51% of these dimensional alterations occurred within 2 wk of healing. Even though the observed spontaneous soft tissue thickening in thin bone phenotypes following tooth extraction conceals the pronounced underlying bone resorption pattern by masking the true bone deficiency, spontaneous soft tissue thickening offers advantages for subsequent bone regeneration and implant therapies in sites with high esthetic demand (Clinicaltrials.gov NCT02403700). © International & American Associations for Dental Research.

Hyaluronic Acid Hydrogels for Biomedical Applications

PubMed Central

Burdick, Jason A.; Prestwich, Glenn D.

2013-01-01

Hyaluronic acid (HA), an immunoneutral polysaccharide that is ubiquitous in the human body, is crucial for many cellular and tissue functions and has been in clinical use for over thirty years. When chemically modified, HA can be transformed into many physical forms -- viscoelastic solutions, soft or stiff hydrogels, electrospun fibers, non-woven meshes, macroporous and fibrillar sponges, flexible sheets, and nanoparticulate fluids -- for use in a range of preclinical and clinical settings. Many of these forms are derived from the chemical crosslinking of pendant reactive groups by addition/condensation chemistry or by radical polymerization. Clinical products for cell therapy and regenerative medicine require crosslinking chemistry that is compatible with the encapsulation of cells and injection into tissues. Moreover, an injectable clinical biomaterial must meet marketing, regulatory, and financial constraints to provide affordable products that can be approved, deployed to the clinic, and used by physicians. Many HA-derived hydrogels meet these criteria, and can deliver cells and therapeutic agents for tissue repair and regeneration. This progress report covers both basic concepts and recent advances in the development of HA-based hydrogels for biomedical applications. PMID:21394792

Transillumination for needle localization in the larynx.

PubMed

Hoffman, Henry T; Dailey, Seth H; Bock, Jonathan M; Thibeault, Susan L; McCulloch, Timothy M

2015-10-01

Transillumination through laryngeal soft tissue may be used to direct percutaneous transcricothyroid membrane subepithelial needle placement in the larynx. Cadaver simulation (canine and human). Lighted devices, including sialendoscopes and fiberoptic cables, were tested as transilluminating obturators in trocars and needles through multiple studies to identify appropriate illumination, monitoring, and equipment for successful localization of needle/trocar tips placed within laryngeal tissue. Lighted 250-micron fiberoptic cables within 23-gauge needles were successfully placed percutaneously through the cricothyroid membrane and maneuvered submucosally into Reinke's space, the midlateral vocal fold, and through the thyroarytenoid gap with monitoring via flexible transnasal laryngoscopy. Technical adaptations in the course of study permitted successful simulation of clinical use in full cadaver study for accurate injection laryngoplasty, confirmed by laryngeal dissection following collagen injection. Small caliber fiberoptic cables are useful as transilluminating obturators to accurately direct needle position within laryngeal tissue. Clinical application of this new technique is anticipated to improve the accuracy of percutaneous needle localization in the larynx, as well as to assist in directed instrumentation of the larynx from an external approach. N/A. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Cone-Beam Computed Tomography Evaluation of Horizontal and Vertical Dimensional Changes in Buccal Peri-Implant Alveolar Bone and Soft Tissue: A 1-Year Prospective Clinical Study.

PubMed

Kaminaka, Akihiro; Nakano, Tamaki; Ono, Shinji; Kato, Tokinori; Yatani, Hirofumi

2015-10-01

This study evaluated changes in the horizontal and vertical dimensions of the buccal alveolar bone and soft tissue over a 1-year period following implant prosthesis. Thirty-three participants with no history of guided bone regeneration or soft tissue augmentation underwent dental implant placement with different types of connections. The dimensions of the buccal alveolar bone and soft tissue were evaluated immediately and at 1 year after prosthesis from reconstructions of cross-sectional cone-beam computed tomography images. The vertical and horizontal loss of buccal bone and soft tissue around implants with conical connections were lower than around those with external or internal connections. Statistically significant negative correlations were observed between initial horizontal bone thickness and changes in vertical bone and soft tissue height (p < .05), and between initial horizontal soft tissue thickness and the change in vertical soft tissue height (p < .05). Implants with a conical connection preserve peri-implant alveolar bone and soft tissue more effectively than other connection types. Furthermore, the initial buccal alveolar bone and soft tissue thickness around the implant platform may influence their vertical dimensional changes at 1 year after implant prosthesis. © 2014 Wiley Periodicals, Inc.

An overview of anthrax infection including the recently identified form of disease in injection drug users

PubMed Central

Hicks, Caitlin W.; Sweeney, Daniel A.; Cui, Xizhong; Li, Yan

2012-01-01

Purpose Bacillus anthracis infection (anthrax) can be highly lethal. Two recent outbreaks related to contaminated mail in the USA and heroin in the UK and Europe and its potential as a bioterrorist weapon have greatly increased concerns over anthrax in the developed world. Methods This review summarizes the microbiology, pathogenesis, diagnosis, and management of anthrax. Results and conclusions Anthrax, a gram-positive bacterium, has typically been associated with three forms of infection: cutaneous, gastrointestinal, and inhalational. However, the anthrax outbreak among injection drug users has emphasized the importance of what is now considered a fourth disease form (i.e., injectional anthrax) that is characterized by severe soft tissue infection. While cutaneous anthrax is most common, its early stages are distinct and prompt appropriate treatment commonly produces a good outcome. However, early symptoms with the other three disease forms can be nonspecific and mistaken for less lethal conditions. As a result, patients with gastrointestinal, inhalational, or injectional anthrax may have advanced infection at presentation that can be highly lethal. Once anthrax is suspected, the diagnosis can usually be made with gram stain and culture from blood or tissue followed by confirmatory testing (e.g., PCR). While antibiotics are the mainstay of anthrax treatment, use of adjunctive therapies such as anthrax toxin antagonists are a consideration. Prompt surgical therapy appears to be important for successful management of injectional anthrax. PMID:22527064

Functionalised Polysiloxanes as Injectable, In Situ Curable Accommodating Intraocular Lenses

PubMed Central

Hao, Xiaojuan; Jeffery, Justine L.; Wilkie, John S.; Meijs, Gordon; Clayton, Anthony; Watling, Jason; Ho, Arthur; Fernandez, Viviana; Acosta, Carolina; Yamamoto, Hideo; Aly, Mohamed G. M.; Parel, Jean-Marie; Hughes, Timothy C.

2010-01-01

The aged eye’s ability to change focus (accommodation) may be restored by replacing the hardened natural lens with a soft gel. Functionalised polysiloxane macromonomers, designed for application as an injectable, in situ curable accommodating intraocular lens (A-IOL), were prepared via a two-step synthesis. Prepolymers were synthesised via ring opening polymerisation (ROP) of octamethylcyclotetrasiloxane (D4) and 2,4,6,8-tetramethylcyclotetrasiloxane (D4H) in toluene using trifluoromethanesulfonic acid (TfOH) as catalyst. Hexaethyldisiloxane (HEDS) was used as the end group to control the molecular weight of the prepolymers, which were then converted to macromonomers by hydrosilylation of the SiH groups with allyl methacrylate (AM) to introduce polymerisable groups. The resulting macromonomers had an injectable consistency and thus, were able to be injected into and refill the empty lens capsular bag. The macromonomers also contained a low ratio of polymerisable groups so that they may be cured on demand, in situ, under irradiation of blue light, in the presence of a photo-initiator, to form a soft polysiloxane gel (an intraocular lens) in the eye. The pre-cure viscosity and post-cure modulus of the polysiloxanes, which are crucial factors for an injectable, in situ curable A-IOL application, were controlled by adjusting the end group and D4H concentrations, respectively, in the ROP. The macromonomers were fully cured within 5 minutes under light irradiation, as shown by the rapid change in modulus monitored by photorheology. Ex vivo primate lens stretching experiments on an Ex Vivo Accommodation Simulator (EVAS) showed that the polysiloxane gel refilled lenses achieved over 60% of the accommodation amplitude of the natural lens. An in vivo biocompatibility study in rabbits using the lens refilling (Phaco-Ersatz) procedure demonstrated that the soft gels were biocompatible with the ocular tissue. The polysiloxane macromonomers meet the targeted optical and mechanical properties of a young natural crystalline lens and show promise as candidate materials for use as injectable, in situ curable A-IOLs for lens refilling procedures. PMID:20692702

Exploring the potential of polyurethane-based soft foam as cell-free scaffold for soft tissue regeneration.

PubMed

Gerges, Irini; Tamplenizza, Margherita; Martello, Federico; Recordati, Camilla; Martelli, Cristina; Ottobrini, Luisa; Tamplenizza, Mariacaterina; Guelcher, Scott A; Tocchio, Alessandro; Lenardi, Cristina

2018-06-01

Reconstructive treatment after trauma and tumor resection would greatly benefit from an effective soft tissue regeneration. The use of cell-free scaffolds for adipose tissue regeneration in vivo is emerging as an attractive alternative to tissue-engineered constructs, since this approach avoids complications due to cell manipulation and lack of synchronous vascularization. In this study, we developed a biodegradable polyurethane-based scaffold for soft tissue regeneration, characterized by an exceptional combination between softness and resilience. Exploring the potential as a cell-free scaffold required profound understanding of the impact of its intrinsic physico-chemical properties on the biological performance in vivo. We investigated the effect of the scaffold's hydrophilic character, degradation kinetics, and internal morphology on (i) the local inflammatory response and activation of MGCs (foreign body response); (ii) its ability to promote rapid vascularisation, cell infiltration and migration through the scaffold over time; and (iii) the grade of maturation of the newly formed tissue into vascularized soft tissue in a murine model. The study revealed that soft tissue regeneration in vivo proceeded by gradual infiltration of undifferentiated mesenchymal cells though the periphery toward the center of the scaffold, where the rapid formation of a functional and well-formed vascular network supported cell viability overtime. Exploring the potential of polyurethane-based soft foam as cell-free scaffold for soft tissue regeneration. In this work, we address the unmet need for synthetic functional soft tissue substitutes that provide adequate biological and mechanical support to soft tissue. We developed a series of flexible cross-linked polyurethane copolymer scaffolds with remarkable fatigue-resistance and tunable physico-chemical properties for soft tissue regeneration in vivo. Accordingly, we could extend the potential of this class of biomaterials, which was so far confined for bone and osteochondral tissue regeneration, to other types of connective tissue. Copyright © 2018 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Combination Chemotherapy in Treating Patients With Previously Untreated Rhabdomyosarcoma

ClinicalTrials.gov

2013-06-13

Adult Malignant Mesenchymoma; Adult Rhabdomyosarcoma; Alveolar Childhood Rhabdomyosarcoma; Childhood Malignant Mesenchymoma; Embryonal Childhood Rhabdomyosarcoma; Embryonal-botryoid Childhood Rhabdomyosarcoma; Nonmetastatic Childhood Soft Tissue Sarcoma; Previously Untreated Childhood Rhabdomyosarcoma; Stage I Adult Soft Tissue Sarcoma; Stage II Adult Soft Tissue Sarcoma; Stage III Adult Soft Tissue Sarcoma

Comparison of fat maintenance in the face with centrifuge versus filtered and washed fat.

PubMed

Asilian, Ali; Siadat, Amir Hossein; Iraji, Razieh

2014-06-01

Autogenous fat injection of the face is a viable and lasting remedy for soft tissue loss and has become a mainstay in facial rejuvenation. Fat transfer as either a stand-alone technique or as an adjunct to other filler technique and lifting depending on patient needs. Although soft tissue augmentation with autologous fat transfer has been increasingly used by esthetic surgeon, but there is no agreement concerning the best way of processing the harvested fat before injection. This study compared the clinical results obtained using simple filtered and washed fat via metal sieve with those achieved by means of pure centrifuged fat. A prospective single-blind analysis on 32 healthy patients undergoing nasolabial fold fat transplantation from 2009 to 2011 (simple sampling). Patients assigned in two groups randomly. The face of half (16 subjects) was injected with centrifuged, another half with simple filtered and washed fat to evaluate the effect of preparation methods on fat graft viability. Objective method was used to evaluate the results, involving the evaluation of postoperative photographs (in month 1, 6 and 12) by an esthetic surgeon (according to the nasolabial scale). Subjective method was a self-assessment obtained from patients about general level of satisfaction and improvement of skin texture, statistical analysis were performed by means of the Wilcoxon and Mann-Whitney test. Acquired data were analyzed using SPSS version 15 and a value of P > 0.05 was considered as significant. There was no significant difference in the survival of grafted fat between the Group 1 (fat-processing with centrifuge at 3400 rpm for 1-min) and Group 2 (washing the fat in the sieve). Our data suggest that the centrifuge of the fat does not enhance survival of grafted fat (P > 0.05).

A rapid recovery program: early home and pain free.

PubMed

Lombardi, Adolph V; Berend, Keith R; Adams, Joanne B

2010-09-07

Enhancement of our perioperative pain management protocols has resulted in accelerated rehabilitation. At our facility, the majority of patients undergoing total and partial knee arthroplasty are treated with a single-shot spinal anesthetic consisting of a combination of bupivacaine and duramorph. The bupivacaine affords the immediate perioperative anesthetic while the duramorph results in sustained analgesia for a period of 12 to 24 hours. We use intra-articular injections delivered directly into the soft tissue of the knee. Our current intra-articular injection is 60 mL of 0.5% ropivacaine with 0.5 mg of epinephrine. In patients with a normal renal function, 30 mg of ketorolac is added. The injection is administered throughout all of the soft tissues in and around the knee. Prophylactic antiemetics are administered in the form of dexamethasone, ondansetron, and a scopolamine patch. The use of this perioperative anesthesia provides effective pain relief with no motor blockade. Patients are able to participate in physiotherapy within several hours of the operative procedure, performing active range of motion and ambulating with assistive devices. Patients with no significant cardiovascular history are given celecoxib preoperatively, which is continued for approximately 2 weeks postoperatively. Additionally, all patients are treated with oxycodone, either preoperatively or within 2 hours of arrival to the floor postoperatively. Patients younger than 70 years are given 20 mg of oxycodone while those older than 70 years are given 10 mg of oxycodone. The oxycodone is continued for the first 24 hours of the hospital stay. Patients are then managed with oxycodone and hydrocodone. Length of stay has decreased and currently averages <2 days. Copyright 2010, SLACK Incorporated.

Comparison of anesthetic efficacy of 2 and 4 % articaine in inferior alveolar nerve block for tooth extraction-a double-blinded randomized clinical trial.

PubMed

Kämmerer, P W; Schneider, D; Palarie, V; Schiegnitz, E; Daubländer, M

2017-01-01

The purpose of this clinical prospective, randomized, double-blind trial was to compare the anesthetic efficacy of 2 % articaine and 4 % articaine in inferior alveolar nerve block anesthesia for extraction of mandibular teeth. In 95 patients, 105 lower molar and premolar teeth were extracted after intraoral inferior alveolar nerve block. In 53 cases, 2 % articaine (group I) and, in 52 cases, 4 % articaine (group II) was administered. The primary objective was to analyze the differences of anesthetic effects between the two groups (complete/sufficient vs. insufficient/none). Furthermore, differences in pulpal anesthesia (onset and depth, examined with pulp vitality tester (min)), as well as in length of soft tissue anesthesia (min), were evaluated. Additionally, the need of a second injection, pain while injecting (numeric rating scale (NRS)), pain during treatment (NRS), pain after treatment (NRS), and other possible complications (excessive pain, bleeding events, prolonged deafness) were analyzed. Anesthesia was sufficient for dental extractions in both groups without significant differences (p = 0.201). The onset of anesthesia did not differ significantly (p = 0.297). A significantly shorter duration of soft tissue anesthesia was seen in group I (2.9 vs. 4 h; p < 0.001). There was no significant difference in the need for a second injection (p = 0.359), in injection pain (p = 0.386), as well as in pain during (p = 0.287) or after treatment (p = 0.121). In both groups, no complications were seen. The local anesthetic effect of the 4 % articaine solution is not significantly better when compared to 2 % articaine. For mandibular tooth extraction, articaine 2 % may be used as alternative as well.

Dimensional soft tissue changes following soft tissue grafting in conjunction with implant placement or around present dental implants: a systematic review.

PubMed

Poskevicius, Lukas; Sidlauskas, Antanas; Galindo-Moreno, Pablo; Juodzbalys, Gintaras

2017-01-01

To systematically review changes in mucosal soft tissue thickness and keratinised mucosa width after soft tissue grafting around dental implants. An electronic literature search was conducted of the MEDLINE database published between 2009 and 2014. Sequential screenings at the title, abstract, and full-text levels were performed. Clinical human studies in the English language that had reported changes in soft tissue thickness or keratinised mucosa width after soft tissue grafting at implant placement or around a present implant at 6-month follow-up or longer were included. The search resulted in fourteen articles meeting the inclusion criteria: Six of them reported connective tissue grafting around present dental implants, compared to eight at the time of implant placement. Better long-term soft tissue thickness outcomes were reported for soft tissue augmentation around dental implants (0.8-1.4 mm), compared with augmentation at implant placement (-0.25-1.43 mm). Both techniques were effective in increasing keratinised tissue width: at implant placement (2.5 mm) or around present dental implants (2.33-2.57 mm). The present systematic review discovered that connective tissue grafts enhanced keratinised mucosa width and soft tissue thickness for an observation period of up to 48 months. However, some shrinkage may occur, resulting in decreases in soft tissue, mostly for the first three months. Further investigations using accurate evaluation methods need to be done to evaluate the appropriate time for grafting. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Development and validation of a custom made indocyanine green fluorescence lymphatic vessel imager

NASA Astrophysics Data System (ADS)

Pallotta, Olivia J.; van Zanten, Malou; McEwen, Mark; Burrow, Lynne; Beesley, Jack; Piller, Neil

2015-06-01

Lymphoedema is a chronic progressive condition often producing significant morbidity. An in-depth understanding of an individual's lymphatic architecture is valuable both in the understanding of underlying pathology and for targeting and tailoring treatment. Severe lower limb injuries resulting in extensive loss of soft tissue require transposition of a flap consisting of muscle and/or soft tissue to close the defect. These patients are at risk of lymphoedema and little is known about lymphatic regeneration within the flap. Indocyanine green (ICG), a water-soluble dye, has proven useful for the imaging of lymphatic vessels. When injected into superficial tissues it binds to plasma proteins in lymph. By exposing the dye to specific wavelengths of light, ICG fluoresces with near-infrared light. Skin is relatively transparent to ICG fluorescence, enabling the visualization and characterization of superficial lymphatic vessels. An ICG fluorescence lymphatic vessel imager was manufactured to excite ICG and visualize real-time fluorescence as it travels through the lymphatic vessels. Animal studies showed successful ICG excitation and detection using this imager. Clinically, the imager has assisted researchers to visualize otherwise hidden superficial lymphatic pathways in patients postflap surgery. Preliminary results suggest superficial lymphatic vessels do not redevelop in muscle flaps.

Soft-tissue tension total knee arthroplasty.

PubMed

Asano, Hiroshi; Hoshino, Akiho; Wilton, Tim J

2004-08-01

It is far from clear how best to define the proper strength of soft-tissue tensioning in total knee arthroplasty (TKA). We attached a torque driver to the Monogram balancer/tensor device and measured soft-tissue tension in full extension and 90 degrees flexion during TKA. In our surgical procedure, when we felt proper soft-tissue tension was being applied, the mean distraction force was noted to be 126N in extension and 121N in flexion. There was no significant correlation between soft-tissue tension and the postoperative flexion angle finally achieved. To the best of our knowledge, this is the first study to assess the actual distraction forces in relation to soft-tissue tension in TKA. Further study may reveal the most appropriate forces to achieve proper soft-tissue tension in the wide variety of circumstances presenting at knee arthroplasty.

One-Year Relapse of Mandibular Distraction for Hemifacial Microsomia Using Masseteric Botulinum Toxin Type A Injections.

PubMed

Yin, Hong-Yu; Wang, Chuan; Zhang, Zhi-Yong; Shi, Lei; Yin, Lin; Liu, Wei; Feng, Shi; Cao, Yi-Lin; Tang, Xiao-Jun

2018-06-11

The relapse of hemifacial microsomia was thought to be highly related to the soft tissue envelope around the mandible angle mainly composed by masseter and medial pterygoid. According to the reason, we tried to apply masseter injection of type A botulinum toxin to weaken the soft envelope tension on the early stage post mandible distraction in adult HFM patients. Eight patients diagnosed with HFM were studied and randomly assigned to an experimental or control group. Patients in the experimental group were treated with DO, orthognathic surgeries, autologous fat grafting, and bilateral masseter muscle injection with type A botulinum toxin. The patients in control group were treated with the same procedures as the patients in experimental group except for masseter muscle injection with type A botulinum toxin. The recurrence rates of both groups were evaluated and analyzed after nearly 1 year of follow-up. The mean recurrence rate was 26.30% ± 11.84% (range 7.62%-37.27%) in the 8 patients after 1-year follow-up. The relapse rate was 16.32% ± 7.78% (7.62%-26.22%) in the experimental group and 36.28% ± 1.03% (34.84%-37.27%) in the control group. There was a significant difference (P = 0.002) between the experimental group and the control group. The combination of DO, orthognathic surgeries, autologous fat particle transplantation, and masseter muscle type A botulinum toxin injection technique could be a comprehensive treatment plan for adult patients of HFM. Furthermore, masseter injection of type A botulinum toxin might be an alternative method to reduce the early recurrence rate of postoperative adult patients of HFM.

Soft Tissue Sarcoma—Patient Version

Cancer.gov

Soft tissue sarcoma is a cancer that starts in soft tissues like muscle, tendons, fat, lymph vessels, blood vessels, and nerves. These cancers can develop anywhere in the body but are found mostly in the arms, legs, chest, and abdomen. Start here to find information on soft tissue sarcoma treatment and research.

Combination Chemotherapy and Radiation Therapy in Treating Patients With Newly Diagnosed Rhabdomyosarcoma

ClinicalTrials.gov

2017-06-27

Adult Malignant Mesenchymoma; Adult Rhabdomyosarcoma; Childhood Alveolar Rhabdomyosarcoma; Childhood Botryoid-Type Embryonal Rhabdomyosarcoma; Childhood Embryonal Rhabdomyosarcoma; Childhood Malignant Mesenchymoma; Non-Metastatic Childhood Soft Tissue Sarcoma; Stage I Adult Soft Tissue Sarcoma; Stage II Adult Soft Tissue Sarcoma; Stage III Adult Soft Tissue Sarcoma; Untreated Childhood Rhabdomyosarcoma

Experimentally determined spectral optimization for dedicated breast computed tomography.

PubMed

Prionas, Nicolas D; Huang, Shih-Ying; Boone, John M

2011-02-01

The current study aimed to experimentally identify the optimal technique factors (x-ray tube potential and added filtration material/thickness) to maximize soft-tissue contrast, microcalcification contrast, and iodine contrast enhancement using cadaveric breast specimens imaged with dedicated breast computed tomography (bCT). Secondarily, the study aimed to evaluate the accuracy of phantom materials as tissue surrogates and to characterize the change in accuracy with varying bCT technique factors. A cadaveric breast specimen was acquired under appropriate approval and scanned using a prototype bCT scanner. Inserted into the specimen were cylindrical inserts of polyethylene, water, iodine contrast medium (iodixanol, 2.5 mg/ml), and calcium hydroxyapatite (100 mg/ml). Six x-ray tube potentials (50, 60, 70, 80, 90, and 100 kVp) and three different filters (0.2 mm Cu, 1.5 mm Al, and 0.2 mm Sn) were tested. For each set of technique factors, the intensity (linear attenuation coefficient) and noise were measured within six regions of interest (ROIs): Glandular tissue, adipose tissue, polyethylene, water, iodine contrast medium, and calcium hydroxyapatite. Dose-normalized contrast to noise ratio (CNRD) was measured for pairwise comparisons among the six ROIs. Regression models were used to estimate the effect of tube potential and added filtration on intensity, noise, and CNRD. Iodine contrast enhancement was maximized using 60 kVp and 0.2 mm Cu. Microcalcification contrast and soft-tissue contrast were maximized at 60 kVp. The 0.2 mm Cu filter achieved significantly higher CNRD for iodine contrast enhancement than the other two filters (p = 0.01), but microcalcification contrast and soft-tissue contrast were similar using the copper and aluminum filters. The average percent difference in linear attenuation coefficient, across all tube potentials, for polyethylene versus adipose tissue was 1.8%, 1.7%, and 1.3% for 0.2 mm Cu, 1.5 mm Al, and 0.2 mm Sn, respectively. For water versus glandular tissue, the average percent difference was 2.7%, 3.9%, and 4.2% for the three filter types. Contrast-enhanced bCT, using injected iodine contrast medium, may be optimized for maximum contrast of enhancing lesions at 60 kVp with 0.2 mm Cu filtration. Soft-tissue contrast and microcalcification contrast may also benefit from lower tube potentials (60 kVp). The linear attenuation coefficients of water and polyethylene slightly overestimate the values of their corresponding tissues, but the reported differences may serve as guidance for dosimetry and quality assurance using tissue equivalent phantoms.

Fillers in dermatology: from past to present.

PubMed

Chacon, Anna H

2015-11-01

Injectable fillers were introduced in dermatology as a method for reconstructing facial deformities and restoring the aging face. Although fillers have become a popular option among cosmetic patients, clinical experience has shown that fillers must be used with caution, as complications can occur. This article provides a brief review of the history of filler agents currently available for soft tissue augmentation. Although no single filler is ideal for all patients, indications, and situations, residents should be aware of the properties and characteristics that make each product unique.

Pembrolizumab With Intratumoral Injection of Clostridium Novyi-NT

ClinicalTrials.gov

2018-06-22

Malignant Neoplasm of Breast; Malignant Neoplasms of Digestive Organs; Malignant Neoplasms of Eye Brain and Other Parts of Central Nervous System; Malignant Neoplasms of Female Genital Organs; Malignant Neoplasms of Ill-defined Secondary and Unspecified Sites; Malignant Neoplasms of Independent (Primary) Multiple Sites; Malignant Neoplasms of Lip Oral Cavity and Pharynx; Malignant Neoplasms of Male Genital Organs; Malignant Neoplasms of Mesothelial and Soft Tissue; Malignant Neoplasms of Respiratory and Intrathoracic Organs; Malignant Neoplasms of Thyroid and Other Endocrine Glands; Malignant Neoplasms of Urinary Tract

Extracellular Matrix Hydrogel Derived from Human Umbilical Cord as a Scaffold for Neural Tissue Repair and Its Comparison with Extracellular Matrix from Porcine Tissues.

PubMed

Kočí, Zuzana; Výborný, Karel; Dubišová, Jana; Vacková, Irena; Jäger, Aleš; Lunov, Oleg; Jiráková, Klára; Kubinová, Šárka

2017-06-01

Extracellular matrix (ECM) hydrogels prepared by tissue decellularization have been reported as natural injectable materials suitable for neural tissue repair. In this study, we prepared ECM hydrogel derived from human umbilical cord (UC) and evaluated its composition and mechanical and biological properties in comparison with the previously described ECM hydrogels derived from porcine urinary bladder (UB), brain, and spinal cord. The ECM hydrogels did not differ from each other in the concentration of collagen, while the highest content of glycosaminoglycans as well as the shortest gelation time was found for UC-ECM. The elastic modulus was then found to be the highest for UB-ECM. In spite of a different origin, topography, and composition, all ECM hydrogels similarly promoted the migration of human mesenchymal stem cells (MSCs) and differentiation of neural stem cells, as well as axonal outgrowth in vitro. However, only UC-ECM significantly improved proliferation of tissue-specific UC-derived MSCs when compared with the other ECMs. Injection of UC-ECM hydrogels into a photothrombotic cortical ischemic lesion in rats proved its in vivo gelation and infiltration with host macrophages. In summary, this study proposes UC-ECM hydrogel as an easily accessible biomaterial of human origin, which has the potential for neural as well as other soft tissue reconstruction.

Contrast-enhanced color Doppler ultrasonography increases diagnostic accuracy for soft tissue tumors.

PubMed

Oebisu, Naoto; Hoshi, Manabu; Ieguchi, Makoto; Takada, Jun; Iwai, Tadashi; Ohsawa, Masahiko; Nakamura, Hiroaki

2014-10-01

Resolution of ultrasonography (US) has undergone marked development. Additionally, a new-generation contrast medium (Sonazoid) used for US is newly available. Contrast-enhanced US has been widely used for evaluating several types of cancer. In the present study, we evaluated the ability of color Doppler US (CDUS) and Sonazoid to differentiate between benign and malignant soft tissue tumors. A total of 180 patients (87 male, 93 female) were enrolled in the present study. The patient ages ranged from 1 to 91 years (mean 58.1±20.0 years). The maximum size, depth, tumor margins, shape, echogenicity and textural pattern were measured on gray-scale images. CDUS was used to evaluate the intratumoral blood flow with and without Sonazoid. Peak systolic flow velocity (Vp), mean flow velocity (Vm), resistivity index (RI) and pulsatility index (PI) of each detected intratumoral artery were automatically calculated with power Doppler US (PDUS). The present study included 118 benign and 62 malignant tumors. Statistical significances were found in size, depth, tumor margin and textural pattern but not in shape or echogenicity on gray-scale images. Before Sonazoid injection, CDUS findings showed 55% sensitivity, 77% specificity and 69% accuracy, whereas contrast-enhanced CDUS showed 87% sensitivity, 68% specificity and 74% accuracy. There were no statistically significant differences between malignant and benign tumors regarding the mean Vp, Vm, RI and PI values determined on PDUS. In conclusion, contrast-enhanced CDUS proved to be a reliable diagnostic tool for detecting malignant potential in soft tissue tumors.

Soft-Tissue Grafting Techniques Associated With Immediate Implant Placement.

PubMed

Bishara, Mark; Kurtzman, Gregori M; Khan, Waji; Choukroun, Joseph; Miron, Richard J

2018-02-01

Immediate implant placement often presents challenges in terms of predictably obtaining soft-tissue coverage over the implant site. While delayed implant placement offers the ability for soft tissues to grow and invade the extraction socket making their attachment around implants more predictable, immediate implant placement poses a significant risk of bacterial invasion towards the implant surface as a result of insignificant soft-tissue volume. Soft-tissue grafting techniques have often been proposed for use during immediate implant placement to augment soft-tissue deficiencies, including the use of either palatal connective tissue grafts (CTGs) or collagen-derived scaffolds. However, both of these approaches have significant drawbacks in that CTGs are harvested with high patient morbidity and collagen scaffolds remain avascular and acelluar posing a risk of infection/implant contamination. More recently, platelet-rich fibrin (PRF) has been proposed as an economical and biological means to speed soft-tissue wound healing. In combination with immediate implant placement, PRF offers an easily procurable low-cost regenerative modality that offers an efficient way to improve soft-tissue attachment around implants. Furthermore, the supra-physiological concentration of defense-fighting leukocytes in PRF, combined with a dense fibrin meshwork, is known to prevent early bacterial contamination of implant surfaces, and the biological concentrations of autologous growth factors in PRF is known to increase tissue regeneration. This article discusses soft-tissue grafting techniques associated with immediate implant placement, presents several cases demonstrating the use of PRF in routine immediate implant placement, and further discusses the biological and economic advantages of PRF for the management of soft-tissue grafting during immediate implant placement.

Hyaluronic acid fillers with cohesive polydensified matrix for soft-tissue augmentation and rejuvenation: a literature review

PubMed Central

Prasetyo, Adri D; Prager, Welf; Rubin, Mark G; Moretti, Ernesto A; Nikolis, Andreas

2016-01-01

Background Cohesive monophasic polydensified fillers show unique viscoelastic properties and variable density of hyaluronic acid, allowing for a homogeneous tissue integration and distribution of the material. Objective The aim of this paper was to review the clinical data regarding the performance, tolerability, and safety of the Belotero® fillers for soft-tissue augmentation and rejuvenation. Methods A literature search was performed up until May 31, 2015 to identify all relevant articles on Belotero® fillers (Basic/Balance, Hydro, Soft, Intense, Volume) and equivalent products (Esthélis®, Mesolis®, Fortélis®, Modélis®). Results This comprehensive review included 26 papers. Findings from three randomized controlled trials showed a greater reduction in nasolabial fold severity with Belotero® Basic/Balance than with collagen (at 8, 12, 16, and 24 weeks, n=118) and Restylane® (at 4 weeks, n=40), and higher patient satisfaction with Belotero® Intense than with Perlane® (at 2 weeks, n=20). With Belotero® Basic/Balance, an improvement of at least 1 point on the severity scale can be expected in ~80% of patients 1–6 months after injection, with an effect still visible at 8–12 months. Positive findings were also reported with Belotero® Volume (no reduction in hyaluronic acid volume at 12 months, as demonstrated by magnetic resonance imaging), Soft (improvement in the esthetic outcomes when used in a sequential approach), and Hydro (improvement in skin appearance in all patients). The most common adverse effects were mild-to-moderate erythema, edema, and hematoma, most of which were temporary. There were no reports of Tyndall effect, nodules, granulomas, or tissue necrosis. Conclusion Clinical evidence indicates sustainable esthetic effects, good safety profile, and long-term tolerability of the Belotero® fillers, particularly Belotero® Basic/Balance and Intense. PMID:27660479

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.

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

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.

Concomitant Correction of a Soft-Tissue Fenestration with Keratinised Tissue Augmentation By Using A Rotated Double-Pedicle Flap During Second-Stage Implant Surgery- A Case Report

PubMed Central

Reddy, Aileni Amarender; Kumar, P. Anoop; Sailaja, Sistla; Chakravarthy, Yshs

2015-01-01

Soft tissue deficiencies and defects around dental implants have been observed frequently. Soft-tissue defects after implant procedures originate from the process of modelling of periimplant mucosa and often cause aesthetic disharmony, food debris accumulation and soft tissue shrinkage. Periimplant mucogingival surgery focuses on creating an optimum band of keratinized tissue resulting in soft tissue architecture similar to the gingiva around natural teeth. A 23-year-old male reported to the Department of Periodontology with a complaint of gum soreness, foul smell and food accumulation at a site where a 3.75 x 11.5mm implant was placed previously. On clinical examination, fenestration of tissue above the cover screw was observed and there appeared to be a keratinized tissue of 1mm surrounding the implant. The case was managed by use of a rotated double-pedicle flap during second-stage implant surgery to correct the soft-tissue fenestration defect and to obtain a keratinized periimplant soft tissue. A periosteal bed was prepared by giving a horizontal incision at the mucogingival junction to a depth of 4 mm. Two split-thickness keratinized pedicles were dissected from the mesial and distal interproximal tissues near the implant. After rotation, both the pedicles were sutured to each other mid-buccally and the pedicles were rigidly immobilized with sutures. At 1 month, there was a 3mm band of stable and firm keratinized tissue over the underlying tissues. The procedure resulted in an aesthetic improvement due to enhanced soft tissue architecture and optimum integration between the peri-implant soft tissue and the final prosthesis. PMID:26816998

Prevalence of Soft Tissue Calcifications in CBCT Images of Mandibular Region.

PubMed

Khojastepour, Leila; Haghnegahdar, Abdolaziz; Sayar, Hamed

2017-06-01

Most of the soft tissue calcifications within the head and neck region might not be accompanied by clinical symptoms but may indicate some pathological conditions. The aim of this research was to determine the prevalence of soft tissue calcifications in cone beam computed tomography (CBCT) images of mandibular region. In this cross sectional study the CBCT images of 602 patients including 294 men and 308 women with mean age 41.38±15.18 years were evaluated regarding the presence, anatomical location; type (single or multiple) and size of soft tissue calcification in mandibular region. All CBCT images were acquired by NewTom VGi scanner. Odds ratio and chi-square tests were used for data analysis and p < 0.05 was considered to be statistically significant. 156 out of 602 patients had at least one soft tissue calcification in their mandibular region (25.9%. of studied population with mean age 51.7±18.03 years). Men showed significantly higher rate of soft tissue calcification than women (30.3% vs. 21.8%). Soft tissue calcification was predominantly seen at posterior region of the mandible (88%) and most of them were single (60.7%). The prevalence of soft tissue calcification increased with age. Most of the detected soft tissue calcifications were smaller than 3mm (90%). Soft tissue calcifications in mandibular area were a relatively common finding especially in posterior region and more likely to happen in men and in older age group.

[Study of susceptibility weighted imaging on MR and pathologic findings to distinguish benign or malignant soft tissue tumor].

PubMed

Liu, J; Chen, Y; Bao, X M; Ling, X L; Ding, J P; Zhang, Z K

2017-05-23

Objective: To explore the diagnostic performance of susceptibility weighted imaging (SWI)in distinguishing benign or malignant soft tissue tumor, and to study pathological observation. Methods: Sixty-eight patients with soft tissue tumor, who received no previous treatment or invasive examination, received routine preoperative MRI examination and SWI scanning. The graduation and distribution of intratumoral susceptibility signal intensity(ITSS) and proportion of tumor volume were observed.The pathological results were also included for comparative analysis. Results: Fourty of 68 patients were benign and 28 were malignant. 72.5% (29/40) patients with benign soft tissue tumors were ITSS grade 1 and ITSS grade 3 (hemangioma). 89.3%(25/28) patients with malignant soft tissue tumors were ITSS grade 2 and ITSS grade 3. The difference was statistically significant ( P <0.01). The distribution of ITSS in patients with benign soft tissue tumors was dominated by peripheral distribution and diffuse distribution (hemangioma), accounting for 90.0% (36/40). The distribution of ITSS in patients with malignant soft tissue tumors mainly distributed in the central region, accounting for 78.6% (22 /28). The difference was statistically significant ( P <0.01). The proportion of tumor volume occupied by ITSS in benign soft tissue tumors was <1/3 and> 2/3 (hemangioma), accounting for 90.0% (36/40). The volume of malignant soft tissue tumors were predominantly <1/3 , accounting for 82.1% (23/28). The difference was statistically significant ( P <0.01). Conclusion: SWI is sensitive in displaying the vein and blood metabolites in soft tissue lesions, which is helpful for the differential diagnosis of benign and malignant tumors in soft tissue.

The efficacy of the modified classification system of soft tissue injury in extension injury of the lower cervical spine.

PubMed

Song, Kyung-Jin; Kim, Gyu-Hyung; Lee, Kwang-Bok

2008-07-01

To classify comprehensively the severity of soft tissue injury for extension injuries of the lower cervical spine by magnetic resonance imaging (MRI). To investigate severity of extension injuries using a modified classification system for soft tissue injury by MRI, and to determine the possibility of predicting cord injury by determining the severity of soft tissue injury. It is difficult to diagnose extension injuries by plain radiography and computed tomography. MRI is considered to be the best method of diagnosing soft tissue injuries. The authors examined whether an MRI based diagnostic standard could be devised for extension injuries of the cervical spine. MRI was performed before surgery in 81 patients that had experienced a distractive-extension injury during the past 5 years. Severities of soft tissue injury were subdivided into 5 stages. The retropharyngeal space and the retrotracheal space were measured, and their correlations with the severity of soft tissue injury were examined, as was the relation between canal stenosis and cord injury. Cord injury developed in injuries greater than Grade III (according to our devised system) accompanied by posterior longitudinal ligament rupture (P < 0.01). As the severity of soft tissue injury increased, the cord signal change increased (P < 0.01), the retropharyngeal space and the retrotracheal space increased, and swelling severity in each stage were statistically significant (P < 0.01). In canal stenosis patients, soft tissue damage and cord injury were not found to be associated (P = 0.45). In cases of distractive-extension injury, levels of soft tissue injury were determined accurately by MRI. Moreover, the severity of soft tissue injury was found to be closely associated with the development of cord injury.

A study of cephalometric soft tissue profile among adolescents from the three West African countries of Nigeria, Ghana and Senegal.

PubMed

Fadeju, A D; Otuyemi, O D; Ngom, P I; Newman-Nartey, M

2013-03-01

Since the introduction of cephalometry, numerous studies have established normal values for Caucasian populations. In Africa, most investigations have established norms and ethnic variations associated with the skeletal pattern. To date, there has been no study comparing soft tissue patterns among adolescents in the West African sub-region. The objective of this investigation was to determine and compare soft tissue patterns among 12- to 16-year-old Nigerian, Ghanaian and Senegalese adolescents, establish any gender dimorphism and compare them with published Caucasian norms. Lateral cephalometric radiographs of adolescents with a normal incisor relationship aged between 12 and 16 years from Nigeria, Ghana, and Senegal were taken under standardized conditions and traced to determine soft tissue patterns. Data obtained were subjected to statistical analysis. The total sample consisted of 165 females and 135 males with a mean age of 13·96 (1·58) years. A number of soft tissue parameters showed significant differences (P<0·05). These included comparison between males and females, and Nigerian, Ghanaian and Senegalese, including lip separation, upper lip length, upper lip exposure, Li-esthetic line, lower lip-NP, nasal tip angle, N-Pr-Pg, Pg-Ls, B-N pogonion and pogonion-mandibular angle. Differences also existed between these West African soft tissue values and published Caucasian norms, including nasolabial angle, mentolabial angle, nasal depth, nose tip, total soft tissue facial convexity and nasal depth angle. The comparative analysis of soft tissue patterns among 12- to 16-year-old adolescents from Nigeria, Ghana and Senegal demonstrated statistically significant differences in soft tissue value between these West African adolescents and published Caucasian soft tissue norms. This study provides useful data in relation to soft tissue parameters for subjects originating from the West African sub-region.

Macrolane (large particle biphasic hyaluronic acid) filler injection for correction of defect contour after liposuction.

PubMed

Cerqua, Sandro; Angelucci, Francesco

2013-08-01

In a minority of patients undergoing liposuction, superficial irregularities (or skin depression) in the operated area may occur. Macrolane is a gel composed of hyaluronic acid (HA), used for volume restoration of soft tissues. In this study, the authors investigated the effectiveness, maintenance, and safety of Macrolane as a "non-surgical" treatment to correct skin depression after liposuction. Twelve female patients were included. Macrolane was injected at a subdermal superficial plane using an intramuscular or spinal needle. In all patients, Macrolane was successful in correcting skin depression. No relevant side effects were observed. At 8 months post-injection, a persistence of correction of 60-70% was still present in 90% of the patients. In conclusion, Macrolane filler injections are a predictable, safe, and long-lasting non-surgical procedure to fill contour defects that arise after liposuction, and represent a good option for patients who refuse to undergo an additional surgery to fill the arisen skin depressions.

An unusual course after injection of industrial silicone for penile augmentation.

PubMed

Shin, Yu Seob; You, Jae Hyung; Choi, Hwang; Zhang, Li Tao; Zhao, Chen; Choi, In Sung; Park, Jong Kwan

2015-01-01

A 48-year-old male patient had an injection of industrial silicone under the penile skin for augmentation by non-medical practitioners a week before. There was complete necrosis of the dorsal part of the penile skin and soft tissue. In a penile magnetic resonance image, big masses of silicone under the penile skin were found and a part of the silicone was partially exposed. Debridement of the necrotic tissue was done. As the right side of the tunica albuginea was thin-walled, a silicone-induced infection developed. Because of this, the wet dressing was done daily without closing the wound for the next 23 days. Finally, both scrotal skins were drawn and sutured to the dorsal glandular skin after the total penile skin was completely removed and sutured with T-style anastomosis. The ventral flap was anastomosed to the ventral glandular skin with the end-to-end technique with inverted V incision at 1 cm proximal from the sutured margin. Flaps survived completely without skin necrosis or dehiscence.

Single-stage Reconstruction of Elbow Flexion Associated with Massive Soft-Tissue Defect Using the Latissimus Dorsi Muscle Bipolar Rotational Transfer

PubMed Central

Cuéllar, Vanessa G.; Ghiassi, Alidad; Sharpe, Frances

2016-01-01

Introduction: In the upper extremity, the latissimus dorsi muscle can be used as an ipsilateral rotational muscle flap for soft-tissue coverage or functional reconstruction of arm and elbow. Patients who have both major soft-tissue loss and functional deficits can be successfully treated with a single-stage functional latissimus dorsi rotational muscle transfer that provides simultaneous soft-tissue coverage and functional reconstruction. Methods: Our data base was queried for all patients undergoing a rotational latissimus dorsi muscle transfer for simultaneous soft-tissue coverage and functional reconstruction of elbow flexion. Four patients were identified. A chart review documented the mechanism of injury, associated injuries, soft-tissue defect size, number of surgical procedures, length of follow-up, last elbow range of motion, and flexion strength. Results: Four patients with loss of elbow flexion due to traumatic loss of the anterior compartment muscles and the overlying soft tissue underwent simultaneous soft-tissue coverage and elbow flexorplasty using the ipsilateral latissimus dorsi as a bipolar muscle rotational tissue transfer. All flaps survived and had a recovery of Medical Research Council Grade 4/5 elbow flexion strength. No additional procedures were required for elbow flexion. The surgical technique is described and supplemented with surgical technique video and patient outcome. Conclusions: This patient series augments the data provided in other series supporting the safety and efficacy of this procedure which provides both soft-tissue coverage and functional restoration of elbow flexion as a single-stage procedure in the setting of massive traumatic soft-tissue loss of the arm. PMID:27757363

Single-stage Reconstruction of Elbow Flexion Associated with Massive Soft-Tissue Defect Using the Latissimus Dorsi Muscle Bipolar Rotational Transfer.

PubMed

Stevanovic, Milan V; Cuéllar, Vanessa G; Ghiassi, Alidad; Sharpe, Frances

2016-09-01

In the upper extremity, the latissimus dorsi muscle can be used as an ipsilateral rotational muscle flap for soft-tissue coverage or functional reconstruction of arm and elbow. Patients who have both major soft-tissue loss and functional deficits can be successfully treated with a single-stage functional latissimus dorsi rotational muscle transfer that provides simultaneous soft-tissue coverage and functional reconstruction. Our data base was queried for all patients undergoing a rotational latissimus dorsi muscle transfer for simultaneous soft-tissue coverage and functional reconstruction of elbow flexion. Four patients were identified. A chart review documented the mechanism of injury, associated injuries, soft-tissue defect size, number of surgical procedures, length of follow-up, last elbow range of motion, and flexion strength. Four patients with loss of elbow flexion due to traumatic loss of the anterior compartment muscles and the overlying soft tissue underwent simultaneous soft-tissue coverage and elbow flexorplasty using the ipsilateral latissimus dorsi as a bipolar muscle rotational tissue transfer. All flaps survived and had a recovery of Medical Research Council Grade 4/5 elbow flexion strength. No additional procedures were required for elbow flexion. The surgical technique is described and supplemented with surgical technique video and patient outcome. This patient series augments the data provided in other series supporting the safety and efficacy of this procedure which provides both soft-tissue coverage and functional restoration of elbow flexion as a single-stage procedure in the setting of massive traumatic soft-tissue loss of the arm.

Injectable, cellular-scale optoelectronics with applications for wireless optogenetics.

PubMed

Kim, Tae-il; McCall, Jordan G; Jung, Yei Hwan; Huang, Xian; Siuda, Edward R; Li, Yuhang; Song, Jizhou; Song, Young Min; Pao, Hsuan An; Kim, Rak-Hwan; Lu, Chaofeng; Lee, Sung Dan; Song, Il-Sun; Shin, Gunchul; Al-Hasani, Ream; Kim, Stanley; Tan, Meng Peun; Huang, Yonggang; Omenetto, Fiorenzo G; Rogers, John A; Bruchas, Michael R

2013-04-12

Successful integration of advanced semiconductor devices with biological systems will accelerate basic scientific discoveries and their translation into clinical technologies. In neuroscience generally, and in optogenetics in particular, the ability to insert light sources, detectors, sensors, and other components into precise locations of the deep brain yields versatile and important capabilities. Here, we introduce an injectable class of cellular-scale optoelectronics that offers such features, with examples of unmatched operational modes in optogenetics, including completely wireless and programmed complex behavioral control over freely moving animals. The ability of these ultrathin, mechanically compliant, biocompatible devices to afford minimally invasive operation in the soft tissues of the mammalian brain foreshadow applications in other organ systems, with potential for broad utility in biomedical science and engineering.

Necrotizing Fasciitis as a Complication of a Continuous Sciatic Nerve Catheter Using the Lateral Popliteal Approach.

PubMed

Dott, Daltry; Canlas, Christopher; Sobey, Christopher; Obremskey, William; Thomson, Andrew Brian

Necrotizing fasciitis is an infection of the soft tissue that is characterized by rapidly spreading inflammation and subsequent necrosis. It is a rare complication of peripheral nerve blocks. We report a rare case of necrotizing fasciitis after placement of a peripheral nerve catheter. A 58-year-old woman presented for an elective right second metatarsal resection and received a sciatic nerve catheter for postoperative pain control. On postoperative day 7, clinical examination and imaging supported the diagnosis of necrotizing fasciitis. Multiple reports have been published of necrotizing fasciitis after single-shot peripheral nerve block injections, neuraxial anesthesia, and intramuscular injections. This case highlights the potential for the rare complication of necrotizing fasciitis after peripheral nerve catheter placement.

Effect of tissue composition on dose distribution in brachytherapy with various photon emitting sources

PubMed Central

Ghorbani, Mahdi; Salahshour, Fateme; Haghparast, Abbas; Knaup, Courtney

2014-01-01

Purpose The aim of this study is to compare the dose in various soft tissues in brachytherapy with photon emitting sources. Material and methods 103Pd, 125I, 169Yb, 192Ir brachytherapy sources were simulated with MCNPX Monte Carlo code, and their dose rate constant and radial dose function were compared with the published data. A spherical phantom with 50 cm radius was simulated and the dose at various radial distances in adipose tissue, breast tissue, 4-component soft tissue, brain (grey/white matter), muscle (skeletal), lung tissue, blood (whole), 9-component soft tissue, and water were calculated. The absolute dose and relative dose difference with respect to 9-component soft tissue was obtained for various materials, sources, and distances. Results There was good agreement between the dosimetric parameters of the sources and the published data. Adipose tissue, breast tissue, 4-component soft tissue, and water showed the greatest difference in dose relative to the dose to the 9-component soft tissue. The other soft tissues showed lower dose differences. The dose difference was also higher for 103Pd source than for 125I, 169Yb, and 192Ir sources. Furthermore, greater distances from the source had higher relative dose differences and the effect can be justified due to the change in photon spectrum (softening or hardening) as photons traverse the phantom material. Conclusions The ignorance of soft tissue characteristics (density, composition, etc.) by treatment planning systems incorporates a significant error in dose delivery to the patient in brachytherapy with photon sources. The error depends on the type of soft tissue, brachytherapy source, as well as the distance from the source. PMID:24790623

A randomized, multicenter, open-label study of poly-L-lactic acid for HIV-1 facial lipoatrophy.

PubMed

Carey, Dianne L; Baker, David; Rogers, Gary D; Petoumenos, Kathy; Chuah, John; Easey, Nicole; Machon, Kirsty; Cooper, David A; Emery, Sean; Carr, Andrew

2007-12-15

Facial lipoatrophy can stigmatize and can reduce quality of life, self esteem, and antiretroviral adherence. Poly-L-lactic acid (PLA) injections seem safe and effective, but no randomized study has included objective endpoints. HIV-positive adults with moderate/severe facial lipoatrophy were randomized to 4 open-label PLA treatments administered every 2 weeks from week 0 (immediate group, n = 51) or after week 24 (deferred group, n = 50). The primary endpoint was mean change in facial soft tissue volume (FSTV), as assessed by spiral computed tomography. Analyses were by intention to treat. At week 24, mean changes in FSTV were 0 cm3 in the intermediate group and -10 cm3 in the deferred group (between-group difference of 10 [95% confidence interval (CI): -7 to 28] cm3; P = 0.24). The immediate group had a greater mean change in soft tissue depth at the maxilla (2.2 mm [95% CI: 1.6 to 2.9]; P < 0.0001) and base of the nasal septum (1.0 mm [95% CI: 0.3 to 1.6]; P = 0.003) levels. PLA did not have an impact on peripheral fat mass, viral load, or antiretroviral adherence. Patient and physician subjectively assessed facial lipoatrophy severity (P < 0.0001), 2 of 8 Short Form-36 Health Survey and 2 of 5 Multidimensional Body-Self Relations Questionnaire-Appearance Scales, scores improved significantly. The median duration of treatment-related adverse events was 2 (interquartile range: 1 to 3) days. PLA did not increase FSTV, although tissue thickness in injection planes increased modestly, an improvement observed by patients. PLA was safe and well tolerated. Facial lipoatrophy severity and some quality-of-life domains improved.

Melorheostosis of the axial skeleton with associated fibrolipomatous lesions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Garver, P.; Resnick, D.; Haghighi, P.

1982-11-01

Two patients with melorheostotic-like lesions of the axial skeleton are described. In each case adjacent soft tissue masses containing both fatty and fibrous tissues were evident. The presence of such soft tissue tumors as well as other soft tissue abnormalities in melorheostosis emphasizes that the diesease should not be regarded as one confined to bone. The precise pathogenesis of the osseous and soft tissue abnormalities in melorheostosis remains obscure.

Mechanical verification of soft-tissue attachment on bioactive glasses and titanium implants.

PubMed

Zhao, Desheng; Moritz, Niko; Vedel, Erik; Hupa, Leena; Aro, Hannu T

2008-07-01

Soft-tissue attachment is a desired feature of many clinical biomaterials. The aim of the current study was to design a suitable experimental method for tensile testing of implant incorporation with soft-tissues. Conical implants were made of three compositions of bioactive glass (SiO(2)-P(2)O(5)-B(2)O(3)-Na(2)O-K(2)O-CaO-MgO) or titanium fiber mesh (porosity 84.7%). The implants were surgically inserted into the dorsal subcutaneous soft-tissue or back muscles in the rat. Soft-tissue attachment was evaluated by pull-out testing using a custom-made jig 8 weeks after implantation. Titanium fiber mesh implants had developed a relatively high pull-out force in subcutaneous tissue (12.33+/-5.29 N, mean+/-SD) and also measurable attachment with muscle tissue (2.46+/-1.33 N). The bioactive glass implants failed to show mechanically relevant soft-tissue bonding. The experimental set-up of mechanical testing seems to be feasible for verification studies of soft-tissue attachment. The inexpensive small animal model is beneficial for large-scale in vivo screening of new biomaterials.

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

ClinicalTrials.gov

2017-11-01

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

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

ClinicalTrials.gov

2017-05-18

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

Prevalence of Soft Tissue Calcifications in CBCT Images of Mandibular Region

PubMed Central

Khojastepour, Leila; Haghnegahdar, Abdolaziz; Sayar, Hamed

2017-01-01

Statement of the Problem: Most of the soft tissue calcifications within the head and neck region might not be accompanied by clinical symptoms but may indicate some pathological conditions. Purpose: The aim of this research was to determine the prevalence of soft tissue calcifications in cone beam computed tomography (CBCT) images of mandibular region. Materials and Method: In this cross sectional study the CBCT images of 602 patients including 294 men and 308 women with mean age 41.38±15.18 years were evaluated regarding the presence, anatomical location; type (single or multiple) and size of soft tissue calcification in mandibular region. All CBCT images were acquired by NewTom VGi scanner. Odds ratio and chi-square tests were used for data analysis and p< 0.05 was considered to be statistically significant. Results: 156 out of 602 patients had at least one soft tissue calcification in their mandibular region (25.9%. of studied population with mean age 51.7±18.03 years). Men showed significantly higher rate of soft tissue calcification than women (30.3% vs. 21.8%). Soft tissue calcification was predominantly seen at posterior region of the mandible (88%) and most of them were single (60.7%). The prevalence of soft tissue calcification increased with age. Most of the detected soft tissue calcifications were smaller than 3mm (90%). Conclusion: Soft tissue calcifications in mandibular area were a relatively common finding especially in posterior region and more likely to happen in men and in older age group. PMID:28620632

Soft tissue changes from maxillary distraction osteogenesis versus orthognathic surgery in patients with cleft lip and palate--a randomized controlled clinical trial.

PubMed

Chua, Hannah Daile P; Cheung, Lim Kwong

2012-07-01

The objective of this randomized controlled clinical trial was to compare the soft tissue changes after maxillary advancement using conventional orthognathic surgery (CO) and distraction osteogenesis (DO) in patients with cleft lip and palate (CLP). The study group of 39 CLP patients with maxillary hypoplasia underwent either CO or DO with 4 to 10 mm of maxillary advancement. Lateral cephalographs were taken preoperatively and postoperatively at regular intervals. A series of skeletal, dental, and soft tissue landmarks was used to evaluate the changes in the soft tissue and the correlation of hard and soft tissue changes and ratios. Significant differences were found between the CO and DO patients at A point in both maxillary advancement and downgrafting in the early follow-up period. On soft tissue landmarks of pronasale, subnasale, and labial superius, significant differences were found between the 2 groups at 6 months postoperatively only with maxillary advancement. There was better correlation of hard and soft tissue changes with maxillary advancement. The nasal projection was significantly different between the 2 groups at the early and intermediate period. There was much more consistent hard to soft tissue ratios in maxillary advancement with DO than with CO. Both CO and DO can induce significant soft tissue changes of the upper lip and nose, particularly with maxillary advancement. DO generates more consistent hard to soft tissue ratios. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Cabozantinib-S-Malate in Treating Younger Patients With Recurrent, Refractory, or Newly Diagnosed Sarcomas, Wilms Tumor, or Other Rare Tumors

ClinicalTrials.gov

2018-06-25

Adrenal Cortex Carcinoma; Adult Alveolar Soft Part Sarcoma; Adult Clear Cell Sarcoma of Soft Parts; Adult Hepatocellular Carcinoma; Adult Rhabdomyosarcoma; Adult Soft Tissue Sarcoma; Childhood Alveolar Soft Part Sarcoma; Childhood Central Nervous System Neoplasm; Childhood Clear Cell Sarcoma of Soft Parts; Childhood Hepatocellular Carcinoma; Childhood Rhabdomyosarcoma; Childhood Soft Tissue Sarcoma; Childhood Solid Neoplasm; Ewing Sarcoma; Hepatoblastoma; Hepatocellular Carcinoma; Recurrent Adrenal Cortex Carcinoma; Recurrent Adult Hepatocellular Carcinoma; Recurrent Adult Soft Tissue Sarcoma; Recurrent Alveolar Soft Part Sarcoma; Recurrent Childhood Central Nervous System Neoplasm; Recurrent Childhood Hepatocellular Carcinoma; Recurrent Childhood Soft Tissue Sarcoma; Recurrent Ewing Sarcoma; Recurrent Hepatoblastoma; Recurrent Malignant Solid Neoplasm; Recurrent Osteosarcoma; Recurrent Renal Cell Carcinoma; Recurrent Rhabdomyosarcoma; Refractory Osteosarcoma; Renal Cell Carcinoma; Thyroid Gland Medullary Carcinoma; Wilms Tumor

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.

[Fitting of the reconstructed craniofacial hard and soft tissues based on 2-D digital radiographs].

PubMed

Feng, Yao-Pu; Qiao, Min; Zhou, Hong; Zhang, Yan-Ning; Si, Xin-Qin

2017-02-01

In this study, we reconstructed the craniofacial hard and soft tissues based on the data from digital cephalometric radiographs and laser scanning. The effective fitting of the craniofacial hard and soft tissues was performed in order to increase the level of orthognathic diagnosis and treatment, and promote the communication between doctors and patients. A small lead point was put on the face of a volunteer and frontal and lateral digital cephalometric radiographs were taken. 3-D reconstruction system of the craniofacial hard tissue based on 2-D digital radiograph was used to get the craniofacial hard tissue model by means of hard tissue deformation modeling. 3-D model of facial soft tissue was obtained by using laser scanning data. By matching the lead point coordinate, the hard tissue and soft tissue were fitted. The 3-D model of the craniofacial hard and soft tissues was rebuilt reflecting the real craniofacial tissue structure, and effective fitting of the craniofacial hard and soft tissues was realized. The effective reconstruction and fitting of the 3-D craniofacial structures have been realized, which lays a foundation for further orthognathic simulation and facial appearance prediction. The fitting result is reliable, and could be used in clinical practice.

The Diagnostic and Prognostic Value of Hematological and Chemical Abnormalities in Soft Tissue Sarcoma: A Comparative Study in Patients with Benign and Malignant Soft Tissue Tumors.

PubMed

Ariizumi, Takashi; Kawashima, Hiroyuki; Ogose, Akira; Sasaki, Taro; Hotta, Tetsuo; Hatano, Hiroshi; Morita, Tetsuro; Endo, Naoto

2018-01-01

The value of routine blood tests in malignant soft tissue tumors remains uncertain. To determine if these tests can be used for screening, the routine pretreatment blood test findings were retrospectively investigated in 359 patients with benign and malignant soft tissue tumors. Additionally, the prognostic potential of pretreatment blood abnormalities was evaluated in patients with soft tissue sarcomas. We compared clinical factors and blood tests findings between patients with benign and malignant soft tissue tumors using univariate and multivariate analysis. Subsequently, patients with malignant tumors were divided into two groups based on blood test reference values, and the prognostic significance of each parameter was evaluated. In the univariate analysis, age, tumor size, and tumor depth were significant clinical diagnostic factors. Significant increases in the granulocyte count, C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), and γ-glutamyl transpeptidase (γ-GTP) levels were found in patients with malignant soft tissue tumors. Multiple logistic regression showed that tumor size and ESR were independent factors that predicted malignant soft tissue tumors. The Kaplan-Meier survival analysis revealed that granulocyte counts, γ-GTP levels, and CRP levels correlated significantly with overall survival. Thus, pretreatment routine blood tests are useful diagnostic and prognostic markers for diagnosing soft tissue sarcoma. © 2018 by the Association of Clinical Scientists, Inc.

Radiation Therapy With or Without Combination Chemotherapy or Pazopanib Hydrochloride Before Surgery in Treating Patients With Newly Diagnosed Non-rhabdomyosarcoma Soft Tissue Sarcomas That Can Be Removed by Surgery

ClinicalTrials.gov

2018-06-20

Adult Fibrosarcoma; Alveolar Soft Part Sarcoma; Angiomatoid Fibrous Histiocytoma; Atypical Fibroxanthoma; Clear Cell Sarcoma of Soft Tissue; Epithelioid Malignant Peripheral Nerve Sheath Tumor; Epithelioid Sarcoma; Extraskeletal Myxoid Chondrosarcoma; Extraskeletal Osteosarcoma; Fibrohistiocytic Neoplasm; Glomus Tumor of the Skin; Inflammatory Myofibroblastic Tumor; Intimal Sarcoma; Leiomyosarcoma; Liposarcoma; Low Grade Fibromyxoid Sarcoma; Low Grade Myofibroblastic Sarcoma; Malignant Cutaneous Granular Cell Tumor; Malignant Peripheral Nerve Sheath Tumor; Malignant Triton Tumor; Mesenchymal Chondrosarcoma; Myxofibrosarcoma; Myxoid Chondrosarcoma; Myxoinflammatory Fibroblastic Sarcoma; Nerve Sheath Neoplasm; PEComa; Pericytic Neoplasm; Plexiform Fibrohistiocytic Tumor; Sclerosing Epithelioid Fibrosarcoma; Stage IB Soft Tissue Sarcoma AJCC v7; Stage IIB Soft Tissue Sarcoma AJCC v7; Stage III Soft Tissue Sarcoma AJCC v7; Stage IV Soft Tissue Sarcoma AJCC v7; Synovial Sarcoma; Undifferentiated (Embryonal) Sarcoma; Undifferentiated High Grade Pleomorphic Sarcoma of Bone

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;…

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

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

Utilization of robotic-arm assisted total knee arthroplasty for soft tissue protection.

PubMed

Sultan, Assem A; Piuzzi, Nicolas; Khlopas, Anton; Chughtai, Morad; Sodhi, Nipun; Mont, Michael A

2017-12-01

Despite the well-established success of total knee arthroplasty (TKA), iatrogenic ligamentous and soft tissue injuries are infrequent, but potential complications that can have devastating impact on clinical outcomes. These injuries are often related to technical errors and excessive soft tissue manipulation, particularly during bony resections. Recently, robotic-arm assisted TKA was introduced and demonstrated promising results with potential technical advantages over manual surgery in implant positioning and mechanical accuracy. Furthermore, soft tissue protection is an additional potential advantage offered by these systems that can reduce inadvertent human technical errors encountered during standard manual resections. Therefore, due to the relative paucity of literature, we attempted to answer the following questions: 1) does robotic-arm assisted TKA offer a technical advantage that allows enhanced soft tissue protection? 2) What is the available evidence about soft tissue protection? Recently introduced models of robotic-arm assisted TKA systems with advanced technology showed promising clinical outcomes and soft tissue protection in the short- and mid-term follow-up with results comparable or superior to manual TKA. In this review, we attempted to explore this dimension of robotics in TKA and investigate the soft tissue related complications currently reported in the literature.

Mitigating the heroin crisis in Baltimore, MD, USA: a cost-benefit analysis of a hypothetical supervised injection facility.

PubMed

Irwin, Amos; Jozaghi, Ehsan; Weir, Brian W; Allen, Sean T; Lindsay, Andrew; Sherman, Susan G

2017-05-12

In Baltimore, MD, as in many cities throughout the USA, overdose rates are on the rise due to both the increase of prescription opioid abuse and that of fentanyl and other synthetic opioids in the drug market. Supervised injection facilities (SIFs) are a widely implemented public health intervention throughout the world, with 97 existing in 11 countries worldwide. Research has documented the public health, social, and economic benefits of SIFs, yet none exist in the USA. The purpose of this study is to model the health and financial costs and benefits of a hypothetical SIF in Baltimore. We estimate the benefits by utilizing local health data and data on the impact of existing SIFs in models for six outcomes: prevented human immunodeficiency virus transmission, Hepatitis C virus transmission, skin and soft-tissue infection, overdose mortality, and overdose-related medical care and increased medication-assisted treatment for opioid dependence. We predict that for an annual cost of $1.8 million, a single SIF would generate $7.8 million in savings, preventing 3.7 HIV infections, 21 Hepatitis C infections, 374 days in the hospital for skin and soft-tissue infection, 5.9 overdose deaths, 108 overdose-related ambulance calls, 78 emergency room visits, and 27 hospitalizations, while bringing 121 additional people into treatment. We conclude that a SIF would be both extremely cost-effective and a significant public health and economic benefit to Baltimore City.

Use of various free flaps in progressive hemifacial atrophy.

PubMed

Baek, Rongmin; Heo, Chanyeong; Kim, Baek-kyu

2011-11-01

Romberg disease is an uncommon condition manifested by progressive hemifacial atrophy of the skin, soft tissue, and bone. Facial asymmetry with soft tissue deficiency in Romberg disease causes a significant disability affecting the social life and can bring about many psychological problems. The aim of surgical treatment is cosmetic amelioration of the defect. Several conventional reconstructive procedures have been used for correcting facial asymmetry. They include fat injections, dermal fat grafts, filler injections, cartilage and bone grafts, and pedicled and free flaps. We report our experiences with 11 patients involving 11 free flaps with a minimum 1-year follow-up. All patients were classified as having moderate to severe atrophy. The average age at disease onset was 4.5 years; the average duration of atrophy was 5.2 years. No patients were operated on with a quiescent interval of less than 1 year. The average age at operation was 20.1 years, ranging from 10 to 55 years. Reconstruction was performed using 4 groin dermofat free flaps, 4 latissimus dorsi muscle free flaps, and 3 other perforator flaps. To achieve the finest symmetrical and aesthetic results, several ancillary procedures were performed in 4 patients. These procedures included Le Fort I leveling osteotomy, sagittal split ramus osteotomy, reduction malarplasty and angle plasty, rib and calvarial bone graft, correction of alopecia, and additional fat graft. All patients were satisfied with the results. We believe that a free flap transfer is the requisite treatment modality for severe degree of facial asymmetry in Romberg disease.

The Local Pharmacokinetics of 3H-Ropivacaine and 14C-Lidocaine After Maxillary Infiltration Anesthesia in Rats

PubMed Central

Kimi, Hiromi; Yamashiro, Mikiko; Hashimoto, Shuichi

2012-01-01

The effects of infiltration anesthesia with ropivacaine on the dental pulp are considered to be weak. This may be partly associated with its permeation into the oral tissue. With the objective of investigating the local pharmacokinetics of ropivacaine and lidocaine following infiltration anesthesia, we injected 3H-ropivacaine or 14C-lidocaine to the palatal mucosa in rats, measured distributions of radioactivity in the maxilla, and compared the local pharmacokinetics of these agents. The animals were sacrificed at various times and the maxillas were removed. The palatal mucosa and maxillary nerve were resected, and the bone was divided into 6 portions. We measured radioactivity in each tissue and calculated the level of each local anesthetic (n  =  8). Lidocaine diffused to the surrounding tissue immediately after the injection, whereas ropivacaine tended to remain in the palatal mucosa for a longer period. Lidocaine showed a higher affinity for the maxillary bone than ropivacaine. There was a correlation between the distribution level of local anesthetics in the maxillary bone and that in the maxillary nerve. The lower-level effects of infiltration anesthesia with ropivacaine on the dental pulp may be because ropivacaine has a high affinity for soft tissue, and its transfer to bone is slight. PMID:22822994

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.

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

PubMed

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

2017-07-12

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.

Direct microCT imaging of non-mineralized connective tissues at high resolution.

PubMed

Naveh, Gili R S; Brumfeld, Vlad; Dean, Mason; Shahar, Ron; Weiner, Steve

2014-01-01

The 3D imaging of soft tissues in their native state is challenging, especially when high resolution is required. An X-ray-based microCT is, to date, the best choice for high resolution 3D imaging of soft tissues. However, since X-ray attenuation of soft tissues is very low, contrasting enhancement using different staining materials is needed. The staining procedure, which also usually involves tissue fixation, causes unwanted and to some extent unknown tissue alterations. Here, we demonstrate that a method that enables 3D imaging of soft tissues without fixing and staining using an X-ray-based bench-top microCT can be applied to a variety of different tissues. With the sample mounted in a custom-made loading device inside a humidity chamber, we obtained soft tissue contrast and generated 3D images of fresh, soft tissues with a resolution of 1 micron voxel size. We identified three critical conditions which make it possible to image soft tissues: humidified environment, mechanical stabilization of the sample and phase enhancement. We demonstrate the capability of the technique using different specimens: an intervertebral disc, the non-mineralized growth plate, stingray tessellated radials (calcified cartilage) and the collagenous network of the periodontal ligament. Since the scanned specimen is fresh an interesting advantage of this technique is the ability to scan a specimen under load and track the changes of the different structures. This method offers a unique opportunity for obtaining valuable insights into 3D structure-function relationships of soft tissues.

Local deformation for soft tissue simulation

PubMed Central

Omar, Nadzeri; Zhong, Yongmin; Smith, Julian; Gu, Chengfan

2016-01-01

ABSTRACT This paper presents a new methodology to localize the deformation range to improve the computational efficiency for soft tissue simulation. This methodology identifies the local deformation range from the stress distribution in soft tissues due to an external force. A stress estimation method is used based on elastic theory to estimate the stress in soft tissues according to a depth from the contact surface. The proposed methodology can be used with both mass-spring and finite element modeling approaches for soft tissue deformation. Experimental results show that the proposed methodology can improve the computational efficiency while maintaining the modeling realism. PMID:27286482

Human histology and persistence of various injectable filler substances for soft tissue augmentation.

PubMed

Lemperle, Gottfried; Morhenn, Vera; Charrier, Ulrich

2003-01-01

An increasing number of soft tissue filler substances have been introduced to the beauty market outside the U.S. which lack experimental and clinical data in support of their claim. Ten commercially available filler substances were examined for biocompatibility and durability: 0.1 cc of each substance was injected deep intradermally into the volar forearm of one of the authors and observed for clinical reaction and permanence. At 1, 3, 6, and 9 months the test sites were excised, histologically examined, and graded according to foreign body reactions classification. Collagen (Zyplast) was phagocytosed at 6 months and hyaluronic acid (Restylane) at 9 months. PMMA microspheres (Artecoll) had encapsulated with connective tissue, macrophages, and sporadic giant cells. Silicone oil (PMS 350) was clinically inconspicuous but dissipated into the tissue, causing a chronic foreign body reaction. Polylactic acid microspheres (New-Fill) induced a mild inflammatory response and had disappeared clinically at 4 months. Dextran microspheres (Reviderm intra) induced a pronounced foreign body reaction and had disappeared at 6 months. Polymethylacrylate particles (Dermalive) induced the lowest cellular reaction but had disappeared clinically at 6 months. Polyacrylamide (Aquamid) was well tolerated and remained palpable to a lessening degree over the entire testing period. Histologically, it dissipated more slowly and was kept in place through fine fibrous capsules. Polyvinylhydroxide microspheres suspended in acrylamide (Evolution) were well tolerated, slowly diminishing over 9 months. Calcium hydroxylapatite microspheres (Radiance FN) induced almost no foreign body reaction but were absorbed by the skin at 12 months. Host defense mechanisms react differently to the various filler materials, but all substances-resorbable or nonresorbable-appeared to be clinically and histologically safe, although all exhibit undesirable side effects. Since the mechanism of late inflammation or granuloma formation is still unknown, early histological findings are not useful in predicting possible late reactions to filler substances.

Contribution of trochanteric soft tissues to fall force estimates, the factor of risk, and prediction of hip fracture risk.

PubMed

Bouxsein, Mary L; Szulc, Pawel; Munoz, Fracoise; Thrall, Erica; Sornay-Rendu, Elizabeth; Delmas, Pierre D

2007-06-01

We compared trochanteric soft tissue thickness, femoral aBMD, and the ratio of fall force to femoral strength (i.e., factor of risk) in 21 postmenopausal women with incident hip fracture and 42 age-matched controls. Reduced trochanteric soft tissue thickness, low femoral aBMD, and increased ratio of fall force to femoral strength (i.e., factor of risk) were associated with increased risk of hip fracture. The contribution of trochanteric soft tissue thickness to hip fracture risk is incompletely understood. A biomechanical approach to assessing hip fracture risk that compares forces applied to the hip during a sideways fall to femoral strength may by improved by incorporating the force-attenuating effects of trochanteric soft tissues. We determined the relationship between femoral areal BMD (aBMD) and femoral failure load in 49 human cadaveric specimens, 53-99 yr of age. We compared femoral aBMD, trochanteric soft tissue thickness, and the ratio of fall forces to bone strength (i.e., the factor of risk for hip fracture, phi), before and after accounting for the force-attenuating properties of trochanteric soft tissue in 21 postmenopausal women with incident hip fracture and 42 age-matched controls. Femoral aBMD correlated strongly with femoral failure load (r2 = 0.73-0.83). Age, height, and weight did not differ; however, women with hip fracture had lower total femur aBMD (OR = 2.06; 95% CI, 1.19-3.56) and trochanteric soft tissue thickness (OR = 1.82; 95% CI, 1.01, 3.31). Incorporation of trochanteric soft tissue thickness measurements reduced the estimates of fall forces by approximately 50%. After accounting for force-attenuating properties of trochanteric soft tissue, the ratio of fall forces to femoral strength was 50% higher in cases than controls (0.92 +/- 0.44 versus 0.65 +/- 0.50, respectively; p = 0.04). It is possible to compute a biomechanically based estimate of hip fracture risk by combining estimates of femoral strength based on an empirical relationship between femoral aBMD and bone strength in cadaveric femora, along with estimates of loads applied to the hip during a sideways fall that account for thickness of trochanteric soft tissues. Our findings suggest that trochanteric soft tissue thickness may influence hip fracture risk by attenuating forces applied to the femur during a sideways fall and provide rationale for developing improved measurements of trochanteric soft tissue and for studying a larger cohort to determine whether trochanteric soft tissue thickness contributes to hip fracture risk independently of aBMD.

Subcutaneous fluid port-associated soft tissue sarcoma in a cat.

PubMed

McLeland, Shannon M; Imhoff, Darren J; Thomas, Michelle; Powers, Barb E; Quimby, Jessica M

2013-10-01

A 20-year-old male castrated domestic longhair cat was evaluated for assessment of its chronic kidney disease (CKD) and a non-healing ulcerated mass at the site of a previously placed and subsequently removed GIF tube. The cat had been diagnosed with CKD 10 years prior and two GIF tubes had been placed over a 5-year period, the second of which was associated with secondary infection. Biopsy of the non-healing ulcerated mass was consistent with grade 2 soft tissue sarcoma. At necropsy there was a discrete, serpentine, subcutaneous mass measuring approximately 8 mm in diameter that extended approximately 20 cm along the dorsum to the caudal thorax, following the path of the GIF tube, from the main intrascapular, ulcerated mass where the fluid port injection site was located. This is the first report of a fibrosarcoma arising at the site of a subcutaneous fluid port in a cat. Although the cat's owners were pleased with the 4 years of quality of life provided by this device, this complication should be considered when a decision to place ports for long-term management of disease is made.

Checklist and Scoring System for the Assessment of Soft Tissue Preservation in CT Examinations of Human Mummies: Application to the Tyrolean Iceman.

PubMed

Panzer, Stephanie; Pernter, Patrizia; Piombino-Mascali, Dario; Jankauskas, Rimantas; Zesch, Stephanie; Rosendahl, Wilfried; Hotz, Gerhard; Zink, Albert R

2017-12-01

Purpose  Soft tissues make a skeleton into a mummy and they allow for a diagnosis beyond osteology. Following the approach of structured reporting in clinical radiology, a recently developed checklist was used to evaluate the soft tissue preservation status of the Tyrolean Iceman using computed tomography (CT). The purpose of this study was to apply the "Checklist and Scoring System for the Assessment of Soft Tissue Preservation in CT Examinations of Human Mummies" to the Tyrolean Iceman, and to compare the Iceman's soft tissue preservation score to the scores calculated for other mummies. Materials and Methods  A whole-body (CT) (SOMATOM Definition Flash, Siemens, Forchheim, Germany) consisting of five scans, performed in January 2013 in the Department of Radiodiagnostics, Central Hospital, Bolzano, was used (slice thickness 0.6 mm; kilovolt ranging from 80 to 140). For standardized evaluation the "CT Checklist and Scoring System for the Assessment of Soft Tissue Preservation in Human Mummies" was used. Results  All checkpoints under category "A. Soft Tissues of Head and Musculoskeletal System" and more than half in category "B. Organs and Organ Systems" were observed. The scoring system accounted for a total score of 153 (out of 200). The comparison of the scores between the Iceman and three mummy collections from Vilnius, Lithuania, and Palermo, Sicily, as well as one Egyptian mummy resulted in overall higher soft tissue preservation scores for the Iceman. Conclusion  Application of the checklist allowed for standardized assessment and documentation of the Iceman's soft tissue preservation status. The scoring system allowed for a quantitative comparison between the Iceman and other mummies. The Iceman showed remarkable soft tissue preservation. Key Points   · The approach of structured reporting can be transferred to paleoradiology.. · The checklist allowed for standardized soft tissue assessment and documentation.. · The scoring system facilitated a quantitative comparison among mummies.. · Based on CT, the Tyrolean Iceman demonstrated remarkable soft tissue preservation.. Citation Format · Panzer S, Pernter P, Piombino-Mascali D et al. Checklist and Scoring System for the Assessment of Soft Tissue Preservation in CT Examinations of Human Mummies: Application to the Tyrolean Iceman. Fortschr Röntgenstr 2017; 189: 1152 - 1160. © Georg Thieme Verlag KG Stuttgart · New York.

Pressure monitoring during lipofilling procedures.

PubMed

Klein, S M; Prantl, L; Geis, S; Eisenmann-Klein, M; Dolderer, J; Felthaus, O; Loibl, M; Heine, N

2014-01-01

Grafting of autologous lipoaspirate for various clinical applications has become a common procedure in clinical practice. With an estimated mortality rate of 10-15 percent, fat embolism is among the most severe complications to be expected after lipofilling therapies. The aim of this study was to determine the level of interstitial pressure after the injection of defined volumes of lipoaspirate into the subcutaneous tissue of female breasts. It was hypothesized, that interstitial pressure levels exceed the physiologic capillary pressure during lipofilling procedures and hence increase the potential risk for fat embolism. Further it was investigated if external tissue expansion has the potential to significantly reduce interstitial tissue pressure. Interstitial pressure was monitored in 36 female patients, that underwent autologous fat injections into the breast. Measurements were conducted with a sensor needle connected to a pressure transducer (LogiCal Pressure Monitoring Kit, Smiths medical int. Ltd., UK). Patients were divided into 4 subcohorts differing in their pre-treatment regimen or local tissue conditions. Pre-treatment consisted of tissue expansion, achieved with the Brava™ (Brava LLC Miami, Fla., USA) vacuum-chamber. The increase in interstitial pressure after injection volumes of 100 ml (p = 0.006), 200 ml (p = 0.000) and between 100 ml and 200 ml (p = 0.004) respectively, were significant in non-mastectomized patients without pre-treatment. Patients pre-treated with Brava™ did not show such statistically significant differences in interstitial pressures before and after the injection of 100 ml and 200 ml of lipoaspirate (p = 0.178). The difference in interstitial pressure in mastectomized patients between 0 ml and 100 ml (p = 0.003), as well as 0 ml and 200 ml (p = 0.028) was significant. The difference in pressures between pre-treated patients and patients without pre-treatment did not differ significantly in the mastectomized patient cohort. During lipofilling procedures interstitial pressures are reached that exceed pressure limits defined as hazardous for fat embolism. To date it is unknown what pressure levels need to be considered critical for complications in soft tissue interventions. Further the results indicate higher interstitial pressures for patients that had undergone mastectomy, whereas pre-treatment with external tissue expansion seemed to diminish pressure values.

Iatrogenic Bone and Soft Tissue Trauma in Robotic-Arm Assisted Total Knee Arthroplasty Compared With Conventional Jig-Based Total Knee Arthroplasty: A Prospective Cohort Study and Validation of a New Classification System.

PubMed

Kayani, Babar; Konan, Sujith; Pietrzak, Jurek R T; Haddad, Fares S

2018-03-27

The objective of this study was to compare macroscopic bone and soft tissue injury between robotic-arm assisted total knee arthroplasty (RA-TKA) and conventional jig-based total knee arthroplasty (CJ-TKA) and create a validated classification system for reporting iatrogenic bone and periarticular soft tissue injury after TKA. This study included 30 consecutive CJ-TKAs followed by 30 consecutive RA-TKAs performed by a single surgeon. Intraoperative photographs of the femur, tibia, and periarticular soft tissues were taken before implantation of prostheses. Using these outcomes, the macroscopic soft tissue injury (MASTI) classification system was developed to grade iatrogenic bone and soft tissue injuries. Interobserver and Intraobserver validity of the proposed classification system was assessed. Patients undergoing RA-TKA had reduced medial soft tissue injury in both passively correctible (P < .05) and noncorrectible varus deformities (P < .05); more pristine femoral (P < .05) and tibial (P < .05) bone resection cuts; and improved MASTI scores compared to CJ-TKA (P < .05). There was high interobserver (intraclass correlation coefficient 0.92 [95% confidence interval: 0.88-0.96], P < .05) and intraobserver agreement (intraclass correlation coefficient 0.94 [95% confidence interval: 0.92-0.97], P < .05) of the proposed MASTI classification system. There is reduced bone and periarticular soft tissue injury in patients undergoing RA-TKA compared to CJ-TKA. The proposed MASTI classification system is a reproducible grading scheme for describing iatrogenic bone and soft tissue injury in TKA. RA-TKA is associated with reduced bone and soft tissue injury compared with conventional jig-based TKA. The proposed MASTI classification may facilitate further research correlating macroscopic soft tissue injury during TKA to long-term clinical and functional outcomes. Copyright © 2018 Elsevier Inc. All rights reserved.

Long-term stability of peri-implant tissues after bone or soft tissue augmentation. Effect of zirconia or titanium abutments on peri-implant soft tissues. Summary and consensus statements. The 4th EAO Consensus Conference 2015.

PubMed

Sicilia, Alberto; Quirynen, Marc; Fontolliet, Alain; Francisco, Helena; Friedman, Anton; Linkevicius, Tomas; Lutz, Rainer; Meijer, Henny J; Rompen, Eric; Rotundo, Roberto; Schwarz, Frank; Simion, Massimo; Teughels, Wim; Wennerberg, Ann; Zuhr, Otto

2015-09-01

Several surgical techniques and prosthetic devices have been developed in the last decades, aiming to improve aesthetic, hygienic and functional outcomes that may affect the peri-implant tissues, such as procedures of bone and soft tissue augmentation and the use of custom-made abutments of titanium and zirconium. Three systematic reviews, based on randomized clinical trials and prospective studies covering the above reported topics were analysed, and the detected evidence was exposed to interactive experts' discussion during the group's and general assembly's meetings of the 4th EAO Consensus Conference. The results are reported using the following abbreviations: S-T: short-term evidence, M-T: medium-term evidence; L-T: long-term evidence; LE: limited evidence. Soft tissue augmentation procedures may be indicated for the increase of soft tissue thickness and keratinized tissue, the reduction of interproximal peri-implant bone loss, and the coverage of shallow peri-implant soft tissue recessions (S-T, LE), L-T is lacking. Guided bone regeneration approaches (GBR) showed efficacy when used for ridge reconstruction after the complete healing of the soft tissues (S-T & L-T), and the stability of the augmented bone may play a role in the maintenance of the soft tissue position and dimensions (LE). No significant differences were observed between titanium and zirconia abutments when evaluating probing pocket depth, bleeding on probing, marginal bone levels and mucosal recessions. Zirconia abutments were associated with more biological complications but demonstrated superiority in terms of achieving natural soft tissue colour (S-T). © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

ClinicalTrials.gov

2018-02-08

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

Fluid-Driven Deformation of a Soft Granular Material

NASA Astrophysics Data System (ADS)

MacMinn, Christopher W.; Dufresne, Eric R.; Wettlaufer, John S.

2015-01-01

Compressing a porous, fluid-filled material drives the interstitial fluid out of the pore space, as when squeezing water out of a kitchen sponge. Inversely, injecting fluid into a porous material can deform the solid structure, as when fracturing a shale for natural gas recovery. These poromechanical interactions play an important role in geological and biological systems across a wide range of scales, from the propagation of magma through Earth's mantle to the transport of fluid through living cells and tissues. The theory of poroelasticity has been largely successful in modeling poromechanical behavior in relatively simple systems, but this continuum theory is fundamentally limited by our understanding of the pore-scale interactions between the fluid and the solid, and these problems are notoriously difficult to study in a laboratory setting. Here, we present a high-resolution measurement of injection-driven poromechanical deformation in a system with granular microsctructure: We inject fluid into a dense, confined monolayer of soft particles and use particle tracking to reveal the dynamics of the multiscale deformation field. We find that a continuum model based on poroelasticity theory captures certain macroscopic features of the deformation, but the particle-scale deformation field exhibits dramatic departures from smooth, continuum behavior. We observe particle-scale rearrangement and hysteresis, as well as petal-like mesoscale structures that are connected to material failure through spiral shear banding.

High-level expression of podoplanin in benign and malignant soft tissue tumors: immunohistochemical and quantitative real-time RT-PCR analysis.

PubMed

Xu, Yongjun; Ogose, Akira; Kawashima, Hiroyuki; Hotta, Tetsuo; Ariizumi, Takashi; Li, Guidong; Umezu, Hajime; Endo, Naoto

2011-03-01

Podoplanin is a 38 kDa mucin-type transmembrane glycoprotein that was first identified in rat glomerular epithelial cells (podocytes). It is expressed in normal lymphatic endothelium, but is absent from vascular endothelial cells. D2-40 is a commercially available mouse monoclonal antibody which binds to an epitope on human podoplanin. D2-40 immunoreactivity is therefore highly sensitive and specific for lymphatic endothelium. Recent investigations have shown widespread applications of immunohistochemical staining with D2-40 in evaluating podoplanin expression as an immunohistochemical marker for diagnosis and prognosis in various tumors. To determine whether the podoplanin (D2-40) antibody may be useful for the diagnosis of soft tissue tumors, 125 cases, including 4 kinds of benign tumors, 15 kinds of malignant tumors and 3 kinds of tumor-like lesions were immunostained using the D2-40 antibody. Total RNA was extracted from frozen tumor tissue obtained from 41 corresponding soft tissue tumor patients and 12 kinds of soft tissue tumor cell lines. Quantitative real-time PCR reactions were performed. Immunohistochemical and quantitative real-time RT-PCR analyses demonstrated the expression of the podoplanin protein and mRNA in the majority of benign and malignant soft tissue tumors and tumor-like lesions examined, with the exception of alveolar soft part sarcoma, embryonal and alveolar rhabdomyosarcoma, extraskeletal Ewing's sarcoma/peripheral primitive neuro-ectodermal tumor and lipoma, which were completely negative for podoplanin. Since it is widely and highly expressed in nearly all kinds of soft tissue tumors, especially in spindle cell sarcoma, myxoid type soft tissue tumors and soft tissue tumors of the nervous system, podoplanin is considered to have little value in the differential diagnosis of soft tissue tumors.

A Novel Esthetic Approach using Connective Tissue Graft for Soft Tissue Defect Following Surgical Excision of Gingival Fibrolipoma

PubMed Central

Parthasarathy, Harinath; Kumar, Praveenkrishna; Gajendran, Priyalochana; Appukuttan, Devapriya

2014-01-01

The aim of the present case report is to evaluate the adjunctive use of a connective tissue graft to overcome soft tissue defects following excision of a gingival fibrolipoma in the aesthetic region. Connective tissue graft has been well documented for treating defects of esthetic concern. However, the literature does not contain many reports on the esthetic clinical outcome following the use of connective tissue graft secondary to excision of soft tissue tumours. A 28-year-old male patient reported with a complaint of a recurrent growth in relation to his lower front tooth region. The lesion which was provisionally diagnosed as fibroma was treated with a complete surgical excision, following which a modified coronally advanced flap and connective tissue graft was adopted to overcome the soft tissue defect. The excised growth was diagnosed histologically as fibrolipoma. One year follow up showed no recurrence of the lesion and good esthetics.The adjunctive use of the connective tissue graft and modified coronally advanced flap predictably yields optimal soft tissue fill and excellent esthetics. Hence, routine use of this procedure may be recommended for surgical excision of soft tissue growths in esthetically sensitive areas. PMID:25584336

Evidence-based knowledge on the aesthetics and maintenance of peri-implant soft tissues: Osteology Foundation Consensus Report Part 1-Effects of soft tissue augmentation procedures on the maintenance of peri-implant soft tissue health.

PubMed

Giannobile, William V; Jung, Ronald E; Schwarz, Frank

2018-03-01

The goal of Working Group 1 at the 2nd Consensus Meeting of the Osteology Foundation was to comprehensively assess the effects of soft tissue augmentation procedures on peri-implant health or disease. A systematic review and meta-analysis on the effects of soft tissue augmentation procedures included a total of 10 studies (mucosal thickness: n = 6; keratinized tissue: n = 4). Consensus statements, clinical recommendations, and implications for future research were based on structured group discussions and a plenary session approval. Soft tissue grafting to increase the width of keratinized tissue around implants was associated with greater reductions in gingival and plaque indices when compared to non-augmented sites. Statistically significant differences were noted for final marginal bone levels in favor of an apically positioned flap plus autogenous graft vs. all standard-of-care control treatments investigated. Soft tissue grafting (i.e., autogenous connective tissue) to increase the mucosal thickness around implants in the aesthetic zone was associated with significantly less marginal bone loss over time, but no significant changes in bleeding on probing, probing depths, or plaque scores when compared to sites without grafting. The limited evidence available supports the use of soft tissue augmentation procedures to promote peri-implant health. © 2018 The Authors. Clinical Oral Implants Research Published by John Wiley & Sons Ltd.

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

Inner power, physical strength and existential well-being in daily life: relatives' experiences of receiving soft tissue massage in palliative home care.

PubMed

Cronfalk, Berit Seiger; Strang, Peter; Ternestedt, Britt-Marie

2009-08-01

This article explores relatives' experiences of receiving soft tissue massage as a support supplement while caring for a dying family member at home. In palliative home care, relatives play an important role as carers to seriously ill and dying family members. To improve their quality of life, different support strategies are of importance. Complementary methods, such as soft tissue massage have become an appreciated supplement for these patients. However, only few studies focus on relatives experiences of receiving soft tissue massage as a supplemental support. Qualitative design Nineteen relatives received soft tissue massage (hand or foot) nine times (25 minutes) in their homes. Open-ended semi-structured tape-recorded interviews were conducted once per relative after the nine times of massage, using qualitative content analysis. Soft tissue massage gave the relatives' feelings of 'being cared for', 'body vitality' and 'peace of mind'. For a while, they put worries of daily life aside as they just experienced 'being'. During massage, it became apparent that body and mind is constituted of an indestructible completeness. The overarching theme was 'inner power, physical strength and existential well-being in their daily lives'. All relatives experienced soft tissue massage positively, although they were under considerable stress. Soft tissue massage could be an option to comfort and support relatives in palliative home care. In palliative nursing care, soft tissue massage could present a worthy supplement in supporting caring relatives.

Soft tissue thin-plate spline analysis of pre-pubertal Korean and European-Americans with untreated Angle's Class III malocclusions.

PubMed

Singh, G D; McNamara, J A; Lozanoff, S

1999-01-01

The purpose of this study was to assess soft tissue facial matrices in subjects of diverse ethnic origins with underlying dentoskeletal malocclusions. Pre-treatment lateral cephalographs of 71 Korean and 70 European-American children aged between 5 and 11 years with Angle's Class III malocclusions were traced, and 12 homologous, soft tissue landmarks digitized. Comparing mean Korean and European-American Class III soft tissue profiles, Procrustes analysis established statistical difference (P < 0.001) between the configurations, and this difference was also true at all seven age groups tested (P < 0.001). Comparing the overall European-American and Korean transformation, thin-plate spline analysis indicated that both affine and non-affine transformations contribute towards the total spline (deformation) of the averaged Class III soft tissue configurations. For non-affine transformations, partial warp (PW) 8 had the highest magnitude, indicating large-scale deformations visualized as labio-mental protrusion, predominantly. In addition, PW9, PW4, and PW5 also had high magnitudes, demonstrating labio-mental vertical compression and antero-posterior compression of the lower labio-mental soft tissues. Thus, Korean children with Class III malocclusions demonstrate antero-posterior and vertical deformations of the labio-mental soft tissue complex with respect to their European-American counterparts. Morphological heterogeneity of the soft tissue integument in subjects of diverse ethnic origin may obscure the underlying skeletal morphology, but the soft tissue integument appears to have minimal ontogenetic association with Class III malocclusions.

Maximum imaging depth comparison in porcine vocal folds using 776-nm vs. 1552-nm excitation wavelengths

NASA Astrophysics Data System (ADS)

Yildirim, Murat; Ferhanoglu, Onur; Kobler, James B.; Zeitels, Steven M.; Ben-Yakar, Adela

2013-02-01

Vocal fold scarring is one of the major causes of voice disorders and may arise from overuse or post-surgical wound healing. One promising treatment utilizes the injection of soft biomaterials aimed at restoring viscoelasticity of the outermost vibratory layer of the vocal fold, superficial lamina propria (SLP). However, the density of the tissue and the required injection pressure impair proper localization of the injected biomaterial in SLP. To enhance treatment effectiveness, we are investigating a technique to image and ablate sub-epithelial planar voids in vocal folds using ultrafast laser pulses to better localize the injected biomaterial. It is challenging to optimize the excitation wavelength to perform imaging and ablation at depths suitable for clinical use. Here, we compare maximum imaging depth using two photon autofluorescence and second harmonic generation with third-harmonic generation imaging modalities for healthy porcine vocal folds. We used a home-built inverted nonlinear scanning microscope together with a high repetition rate (2 MHz) ultrafast fiber laser (Raydiance Inc.). We acquired both two-photon autofluorescence and second harmonic generation signals using 776 nm wavelength and third harmonic generation signals using 1552 nm excitation wavelength. We observed that maximum imaging depth with 776 nm wavelength is significantly improved from 114 μm to 205 μm when third harmonic generation is employed using 1552 nm wavelength, without any observable damage in the tissue.

Stretchable and Soft Electronics using Liquid Metals.

PubMed

Dickey, Michael D

2017-07-01

The use of liquid metals based on gallium for soft and stretchable electronics is discussed. This emerging class of electronics is motivated, in part, by the new opportunities that arise from devices that have mechanical properties similar to those encountered in the human experience, such as skin, tissue, textiles, and clothing. These types of electronics (e.g., wearable or implantable electronics, sensors for soft robotics, e-skin) must operate during deformation. Liquid metals are compelling materials for these applications because, in principle, they are infinitely deformable while retaining metallic conductivity. Liquid metals have been used for stretchable wires and interconnects, reconfigurable antennas, soft sensors, self-healing circuits, and conformal electrodes. In contrast to Hg, liquid metals based on gallium have low toxicity and essentially no vapor pressure and are therefore considered safe to handle. Whereas most liquids bead up to minimize surface energy, the presence of a surface oxide on these metals makes it possible to pattern them into useful shapes using a variety of techniques, including fluidic injection and 3D printing. In addition to forming excellent conductors, these metals can be used actively to form memory devices, sensors, and diodes that are completely built from soft materials. The properties of these materials, their applications within soft and stretchable electronics, and future opportunities and challenges are considered. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Improved Rubin-Bodner Model for the Prediction of Soft Tissue Deformations

PubMed Central

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

2016-01-01

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. PMID:27717593

Alveolar soft part sarcoma causing perianal abscess.

PubMed

Sullivan, Niall; McCulloch, Tom; Leverton, David

2011-07-01

A 34-year-old woman presented with a perianal abscess that communicated with the vagina. There was a background of a one-year history of a conservatively treated, traumatic, paravaginal haematoma. Histology of the fistula tract showed alveolar soft part sarcoma and subsequent imaging identified a large soft tissue mass in the pelvis with lung metastases. Alveolar soft part sarcoma is a rare soft tissue sarcoma of unknown cellular origin affecting predominantly young women, often in deep soft tissues and lower extremities.

Late revision or correction of facial trauma-related soft-tissue deformities.

PubMed

Rieck, Kevin L; Fillmore, W Jonathan; Ettinger, Kyle S

2013-11-01

Surgical approaches used in accessing the facial skeleton for fracture repair are often the same as or similar to those used for cosmetic enhancement of the face. Rarely does facial trauma result in injuries that do not in some way affect the facial soft-tissue envelope either directly or as sequelae of the surgical repair. Knowledge of both skeletal and facial soft-tissue anatomy is paramount to successful clinical outcomes. Facial soft-tissue deformities can arise that require specific evaluation and management for correction. This article focuses on revision and correction of these soft-tissue-related injuries secondary to facial trauma. Copyright © 2013. Published by Elsevier Inc.

General Information about Childhood Soft Tissue Sarcoma

MedlinePlus

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

General Information about Adult Soft Tissue Sarcoma

MedlinePlus

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

Biomechanical and histological effects of augmented soft tissue mobilization therapy on achilles tendinopathy in a rabbit model.

PubMed

Imai, Kan; Ikoma, Kazuya; Chen, Qingshan; Zhao, Chunfeng; An, Kai-Nan; Gay, Ralph E

2015-02-01

Augmented soft tissue mobilization (ASTM) has been used to treat Achilles tendinopathy and is thought to promote collagen fiber realignment and hasten tendon regeneration. The objective of this study was to evaluate the biomechanical and histological effects of ASTM therapy on rabbit Achilles tendons after enzymatically induced injury. This study was a non-human bench controlled research study using a rabbit model. Both Achilles tendons of 12 rabbits were injected with collagenase to produce tendon injury simulating Achilles tendinopathy. One side was then randomly allocated to receive ASTM, while the other received no treatment (control). ASTM was performed on the Achilles tendon on postoperative days 21, 24, 28, 31, 35, and 38. Tendons were harvested 10 days after treatment and examined with dynamic viscoelasticity and light microscopy. Cross-sectional area in the treated tendons was significantly greater than in controls. Storage modulus tended to be lower in the treated tendons but elasticity was not significantly increased. Loss modulus was significantly lower in the treated tendons. There was no significant difference found in tangent delta (loss modulus/storage modulus). Microscopy of control tendons showed that the tendon fibers were wavy and type III collagen was well stained. The tendon fibers of the augmented soft tissue mobilization treated tendons were not wavy and type III collagen was not prevalent. Biomechanical and histological findings showed that the Achilles tendons treated with ASTM had better recovery of biomechanical function than did control tendons. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

[Reconstruction of facial soft tissue defects with pedicled expanded flaps].

PubMed

Yangqun, Li; Yong, Tang; Wen, Chen; Zhe, Yang; Muxin, Zhao; Lisi, Xu; Chunmei, Hu; Yuanyuan, Liu; Ning, Ma; Jun, Feng; Weixin, Wang

2014-09-01

To investigate the application of pedicled expanded flaps for the reconstruction of facial soft tissue defects. The expanded skin flaps, pedicled with orbicularis oculi muscle, submental artery, the branch of facial artery, superficial temporal artery, interior upper arm artery, had similar texture and color as facial soft tissue. The pedicled expanded flaps have repaired the facial soft tissue defects. Between Jan. 2003 to Dec. 2013, 157 cases with facial soft tissue defects were reconstructed by pedicled expanded flaps. Epidermal necrosis happened at the distal end of 8 expanded flaps, pedicled with interior upper arm artery(4 cases), orbicularis oculi muscle(3 cases) and submental artery(1 case), which healed spontaneously after dressing. All the other flaps survived completely with similar color and inconspicuous scar. 112 cases were followed up for 8 months to 8 years. Satisfactory results were achieved in 75 cases. 37 cases with hypertrophic scar at incisions need secondary operation. Island pedicled expanded flap with similar texture and color as facial soft tissue is suitable for facial soft tissue defects. The facial extra-incision and large dog-ear deformity could be avoided.

Differential diagnosis between benign and malignant soft tissue tumors utilizing ultrasound parameters.

PubMed

Morii, Takeshi; Kishino, Tomonori; Shimamori, Naoko; Motohashi, Mitsue; Ohnishi, Hiroaki; Honya, Keita; Aoyagi, Takayuki; Tajima, Takashi; Ichimura, Shoichi

2018-01-01

Preoperative discrimination between benign and malignant soft tissue tumors is critical for the prevention of excess application of magnetic resonance imaging and biopsy as well as unplanned resection. Although ultrasound, including power Doppler imaging, is an easy, noninvasive, and cost-effective modality for screening soft tissue tumors, few studies have investigated reliable discrimination between benign and malignant soft tissue tumors. To establish a modality for discrimination between benign and malignant soft tissue tumors using ultrasound, we extracted the significant risk factors for malignancy based on ultrasound information from 40 malignant and 56 benign pathologically diagnosed soft tissue tumors and established a scoring system based on these risk factors. The maximum size, tumor margin, and vascularity evaluated using ultrasound were extracted as significant risk factors. Using the odds ratio from a multivariate regression model, a scoring system was established. Receiver operating characteristic analyses revealed a high area under the curve value (0.85), confirming the accuracy of the scoring system. Ultrasound is a useful modality for establishing the differential diagnosis between benign and malignant soft tissue tumors.

Childhood Soft Tissue Sarcoma Treatment (PDQ®)—Health Professional Version

Cancer.gov

Pediatric soft tissue sarcomas are a heterogenous group of malignant tumors that originate from primitive mesenchymal tissue and account for 7% of all childhood tumors. Get detailed information about clinical presentation, diagnosis, prognosis, and treatment of newly diagnosed and recurrent soft tissue sarcoma in this summary for clinicians.

Alisertib in Treating Patients With Advanced or Metastatic Sarcoma

ClinicalTrials.gov

2017-11-29

Myxofibrosarcoma; Recurrent Adult Soft Tissue Sarcoma; Recurrent Leiomyosarcoma; Recurrent Liposarcoma; Recurrent Malignant Peripheral Nerve Sheath Tumor; Recurrent Undifferentiated Pleomorphic Sarcoma; Stage III Soft Tissue Sarcoma AJCC v7; Stage IV Soft Tissue Sarcoma AJCC v7

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

[Soft tissue melanoma: a clinical case].

PubMed

Frikh, Rachid; Oumakhir, Siham; Chahdi, Hafsa; Oukabli, Mohammed; Albouzidi, Abderrahmane; Baba, Noureddine; Hjira, Naoufal; Boui, Mohammed

2017-01-01

Soft tissue melanoma was first described by Enzinger in 1965 under the name of clear cell sarcoma. In 1983, Chung and Enzinger renamed it soft tissue melanoma due to its immunohistochemical similarities with melanoma. We here report the case of a 22-year old young man with this rare type of melanoma, presenting with molluscoid lesion on his ankle without any clinical sign of malignancy. Histology examination confirmed the diagnosis of soft tissue melanoma.

Soft-Tissue Injuries Associated With High-Energy Extremity Trauma: Principles of Management.

PubMed

Norris; Kellam

1997-01-01

The management of high-energy extremity trauma has evolved over the past several decades, and appropriate treatment of associated soft-tissue injuries has proved to be an important factor in achieving a satisfactory outcome. Early evaluation of the severely injured extremity is crucial. Severe closed injuries require serial observation of the soft tissues and early skeletal stabilization. Open injuries require early aggressive debridement of the soft tissues followed by skeletal stabilization. Temporary wound dressings should remain in place until definitive soft-tissue coverage has been obtained. Definitive soft-tissue closure will be expedited by serial debridements performed every 48 to 72 hours in a sterile environment. Skeletal union is facilitated by early bone grafting and/or modification of the stabilizing device. Aggressive rehabilitation, includ-ing early social reintegration, are crucial for a good functional outcome. Adherence to protocols is especially beneficial in the management of salvageable severely injured extremities.

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 for compensating the needle-targeting error in the rigid needle insertion procedure, especially for percutaneous needle insertion into organs.

Effect of antipronation foot orthosis geometry on compression of heel and arch soft tissues.

PubMed

Sweeney, Declan; Nester, Christopher; Preece, Stephen; Mickle, Karen

2015-01-01

This study aimed to understand how systematic changes in arch height and two designs of heel wedging affect soft tissues under the foot. Soft tissue thickness under the heel and navicular was measured using ultrasound. Heel pad thickness was measured when subjects were standing on a flat surface and standing on an orthosis with 4 and 8 degree extrinsic wedges and 4 mm and 8 mm intrinsic wedges (n = 27). Arch soft tissue thickness was measured when subjects were standing and when standing on an orthosis with -6 mm, standard, and +6 mm increments in arch height (n = 25). Extrinsic and intrinsic heel wedges significantly increased soft tissue thickness under the heel compared with no orthosis. The 4 and 8 degree extrinsic wedges increased tissue thickness by 28% and 27.6%, respectively, while the 4 mm and 8 mm intrinsic wedges increased thickness by 23% and 14.6%, respectively. Orthotic arch height significantly affected arch soft tissue thickness. Compared with the no orthosis condition, the -6 mm, standard, and +6 mm arch heights decreased arch tissue thickness by 9%, 10%, and 11.8%, respectively. This study demonstrates that change in orthotic geometry creates different plantar soft tissue responses that we expect to affect transmission of force to underlying foot bones.

Cell-based regenerative approaches to the treatment of oral soft tissue defects.

PubMed

Bates, Damien; Kampa, Peggy

2013-01-01

Oral soft tissue plays an important role in the structure and function of the oral cavity by protecting against exogenous substances, pathogens, and mechanical stresses. Repair of oral soft tissue defects that arise as a result of disease, trauma, or congenital abnormalities is often accomplished via transplantation or transfer of autologous mucosal tissue. However, this method of treatment can be complicated by the relatively small amount of autologous mucosal tissue that is available, as well as by the morbidity that may be associated with the donor site and patient reluctance to have oral (eg, palatal) surgery. To circumvent these problems, clinicians have turned to the fields of tissue engineering and regenerative medicine to develop acellular and cellular strategies for regenerating oral soft tissue. This review focuses on the efficacy and safety of cell-based investigational approaches to the regeneration of oral soft tissue.

Finite element dynamic analysis of soft tissues using state-space model.

PubMed

Iorga, Lucian N; Shan, Baoxiang; Pelegri, Assimina A

2009-04-01

A finite element (FE) model is employed to investigate the dynamic response of soft tissues under external excitations, particularly corresponding to the case of harmonic motion imaging. A solid 3D mixed 'u-p' element S8P0 is implemented to capture the near-incompressibility inherent in soft tissues. Two important aspects in structural modelling of these tissues are studied; these are the influence of viscous damping on the dynamic response and, following FE-modelling, a developed state-space formulation that valuates the efficiency of several order reduction methods. It is illustrated that the order of the mathematical model can be significantly reduced, while preserving the accuracy of the observed system dynamics. Thus, the reduced-order state-space representation of soft tissues for general dynamic analysis significantly reduces the computational cost and provides a unitary framework for the 'forward' simulation and 'inverse' estimation of soft tissues. Moreover, the results suggest that damping in soft-tissue is significant, effectively cancelling the contribution of all but the first few vibration modes.

Soft-tissue reactions following irradiation of primary brain and pituitary tumors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baglan, R.J.; Marks, J.E.

1981-04-01

One hundred and ninety-nine patients who received radiation therapy for a primary brain or pituitary tumor were studied for radiation-induced soft-tissue reactions of the cranium, scalp, ears and jaw. The frequency of these reactions was studied as a function of: the radiation dose 5 mm below the skin surface, dose distribution, field size and fraction size. Forty percent of patients had complete and permanent epilation, while 21% had some other soft-tissue complication, including: scalp swelling-6%, external otitis-6%, otitis media-5%, ear swelling-4%, etc. The frequency of soft-tissue reactions correlates directly with the radiation dose at 5 mm below the skin surface.more » Patients treated with small portals (<70 cm/sup 2/) had few soft-tissue reactions. The dose to superficial tissues, and hence the frequency of soft-tissue reactions can be reduced by: (1) using high-energy megavoltage beams; (2) using equal loading of beams; and (3) possibly avoiding the use of electron beams.« less

The use of acellular dermal matrix membrane for vertical soft tissue augmentation during submerged implant placement: a case series.

PubMed

Puisys, Algirdas; Vindasiute, Egle; Linkevciene, Laura; Linkevicius, Tomas

2015-04-01

To evaluate the efficiency of acellular dermal matrix membrane to augment vertical peri-implant soft tissue thickness during submerged implant placement. Forty acellular dermal matrix-derived allogenic membranes (AlloDerm, BioHorizons, Birmingham, AL, USA) and 42 laser-modified surface internal hex implants (BioHorizons Tapered Laser Lok, Birmingham, AL, USA) were placed in submerged approach in 40 patients (15 males and 25 females, mean age 42.5 ± 1.7) with a thin vertical soft tissue thickness of 2 mm or less. After 3 months, healing abutments were connected to implants, and the augmented soft tissue thickness was measured with periodontal probe. The gain in vertical soft tissue volume was calculated. Mann-Whitney U-test was applied and significance was set to 0.05. All 40 allografts healed successfully. Thin soft tissue before augmentation had an average thickness of 1.54 ± 0.51 mm SD (range, 0.5-2.0 mm, median 1.75 mm), and after soft tissue augmentation with acellular dermal matrix, thickness increased to 3.75 ± 0.54 mm SD (range, 3.0-5.0 mm, median 4.0 mm) at 3 months after placement. This difference between medians was found to be statistically significant (P < 0.001). Mean increase in soft tissue thickness was 2.21 ± 0.85 mm SD (range, 1.0-4.5 mm, median 2.0 mm). It can be concluded that acellular dermal matrix membrane can be successfully used for vertical soft tissue augmentation. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Soft tissue molding technique in cleft lip and palate patient using laser surgery in combination with orthodontic appliance: A case report.

PubMed

Theerasopon, Pornpat; Wangsrimongkol, Tasanee; Sattayut, Sajee

2017-03-31

Although surgical treatment protocols for cleft lip and palate patients have been established, many patients still have some soft tissue defects after complete healing from surgical interventions. These are excess soft tissue, high attached fraena and firmed tethering scares. These soft tissue defects resulted shallowing of vestibule, restricted tooth movement, compromised periodontal health and trended to limit the maxillary growth. The aim of this case report was to present a method of correcting soft tissue defects after conventional surgery in cleft lip and palate patient by using combined laser surgery and orthodontic appliance. A bilateral cleft lip and palate patient with a clinical problem of shallow upper anterior vestibule after alveolar bone graft received a vestibular extension by using CO 2 laser with ablation and vaporization techniques at 4 W and continuous wave. A customized orthodontic appliance, called a buccal shield, was placed immediately after surgery and retained for 1 month to 3 months until complete soft tissue healing. The procedures were performed 2 episodes. Both interventions used the same CO 2 laser procedure. The first treatment resulted in partial re-attachment of soft tissue at surgical area. The second laser operation with the proper design of buccal shield providing passive contact with more extended flange resulting in a favorable outcome from 1 year follow up. Then the corrective orthodontic treatment could be continued effectively. The CO 2 laser surgery was a proper treatment for correcting soft tissue defects and the design of buccal shield was a key for success in molding surgical soft tissue.

Non-interventional 1-year follow-up study of peri-implant soft tissues following previous soft tissue augmentation and crown insertion in single-tooth gaps.

PubMed

Huber, Samuel; Zeltner, Marco; Hämmerle, Christoph H F; Jung, Ronald E; Thoma, Daniel S

2018-04-01

To assess peri-implant soft tissue dimensions at implant sites, previously augmented with a collagen matrix (VCMX) or an autogenous subepithelial connective tissue graft (SCTG), between crown insertion and 1 year. Twenty patients with single-tooth implants received soft tissue augmentation prior to abutment connection randomly using VCMX or SCTG. Following abutment connection 3 months later, final reconstructions were fabricated and inserted (baseline). Patients were recalled at 6 months (6M) and at 1 year (FU-1). Measurements included clinical data, soft tissue thickness, volumetric outcomes and patient-reported outcome measures (PROMs). The buccal soft tissue thickness showed a median decrease of -0.5 mm (-1.0;0.3) (VCMX) and 0.0 mm (-0.5;1.0) (SCTG) (p = .243) up to FU-1. The soft tissue volume demonstrated a median decrease between BL and FU-1 of -0.1 mm (-0.2;0.0) (p = .301) for VCMX and a significant decrease of -0.2 mm (-0.4; -0.1) (p = .002) for SCTG, respectively. Intergroup comparisons did not reveal any significant differences between the groups for peri-implant soft tissue dimensions and changes up to FU-1 (p > .05). PROMs did not show any significant changes over time nor differences between the groups. Between crown insertion and 1 year, the buccal peri-implant soft tissue dimensions remained stable without relevant differences between sites that had previously been grafted with VCMX or SCTG. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

PubMed

Maetevorakul, Suhatcha; Viteporn, Smorntree

2016-01-01

Several studies have shown soft tissue profile changes after orthodontic treatment in Class II Division 1 patients. However, a few studies have described factors influencing the soft tissue changes. The purpose of this study was to investigate the factors influencing the soft tissue profile changes following orthodontic treatment in Class II Division 1 patients. The subjects comprised 104 Thai patients age 8-16 years who presented Class II Division 1 malocclusions and were treated with different orthodontic modalities comprising cervical headgear, Class II traction and extraction of the four first premolars. The profile changes were evaluated from the lateral cephalograms before and after treatment by means of the X-Y coordinate system. Significant soft tissue profile changes were evaluated by paired t test at a 0.05 significance level. The correlations among significant soft tissue changes and independent variables comprising treatment modality, age, sex, pretreatment skeletal, dental and soft tissue morphology were evaluated by stepwise multiple regression analysis at a 0.05 significance level. The multiple regression analysis indicated that different treatment modalities, age, sex, pretreatment skeletal, dental and soft tissue morphology were related to the profile changes. The predictive power of these variables on the soft tissue profile changes ranged from 9.9 to 40.3%. Prediction of the soft tissue profile changes following treatment of Class II Division 1 malocclusion from initial patient morphology, age, sex and types of treatment was complicated and required several variables to explain their variations. Upper lip change in horizontal direction could be found only at the stomion superius and was less predictable than those of the lower lip. Variations in upper lip retraction at the stomion superius were explained by types of treatment (R(2) = 0.099), whereas protrusion of the lower lip at the labrale inferius was correlated with initial inclination of the lower incisor (L1 to NB), jaw relation (ANB angle), lower lip thickness and sex (R(2) = 0.403). Prediction of chin protrusion at the soft tissue pogonion was also low predictable (R(2) = 0.190) depending upon sex, age and initial mandibular plane angle (SN-GoGn). Additionally, age and sex also had mainly effect on change of the soft tissue profile in the vertical direction.

Orthodontic-periodontal interactions: Orthodontic extrusion in interdisciplinary regenerative treatments.

PubMed

Paolone, Maria Giacinta; Kaitsas, Roberto

2018-06-01

Orthodontics is a periodontal treatment. "Guided orthodontic regeneration" (GOR) procedures use orthodontic movements in perio-restorative patients. The GOR technique includes a guided orthodontic "soft tissue" regeneration (GOTR) and a guided orthodontic "bone" regeneration (GOBR) with a plastic soft tissue approach and a regenerating reality. The increased amount of soft tissue gained with orthodontic movement can be used for subsequent periodontal regenerative techniques. The increased amount of bone can as well improve primary implant stability and, eventually, simplify a GTR technique to regenerate soft tissues, to restore tooth with external resorption in aesthetic zone or to extract a tooth to create new hard-soft tissue for adjacent teeth. Copyright © 2018. Published by Elsevier Masson SAS.

Histomorphometrical analysis following augmentation of infected extraction sites exhibiting severe bone loss and primarily closed by intrasocket reactive soft tissue.

PubMed

Mardinger, Ofer; Vered, Marilena; Chaushu, Gavriel; Nissan, Joseph

2012-06-01

Intrasocket reactive soft tissue can be used for primary closure during augmentation of infected extraction sites exhibiting severe bone loss prior to implant placement. The present study evaluated the histological characteristics of the initially used intrasocket reactive soft tissue, the overlying soft tissue, and the histomorphometry of the newly formed bone during implant placement. Thirty-six consecutive patients (43 sites) were included in the study. Extraction sites demonstrating extensive bone loss on preoperative periapical and panoramic radiographs served as inclusion criteria. Forty-three implants were inserted after a healing period of 6 months. Porous bovine xenograft bone mineral was used as a single bone substitute. The intrasocket reactive soft tissue was sutured over the grafting material to seal the coronal portion of the socket. Biopsies of the intrasocket reactive soft tissue at augmentation, healed mucosa, and bone cores at implant placement were retrieved and evaluated. The intrasocket reactive soft tissue demonstrated features compatible with granulation tissue and long junctional epithelium. The mucosal samples at implant placement demonstrated histopathological characteristics of keratinized mucosa with no residual elements of granulation tissue. Histomorphometrically, the mean composition of the bone cores was - vital bone 40 ± 19% (13.7-74.8%); bone substitute 25.7 ± 13% (0.6-51%); connective tissue 34.3 ± 15% (13.8-71.9%). Intrasocket reactive soft tissue used for primary closure following ridge augmentation is composed of granulation tissue and long junctional epithelium. At implant placement, clinical and histological results demonstrate its replacement by keratinized gingiva. The histomorphometrical results reveal considerable bone formation. Fresh extraction sites of hopeless teeth demonstrating chronic infection and severe bone loss may be grafted simultaneously with their removal. © 2010 Wiley Periodicals, Inc.

Changes of the peri-implant soft tissue thickness after grafting with a collagen matrix.

PubMed

Zafiropoulos, Gregory-George; Deli, Giorgio; Hoffmann, Oliver; John, Gordon

2016-01-01

The aim of this study was to determine the treatment outcome of the use of a porcine monolayer collagen matrix (mCM) to increase soft-tissue volume as a part of implant site development. Implants were placed in single sites in 27 patients. In the test group, mCM was used for soft-tissue augmentation. No graft was placed in the control group. Soft-tissue thickness (STTh) was measured at the time of surgery (T0) and 6 months postoperatively (T1) at two sites (STTh 1, 1 mm below the gingival margin; STTh 2, 3 mm below the mucogingival margin). Significant increases ( P < 0.001) in STTh (STTh 1 = 1.06 mm, 117%; STTh 2 = 0.89 mm, 81%) were observed in the test group. Biopsy results showed angiogenesis and mature connective tissue covered by keratinized epithelium. Within the limitations of this study, it could be concluded that mCM leads to a significant increase of peri-implant soft-tissue thickness, with good histological integration and replacement by soft tissue and may serve as an alternative to connective tissue grafting.

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

PubMed

Zeng, Qing-yu; Zang, Chang-hai; Lin, Ling; Chen, Su-biao; Li, Xiao-feng; Xiao, Zheng-yu; Dong, Hai-yuan; Zhang, Ai-lian; Chen, Ren

2010-08-05

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

Factors influencing on retro-odontoid soft-tissue thickness: analysis by magnetic resonance imaging.

PubMed

Tojo, Shinjiro; Kawakami, Reina; Yonenaga, Takenori; Hayashi, Daichi; Fukuda, Kunihiko

2013-03-01

A retrospective, consecutive case series. To analyze the relationship between retro-odontoid soft-tissue thickness and patients' age, sex, and degenerative changes of cervical spine and to investigate the effect these factors have on retro-odontoid soft-tissue thickness. Thickening of the soft tissue posterior to the odontoid process can form a retro-odontoid pseudotumor causing symptoms of spinal cord compression. Rheumatoid arthritis and long-term dialysis have been reported as possible causes for this. However, there have been reports of retro-odontoid pseudotumors without coexisting diseases. Findings from a total of 503 cases of cervical spine magnetic resonance images were reviewed, and retro-odontoid soft-tissue thickness was measured. The values were matched for age, sex, presence of degenerative changes, rheumatoid arthritis, and dialysis and were analyzed for significance. Retro-odontoid soft tissue thickened with age, and this was also seen in male patients and patients with degenerative changes. Significant increase in thickness was also observed in patients undergoing dialysis and further increased with prolonged dialysis. There was no significant association with presence of rheumatoid arthritis. There is association between age, sex, degenerative cervical spine changes, and dialysis with retro-odontoid soft-tissue thickness. With dialysis, retro-odontoid soft-tissue thickness increases with increasing duration. Thus, reviewing magnetic resonance image from daily practice indicates that cervical spine degeneration is associated with the development of retro-odontoid pseudotumors.

[Inconformity between soft tissue defect and bony defect in incomplete cleft palate].

PubMed

Zhou, Xia; Ma, Lian

2014-12-01

To evaluate the inconformity between soft tissue defect and bony defect by observing the cleft extent of palate with complete secondary palate bony cleft in incomplete cleft palate patient. The patients with incomplete cleft palate treated in Hospital of Stomatology Peking University from July 2012 to June 2013 were reviewed, of which 75 cases with complete secondary palate bony cleft were selected in this study. The CT scan and intraoral photograph were taken before operation. The patients were classified as four types according to the extent of soft tissue defect. Type 1: soft tissue defect reached incisive foremen region, Type 2 was hard and soft cleft palate, Type 3 soft cleft palate and Type 4 submucous cleft palate. Type 1 was defined as conformity group (CG). The other three types were defined as inconformity group (ICG) and divided into three subgroups (ICG-I), (ICG-II) and (ICG-III). Fifty-seven patients were in ICG group, and the rate of inconformity was 76% (57/75). The percentage of ICG-I, ICG-II and ICG-III was 47% (27/57), 23% (13/57) and 30% (17/57), respevtively. There are different types of soft tissue deformity with complete secondary palate bony cleft. The inconformity between soft tissue and hard tissue defect exits in 3/4 of isolated cleft palate patients.

Noncontact measurement of elasticity for the detection of soft-tissue tumors using phase-sensitive optical coherence tomography combined with a focused air-puff system.

PubMed

Wang, Shang; Li, Jiasong; Manapuram, Ravi Kiran; Menodiado, Floredes M; Ingram, Davis R; Twa, Michael D; Lazar, Alexander J; Lev, Dina C; Pollock, Raphael E; Larin, Kirill V

2012-12-15

We report on an optical noncontact method for the detection of soft-tissue tumors based on the measurement of their elasticity. A focused air-puff system is used to excite surface waves (SWs) on soft tissues with transient static pressure. A high-speed phase-sensitive optical coherence tomography system is used to measure the SWs as they propagate from the point of excitation. To evaluate the stiffness of soft tissues, the Young's modulus is quantified based on the group velocity of SWs. Pilot experiments were performed on ex vivo human myxoma and normal fat. Results demonstrate the feasibility of the proposed method to measure elasticity and differentiate soft-tissue tumors from normal tissues.

Childhood Soft Tissue Sarcoma Treatment (PDQ®)—Patient Version

Cancer.gov

Childhood soft tissue sarcoma treatment options include surgery, radiation therapy, chemotherapy, observation, targeted therapy, immunotherapy and other medications.  Learn more about the diagnosis and treatment of the many types of childhood soft tissue sarcoma in this expert-reviewed summary.

Hard and soft tissue augmentation in a postorthodontic patient: a case report.

PubMed

Bonacci, Fred J

2011-02-01

A combination of hard and soft tissue grafting is used to augment a thin biotype. A 26-year-old woman with mandibular anterior flaring and Miller Class I and III recessions requested interceptive treatment. Surgery included a full-thickness buccal flap, intramarrow penetrations, bone graft placement, and primary flap closure. Postoperative visits were at 2 and 4 weeks and 2, 3, and 6 months. Stage-two surgery consisted of submerged connective tissue graft placement. Postoperative visits were completed at 2, 4, 6, and 8 weeks and 1 year. Follow-up was completed 3 years after the initial surgery. Interradicular concavities were resolved and gingival biotype was augmented. Soft tissue recession remained at 6 months. Reentry revealed clinical labial plate augmentation; 2 mm was achieved at the lateral incisors and the left central incisor and 3 mm was achieved at the right canine. No bone augmentation was achieved on the left canine and right central incisor. The dehiscence at the right central incisor appeared narrower. Overall, a 2- to 3-mm gain in alveolar bone thickness/height was observed. Two months after stage-two surgery, near complete root coverage was achieved; 1 mm of recession remained on the left central incisor. There was a soft tissue thickness gain of 2 mm without any visual difference in keratinized tissue height. Interradicular concavities were eliminated; the soft tissue was augmented and the gingival biotype was altered. Interdental soft tissue craters remained. One year after connective tissue graft placement, there was near complete root coverage at the left central incisor, which at 2 months experienced residual recession. Interradicular concavities and interdental soft tissue craters were eliminated with soft tissue augmentation, including clinical reestablishment of the mucogingival junction. Clinical stability remained 3 years after the initial surgery, with the patient noting comfort during mastication and routine oral hygiene. A clinical increase in labial plate thickness, in conjunction with soft tissue augmentation, appears to provide for continued stability and decreased potential for future clinical attachment loss.

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

PubMed

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

2017-09-01

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

Acute toxicity evaluation of proliferol: a dose-escalating, placebo-controlled study in swine.

PubMed

Dagenais, Simon; Wooley, James; Hite, Mark; Green, Robert; Mayer, John

2009-01-01

Prolotherapy is one of the many treatments available for chronic musculoskeletal disorders. A commonly used drug contains dextrose 12.5%, glycerin 12.5%, phenol 1.0%, and lidocaine hydrochloride 0.25% in aqueous solution (recently termed Proliferol). For chronic low back pain, this is injected into lumbosacral ligaments to stimulate connective tissue repair. Despite generally positive clinical results, the toxicity of this drug is not well characterized and was assessed in 48 (24 male, 24 female) Yucatan miniature swine randomly assigned to low (1x), medium (5x), or high (10x) dose or saline placebo. Outcomes included clinical observations, clinical chemistry, hematology, coagulation, urinalysis, toxicokinetics, and full gross and microscopic histopathology after 24 hours or 14 days. Findings attributable to Proliferol after 24 hours included dose-response elevations in alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and creatine kinase, which returned to normal after 14 days. There were no remarkable findings in hematology, coagulation, or urinalysis. Urine concentrations of lidocaine and phenol both peaked after 8 hours. Histopathology findings after 24 hours included hemorrhage, inflammation, necrosis, and vascular changes in the ligaments and adjacent soft tissues at the sites of injection. After 14 days, there was evidence of repair under way, with fibrosis and skeletal muscle regeneration at the injection sites.

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.

A Computational Modeling Approach for Investigating Soft Tissue Balancing in Bicruciate Retaining Knee Arthroplasty

PubMed Central

Amiri, Shahram; Wilson, David R.

2012-01-01

Bicruciate retaining knee arthroplasty, although has shown improved functions and patient satisfaction compared to other designs of total knee replacement, remains a technically demanding option for treating severe cases of arthritic knees. One of the main challenges in bicruciate retaining arthroplasty is proper balancing of the soft tissue during the surgery. In this study biomechanics of soft tissue balancing was investigated using a validated computational model of the knee joint with high fidelity definitions of the soft tissue structures along with a Taguchi method for design of experiments. The model was used to simulate intraoperative balancing of soft tissue structures following the combinations suggested by an orthogonal array design. The results were used to quantify the corresponding effects on the laxity of the joint under anterior-posterior, internal-external, and varus-valgus loads. These effects were ranked for each ligament bundle to identify the components of laxity which were most sensitive to the corresponding surgical modifications. The resulting map of sensitivity for all the ligament bundles determined the components of laxity most suitable for examination during intraoperative balancing of the soft tissue. Ultimately, a sequence for intraoperative soft tissue balancing was suggested for a bicruciate retaining knee arthroplasty. PMID:23082090

Health, Maintenance, and Recovery of Soft Tissues around Implants.

PubMed

Wang, Yulan; Zhang, Yufeng; Miron, Richard J

2016-06-01

The health of peri-implant soft tissues is one of the most important aspects of osseointegration necessary for the long-term survival of dental implants. To review the process of soft tissue healing around osseointegrated implants and discuss the maintenance requirements as well as the possible short-comings of peri-implant soft tissue integration. Literature search on the process involved in osseointegration, soft tissue healing and currently available treatment modalities was performed and a brief description of each process was provided. The peri-implant interface has been shown to be less effective than natural teeth in resisting bacterial invasion because gingival fiber alignment and reduced vascular supply make it more vulnerable to subsequent peri-implant disease and future bone loss around implants. And we summarized common procedures which have been shown to be effective in preventing peri-implantitis disease progression as well as clinical techniques utilized to regenerate soft tissues with bone loss in advanced cases of peri-implantitis. Due to the difference between peri-implant interface and natural teeth, clinicians and patients should pay more attention in the maintenance and recovery of soft tissues around implants. © 2015 Wiley Periodicals, Inc.

Prospective Cohort Study Investigating Changes in Body Image, Quality of Life, and Self-Esteem Following Minimally Invasive Cosmetic Procedures.

PubMed

Sobanko, Joseph F; Dai, Julia; Gelfand, Joel M; Sarwer, David B; Percec, Ivona

2018-04-13

Minimally invasive cosmetic injectable procedures are increasingly common. However, a few studies have investigated changes in psychosocial functioning following these treatments. To assess changes in body image, quality of life, and self-esteem following cosmetic injectable treatment with soft tissue fillers and neuromodulators. Open, prospective study of 75 patients undergoing cosmetic injectable procedures for facial aging to evaluate changes in psychosocial functioning within 6 weeks of treatment. Outcome measures included the Derriford appearance scale (DAS-24), body image quality of life inventory (BIQLI), and the Rosenberg self-esteem scale. Body image dissatisfaction, as assessed by the DAS-24, improved significantly 6 weeks after the treatment. Body image quality of life, as assessed by the BIQLI, improved, but the change did not reach statistical significance. Self-esteem was unchanged after the treatment. Minimally invasive cosmetic injectable procedures were associated with reductions in body image dissatisfaction. Future research, using recently developed cosmetic surgery-specific instruments, may provide further insight into the psychosocial benefits of minimally invasive procedures.

A novel laparoscopic grasper with two parallel jaws capable of extracting the mechanical behaviour of soft tissues.

PubMed

Nazarynasab, Dariush; Farahmand, Farzam; Mirbagheri, Alireza; Afshari, Elnaz

2017-07-01

Data related to force-deformation behaviour of soft tissue plays an important role in medical/surgical applications such as realistically modelling mechanical behaviour of soft tissue as well as minimally invasive surgery (MIS) and medical diagnosis. While the mechanical behaviour of soft tissue is very complex due to its different constitutive components, some issues increase its complexity like behavioural changes between the live and dead tissues. Indeed, an adequate quantitative description of mechanical behaviour of soft tissues requires high quality in vivo experimental data to be obtained and analysed. This paper describes a novel laparoscopic grasper with two parallel jaws capable of obtaining compressive force-deformation data related to mechanical behaviour of soft tissues. This new laparoscopic grasper includes four sections as mechanical hardware, sensory part, electrical/electronical part and data storage part. By considering a unique design for mechanical hardware, data recording conditions will be close to unconfined-compression-test conditions; so obtained data can be properly used in extracting the mechanical behaviour of soft tissues. Also, the other distinguishing feature of this new system is its applicability during different laparoscopic surgeries and subsequently obtaining in vivo data. However, more preclinical examinations are needed to evaluate the practicality of the novel laparoscopic grasper with two parallel jaws.

Facial soft tissue thickness in skeletal type I Japanese children.

PubMed

Utsuno, Hajime; Kageyama, Toru; Deguchi, Toshio; Umemura, Yasunobu; Yoshino, Mineo; Nakamura, Hiroshi; Miyazawa, Hiroo; Inoue, Katsuhiro

2007-10-25

Facial reconstruction techniques used in forensic anthropology require knowledge of the facial soft tissue thickness of each race if facial features are to be reconstructed correctly. If this is inaccurate, so also will be the reconstructed face. Knowledge of differences by age and sex are also required. Therefore, when unknown human skeletal remains are found, the forensic anthropologist investigates for race, sex, and age, and for other variables of relevance. Cephalometric X-ray images of living persons can help to provide this information. They give an approximately 10% enlargement from true size and can demonstrate the relationship between soft and hard tissue. In the present study, facial soft tissue thickness in Japanese children was measured at 12 anthropological points using X-ray cephalometry in order to establish a database for facial soft tissue thickness. This study of both boys and girls, aged from 6 to 18 years, follows a previous study of Japanese female children only, and focuses on facial soft tissue thickness in only one skeletal type. Sex differences in thickness of tissue were found from 12 years of age upwards. The study provides more detailed and accurate measurements than past reports of facial soft tissue thickness, and reveals the uniqueness of the Japanese child's facial profile.

Non Lipomatous Benign Lesions Mimicking Soft-tissue Sarcomas: A Pictorial Essay

PubMed Central

CORAN, ALESSANDRO; ORSATTI, GIOVANNA; CRIMÌ, FILIPPO; RASTRELLI, MARCO; DI MAGGIO, ANTONIO; PONZONI, ALBERTO; ATTAR, SHADY; STRAMARE, ROBERTO

2018-01-01

The incidental finding of soft tissue masses is a challenge for the radiologist. Benign and malignant lesions can be differentiated relying on patient history, symptoms and mostly with the help of imaging. Ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) become fundamental in order to distinguish these lesions but the radiologist needs to know the main characteristics of benign soft tissue masses and sarcomas. Herein, we present a pictorial review of lesions mimicking soft tissue sarcomas features. PMID:29475903

Fabrication of polyurethane and polyurethane based composite fibres by the electrospinning technique for soft tissue engineering of cardiovascular system.

PubMed

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

2015-01-01

Electrospinning is a unique technique, which provides forming of polymeric scaffolds for soft tissue engineering, which include tissue scaffolds for soft tissues of the cardiovascular system. Such artificial soft tissues of the cardiovascular system may possess mechanical properties comparable to native vascular tissues. Electrospinning technique gives the opportunity to form fibres with nm- to μm-scale in diameter. The arrangement of obtained fibres and their surface determine the biocompatibility of the scaffolds. Polyurethanes (PUs) are being commonly used as a prosthesis of cardiovascular soft tissues due to their excellent biocompatibility, non-toxicity, elasticity and mechanical properties. PUs also possess fine spinning properties. The combination of a variety of PU properties with an electrospinning technique, conducted at the well tailored conditions, gives unlimited possibilities of forming novel polyurethane materials suitable for soft tissue scaffolds applied in cardiovascular tissue engineering. This paper can help researches to gain more widespread and deeper understanding of designing electrospinable PU materials, which may be used as cardiovascular soft tissue scaffolds. In this paper we focus on reagents used in PU synthesis designed to increase PU biocompatibility (polyols) and biodegradability (isocyanates). We also describe suggested surface modifications of electrospun PUs, and the direct influence of surface wettability on providing enhanced biocompatibility of scaffolds. We indicate a great influence of electrospinning parameters (voltage, flow rate, working distance) and used solvents (mostly DMF, THF and HFIP) on fibre alignment and diameter - what impacts the biocompatibility and hemocompatibility of such electrospun PU scaffolds. Moreover, we present PU modifications with natural polymers with novel approach applied in electrospinning of PU scaffolds. This work may contribute with further developing of novel electrospun PUs, which may be applied as soft tissue scaffolds of the cardiovascular system. Copyright © 2014. Published by Elsevier B.V.

Wound Healing Complications Following Guided Bone Regeneration for Ridge Augmentation: A Systematic Review and Meta-Analysis.

PubMed

Lim, Glendale; Lin, Guo-Hao; Monje, Alberto; Chan, Hsun-Liang; Wang, Hom-Lay

The rate of developing soft tissue complications that accompany guided bone regeneration (GBR) procedures varies widely, from 0% to 45%. The present review was conducted to investigate the rate for resorbable versus nonresorbable membranes and the timing of soft tissue complications. Electronic and manual literature searches were conducted by two independent reviewers using several databases, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register, for articles published through July 2015, with no language restriction. Articles were included if they were clinical trials aimed at demonstrating the incidence of soft tissue complications following GBR procedures. Overall, 21 and 15 articles were included in the qualitative and quantitative synthesis, respectively. The weighted complication rate of the overall soft tissue complications, including membrane exposure, soft tissue dehiscence, and acute infection/abscess, into the calculation was 16.8% (95% CI = 10.6% to 25.4%). When considering the complication rate based on membrane type used, resorbable membrane was associated with a weighted complication rate of 18.3% (95% CI: 10.4% to 30.4%) and nonresorbable membrane with a rate of 17.6% (95% CI: 10.0% to 29.3%). Moreover, soft tissue lesions were reported as early as 1 week and as late as 6 months based on the included studies. Soft tissue complications after GBR are common (16.8%). Membrane type did not appear to significantly affect the complication rate, based on the limited number of data retrieved in this study. Technique sensitivity (ie, soft tissue management) may still be regarded as the main component to avoid soft tissue complications and, hence, to influence the success of bone regenerative therapy.

Soft-Tissue Sarcomas of the Abdomen and Pelvis: Radiologic-Pathologic Features, Part 1-Common Sarcomas: From the Radiologic Pathology Archives.

PubMed

Levy, Angela D; Manning, Maria A; Al-Refaie, Waddah B; Miettinen, Markku M

2017-01-01

Soft-tissue sarcomas are a diverse group of rare mesenchymal malignancies that can arise at any location in the body and affect all age groups. These sarcomas are most common in the extremities, trunk wall, retroperitoneum, and head and neck. In the adult population, soft-tissue sarcomas arising in the abdomen and pelvis are often large masses at the time of diagnosis because they are usually clinically silent or cause vague or mild symptoms until they invade or compress vital organs. In contrast, soft-tissue sarcomas arising from the abdominal wall come to clinical attention earlier in the course of disease because they cause a palpable mass, abdominal wall deformity, or pain that is more clinically apparent. The imaging features of abdominal and pelvic sarcomas and abdominal wall sarcomas can be nonspecific and overlap with more common pathologic conditions, making diagnosis difficult or, in some cases, delaying diagnosis. Liposarcoma (well-differentiated and dedifferentiated liposarcomas), leiomyosarcoma, and gastrointestinal stromal tumor (GIST) are the most common intra-abdominal primary sarcomas. Any soft-tissue sarcoma can arise in the abdominal wall. Knowledge of the classification and pathologic features of soft-tissue sarcomas, the anatomic locations where they occur, and their cross-sectional imaging features helps the radiologist establish the diagnosis or differential diagnosis so that patients with soft-tissue sarcomas can receive optimal treatment and management. In part 1 of this article, the most common soft-tissue sarcomas (liposarcoma, leiomyosarcoma, and GIST) are reviewed, with a discussion on anatomic locations, classification, clinical considerations, and differential diagnosis. Part 2 will focus on the remainder of the soft-tissue sarcomas occurring in the abdomen and pelvis.

Arthroscopic evaluation of soft tissue injuries in tibial plateau fractures: retrospective analysis of 98 cases.

PubMed

Abdel-Hamid, Mohamed Zaki; Chang, Chung-Hsun; Chan, Yi-Sheng; Lo, Yang-Pin; Huang, Jau-Wen; Hsu, Kuo-Yao; Wang, Ching-Jen

2006-06-01

This investigation arthroscopically assesses the frequency of soft tissue injury in tibial plateau fracture according to the severity of fracture patterns. We hypothesized that use of arthroscopy to evaluate soft tissue injury in tibial plateau fractures would reveal a greater number of associated injuries than have previously been reported. From March 1996 to December 2003, 98 patients with closed tibial plateau fractures were treated with arthroscopically assisted reduction and osteosynthesis, with precise diagnosis and management of associated soft tissue injuries. Arthroscopic findings for associated soft tissue injuries were recorded, and the relationship between fracture type and soft tissue injury was then analyzed. The frequency of associated soft tissue injury in this series was 71% (70 of 98). The menisci were injured in 57% of subjects (56 in 98), the anterior cruciate ligament (ACL) in 25% (24 of 98), the posterior cruciate ligament (PCL) in 5% (5 of 98), the lateral collateral ligament (LCL) in 3% (3 of 98), the medial collateral ligament (MCL) in 3% (3 of 98), and the peroneal nerve in 1% (1 of 98); none of the 98 patients exhibited injury to the arteries. No significant association was noted between fracture type and incidence of meniscus, PCL, LCL, MCL, artery, and nerve injury. However, significantly higher injury rates for the ACL were observed in type IV and VI fractures. Soft tissue injury was associated with all types of tibial plateau fracture. Menisci (peripheral tear) and ACL (bony avulsion) were the most commonly injured sites. A variety of soft tissue injuries are common with tibial plateau fracture; these can be diagnosed with the use of an arthroscope. Level III, diagnostic study.

Soft-Tissue Sarcomas of the Abdomen and Pelvis: Radiologic-Pathologic Features, Part 1—Common Sarcomas: From the Radiologic Pathology Archives

PubMed Central

Manning, Maria A.; Al-Refaie, Waddah B.; Miettinen, Markku M.

2017-01-01

Soft-tissue sarcomas are a diverse group of rare mesenchymal malignancies that can arise at any location in the body and affect all age groups. These sarcomas are most common in the extremities, trunk wall, retroperitoneum, and head and neck. In the adult population, soft-tissue sarcomas arising in the abdomen and pelvis are often large masses at the time of diagnosis because they are usually clinically silent or cause vague or mild symptoms until they invade or compress vital organs. In contrast, soft-tissue sarcomas arising from the abdominal wall come to clinical attention earlier in the course of disease because they cause a palpable mass, abdominal wall deformity, or pain that is more clinically apparent. The imaging features of abdominal and pelvic sarcomas and abdominal wall sarcomas can be nonspecific and overlap with more common pathologic conditions, making diagnosis difficult or, in some cases, delaying diagnosis. Liposarcoma (well-differentiated and dedifferentiated liposarcomas), leiomyosarcoma, and gastrointestinal stromal tumor (GIST) are the most common intra-abdominal primary sarcomas. Any soft-tissue sarcoma can arise in the abdominal wall. Knowledge of the classification and pathologic features of soft-tissue sarcomas, the anatomic locations where they occur, and their cross-sectional imaging features helps the radiologist establish the diagnosis or differential diagnosis so that patients with soft-tissue sarcomas can receive optimal treatment and management. In part 1 of this article, the most common soft-tissue sarcomas (liposarcoma, leiomyosarcoma, and GIST) are reviewed, with a discussion on anatomic locations, classification, clinical considerations, and differential diagnosis. Part 2 will focus on the remainder of the soft-tissue sarcomas occurring in the abdomen and pelvis. PMID:28287938

Localized thermo-cisplatin therapy: a pilot study in spontaneous canine and feline tumours.

PubMed

Théon, A P; Madewell, B R; Moore, A S; Stephens, C; Krag, D N

1991-01-01

Local hyperthermia combined with intralesional cisplatin chemotherapy is a logical and potentially effective therapeutic approach for localized cancers. A trial using outbred animals with spontaneously occurring tumours was initiated to evaluate the toxicity and efficacy of this approach. Treatment consisted of injection of a colloidal suspension of cisplatin into the tumour prior to hyperthermia once a week for 4 weeks. Immediately after intratumoral injection of a mixture of cisplatin and collagen, thermotherapy was given. The goal temperature was 42 +/- 1 degrees C for 30 min. Ten animals (nine dogs and one cat) with soft tissue neoplasms were treated with one to four hyperthermia and cisplatin sessions for a total of 30 treatment sessions. Complete responses occurred in 4/10 cases (one carcinoma, two sarcomas, one melanoma). One dog with haemangiopericytoma had partial response. The lack of systemic toxicity and the minimal local normal tissue reactions indicate that the treatments were well tolerated. These data provide preliminary evidence that a combination of local hyperthermia and intratumoral cisplatin chemotherapy is a safe and effective method for the treatment of selected localized neoplasms.

Palatal Perforation: A Rare Complication of Postanesthetic Necrosis

PubMed Central

Gargi, Vidisha; Mohan, Ravi Prakash Sasankoti; Kamarthi, Nagaraju; Gupta, Swati

2017-01-01

The everyday practice of dentistry relies heavily on achieving adequate local anesthesia. Even though the safety record of local anesthetic agents is high, complications do occur. Palate is a favorable site for soft-tissue lesions. Various factors such as direct effects of the drug, blanching of the tissues during injection, relatively poor blood supply, and reactivation of the latent forms of herpes can all promote to tissue ischemia and a lesion in the palate. Among various complications, anesthetic necrotic ulcer is a rare and uncommon condition occurring mostly in the hard palate possibly after a local anesthetic infiltration. The ulceration is often deep and shows spontaneous but delayed healing. If proper treatment is not instituted on time, the necrosis can reach deep into the bone causing sequestrum formation and ultimately leading to palatal perforation. Here, we report a case of palatal perforation in a male patient followed by surgical interventions and follow-up. PMID:29042744

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

PubMed Central

Lu, Min-Hua; Mao, Rui; Lu, Yin; Liu, Zheng; Wang, Tian-Fu; Chen, Si-Ping

2012-01-01

Indentation testing is a widely used approach to evaluate mechanical characteristics of soft tissues quantitatively. Young's modulus of soft tissue can be calculated from the force-deformation data with known tissue thickness and Poisson's ratio using Hayes' equation. Our group previously developed a noncontact indentation system using a water jet as a soft indenter as well as the coupling medium for the propagation of high-frequency ultrasound. The novel system has shown its ability to detect the early degeneration of articular cartilage. However, there is still lack of a quantitative method to extract the intrinsic mechanical properties of soft tissue from water jet indentation. The purpose of this study is to investigate the relationship between the loading-unloading curves and the mechanical properties of soft tissues to provide an imaging technique of tissue mechanical properties. A 3D finite element model of water jet indentation was developed with consideration of finite deformation effect. An improved Hayes' equation has been derived by introducing a new scaling factor which is dependent on Poisson's ratios v, aspect ratio a/h (the radius of the indenter/the thickness of the test tissue), and deformation ratio d/h. With this model, the Young's modulus of soft tissue can be quantitatively evaluated and imaged with the error no more than 2%. PMID:22927890

Nationwide Increase in Hospitalizations for Heroin-related Soft Tissue Infections: Associations with Structural Market Conditions

PubMed Central

Ciccarone, Dan; Unick, George Jay; Cohen, Jenny; Mars, Sarah G.; Rosenblum, Dan

2016-01-01

Introduction Little is known about trends in national rates of injection-related skin and soft tissue infections (SSTI) and their relationship to the structural risk environment for heroin users. Use of Mexican-sourced “Black Tar” heroin, predominant in western US states, may have greater risk for SSTI compared with eastern US powder heroin (Colombian-sourced) due to its association with non-intravenous injection or from possible contamination. Methods Using nationally representative hospital admissions data from the Nationwide Inpatient Sample and heroin price and purity data from the Drug Enforcement Administration, we looked at rates of hospital admissions for opiate-related SSTI (O-SSTI) between 1993 and 2010. Regression analyses examined associations between O-SSTI and heroin source, form and price. Results Hospitalization rates of O-SSTI doubled from 4 to 9 per 100,000 nationally between 1993 and 2010; the increase concentrated among individuals aged 20 to 40. Heroin market features were strongly associated with changes in the rate of SSTI. Each $100 increase in yearly heroin price-per–gram-pure was associated with a 3% decrease in the rate of heroin-related SSTI admissions. Mexican-sourced-heroin-dominant cities had twice the rate of O-SSTI compared to Colombian-sourced-heroin-dominant cities. Discussion Heroin-related SSTI are increasing and structural factors, including heroin price and source-form, are associated with higher rates of SSTI hospital admissions. Clinical and harm reduction efforts should educate heroin users on local risk factors, e.g., heroin type, promote vein health strategies and provide culturally sensitive treatment services for persons suffering with SSTI. PMID:27155756

Nationwide increase in hospitalizations for heroin-related soft tissue infections: Associations with structural market conditions.

PubMed

Ciccarone, Daniel; Unick, George Jay; Cohen, Jenny K; Mars, Sarah G; Rosenblum, Daniel

2016-06-01

Little is known about trends in national rates of injection-related skin and soft tissue infections (SSTI) and their relationship to the structural risk environment for heroin users. Use of Mexican-sourced "Black Tar" heroin, predominant in western US states, may have greater risk for SSTI compared with eastern US powder heroin (Colombian-sourced) due to its association with non-intravenous injection or from possible contamination. Using nationally representative hospital admissions data from the Nationwide Inpatient Sample and heroin price and purity data from the Drug Enforcement Administration, we looked at rates of hospital admissions for opiate-related SSTI (O-SSTI) between 1993 and 2010. Regression analyses examined associations between O-SSTI and heroin source, form and price. Hospitalization rates of O-SSTI doubled from 4 to 9 per 100,000 nationally between 1993 and 2010; the increase concentrated among individuals aged 20-40. Heroin market features were strongly associated with changes in the rate of SSTI. Each $100 increase in yearly heroin price-per-gram-pure was associated with a 3% decrease in the rate of heroin-related SSTI admissions. Mexican-sourced-heroin-dominant cities had twice the rate of O-SSTI compared to Colombian-sourced-heroin-dominant cities. Heroin-related SSTI are increasing and structural factors, including heroin price and source-form, are associated with higher rates of SSTI hospital admissions. Clinical and harm reduction efforts should educate heroin users on local risk factors, e.g., heroin type, promote vein health strategies and provide culturally sensitive treatment services for persons suffering with SSTI. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

PubMed

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

2015-01-01

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

Proteomic Analysis of Gingival Tissue and Alveolar Bone during Alveolar Bone Healing*

PubMed Central

Yang, Hee-Young; Kwon, Joseph; Kook, Min-Suk; Kang, Seong Soo; Kim, Se Eun; Sohn, Sungoh; Jung, Seunggon; Kwon, Sang-Oh; Kim, Hyung-Seok; Lee, Jae Hyuk; Lee, Tae-Hoon

2013-01-01

Bone tissue regeneration is orchestrated by the surrounding supporting tissues and involves the build-up of osteogenic cells, which orchestrate remodeling/healing through the expression of numerous mediators and signaling molecules. Periodontal regeneration models have proven useful for studying the interaction and communication between alveolar bone and supporting soft tissue. We applied a quantitative proteomic approach to analyze and compare proteins with altered expression in gingival soft tissue and alveolar bone following tooth extraction. For target identification and validation, hard and soft tissue were extracted from mini-pigs at the indicated times after tooth extraction. From triplicate experiments, 56 proteins in soft tissue and 27 proteins in alveolar bone were found to be differentially expressed before and after tooth extraction. The expression of 21 of those proteins was altered in both soft tissue and bone. Comparison of the activated networks in soft tissue and alveolar bone highlighted their distinct responsibilities in bone and tissue healing. Moreover, we found that there is crosstalk between identified proteins in soft tissue and alveolar bone with respect to cellular assembly, organization, and communication. Among these proteins, we examined in detail the expression patterns and associated networks of ATP5B and fibronectin 1. ATP5B is involved in nucleic acid metabolism, small molecule biochemistry, and neurological disease, and fibronectin 1 is involved in cellular assembly, organization, and maintenance. Collectively, our findings indicate that bone regeneration is accompanied by a profound interaction among networks regulating cellular resources, and they provide novel insight into the molecular mechanisms involved in the healing of periodontal tissue after tooth extraction. PMID:23824910

Correlates of risky injection practices among past-year injection drug users among the US general population.

PubMed

Ropelewski, Lauren R; Mancha, Brent E; Hulbert, Alicia; Rudolph, Abby E; Martins, Silvia S

2011-07-01

With an estimated 1 million active injection drug users (IDUs), injection drug use continues to be a public health concern in the United States. Risky injection practices have been associated with the transmission of HIV, Hepatitis B and C, as well as other skin and soft tissue infections. We used data from 463 respondents, aged 18 and older, who were past-year IDUs in the 2005-2008 National Survey of Drug Use and Health (NSDUH). We investigated correlates of risky injection behavior among these recent IDUs. Older age (≥ 35 versus 18-25) was associated with reusing one's own needle at last injection (aOR=1.80 [1.02-3.17], as were past year heroin (aOR=2.59 [1.18-5.66]) and cocaine injection (aOR=2.17 [1.13-4.15]). Past year crack cocaine use was positively associated with not cleaning needles with bleach (aOR=2.18 [1.10-4.33]). Past year cocaine injection was associated with obtaining needles in a risky manner (aOR=2.29 [1.23-4.25]). Methamphetamine injection was associated with obtaining needles in less risky ways (aOR=0.41 [0.20-0.84]). Our findings indicate that some IDUs are continuing to engage in high risk injection behaviors. The identification of potential at-risk populations of IDUs may have implications for harm reduction interventions and HIV prevention programs. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Soft tissue augmentation around osseointegrated and uncovered dental implants: a systematic review.

PubMed

Bassetti, Renzo G; Stähli, Alexandra; Bassetti, Mario A; Sculean, Anton

2017-01-01

The aim was to compile the current knowledge about the efficacy of different soft tissue correction methods around osseointegrated, already uncovered and/or loaded (OU/L) implants with insufficient soft tissue conditions. Procedures to increase peri-implant keratinized mucosa (KM) width and/or soft tissue volume were considered. Screening of two databases: MEDLINE (PubMed) and EMBASE (OVID), and manual search of articles were performed. Human studies reporting on soft tissue augmentation/correction methods around OU/L implants up to June 30, 2016, were considered. Quality assessment of selected full-text articles to weight risk of bias was performed using the Cochrane collaboration's tool. Overall, four randomized controlled trials (risk of bias = high/low) and five prospective studies (risk of bias = high) were included. Depending on the surgical techniques and graft materials, the enlargement of keratinized tissue (KT) ranged between 1.15 ± 0.81 and 2.57 ± 0.50 mm. The apically positioned partial thickness flap (APPTF), in combination with a free gingival graft (FGG), a subepithelial connective tissue graft (SCTG), or a xenogeneic graft material (XCM) were most effective. A coronally advanced flap (CAF) combined with SCTG in three, combined with allogenic graft materials (AMDA) in one, and a split thickness flap (STF) combined with SCTG in another study showed mean soft tissue recession coverage rates from 28 to 96.3 %. STF combined with XCM failed to improve peri-implant soft tissue coverage. The three APPTF-techniques combined with FGG, SCTG, or XCM achieved comparable enlargements of peri-implant KT. Further, both STF and CAF, both in combination with SCTG, are equivalent regarding recession coverage rates. STF + XCM and CAF + AMDA did not reach significant coverage. In case of soft tissue deficiency around OU/L dental implants, the selection of both an appropriate surgical technique and a suitable soft tissue graft material is of utmost clinical relevance.

ChainMail based neural dynamics modeling of soft tissue deformation for surgical simulation.

PubMed

Zhang, Jinao; Zhong, Yongmin; Smith, Julian; Gu, Chengfan

2017-07-20

Realistic and real-time modeling and simulation of soft tissue deformation is a fundamental research issue in the field of surgical simulation. In this paper, a novel cellular neural network approach is presented for modeling and simulation of soft tissue deformation by combining neural dynamics of cellular neural network with ChainMail mechanism. The proposed method formulates the problem of elastic deformation into cellular neural network activities to avoid the complex computation of elasticity. The local position adjustments of ChainMail are incorporated into the cellular neural network as the local connectivity of cells, through which the dynamic behaviors of soft tissue deformation are transformed into the neural dynamics of cellular neural network. Experiments demonstrate that the proposed neural network approach is capable of modeling the soft tissues' nonlinear deformation and typical mechanical behaviors. The proposed method not only improves ChainMail's linear deformation with the nonlinear characteristics of neural dynamics but also enables the cellular neural network to follow the principle of continuum mechanics to simulate soft tissue deformation.

The Adjunctive Soft-Tissue Diode Laser in Orthodontics.

PubMed

Borzabadi-Farahani, Ali

2017-04-01

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

Gas-producing cellulitis from injection of spot remover fluid (n-Hexane).

PubMed

Omori, Naoko; Mitsukawa, Nobuyuki; Kubota, Yoshitaka; Satoh, Kaneshige

2013-02-01

Subcutaneous administration of hydrocarbons, categorized according to their toxicological profiles, is rare compared to oral, inhalational, and cutaneous routes of exposure. Furthermore, injection of n-hexane in humans has not been described. This report demonstrates a singular case of subcutaneous administration of n-hexane. A 21-year-old man presented to the Emergency Department (ED) 7 h after injecting his left antecubital fossa with approximately 5 cc of spot remover fluid, which contained more than 95% n-hexane, in a suicide attempt. There was redness in the left forearm, but no apparent swelling was observed. He was administered tetanus prophylaxis and discharged with follow-up. However, the patient returned to the ED 14 h later, complaining of progression of the swelling around the injection site extending to the axilla. Significant volume of air in the soft tissue of the affected extremity was noted on both the radiograph and computed tomography scan; therefore, an immediate extensive incision and debridement of the diseased limb was performed. The postoperative course was uneventful, and a complete resolution of emphysema without any functional deficits was obtained for 5 months of follow-up. In patients suffering from n-hexane injection, initial physical examination findings may not be apparent. Thus, the patient must be monitored closely for evidence of a spread of subcutaneous gas with elevation and immobilization. If increase in tissue pressure or spread of gas is not prevented, as in our case, immediate incision and removal of the toxic substances should be planned. Copyright © 2013 Elsevier Inc. All rights reserved.

Comparison of fat maintenance in the face with centrifuge versus filtered and washed fat

PubMed Central

Asilian, Ali; Siadat, Amir Hossein; Iraji, Razieh

2014-01-01

Background: Autogenous fat injection of the face is a viable and lasting remedy for soft tissue loss and has become a mainstay in facial rejuvenation. Fat transfer as either a stand-alone technique or as an adjunct to other filler technique and lifting depending on patient needs. Although soft tissue augmentation with autologous fat transfer has been increasingly used by esthetic surgeon, but there is no agreement concerning the best way of processing the harvested fat before injection. This study compared the clinical results obtained using simple filtered and washed fat via metal sieve with those achieved by means of pure centrifuged fat. Materials and Methods: A prospective single-blind analysis on 32 healthy patients undergoing nasolabial fold fat transplantation from 2009 to 2011 (simple sampling). Patients assigned in two groups randomly. The face of half (16 subjects) was injected with centrifuged, another half with simple filtered and washed fat to evaluate the effect of preparation methods on fat graft viability. Objective method was used to evaluate the results, involving the evaluation of postoperative photographs (in month 1, 6 and 12) by an esthetic surgeon (according to the nasolabial scale). Subjective method was a self-assessment obtained from patients about general level of satisfaction and improvement of skin texture, statistical analysis were performed by means of the Wilcoxon and Mann–Whitney test. Acquired data were analyzed using SPSS version 15 and a value of P > 0.05 was considered as significant. Results: There was no significant difference in the survival of grafted fat between the Group 1 (fat-processing with centrifuge at 3400 rpm for 1-min) and Group 2 (washing the fat in the sieve). Conclusion: Our data suggest that the centrifuge of the fat does not enhance survival of grafted fat (P > 0.05). PMID:25197299

The role of radiology in paediatric soft tissue sarcomas

PubMed Central

van Rijn, R.; McHugh, K.

2008-01-01

Abstract Paediatric soft tissue sarcomas (STS) are a group of malignant tumours that originate from primitive mesenchymal tissue and account for 7% of all childhood tumours. Rhabdomyosarcomas (RMS) and undifferentiated sarcomas account for approximately 50% of soft tissue sarcomas in children and non-rhabdomyomatous soft tissue sarcomas (NRSTS) the remainder. The prognosis and biology of STS tumours vary greatly depending on the age of the patient, the primary site, tumour size, tumour invasiveness, histologic grade, depth of invasion, and extent of disease at diagnosis. Over recent years, there has been a marked improvement in survival rates in children and adolescents with soft tissue sarcoma and ongoing international studies continue to aim to improve these survival rates whilst attempting to reduce the morbidity associated with treatment. Radiology plays a crucial role in the initial diagnosis and staging of STS, in the long term follow-up and in the assessment of many treatment related complications. We review the epidemiology, histology, clinical presentation, staging and prognosis of soft tissue sarcomas and discuss the role of radiology in their management. PMID:18442956

[Myonecrosis in users of injecting drugs (a clinical case)].

PubMed

Shestakova, I V; Iushchuk, N D; Tishkevich, O L

2010-01-01

Myonecrosis remains one of the severest manifestations of skin and soft tissue infections. Clostridia (C. perfringens, C. novyi, C. septicum, C. sordellii, C. histolyticum) are dominant and Staphylococcus aureus, Streptococcus pyogenes, Bacillus cereus, and Bacteriodes fragilis are much less in the etiology of myonecrosis. Cases of gas gangrene have recently become more frequent among injection drug users all over the world. Russia has become the largest opiate market in Europe and consumption of these narcotic drugs is annually growing. In the Russian Federation, a larger number of injection drug users uniquely results in a rise of cases of Clostridium- and mixed flora-induced myonecrosis. Gas gangrene in HIV-positive drug abusers seems to rapidly progress to multiple organ failure and to show high death rates, rather than to develop a localized form. The analyzed case of mixed flora-induced gas gangrene is of interest to physicians of any specialties who can encounter this wound infection in HIV-positive patients.

Ethnic and Gender Considerations in the Use of Facial Injectables: Asian Patients.

PubMed

Liew, Steven

2015-11-01

Asians have distinct facial characteristics due to underlying skeletal and morphological features that differ greatly with those of whites. This together with the higher sun protection factor and the differences in the quality of the skin and soft tissue create a profound effect on their aging process. Understanding of these differences and their effects in the aging process in Asians is crucial in determining effective utilization and placement of injectable products to ensure optimal aesthetic outcomes. For younger Asian women, the main treatment goal is to address the inherent structural deficits through reshaping and the provision of facial support. Facial injectables are used to provide anterior projection, to reduce facial width, and to lengthen facial height. In the older group, the aim is for rejuvenation and also to address the underlying structural issues that has compounded due to age-related volume loss. Asian women requesting cosmetic procedures do not want to be Westernized but rather seeking to enhance and optimize their Asian ethnic features.

Catastrophic complication following injection and extracorporeal shock wave therapy of a medial femoral condyle subchondral cystic lesion in a 14 year old Arabian mare.

PubMed

Moser, Darla K; Schoonover, Mike J; Sippel, Kate M; Dieterly, Alix M; Ritchey, Jerry W; Wall, Corey R

2017-01-01

This report describes fibrous cyst lining injection and extracorporeal shock wave therapy (ESWT) of a medial femoral condyle (MFC) subchondral cystic lesion (SCL) resulting in catastrophic MFC fracture in an Arabian mare. The mare was presented for evaluation of a severe hind limb lameness of approximately 4 months duration. On presentation, a non-weight bearing lameness of the left hind limb with severe effusion and soft tissue swelling of the stifle region was noted. Radiographic evaluation of the stifle revealed a large SCL of the MFC with associated osteoarthritis. Arthroscopic guided intra-lesional injection of the SCL with corticosteroids and autologous bone marrow concentrate was performed followed by ESWT of the MFC. The mare was discharged walking comfortably 48-hours post-operatively. An acute increase in lameness was noted 14 days post-operatively. Imaging revealed catastrophic fracture of the left MFC. Possible mechanisms leading to failure of the MFC secondary to the described treatment are discussed.

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.

Clinical Presentation of Soft-tissue Infections and its Management: A Study of 100 Cases.

PubMed

Singh, Baldev; Singh, Sukha; Khichy, Sudhir; Ghatge, Avinash

2017-01-01

Soft-tissue infections vary widely in their nature and severity. A clear approach to the management must allow their rapid identification and treatment as they can be life-threatening. Clinical presentation of soft-tissue infections and its management. A prospective study based on 100 patients presenting with soft-tissue infections was done. All the cases of soft-tissue infections were considered irrespective of age, sex, etiological factors, or systemic disorders. The findings were evaluated regarding the pattern of soft-tissue infections in relation to age and sex, clinical presentation, complications, duration of hospital stay, management, and mortality. The most commonly involved age group was in the range of 41-60 years with male predominance. Abscess formation (45%) was the most common clinical presentation. Type 2 diabetes mellitus was the most common associated comorbid condition. Staphylococcus aureus was the most common culture isolate obtained. The most common complication seen was renal failure. Patients with surgical site infections had maximum duration of stay in the hospital. About 94% of the cases of soft-tissue infections were managed surgically. Mortality was mostly encountered in the cases of complications of cellulitis. Skin and soft-tissue infections are among the most common infections encountered by the emergency physicians. Ignorance, reluctance to treatment, economic constraints, and illiteracy delay the early detection and the initiation of proper treatment. Adequate and timely surgical intervention in most of the cases is of utmost importance to prevent the complications and reduce the mortality.

Risk factors for pedicled flap necrosis in hand soft tissue reconstruction: a multivariate logistic regression analysis.

PubMed

Gong, Xu; Cui, Jianli; Jiang, Ziping; Lu, Laijin; Li, Xiucun

2018-03-01

Few clinical retrospective studies have reported the risk factors of pedicled flap necrosis in hand soft tissue reconstruction. The aim of this study was to identify non-technical risk factors associated with pedicled flap perioperative necrosis in hand soft tissue reconstruction via a multivariate logistic regression analysis. For patients with hand soft tissue reconstruction, we carefully reviewed hospital records and identified 163 patients who met the inclusion criteria. The characteristics of these patients, flap transfer procedures and postoperative complications were recorded. Eleven predictors were identified. The correlations between pedicled flap necrosis and risk factors were analysed using a logistic regression model. Of 163 skin flaps, 125 flaps survived completely without any complications. The pedicled flap necrosis rate in hands was 11.04%, which included partial flap necrosis (7.36%) and total flap necrosis (3.68%). Soft tissue defects in fingers were noted in 68.10% of all cases. The logistic regression analysis indicated that the soft tissue defect site (P = 0.046, odds ratio (OR) = 0.079, confidence interval (CI) (0.006, 0.959)), flap size (P = 0.020, OR = 1.024, CI (1.004, 1.045)) and postoperative wound infection (P < 0.001, OR = 17.407, CI (3.821, 79.303)) were statistically significant risk factors for pedicled flap necrosis of the hand. Soft tissue defect site, flap size and postoperative wound infection were risk factors associated with pedicled flap necrosis in hand soft tissue defect reconstruction. © 2017 Royal Australasian College of Surgeons.

Adenovirus-mediated transfer of hepatocyte growth factor gene to human dental pulp stem cells under good manufacturing practice improves their potential for periodontal regeneration in swine.

PubMed

Cao, Yu; Liu, Zhenhai; Xie, Yilin; Hu, Jingchao; Wang, Hua; Fan, Zhipeng; Zhang, Chunmei; Wang, Jingsong; Wu, Chu-Tse; Wang, Songlin

2015-12-15

Periodontitis is one of the most widespread infectious diseases in humans. We previously promoted significant periodontal tissue regeneration in swine models with the transplantation of autologous periodontal ligament stem cells (PDLSCs) and PDLSC sheet. We also promoted periodontal tissue regeneration in a rat model with a local injection of allogeneic bone marrow mesenchymal stem cells. The purpose of the present study is to investigate the roles of the hepatocyte growth factor (HGF) and human dental pulp stem cells (DPSCs) in periodontal tissue regeneration in swine. In the present study, we transferred an adenovirus that carried HGF gene into human DPSCs (HGF-hDPSCs) under good manufacturing practice (GMP) conditions. These cells were then transplanted into a swine model for periodontal regeneration. Twenty miniature pigs were used to generate periodontitis with bone defect of 5 mm in width, 7 mm in length, and 3 mm in depth. After 12 weeks, clinical, radiological, quantitative and histological assessment of regenerated periodontal tissues was performed to compare periodontal regeneration in swine treated with cell implantation. Our study showed that injecting HGF-hDPSCs into this large animal model could significantly improve periodontal bone regeneration and soft tissue healing. A hDPSC or HGF-hDPSC sheet showed superior periodontal tissue regeneration compared to the injection of dissociated cells. However, the sheets required surgical placement; thus, they were suitable for surgically-managed periodontitis treatments. The adenovirus-mediated transfer of the HGF gene markedly decreased hDPSC apoptosis in a hypoxic environment or in serum-free medium, and it increased blood vessel regeneration. This study indicated that HGF-hDPSCs produced under GMP conditions significantly improved periodontal bone regeneration in swine; thus, this method represents a potential clinical application for periodontal regeneration.

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.

SU-C-213-01: 3D Printed Patient Specific Phantom Composed of Bone and Soft Tissue Substitute Plastics for Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ehler, E; Sterling, D; Higgins, P

Purpose: 3D printed phantoms constructed of multiple tissue approximating materials could be useful in both clinical and research aspects of radiotherapy. This work describes a 3D printed phantom constructed with tissue substitute plastics for both bone and soft tissue; air cavities were included as well. Methods: 3D models of an anonymized nasopharynx patient were generated for air cavities, soft tissues, and bone, which were segmented by Hounsfield Unit (HU) thresholds. HU thresholds were chosen to define air-to-soft tissue boundaries of 0.65 g/cc and soft tissue-to-bone boundaries of 1.18 g/cc based on clinical HU to density tables. After evaluation of severalmore » composite plastics, a bone tissue substitute was identified as an acceptable material for typical radiotherapy x-ray energies, composed of iron and PLA plastic. PET plastic was determined to be an acceptable soft tissue substitute. 3D printing was performed on a consumer grade dual extrusion fused deposition model 3D printer. Results: MVCT scans of the 3D printed heterogeneous phantom were acquired. Rigid image registration of the patient and the 3D printed phantom scans was performed. The average physical density of the soft tissue and bone regions was 1.02 ± 0.08 g/cc and 1.39 ± 0.14 g/cc, respectively, for the patient kVCT scan. In the 3D printed phantom MVCT scan, the average density of the soft tissue and bone was 1.01 ± 0.09 g/cc and 1.44 ± 0.12 g/cc, respectively. Conclusion: A patient specific phantom, constructed of heterogeneous tissue substitute materials was constructed by 3D printing. MVCT of the 3D printed phantom showed realistic tissue densities were recreated by the 3D printing materials. Funding provided by intra-department grant by University of Minnesota Department of Radiation Oncology.« less

Changes of the peri-implant soft tissue thickness after grafting with a collagen matrix

PubMed Central

Zafiropoulos, Gregory-George; Deli, Giorgio; Hoffmann, Oliver; John, Gordon

2016-01-01

Background: The aim of this study was to determine the treatment outcome of the use of a porcine monolayer collagen matrix (mCM) to increase soft-tissue volume as a part of implant site development. Materials and Methods: Implants were placed in single sites in 27 patients. In the test group, mCM was used for soft-tissue augmentation. No graft was placed in the control group. Soft-tissue thickness (STTh) was measured at the time of surgery (T0) and 6 months postoperatively (T1) at two sites (STTh 1, 1 mm below the gingival margin; STTh 2, 3 mm below the mucogingival margin). Results: Significant increases (P < 0.001) in STTh (STTh 1 = 1.06 mm, 117%; STTh 2 = 0.89 mm, 81%) were observed in the test group. Biopsy results showed angiogenesis and mature connective tissue covered by keratinized epithelium. Conclusions: Within the limitations of this study, it could be concluded that mCM leads to a significant increase of peri-implant soft-tissue thickness, with good histological integration and replacement by soft tissue and may serve as an alternative to connective tissue grafting. PMID:28298828

Therapeutic Angiotensin-(1-7) in Treating Patients With Metastatic Sarcoma That Cannot Be Removed By Surgery

ClinicalTrials.gov

2018-02-27

Bone Cancer; Chondrosarcoma; Clear Cell Sarcoma of the Kidney; Metastatic Osteosarcoma; Ovarian Sarcoma; Recurrent Adult Soft Tissue Sarcoma; Recurrent Osteosarcoma; Recurrent Uterine Sarcoma; Stage III Adult Soft Tissue Sarcoma; Stage III Uterine Sarcoma; Stage IV Adult Soft Tissue Sarcoma; Stage IV Uterine Sarcoma

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

ClinicalTrials.gov

2018-05-09

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

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.

Soft tissue coverage of the elbow in a developing country.

PubMed

Pirela-Cruz, Miguel A; Reddy, Kartheek K; Higgs, Matthew

2007-09-01

Two cases that required soft tissue coverage to the anterior aspect of the elbow are presented. A fasciocutaneous intercostal perforator chest wall flap was used for one patient when only skin and fascia coverage was required. A latissimus dorsi myocutaneous flap was used to provide soft tissue coverage and supply motor power for elbow flexion after contracture release in the other. The surgical techniques for each of these flaps are discussed in the context of addressing soft tissue traumatic injuries about the elbow in a developing country with limited resources.

Relevance of infiltration analgesia in pain relief after total knee arthroplasty

PubMed Central

Znojek-Tymborowska, Justyna; Kęska, Rafał; Paradowski, Przemysław T.; Witoński, Dariusz

2013-01-01

OBJECTIVE: The aim of the study was to assess the effect of different types of anesthesia on pain intensity in early postoperative period. PATIENTS AND METHODS: A total of 87 patients (77 women, 10 men) scheduled for total knee arthroplasty (TKA) were assigned to receive either subarachnoid anesthesia alone or in combination with local soft tissue anesthesia, local soft tissue anesthesia and femoral nerve block and pre-emptive infiltration together with local soft tissue anesthesia. We assessed the pain intensity, opioid consumption, knee joint mobility, and complications of surgery. RESULTS: Subjects with pre-emptive infiltration and local soft tissue anesthesia had lower pain intensity on the first postoperative day compared to those with soft tissue anesthesia and femoral nerve block (P=0.012, effect size 0.68). Subjects who received pre-emptive infiltration and local soft-tissue anesthesia had the greatest range of motion in the operated knee at discharge (mean 90 grades [SD 7], P=0.01 compared to those who received subarachnoid anesthesia alone, and P=0.001 compared to those with subarachnoid together with soft tissue anesthesia). CONCLUSION: Despite the differences in postoperative pain and knee mobility, the results obtained throughout the postoperative period do not enable us to favour neither local nor regional infiltration anesthesia in TKA. Level of Evidence II, Prospective Comparative Study. PMID:24453679

A large parosteal ossifying lipoma of lower limb encircling the femur

PubMed Central

2014-01-01

Introduction Lipoma is a benign soft tissue neoplasm that may contain mesenchymal elements, as a result of metaplastic process. Ossification in benign and malignant soft tissue tumors can also manifest due to metaplastic process. Case presentation A 45 year old woman presented with a large thigh mass. The mass was developed one and a half year ago which insidiously increased in size and was associated with movement restriction. Radiological findings revealed soft tissue neoplasm on antero-medial aspect of thigh encircling the femur and displacing adjacent muscles. Fine trabeculations were seen in neoplasm suggestive of ossification. Excision of the mass was performed and histopathology revealed adipocytes with mature bony trabeculae possessing prominent osteoblastic rimming suggestive of ossifying lipoma. Conclusion It is important to recognize this variant of lipoma as it is associated with a better clinical outcome in contrast to most of the deep seated soft tissue neoplasms. Secondly it should also be differentiated from myositis ossificans and heterologous differentiation in other soft tissue neoplasms. We suggest an algorithmic approach to the diagnosis of ossifying soft tissue neoplasms histopathologically. Mature bony trabeculae with prominent osteoblastic rimming in a soft tissue lesion are due to a metaplastic process and should not be confused with osteosarcoma. PMID:24433545

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. Copyright © 2014 Elsevier Ltd. All rights reserved.

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.

Clinical Results of Platelet-Rich Plasma for Partial Thickness Rotator Cuff Tears: A Case Series.

PubMed

Zafarani, Zohreh; Mirzaee, Fateme; Guity, Mohamadreza; Aslani, Hamidreza

2017-09-01

Partial thickness rotator cuff tears (PTRCTs) are a common pathology among shoulder disorders in people over 50 years. Treatment of PTRCTs remains controversial. Most studies on the treatment of PTRCTs have explained surgical techniques or outcomes; few studies have centralized on the conservative and new management of PTRCTs, like treatment with Platelet-rich plasma (PRP). These case series study have been conducted on Platelet-rich plasma (PRP) injection, as a concentrated source of cytokines that can stimulate healing of soft tissue. PRP injection showed positive effect on improving PTRCTs complains. This method improved pain, function, DASH score and shoulder joint range motion in. Because of PRP products are safe and easy to prepare and apply, and also according to improving patient's condition, this method can be used to treat PTRCTs.

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. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Comparison of success rate and onset time of two different anesthesia techniques

PubMed Central

Haghighat, Abbas; Hasheminia, Dariush; Samandari, Mohammad-Hasan; Safarian, Vajihe; Davoudi, Amin

2015-01-01

Background Using local anesthetic is common to control the pain through blocking the nerve reversibly in dental procedures. Gow-Gates (GG) technique has a high success rate but less common. This study aimed to compare the onset time and success rate in GG and standard technique of inferior alveolar nerve block (IANB). Material and Methods This descriptive, single blind study was consisted of 136 patients (59 males and 77 females) who were randomly received GG or IANB for extraction of mandibular molar teeth. Comparisons between the successes of two anesthetic injection techniques were analyzed with Chi-square test. Incidence of pulpal anesthesia and soft tissue anesthesia were analyzed with Kaplan-Meier method. Mean onset times of pulpal anesthesia, soft tissue and lip numbness were analyzed with Log-Rank test. Comparisons were considered significant at P≤0.05 by using SPSS software ver.15. Results The incidence of pulpal anesthesia in the IANB group (canine 49.3%, premolar 60.3%) were not significantly different from the GG group (canine 41.3%, premolar 74.6%) (P=0.200 and P=0.723). The success rate in the IANB group (80.82%) was not significantly different from the GG group (92.02%) (P=0.123). Furthermore, onset time of lip and buccal soft tissue numbness in GG group (3.25, 4.96 minutes) was quite similar to IANB group (3.22, 4.89 minutes) (all Pvalues >0.05). Conclusions Although this study demonstrated higher clinical success rate for GG than IANB technique, no significant differences in success rates and onset time were observed between two techniques. Key words: Anesthesia, Inferior alveolar nerve, nerve block, success rate. PMID:25858085

TNF-α and Tumor Lysate Promote the Maturation of Dendritic Cells for Immunotherapy for Advanced Malignant Bone and Soft Tissue Tumors

PubMed Central

Miwa, Shinji; Nishida, Hideji; Tanzawa, Yoshikazu; Takata, Munetomo; Takeuchi, Akihiko; Yamamoto, Norio; Shirai, Toshiharu; Hayashi, Katsuhiro; Kimura, Hiroaki; Igarashi, Kentaro; Mizukoshi, Eishiro; Nakamoto, Yasunari; Kaneko, Shuichi; Tsuchiya, Hiroyuki

2012-01-01

Background Dendritic cells (DCs) play a pivotal role in the immune system. There are many reports concerning DC-based immunotherapy. The differentiation and maturation of DCs is a critical part of DC-based immunotherapy. We investigated the differentiation and maturation of DCs in response to various stimuli. Methods Thirty-one patients with malignant bone and soft tissue tumors were enrolled in this study. All the patients had metastatic tumors and/or recurrent tumors. Peripheral blood mononuclear cells (PBMCs) were suspended in media containing interleukin-4 (IL-4) and granulocyte-macrophage colony stimulating factor (GM-CSF). These cells were then treated with or without 1) tumor lysate (TL), 2) TL + TNF-α, 3) OK-432. The generated DCs were mixed and injected in the inguinal or axillary region. Treatment courses were performed every week and repeated 6 times. A portion of the cells were analyzed by flow cytometry to determine the degree of differentiation and maturation of the DCs. Serum IFN-γ and serum IL-12 were measured in order to determine the immune response following the DC-based immunotherapy. Results Approximately 50% of PBMCs differentiated into DCs. Maturation of the lysate-pulsed DCs was slightly increased. Maturation of the TL/TNF-α-pulsed DCs was increased, commensurate with OK-432-pulsed DCs. Serum IFN-γ and serum IL-12 showed significant elevation at one and three months after DC-based immunotherapy. Conclusions Although TL-pulsed DCs exhibit tumor specific immunity, TL-pulsed cells showed low levels of maturation. Conversely, the TL/TNF-α-pulsed DCs showed remarkable maturation. The combination of IL-4/GM-CSF/TL/TNF-α resulted in the greatest differentiation and maturation for DC-based immunotherapy for patients with bone and soft tissue tumors. PMID:23300824

Alginate microencapsulation technology for the percutaneous delivery of adipose-derived stem cells.

PubMed

Moyer, Hunter R; Kinney, Ramsey C; Singh, Kimberly A; Williams, Joseph K; Schwartz, Zvi; Boyan, Barbara D

2010-11-01

Autologous fat is the ideal soft-tissue filler; however, its widespread application is limited because of variable clinical results and poor survival. Engineered fillers have the potential to maximize survival. Alginate is a hydrogel copolymer that can be engineered into spheres of <200 μm, thus facilitating mass transfer, allowing for subcutaneous injection, and protecting cells from shearing forces. Alginate powder was dissolved in saline, and adipose-derived stem cells (ADSCs) were encapsulated (1 million cells/mL) in alginate using an electrostatic bead generator. To assess effects of injection on cell viability, microspheres containing ADSCs were separated into 2 groups: the control group was decanted into culture wells and the injection group was mixed with basal media and injected through a 21-gauge needle into culture wells. Microbeads were cultured for 3 weeks, and cell number and viability were measured weekly using electron and confocal microscopy. To assess effects of percutaneous injection in vivo, twenty-four male nude mice were randomly separated into 2 groups and injected with either empty microcapsules or ADSC-laden microcapsules. Mice were harvested at 1 and 3 months, and the implants were examined microscopically to assess bead and cell viability. A flow rate of 5 mL/h and an electrostatic potential of 7 kV produced viable ADSC-laden microbeads of <200 μm. There were no differences in bead morphology and ADSC viability between microcapsules placed versus injected into tissue culture plates for up to 3 weeks. Microspheres implanted in a nude mouse model show durability up to 3 months with a host response around each individual sphere. ADSCs remained viable and showed signs of mitosis. ADSCs can be readily cultured, encapsulated, and injected in alginate microspheres. Stem cells suspended in alginate microspheres survive in vivo and are seen to replicate in vitro.

Bone scintigraphy in the investigation of occult lameness in the dog.

PubMed

Schwarz, T; Johnson, V S; Voute, L; Sullivan, M

2004-05-01

99mTechnetium methylene diphosphonate (99mTc-MDP) scintigraphy was performed in 14 dogs of different breeds after clinical lameness examination, radiography and synovial fluid analysis failed to localise lameness to a specific area of pain. The scintigraphic protocol included an intravenous injection of 17 MBq 99mTc-MDP/kg bodyweight and vascular, soft tissue and bone phase scans in standardised positions with a low-energy all-purpose collimator. Confirmation of diagnosis was achieved in nine dogs by arthroscopy, repeated lesion-orientated radiography, computed tomography and response to treatment. In seven cases, bone phase scans showed single elbow uptakes, in two cases unilateral limb uptake, and in one case each a single shoulder and tibia uptake; in three cases there was no increased uptake. Vascular and soft tissue phase images did not reveal additional information. Diagnosis of humeral condyle fissures, a fragmented medial coronoid process, panosteitis and arthropathy was possible in nine cases. Skeletal pathology was ruled out in three normal scintigrams. In two dogs with unilateral uptake of multiple joints, no diagnostic benefit was gained from scintigraphy. The highly sensitive and relatively specific uptake allowed localisation and characterisation or exclusion of skeletal lesions in most dogs.

Use of laser in orthodontics: applications and perspectives

PubMed Central

Fornaini, C; Merigo, E; Vescovi, P; Lagori, G; Rocca, JP

2013-01-01

Laser technology got in these years a more and more important role in modern dentistry and, recently, also in orthodontics was proposed the utilization of laser devices. The aim of this work is to describe the utilization of this technology both in soft and hard oral tissues to improve orthodontic treatment. Several cases, with different wavelengths (532, 810, 980, 1064, 2940 and 10600 nm) and in different times of the treatment (before, during and after) are presented. All the cases reported showed, according to the literature, that the use of the laser related to orthodontic treatment offers several advantages when compared with conventional methods. In the soft tissues surgery it allows to reduce or eliminate the use of anesthetic injection, to avoid use of sutures and to bond bracket in dry enamel; associated with orthophosphoric acid, it gives a stronger adhesion of the brackets to the enamel and, in the case of porcelain brackets, it detaches them without damages; at low power (LLLT) it permits to control the pain of the first period after bonding and, by increasing the speed of teeth movement in the bone, reduces the time of the treatment. PMID:24155556

Advanced Hemophilic Arthropathy: Sensitivity of Soft Tissue Discrimination With Musculoskeletal Ultrasound.

PubMed

von Drygalski, Annette; Moore, Randy E; Nguyen, Sonha; Barnes, Richard F W; Volland, Lena M; Hughes, Tudor H; Du, Jiang; Chang, Eric Y

2018-01-24

Point-of-care musculoskeletal ultrasound (US) is increasingly used by hemophilia providers to guide management; however, pathologic tissue differentiation with US is uncertain. We sought to determine the extent to which point-of-care musculoskeletal US can identify and discriminate pathologic soft tissue changes in hemophilic arthropathy. Thirty-six adult patients with hemophilia A/B were prospectively enrolled. Point-of-care musculoskeletal US examinations were performed on arthropathic joints (16 knees, 10 ankles, and 10 elbows) using standard views by a musculoskeletal US-trained and certified hematologist, who recorded abnormal intra-articular soft tissue accumulation. Within 3 days, magnetic resonance imaging was performed using conventional and multiecho ultrashort echo time sequences. Soft tissue identification (synovial proliferation with or without hemosiderin, fat, and/or blood products) was performed by a musculoskeletal radiologist. Findings obtained with both imaging modalities were compared and correlated in a blinded fashion. There was perfect agreement between the modalities on the presence of abnormal soft tissue (34 of 36 cases). However, musculoskeletal US was unable to discriminate between coagulated blood, synovium, intrasynovial or extrasynovial fat tissue, or hemosiderin deposits because of wide variations in echogenicity. Musculoskeletal US is valuable for point-of-care imaging to determine the presence of soft tissue accumulation in discrete areas. However, because of limitations of musculoskeletal US in discriminating the nature of pathologic soft tissues and detecting hemosiderin, magnetic resonance imaging will be required if such discrimination is clinically important. © 2018 by the American Institute of Ultrasound in Medicine.

Soft tissue grafting to improve implant esthetics

PubMed Central

Kassab, Moawia M

2010-01-01

Dental implants are becoming the treatment of choice to replace missing teeth, especially if the adjacent teeth are free of restorations. When minimal bone width is present, implant placement becomes a challenge and often resulting in recession and dehiscence around the implant that leads to subsequent gingival recession. To correct such defect, the author turned to soft tissue autografting and allografting to correct a buccal dehiscence around tooth #24 after a malpositioned implant placed by a different surgeon. A 25-year-old woman presented with the chief complaint of gingival recession and exposure of implant threads around tooth #24. The patient received three soft tissue grafting procedures to augment the gingival tissue. The first surgery included a connective tissue graft to increase the width of the keratinized gingival tissue. The second surgery included the use of autografting (connective tissue graft) to coronally position the soft tissue and achieve implant coverage. The third and final surgery included the use of allografting material Alloderm to increase and mask the implant from showing through the gingiva. Healing period was uneventful for the patient. After three surgical procedures, it appears that soft tissue grafting has increased the width and height of the gingiva surrounding the implant. The accomplished thickness of gingival tissue appeared to mask the showing of implant threads through the gingival tissue and allowed for achieving the desired esthetic that the patient desired. The aim of the study is to present a clinical case with soft tissue grafting procedures. PMID:23662087

Optimization and real-time control for laser treatment of heterogeneous soft tissues.

PubMed

Feng, Yusheng; Fuentes, David; Hawkins, Andrea; Bass, Jon M; Rylander, Marissa Nichole

2009-01-01

Predicting the outcome of thermotherapies in cancer treatment requires an accurate characterization of the bioheat transfer processes in soft tissues. Due to the biological and structural complexity of tumor (soft tissue) composition and vasculature, it is often very difficult to obtain reliable tissue properties that is one of the key factors for the accurate treatment outcome prediction. Efficient algorithms employing in vivo thermal measurements to determine heterogeneous thermal tissues properties in conjunction with a detailed sensitivity analysis can produce essential information for model development and optimal control. The goals of this paper are to present a general formulation of the bioheat transfer equation for heterogeneous soft tissues, review models and algorithms developed for cell damage, heat shock proteins, and soft tissues with nanoparticle inclusion, and demonstrate an overall computational strategy for developing a laser treatment framework with the ability to perform real-time robust calibrations and optimal control. This computational strategy can be applied to other thermotherapies using the heat source such as radio frequency or high intensity focused ultrasound.

Improving Bone Formation in a Rat Femur Segmental Defect by Controlling Bone Morphogenetic Protein-2 Release

DTIC Science & Technology

2011-04-01

tissue and polymer: mineralized tissue stained dark green, osteoid and collagen bright red, soft tissue pink to light green, and erythrocytes bright...of bone, soft tissue , and polymer, high-resolution digital images were acquired at 1.25 · or 20 · . The area of interest comprising the bone defect...bone, soft tissue , and polymer (when present) within the defect were quantified using Metamorph software (Molecular Devices, Inc.) and were calculated

Biomimetic stratified scaffold design for ligament-to-bone interface tissue engineering.

PubMed

Lu, Helen H; Spalazzi, Jeffrey P

2009-07-01

The emphasis in the field of orthopaedic tissue engineering is on imparting biomimetic functionality to tissue engineered bone or soft tissue grafts and enabling their translation to the clinic. A significant challenge in achieving extended graft functionality is engineering the biological fixation of these grafts with each other as well as with the host environment. Biological fixation will require re-establishment of the structure-function relationship inherent at the native soft tissue-to-bone interface on these tissue engineered grafts. To this end, strategic biomimicry must be incorporated into advanced scaffold design. To facilitate integration between distinct tissue types (e.g., bone with soft tissues such as cartilage, ligament, or tendon), a stratified or multi-phasic scaffold with distinct yet continuous tissue regions is required to pre-engineer the interface between bone and soft tissues. Using the ACL-to-bone interface as a model system, this review outlines the strategies for stratified scaffold design for interface tissue engineering, focusing on identifying the relevant design parameters derived from an understanding of the structure-function relationship inherent at the soft-to-hard tissue interface. The design approach centers on first addressing the challenge of soft tissue-to-bone integration ex vivo, and then subsequently focusing on the relatively less difficult task of bone-to-bone integration in vivo. In addition, we will review stratified scaffold design aimed at exercising spatial control over heterotypic cellular interactions, which are critical for facilitating the formation and maintenance of distinct yet continuous multi-tissue regions. Finally, potential challenges and future directions in this emerging area of advanced scaffold design will be discussed.

Influence of Abutment Color and Mucosal Thickness on Soft Tissue Color.

PubMed

Ferrari, Marco; Carrabba, Michele; Vichi, Alessandro; Goracci, Cecilia; Cagidiaco, Maria Crysanti

Zirconia (ZrO₂) and titanium nitride (TiN) implant abutments were introduced mainly for esthetic purposes, as titanium's gray color can be visible through mucosal tissues. This study was aimed at assessing whether ZrO₂ and TiN abutments could achieve better esthetics in comparison with titanium (Ti) abutments, regarding the appearance of soft tissues. Ninety patients were included in the study. Each patient was provided with an implant (OsseoSpeed, Dentsply Implant System). A two-stage surgical technique was performed. Six months later, surgical reentry was performed. After 1 week, provisional restorations were screwed onto the implants. After 8 weeks, implant-level impressions were taken and soft tissue thickness was recorded, ranking thin (≤ 2 mm) or thick (≥ 2 mm). Patients were randomly allocated to three experimental groups, based on abutment type: (1) Ti, (2) TiN, and (3) ZrO₂. After 15 weeks, the final restorations were delivered. The mucosal area referring to each abutment was measured for color using a clinical spectrophotometer (Easyshade, VITA); color measurements of the contralateral areas referring to natural teeth were performed at the same time. The data were collected using the Commission Internationale de l'Eclairage (CIE) L*a*b* color system, and ΔE was calculated between peri-implant and contralateral soft tissues. A critical threshold of ΔE = 3.7 was selected. The chi-square test was used to identify statistically significant differences in ΔE between thin and thick mucosal tissues and among the abutment types. Three patients were lost at follow-up. No statistically significant differences were noticed as to the abutment type (P = .966). Statistically significant differences in ΔE were recorded between thick and thin peri-implant soft tissues (P < .001). Only 2 out of 64 patients with thick soft tissues showed a ΔE higher than 3.7: 1 in the TiN group and 1 in the ZrO₂ group. All the patients with thin soft tissues reported color changes that exceeded the critical threshold. The different abutment materials showed comparable results in terms of influence on soft tissue color. Regarding peri-implant soft tissue thickness, the influence of the tested abutments on soft tissue color became clinically relevant for values ≤ 2 mm.

Limb salvage after gas gangrene: a case report and review of the literature.

PubMed

Aggelidakis, John; Lasithiotakis, Konstantinos; Topalidou, Anastasia; Koutroumpas, John; Kouvidis, Georgios; Katonis, Paulos

2011-08-17

Gas gangrene is a necrotic infection of soft tissue associated with high mortality, often necessitating amputation in order to control the infection. Herein we present a case of gas gangrene of the arm in an intravenous drug user with a history of intramuscular injections with normal saline in the shoulder used to provoke pain for recovery after drug induced coma. The patient was early treated with surgery and antibiotics rendering possible the preservation of the limb and some of its function. Additionally, a review of the literature regarding case reports of limb salvage after gas gangrene is presented.

Myofascial low back pain treatment.

PubMed

Sharan, Deepak; Rajkumar, Joshua Samuel; Mohandoss, Mathankumar; Ranganathan, Rameshkumar

2014-09-01

Myofascial pain is a common musculoskeletal problem, with the low back being one of the commonest affected regions. Several treatments have been used for myofascial low back pain through physical therapies, pharmacologic agents, injections, and other such therapies. This review will provide an update based on recently published literature in the field of myofascial low back pain along with a brief description of a sequenced, multidisciplinary treatment protocol called Skilled Hands-on Approach for the Release of myofascia, Articular, Neural and Soft tissue mobilization (SHARANS) protocol. A comprehensive multidisciplinary approach is recommended for the successful management of individuals with myofascial low back pain.

Expanding harm reduction services through a wound and abscess clinic.

PubMed

Grau, Lauretta E; Arevalo, Silvia; Catchpool, Christopher; Heimer, Robert

2002-12-01

A wound and abscess clinic, held concurrently with a syringe exchange, provided economical treatment and aftercare for injection-associated soft tissue infections. During 20 two-hour clinic sessions, 173 treatment episodes were logged, and the visit cost was estimated at $5 per patient. Increased patient-clinician interactions provided opportunities beyond those afforded by the syringe exchange for patients to obtain resources and referrals to services such as HIV counseling and testing, medical care, and drug treatment. Distribution of cards advertising the clinic was substantially less effective than word of mouth in increasing community awareness of the clinic.

Influence of Microbial Biofilms on the Preservation of Primary Soft Tissue in Fossil and Extant Archosaurs

PubMed Central

Peterson, Joseph E.; Lenczewski, Melissa E.; Scherer, Reed P.

2010-01-01

Background Mineralized and permineralized bone is the most common form of fossilization in the vertebrate record. Preservation of gross soft tissues is extremely rare, but recent studies have suggested that primary soft tissues and biomolecules are more commonly preserved within preserved bones than had been presumed. Some of these claims have been challenged, with presentation of evidence suggesting that some of the structures are microbial artifacts, not primary soft tissues. The identification of biomolecules in fossil vertebrate extracts from a specimen of Brachylophosaurus canadensis has shown the interpretation of preserved organic remains as microbial biofilm to be highly unlikely. These discussions also propose a variety of potential mechanisms that would permit the preservation of soft-tissues in vertebrate fossils over geologic time. Methodology/Principal Findings This study experimentally examines the role of microbial biofilms in soft-tissue preservation in vertebrate fossils by quantitatively establishing the growth and morphology of biofilms on extant archosaur bone. These results are microscopically and morphologically compared with soft-tissue extracts from vertebrate fossils from the Hell Creek Formation of southeastern Montana (Latest Maastrichtian) in order to investigate the potential role of microbial biofilms on the preservation of fossil bone and bound organic matter in a variety of taphonomic settings. Based on these analyses, we highlight a mechanism whereby this bound organic matter may be preserved. Conclusions/Significance Results of the study indicate that the crystallization of microbial biofilms on decomposing organic matter within vertebrate bone in early taphonomic stages may contribute to the preservation of primary soft tissues deeper in the bone structure. PMID:20967227

Influence of microbial biofilms on the preservation of primary soft tissue in fossil and extant archosaurs.

PubMed

Peterson, Joseph E; Lenczewski, Melissa E; Scherer, Reed P

2010-10-12

Mineralized and permineralized bone is the most common form of fossilization in the vertebrate record. Preservation of gross soft tissues is extremely rare, but recent studies have suggested that primary soft tissues and biomolecules are more commonly preserved within preserved bones than had been presumed. Some of these claims have been challenged, with presentation of evidence suggesting that some of the structures are microbial artifacts, not primary soft tissues. The identification of biomolecules in fossil vertebrate extracts from a specimen of Brachylophosaurus canadensis has shown the interpretation of preserved organic remains as microbial biofilm to be highly unlikely. These discussions also propose a variety of potential mechanisms that would permit the preservation of soft-tissues in vertebrate fossils over geologic time. This study experimentally examines the role of microbial biofilms in soft-tissue preservation in vertebrate fossils by quantitatively establishing the growth and morphology of biofilms on extant archosaur bone. These results are microscopically and morphologically compared with soft-tissue extracts from vertebrate fossils from the Hell Creek Formation of southeastern Montana (Latest Maastrichtian) in order to investigate the potential role of microbial biofilms on the preservation of fossil bone and bound organic matter in a variety of taphonomic settings. Based on these analyses, we highlight a mechanism whereby this bound organic matter may be preserved. Results of the study indicate that the crystallization of microbial biofilms on decomposing organic matter within vertebrate bone in early taphonomic stages may contribute to the preservation of primary soft tissues deeper in the bone structure.

Hindfoot containment orthosis for management of bone and soft-tissue defects of the heel.

PubMed

Johnson, Jeffrey E; Rudzki, Jonas R; Janisse, Erick; Janisse, Dennis J; Valdez, Ray R; Hanel, Douglas P; Gould, John S

2005-03-01

Bone, soft-tissue, and nerve deficits of the weightbearing surface of the foot are frequent sequelae from foot trauma or diabetes mellitus and present challenging treatment issues. Injury to the specialized, shock-absorbing, heel-pad tissue containing spirally arranged fat chambers is particularly difficult to manage. Appropriate footwear modifications and shoe inserts for protection of this skin are essential to the long-term management of bone and soft-tissue defects of the heel. This study evaluated the performance of a new custom total contact foot orthosis (Hindfoot Containment Orthosis, HCO) which was designed to contain the soft tissues of the heel, reduce shear forces, redistribute weightbearing load, and accommodate bone or soft-tissue deformity of the heel. Twenty-two patients treated with HCO were retrospectively reviewed. Followup averaged 26 months. The effectiveness of the orthosis was assessed by how well the integrity of the soft tissue was maintained (e.g. the number of ulcerations since dispensing the orthosis), the number of refabrications of the orthosis that were required, and whether or not revision surgery was required. Ten patients had superficial ulcerations. No patient required revision surgery. A total of 62 refabrications of the orthoses in 22 patients were required over a 2-year period. Overall results were good in 17 (77%) patients, fair in four (18%), and poor in one. The HCO is effective for preservation of soft-tissue integrity of the heel pad after bony or soft-tissue injury. Important factors in achieving success with the HCO are patient compliance and periodic monitoring for refabrication of the orthosis to accommodate skeletal growth, change in foot size or shape, and compression or wear of insert materials.

Peri-implant soft tissue colour around titanium and zirconia abutments: a prospective randomized controlled clinical study.

PubMed

Cosgarea, Raluca; Gasparik, Cristina; Dudea, Diana; Culic, Bogdan; Dannewitz, Bettina; Sculean, Anton

2015-05-01

To objectively determine the difference in colour between the peri-implant soft tissue at titanium and zirconia abutments. Eleven patients, each with two contralaterally inserted osteointegrated dental implants, were included in this study. The implants were restored either with titanium abutments and porcelain-fused-to-metal crowns, or with zirconia abutments and ceramic crowns. Prior and after crown cementation, multi-spectral images of the peri-implant soft tissues and the gingiva of the neighbouring teeth were taken with a colorimeter. The colour parameters L*, a*, b*, c* and the colour differences ΔE were calculated. Descriptive statistics, including non-parametric tests and correlation coefficients, were used for statistical analyses of the data. Compared to the gingiva of the neighbouring teeth, the peri-implant soft tissue around titanium and zirconia (test group), showed distinguishable ΔE both before and after crown cementation. Colour differences around titanium were statistically significant different (P = 0.01) only at 1 mm prior to crown cementation compared to zirconia. Compared to the gingiva of the neighbouring teeth, statistically significant (P < 0.01) differences were found for all colour parameter, either before or after crown cementation for both abutments; more significant differences were registered for titanium abutments. Tissue thickness correlated positively with c*-values for titanium at 1 mm and 2 mm from the gingival margin. Within their limits, the present data indicate that: (i) The peri-implant soft tissue around titanium and zirconia showed colour differences when compared to the soft tissue around natural teeth, and (ii) the peri-implant soft tissue around zirconia demonstrated a better colour match to the soft tissue at natural teeth than titanium. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Gain dynamics in a soft X-ray laser ampli er perturbed by a strong injected X-ray eld

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Yong; Wang, Shoujun; Oliva, E

2014-01-01

Seeding soft X-ray plasma ampli ers with high harmonics has been demonstrated to generate high-brightness soft X-ray laser pulses with full spatial and temporal coherence. The interaction between the injected coherent eld and the swept-gain medium has been modelled. However, no exper- iment has been conducted to probe the gain dynamics when perturbed by a strong external seed eld. Here, we report the rst X-ray pump X-ray probe measurement of the nonlinear response of a plasma ampli er perturbed by a strong soft X-ray ultra-short pulse. We injected a sequence of two time-delayed high-harmonic pulses (l518.9 nm) into a collisionallymore » excited nickel-like molybdenum plasma to measure with femto-second resolution the gain depletion induced by the saturated ampli cation of the high-harmonic pump and its subsequent recovery. The measured fast gain recovery in 1.5 1.75 ps con rms the possibility to generate ultra-intense, fully phase-coherent soft X-ray lasers by chirped pulse ampli cation in plasma ampli ers.« less

Sorafenib in Treating Patients With Metastatic, Locally Advanced, or Recurrent Sarcoma

ClinicalTrials.gov

2014-05-07

Adult Angiosarcoma; Adult Epithelioid Sarcoma; Adult Leiomyosarcoma; Adult Malignant Fibrous Histiocytoma; Adult Neurofibrosarcoma; Adult Synovial Sarcoma; Ovarian 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

Isolated Limb Perfusion With Melphalan in Treating Patients With Stage IIIB-IV Melanoma or Sarcoma

ClinicalTrials.gov

2015-07-22

Basal Cell Carcinoma of the Skin; Eccrine Carcinoma of the Skin; Recurrent Adult Soft Tissue Sarcoma; Recurrent Melanoma; Recurrent Skin Cancer; Squamous Cell Carcinoma of the Skin; Stage III Adult Soft Tissue Sarcoma; Stage IIIB Melanoma; Stage IIIC Melanoma; Stage IV Adult Soft Tissue Sarcoma; Stage IV Melanoma

Streptococcal necrotizing myositis: a case report and clinical review.

PubMed

Hourmozdi, Justin J; Hawley, Dean A; Hadi, Christiane M; Tahir, Bilal; Seupaul, Rawle A

2014-03-01

Streptococcal necrotizing myositis, also known as gangrenous myositis, is a very rare and severe soft tissue infection that predominately involves skeletal muscle and, eventually, superficial fascia and surrounding tissues. The presentation is often nonspecific until the rapidly progressing clinical course becomes apparent. A high morbidity and mortality rate has been reported in the small number of cases since 1900. Despite several attempts to better define the different entities causing necrotizing myositis, no single definitive causal relationship has been defined. A review of the literature is presented here to help clinicians distinguish those with necrotizing myositis from those with nonnecrotizing myositis when the clinician is at all confronted with the suspicion for such an infection. The case presented is that of a 48-year-old woman who had streptococcal necrotizing myositis. She died roughly 72 h after admission. After the patient's death, the clinical team sought consent for autopsy. Hospital staff made contact with family, and information was obtained from the family that the onset of the patient's symptoms was allegedly temporally related to her acquisition of a new tattoo on the right back, where the tattoo process allegedly included injection of cremated ashes of a pet dog. A high level of suspicion for necrotizing myositis must be maintained for a patient with unexplained severe muscle pain and soft tissue swelling accompanied by systemic inflammatory response syndrome. Copyright © 2014 Elsevier Inc. All rights reserved.

The use of time-of-flight camera for navigating robots in computer-aided surgery: monitoring the soft tissue envelope of minimally invasive hip approach in a cadaver study.

PubMed

Putzer, David; Klug, Sebastian; Moctezuma, Jose Luis; Nogler, Michael

2014-12-01

Time-of-flight (TOF) cameras can guide surgical robots or provide soft tissue information for augmented reality in the medical field. In this study, a method to automatically track the soft tissue envelope of a minimally invasive hip approach in a cadaver study is described. An algorithm for the TOF camera was developed and 30 measurements on 8 surgical situs (direct anterior approach) were carried out. The results were compared to a manual measurement of the soft tissue envelope. The TOF camera showed an overall recognition rate of the soft tissue envelope of 75%. On comparing the results from the algorithm with the manual measurements, a significant difference was found (P > .005). In this preliminary study, we have presented a method for automatically recognizing the soft tissue envelope of the surgical field in a real-time application. Further improvements could result in a robotic navigation device for minimally invasive hip surgery. © The Author(s) 2014.

Options to avoid the second surgical site: a review of literature.

PubMed

Ramachandra, Srinivas Sulugodu; Rana, Ritu; Reetika, Singhal; Jithendra, K D

2014-09-01

As esthetics gain importance, periodontal plastic surgical procedures involving soft tissue grafts are becoming commoner both around natural teeth as well as around implants. Periodontal soft tissue grafts are primarily used for the purpose of root coverage and in pre-prosthetic surgery to thicken a gingival site or to improve the crestal volume. Soft tissue grafts are usually harvested from the palate. Periodontal plastic surgical procedures involving soft tissue grafts harvested from the palate have two surgical sites; a recipient site and another donor site. Many patients are apprehensive about the soft tissue graft procedures, especially the creation of the second/donor surgical site in the palate. In the past decade, newer techniques and products have emerged which provide an option for the periodontist/patient to avoid the second surgical site. MucoMatrixX, Alloderm(®), Platelet rich fibrin, Puros(®) Dermis and Mucograft(®) are the various options available to the practicing periodontist to avoid the second surgical site. Use of these soft tissue allografts in an apprehensive patient would decrease patient morbidity and increase patient's acceptance towards periodontal plastic surgical procedures.

[Research on adaptive quasi-linear viscoelastic model for nonlinear viscoelastic properties of in vivo soft tissues].

PubMed

Wang, Heng; Sang, Yuanjun

2017-10-01

The mechanical behavior modeling of human soft biological tissues is a key issue for a large number of medical applications, such as surgery simulation, surgery planning, diagnosis, etc. To develop a biomechanical model of human soft tissues under large deformation for surgery simulation, the adaptive quasi-linear viscoelastic (AQLV) model was proposed and applied in human forearm soft tissues by indentation tests. An incremental ramp-and-hold test was carried out to calibrate the model parameters. To verify the predictive ability of the AQLV model, the incremental ramp-and-hold test, a single large amplitude ramp-and-hold test and a sinusoidal cyclic test at large strain amplitude were adopted in this study. Results showed that the AQLV model could predict the test results under the three kinds of load conditions. It is concluded that the AQLV model is feasible to describe the nonlinear viscoelastic properties of in vivo soft tissues under large deformation. It is promising that this model can be selected as one of the soft tissues models in the software design for surgery simulation or diagnosis.

Biomechanical properties of the forefoot plantar soft tissue as measured by an optical coherence tomography-based air-jet indentation system and tissue ultrasound palpation system.

PubMed

Chao, Clare Y L; Zheng, Yong-Ping; Huang, Yan-Ping; Cheing, Gladys L Y

2010-07-01

The forefoot medial plantar area withstand high plantar pressure during locomotion, and is a common site that develops foot lesion problems among elderly people. The aims of the present study were to (1) determine the correlation between the biomechanical properties of forefoot medial plantar soft tissue measured by a newly developed optical coherence tomography-based air-jet indentation system and by tissue ultrasound palpation system, and (2) to compare the biomechanical properties of plantar soft tissues of medial forefoot between a young and old adult group. Thirty healthy subjects were classified as the young or older group. The biomechanical properties of plantar soft tissues measured at the forefoot by the air-jet indentation system and tissue ultrasound palpation system were performed, and the correlation of the findings obtained in the two systems were compared. A strong positive correlation was obtained from the findings in the two systems (r=0.88, P<0.001). The forefoot plantar soft tissue of the older group was significantly stiffer at the second metatarsal head and thinner at both metatarsal heads than that of the young group (all P<0.05). The stiffness coefficient at the second metatarsal head was 28% greater than that at the first metatarsal head in both study groups. Older subjects showed a loss of elasticity and reduced thickness in their forefoot plantar soft tissue, with the second metatarsal head displaying stiffer and thicker plantar tissue than the first metatarsal head. The air-jet indentation system is a useful instrument for characterizing the biomechanical properties of soft tissue. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

[Micro-computed tomography of the vasculature in parenchymal organs and lung alveoli].

PubMed

Langheinrich, A C; Bohle, R M; Breithecker, A; Lommel, D; Rau, W S

2004-09-01

Micro-CT has become a powerful technique in non-destructive 3D imaging and morphometric analysis. First results were limited to the investigation of osteoporosis in cancellous bone. But the availability of systems with almost microscopic resolution and sufficient soft tissue contrast has opened up entirely new applications for laboratory investigation of blood vessels and soft tissues. This article gives an overview of micro-CT technology and the potential of three-dimensional imaging of the vessel wall and soft-tissue architecture imaging in different organs using different contrast perfusion and staining techniques. Micro-CT provides quantitative information on human plaque morphology equivalent to histomorphometric analysis. Based on differences in grey-scale attenuations, micro-CT also correctly identifies atherosclerotic lesions that are histologically classified as fibrous plaques, calcified lesions, fibroatheroma, and lipid rich lesions. Micro-CT is a promising method to visualize the architecture of the renal vasculature and, importantly, to separate cortex and medulla for the visualization of glomeruli and their afferent and efferent arterioles. Micro-CT can determine the vascular surface in a defined placental volume. Combining of micro-CT data and total placental volume enables an estimation of the approximate surface of the placental vasculature. The diameter of opacified vessels in the investigated samples ranged from 2 mm (chorion plate artery) to 14 micro m (smallest vessel diameter, terminal loop). Recognizing that lung parenchyma can only be visualized if the alveoli are completely expanded and the contrast of the thin alveolar walls is enhanced, we tested two preparation methods: (1) fixation of lung tissue with formalin vapour and staining with silver nitrate, and (2) intravenous injection of a barium sulfate-gelatine-thymol mixture in vivo in the anesthetized animal. We evaluated the ability of this mixture to enter the pulmonary microcirculation and the technical feasibility of micro-CT to assess lung micro-architecture.

Comparison of applying particulate demineralized bone matrix (DBM), putty DBM and open flap debridement in periodontal horizontal bone defects. A 12-month longitudinal, multi-centre, triple-blind, split-mouth, randomized, controlled clinical study. Part 2 - evaluation of the interdental soft tissue.

PubMed

Kaya, Y; Yalim, M; Bahçecitapar, M; Baloş, K

2009-07-01

To date, there have been many studies clinically evaluating periodontal regenerative procedures by the help of routinely used hard and soft tissue parameters; however, these parameters are not capable of assessing interdental soft tissue located above the regenerative periodontal surgery area. The purpose of this study was to assess interproximal soft tissue changes following application of (i) particulate form demineralized bone matrix (DBM), (ii) putty form DBM and (ii) open flap debridement (OFD, control), using modified curtain technique in the treatment of interproximal suprabony (horizontal) defects located in anterior maxillary region, as previously reported. Twenty-five chronic periodontitis patients with 125 interproximal surgery sites (radiologically >or=4 mm horizontal bone defect) were also participate in this second stage of the triple-blind, split mouth, randomized, controlled clinical trial. Surgery sites were assessed by (i) plaque index (PI), (ii) gingival index (GI), (iii) the presence of interdental soft tissue clefts or craters and (iv) the loss of interdental papilla height by using papilla presence index (PPI), during the healing period. At the baseline and 3, 6, 9 and 12 months after the operations, these measurements were repeated. In all groups, there is a significant increase in the prevalence of soft tissue cleft and crater formation (P < 0.01), with increase in PI and GI scores at interdental soft tissue defect areas (P < 0.001), 3 months after the operations. There was also an increase in PPI scores after the operations in all treatment groups (P < 0.01). Three procedures affected the interproximal soft tissues similarly. There was no significant difference among groups in terms of all parameters (P > 0.05). Particulate DBM, putty DBM and OFD demostrated similar interproximal soft tissue changes especially increasing interproximal PI and GI scores in 3 months follow-up.

Can the shell of the green-lipped mussel Perna viridis from the west coast of Peninsular Malaysia be a potential biomonitoring material for Cd, Pb and Zn?

NASA Astrophysics Data System (ADS)

Yap, C. K.; Ismail, A.; Tan, S. G.; Abdul Rahim, I.

2003-07-01

The distributions of Cd, Pb and Zn in the total soft tissues and total shells of the green-lipped mussel Perna viridis were studied in field collected samples as well as from laboratory experimental samples. The results showed that Cd, Pb and Zn were readily accumulated in the whole shells. In mussels sampled from 12 locations along the west coast of Peninsular Malaysia, the ratios of the shell metals to the soft tissue metals were different at each sampling site. Nevertheless, the Cd and Pb levels in the shells were always higher than those in the soft tissues, while the Zn level was higher in the soft tissues than in the shells. In comparison with soft tissues, the degrees of variability for Pb and Cd concentrations in the shells were lower. The lower degrees of variability and significant ( P<0.05) correlation coefficients of Cd and Pb within the shells support the use of the mussel shell as a suitable biomonitoring material for the two metals rather than the soft tissue since this indicated that there is more precision (lower CV) in the determination of metal concentrations in the shell than in the soft tissue. Experimental work showed that the pattern of depuration in the shell was not similar to that of the soft tissue although their patterns of accumulation were similar. This indicated that the depuration of heavy metals in the shell was not affected by the physiological conditions of the mussels. Although Zn could be regulated by the soft tissue, the incorporated Cd, Pb and Zn remained in the shell matrices. The present results support the use of the total shell of P. viridis as a potential biomonitoring material for long-term contamination of Cd, Pb and Zn.

Non Lipomatous Benign Lesions Mimicking Soft-tissue Sarcomas: A Pictorial Essay.

PubMed

Coran, Alessandro; Orsatti, Giovanna; Crimì, Filippo; Rastrelli, Marco; DI Maggio, Antonio; Ponzoni, Alberto; Attar, Shady; Stramare, Roberto

2018-01-01

The incidental finding of soft tissue masses is a challenge for the radiologist. Benign and malignant lesions can be differentiated relying on patient history, symptoms and mostly with the help of imaging. Ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) become fundamental in order to distinguish these lesions but the radiologist needs to know the main characteristics of benign soft tissue masses and sarcomas. Herein, we present a pictorial review of lesions mimicking soft tissue sarcomas features. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Cross-sectional evaluation of the prevalence and factors associated with soft tissue scarring after the removal of miniscrews.

PubMed

Jung, Sung-ah; Choi, Yoon Jeong; Lee, Dong-Won; Kim, Kyung-Ho; Chung, Chooryung J

2015-05-01

To investigate the prevalence of distinguishable soft tissue scarring after the removal of temporary anchorage devices (TADs) such as orthodontic miniscrews and to analyze the factors associated with scar formation. The prevalence of soft tissue scarring in 66 patients (202 miniscrew removal sites) was clinically investigated at least 1 year after miniscrew removal. To determine the clinical factors associated with soft tissue scar formation, miniscrew stability; host factors including age, gender, and gingival biotype; and miniscrew-related factors such as insertion site, vertical position, and insertion period were evaluated. The prevalence of a distinguishable scar remaining at least 1 year after miniscrew removal was 44.6%. Patients with flat gingiva showed a significantly higher prevalence of soft tissue scar formation than did those with pronounced scalloped gingiva (P < .05). Maxillary buccal removal sites showed a significantly higher prevalence of soft tissue scar formation than did those in the mandible or palatal slope (P < .05). Miniscrew sites at the alveolar mucosa showed a significantly lower prevalence of soft tissue scar formation than did those in the mucogingival junction or the attached gingiva (P < .01). The prevalence of distinguishable scarring after miniscrew removal was fairly high. On the basis of our results, patients with flat gingiva and buccal interdental gingival insertion sites are more susceptible to scar formation.

Influence of abutment material on peri-implant soft tissues in anterior areas with thin gingival biotype: a multicentric prospective study.

PubMed

Lops, Diego; Stellini, Edoardo; Sbricoli, Luca; Cea, Niccolò; Romeo, Eugenio; Bressan, Eriberto

2017-10-01

The aim of the present clinical trial was to analyze, through spectrophotometric digital technology, the influence of the abutment material on the color of the peri-implant soft tissue in patients with thin gingival biotype. Thirty-seven patients received an endosseous dental implant in the anterior maxilla. At time of each definitive prosthesis delivery, an all-ceramic crown has been tried on gold, titanium and zirconia abutment. Peri-implant soft-tissue color has been measured through a spectrophotometer after the insertion of each single abutment. Also facial peri-implant soft-tissue thickness was measured at the level of the implant neck through a caliper. A specific software has been utilized to identify a standardized tissue area and to collect the data before the statistical analysis in Lab* color space. ΔE parameters of the selected abutments were tested for correlation with mucosal thickness. Pearson correlation test was used. Only 15 patients met the study inclusion criteria on peri-implant soft-tissue thickness. Peri-implant soft-tissue color was different from that around natural teeth, no matter which type of restorative material was selected. Measurements regarding all the abutments were above the critical threshold of ΔE 8.74 for intraoral color distinction by the naked eye. The ΔE mean values of gold and zirconium abutments were similar (11.43 and 11.37, respectively) and significantly lower (P = 0.03 and P = 0.04, respectively) than the titanium abutment (13.55). In patients with a facial soft-tissue thickness ≤2 mm, the ΔE mean value of gold and zirconia abutments was significantly lower than that of titanium abutments (P = 0.03 and P = 0.04, respectively) and much more close to the reference threshold of 8.74. For peri-implant soft tissue of ≤2 mm, gold or zirconia abutments could be selected in anterior areas treatment. Moreover, the thickness of the peri-implant soft tissue seemed to be a crucial factor in the abutment impact on the color of soft tissues with a thickness of ≤2 mm. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Biological characterization of soft tissue sarcomas.

PubMed

Hayashi, Takuma; Horiuchi, Akiko; Sano, Kenji; Kanai, Yae; Yaegashi, Nobuo; Aburatani, Hiroyuki; Konishi, Ikuo

2015-12-01

Soft tissue sarcomas are neoplastic malignancies that typically arise in tissues of mesenchymal origin. The identification of novel molecular mechanisms leading to mesenchymal transformation and the establishment of new therapies and diagnostic biomarker has been hampered by several critical factors. First, malignant soft tissue sarcomas are rarely observed in the clinic with fewer than 15,000 newly cases diagnosed each year in the United States. Another complicating factor is that soft tissue sarcomas are extremely heterogeneous as they arise in a multitude of tissues from many different cell lineages. The scarcity of clinical materials coupled with its inherent heterogeneity creates a challenging experimental environment for clinicians and scientists. Faced with these challenges, there has been extremely limited advancement in clinical treatment options available to patients as compared to other malignant tumours. In order to glean insight into the pathobiology of soft tissue sarcomas, scientists are now using mouse models whose genomes have been specifically tailored to carry gene deletions, gene amplifications, and somatic mutations commonly observed in human soft tissue sarcomas. The use of these model organisms has been successful in increasing our knowledge and understanding of how alterations in relevant oncogenic and/or tumour suppressive signal cascades, i.e., interferon-γ (IFN-γ), tumour protein 53 (TP53) and/or retinoblastoma (RB) pathway directly impact sarcomagenesis. It is the goal of many in the physiological community that the use of several mouse models will serve as powerful in vivo tools for further understanding of sarcomagenesis and potentially identify new diagnostic biomarker and therapeutic strategies against human soft tissue sarcomas.

Prevalence, Type and Etiology of Dental and Soft Tissue Injuries in Children in Croatia.

PubMed

Škaričić, Josip; Vuletić, Marko; Hrvatin, Sandra; Jeličić, Jesenka; Čuković-Bagić, Ivana; Jurić, Hrvoje

2016-06-01

The prevalence, type and etiology of dental and soft tissue injuries and relationship between the time of arrival and sustaining soft tissue injury were analyzed in this retrospective study conducted at the Department of Pediatric Dentistry, University Dental Clinic in Zagreb, Croatia, during the 2010-2014 period using documentation on 447 patients (264 male and 183 female) aged 1-16 years with injuries of primary and permanent teeth. The highest prevalence of traumatic dental injury (TDI) was found in the 7-12 age group and maxillary central incisors were most frequently affected (80.9%) in both primary and permanent dentitions. Enamel-dentin fracture without pulp exposure (31.9%) was the most common TDI of dental hard tissue in both dentitions, whereas subluxation (27.3%) was the most common periodontal tissue injury type. The most frequent location, cause and seasonal variation of trauma were at home, falling and spring. Soft tissue injuries were observed in 203 (45.4%) patients. Soft tissue injuries were less likely when fewer teeth were traumatized (p<0.001). Comparison of children with and without soft tissue injuries yielded a statistically significant difference in the time to arrival between primary and permanent teeth (p<0.01). Because soft tissue injuries include bleeding and clinical presentation appears more dramatic, the time elapsed between injury and initial treatment was shorter than in non-bleeding injuries, pointing to the need of education focused on parents and school teachers regarding the importance of immediate therapy for both bleeding and non-bleeding TDIs.

Estimation of the viscous properties of skin and subcutaneous tissue in uniaxial stress relaxation tests.

PubMed

Wu, John Z; Cutlip, Robert G; Welcome, Daniel; Dong, Ren G

2006-01-01

Knowledge of viscoelastic properties of soft tissues is essential for the finite element modelling of the stress/strain distributions in finger-pad during vibratory loading, which is important in exploring the mechanism of hand-arm vibration syndrome. In conventional procedures, skin and subcutaneous tissue have to be separated for testing the viscoelastic properties. In this study, a novel method has been proposed to simultaneously determine the viscoelastic properties of skin and subcutaneous tissue in uniaxial stress relaxation tests. A mathematical approach has been derived to obtain the creep and relaxation characteristics of skin and subcutaneous tissue using uniaxial stress relaxation data of skin/subcutaneous composite specimens. The micro-structures of collagen fiber networks in the soft tissue, which underline the tissue mechanical characteristics, will be intact in the proposed method. Therefore, the viscoelastic properties of soft tissues obtained using the proposed method would be more physiologically relevant than those obtained using the conventional method. The proposed approach has been utilized to measure the viscoelastic properties of soft tissues of pig. The relaxation curves of pig skin and subcutaneous tissue obtained in the current study agree well with those in literature. Using the proposed approach, reliable material properties of soft tissues can be obtained in a cost- and time-efficient manner, which simultaneously improves the physiological relevance.

Chronic ankle pain and fibrosis successfully treated with a new noninvasive augmented soft tissue mobilization technique (ASTM): a case report.

PubMed

Melham, T J; Sevier, T L; Malnofski, M J; Wilson, J K; Helfst, R H

1998-06-01

This clinical case report demonstrates the clinical effectiveness of a new form of soft tissue mobilization in the treatment of excessive connective tissue fibrosis (scar tissue) around an athlete's injured ankle. The scar tissue was causing the athlete to have pain with activity, pain on palpation of the ankle, decreased range of motion, and loss of function. Surgery and several months of conventional physical therapy failed to alleviate the athlete's symptoms. As a final resort, augmented soft tissue mobilization (ASTM) was administered. ASTM is an alternative nonsurgical treatment modality that is being researched at Performance Dynamics (Muncip, IN). ASTM is a process that uses ergonomically designed instruments that assist therapists in the rapid localization and effective treatment of areas exhibiting excessive soft tissue fibrosis. This is followed by a stretching and strengthening program. Upon the completion of 6 wk of ASTM therapy, the athlete had no pain and had regained full range of motion and function. This case report is an example of how a noninvasive augmented form of soft tissue mobilization (ASTM) demonstrated impressive clinical results in treating a condition caused by connective tissue fibrosis.

Traumatic hallux varus repair utilizing a soft-tissue anchor: a case report.

PubMed

Labovitz, J M; Kaczander, B I

2000-01-01

Hallux varus is usually iatrogenic in nature; however, congenital and acquired etiologies have been described in the literature. The authors present a case of traumatic hallux varus secondary to rupture of the adductor tendon. Surgical correction was performed using a soft tissue anchor for maintenance of the soft tissues utilized for repair.

75 FR 9422 - Orthopaedic and Rehabilitation Devices Panel of the Medical Devices Advisory Committee; Notice of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-02

... repair of soft tissue injuries of the medial meniscus. In repairing and reinforcing medial meniscal... zone of the meniscus to provide sufficient vascularization. The CS reinforces soft tissue and provides a resorbable scaffold that is replaced by the patient's own soft tissue. The CS is not a prosthetic...

Comparison of onset anesthesia time and injection discomfort of 4% articaine and 2% mepivacaine during teeth extractions

PubMed Central

Gazal, Giath; Alharbi, Rashdan; Fareed, Wamiq Musheer; Omar, Esam; Alolayan, Albraa Badr; Al-Zoubi, Hassan; Alnazzawi, Ahmad A.

2017-01-01

Objective: To investigate the speed of action and injection discomfort of 4% articaine and 2% mepivacaine for upper teeth extractions. Materials and Methods: Forty-five patients were included in the articaine 4% group, and 45 in the mepivacaine 2% control group. After all injections, soft and hard tissue numbness was objectively gauged by dental probe at intervals of 15 s. Furthermore, the discomfort of the injections were recorded by the patients after each treatment on standard 100 mm visual analog scales, tagged at the endpoints with “no pain” (0 mm) and “unbearable pain” (100 mm). Results: There were significant differences in the meantime of first numbness to associated palatal mucosa and tooth of patients between mepivacaine and articaine buccal infiltration (BI) groups P = 0.01 and 0.01. Patients in the articaine group recorded earlier palatal mucosa and teeth numbness than those in the mepivacaine group. With regards to the discomfort of the needle injections, palatal injection was significantly more painful than BI (t-test: P < 0.001). Articaine buccal injection was significantly more painful than mepivacaine buccal injection (t-test: P <0.001). However, articaine palatal injection was less painful than articaine BI. Clinically, anesthesia onset time was faster in anterior upper teeth than upper middle and posterior teeth. Conclusions: BIs with 4% articaine was faster in achieving palate and teeth anesthesia than 2% mepivacaine for extraction of upper maxillary teeth. Patients in mepivacaine BI and articaine palatal injection groups reported less pain with needle injection. Failure of anesthesia was noticeable with maxillary multiple-rooted teeth. PMID:28442952

Eccentric Exercise Versus Eccentric Exercise and Soft Tissue Treatment (Astym) in the Management of Insertional Achilles Tendinopathy

PubMed Central

McCormack, Joshua R.; Underwood, Frank B.; Slaven, Emily J.; Cappaert, Thomas A.

2016-01-01

Background: Eccentric exercise is commonly used in the management of Achilles tendinopathy (AT) but its effectiveness for insertional AT has been questioned. Soft tissue treatment (Astym) combined with eccentric exercise could result in better outcomes than eccentric exercise alone. Hypothesis: Soft tissue treatment (Astym) plus eccentric exercise will be more effective than eccentric exercise alone for subjects with insertional AT. Study Design: Prospective randomized controlled trial. Level of Evidence: Level 2. Methods: Sixteen subjects were randomly assigned to either a soft tissue treatment (Astym) and eccentric exercise group or an eccentric exercise–only group. Intervention was completed over a 12-week period, with outcomes assessed at baseline, 4, 8, 12, 26, and 52 weeks. Outcomes included the Victorian Institute of Sport Assessment Achilles-Specific Questionnaire (VISA-A), the numeric pain rating scale (NPRS), and the global rating of change (GROC). Results: Significantly greater improvements on the VISA-A were noted in the soft tissue treatment (Astym) group over the 12-week intervention period, and these differences were maintained at the 26- and 52-week follow-ups. Both groups experienced a similar statistically significant improvement in pain over the short and long term. A significantly greater number of subjects in the soft tissue treatment (Astym) group achieved a successful outcome at 12 weeks. Conclusion: Soft tissue treatment (Astym) plus eccentric exercise was more effective than eccentric exercise only at improving function during both short- and long-term follow-up periods. Clinical Relevance: Soft tissue treatment (Astym) plus eccentric exercise appears to be a beneficial treatment program that clinicians should consider incorporating into the management of their patients with insertional AT. PMID:26893309

Reaction of facial soft tissues to treatment with a Herbst appliance.

PubMed

Meyer-Marcotty, P; Kochel, J; Richter, U; Richter, F; Stellzig-Eisenhauer, Angelika

2012-04-01

The objective of this prospective longitudinal study was to investigate the reaction of facial soft tissues to treatment with a Herbst appliance. We aimed to quantify three-dimensionally (3D) the isolated effect of the Herbst appliance and volume changes in the lip profile. The 3D data of the facial soft tissues of 34 patients with skeletal Class II (17 female and 17 male, mean age 13.5 ± 1.8 years) were prepared in a standardized manner immediately before (T1) and after (T2) treatment with a Herbst appliance. Anthropometric evaluation was carried out in sagittal and vertical dimensions. To quantify volume changes, pretherapeutic and posttherapeutic images were superimposed three-dimensionally and the difference volumes calculated. Following testing for normal distribution, a statistical analysis was carried out using the paired t test. We observed ventral development of the soft tissues of the lower jaw with flattening of the profile curvature and anterior displacement of the sublabial region in a total of 27 patients. Anterior facial height was lengthened and the facial depth at the lower jaw increased. The largest percentage changes were noted in the lip profile, with a reduction in the red margin of the upper lip and an increase in lower lip height. We also observed a reduction of the sublabial fold in conjunction with a simultaneous increase in volume. The influence of the Herbst appliance on the facial soft tissues is expected to result in a positive treatment outcome, particularly in patients with a convex profile, a retrusive lower lip, and a marked sublabial fold. We observed a broad clinical spectrum of individual reactions in the facial soft tissues. It is, thus, not possible to detect a linear relationship between the Herbst treatment and soft tissue changes, making soft tissue changes difficult to predict.

Incidence of Staphylococcus aureus nasal colonization and soft tissue infection among high school football players.

PubMed

Lear, Aaron; McCord, Gary; Peiffer, Jeffrey; Watkins, Richard R; Parikh, Arpan; Warrington, Steven

2011-01-01

Methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections have been documented with increasing frequency in both team and individual sports in recent years. It also seems that the level of MRSA skin and soft tissue infections in the general population has increased. One hundred ninety athletes from 6 local high school football teams were recruited for this prospective observational study to document nasal colonization and the potential role this plays in skin and soft tissue infections in football players and, in particular, MRSA infections. Athletes had nasal swabs done before their season started, and they filled out questionnaires regarding potential risk factors for skin and soft tissue infections. Those enrolled in the study were then observed over the course of the season for skin and soft tissue infections. Those infected had data about their infections collected. One hundred ninety of 386 available student athletes enrolled in the study. Forty-four of the subjects had nasal colonization with methicillin-susceptible S. aureus, and none were colonized with MRSA. There were 10 skin and soft tissue infections (8 bacterial and 2 fungal) documented over the course of the season. All were treated as outpatients with oral or topical antibiotics, and none were considered serious. Survey data from the preseason questionnaire showed 21% with skin infection, 11% with methicillin-susceptible S. aureus, and none with MRSA infection during the past year. Three reported a remote history of MRSA infection. We documented an overall skin infection rate of 5.3% among high school football players over a single season. Our results suggest that skin and soft tissue infection may not be widespread among high school athletes in northeast Ohio.

Soft Tissue Deformations Contribute to the Mechanics of Walking in Obese Adults

PubMed Central

Fu, Xiao-Yu; Zelik, Karl E.; Board, Wayne J.; Browning, Raymond C.; Kuo, Arthur D.

2014-01-01

Obesity not only adds to the mass that must be carried during walking, but also changes body composition. Although extra mass causes roughly proportional increases in musculoskeletal loading, less well understood is the effect of relatively soft and mechanically compliant adipose tissue. Purpose To estimate the work performed by soft tissue deformations during walking. The soft tissue would be expected to experience damped oscillations, particularly from high force transients following heel strike, and could potentially change the mechanical work demands for walking. Method We analyzed treadmill walking data at 1.25 m/s for 11 obese (BMI > 30 kg/m2) and 9 non-obese (BMI < 30 kg/m2) adults. The soft tissue work was quantified with a method that compares the work performed by lower extremity joints as derived using assumptions of rigid body segments, with that estimated without rigid body assumptions. Results Relative to body mass, obese and non-obese individuals perform similar amounts of mechanical work. But negative work performed by soft tissues was significantly greater in obese individuals (p= 0.0102), equivalent to about 0.36 J/kg vs. 0.27 J/kg in non-obese individuals. The negative (dissipative) work by soft tissues occurred mainly after heel strike, and for obese individuals was comparable in magnitude to the total negative work from all of the joints combined (0.34 J/kg vs. 0.33 J/kg for obese and non-obese adults, respectively). Although the joints performed a relatively similar amount of work overall, obese individuals performed less negative work actively at the knee. Conclusion The greater proportion of soft tissues in obese individuals results in substantial changes in the amount, location, and timing of work, and may also impact metabolic energy expenditure during walking. PMID:25380475

Soft-tissue volumetric changes following monobloc distraction procedure: analysis using digital three-dimensional photogrammetry system (3dMD).

PubMed

Chan, Fuan Chiang; Kawamoto, Henry K; Federico, Christina; Bradley, James P

2013-03-01

We have previously reported that monobloc advancement by distraction osteogenesis resulted in decreased morbidity and greater advancement with less relapse compared with acute monobloc advancement with bone grafting. In this study, we examine the three-dimensional (3D) volumetric soft-tissue changes in monobloc distraction.Patients with syndromic craniosynostosis who underwent monobloc distraction from 2002 to 2010 at University of California-Los Angeles Craniofacial Center were studied (n = 12). We recorded diagnosis, indications for the surgery, and volumetric changes for skeletal and soft-tissue midface structures (preoperative/postoperative [6 weeks]/follow-up [>1 year]). Computed tomography scans and a digital 3D photogrammetry system were used for image analysis.Patients ranged from 6 to 14 years of age (mean, 10.1 years) at the time of the operation (follow-up 2-11 years); mean distraction advancement was 19.4 mm (range, 14-25 mm). There was a mean increase in the 3D volumetric soft-tissue changes: 99.5 ± 4.0 cm(3) (P < 0.05) at 6 weeks and 94.9 ± 3.6 cm(3) (P < 0.05) at 1-year follow-up. When comparing soft-tissue changes at 6 weeks postoperative to 1-year follow-up, there were minimal relapse changes. The overall mean 3D skeletal change was 108.9 ± 4.2 cm. For every 1 cm of skeletal gain, there was 0.78 cm(3) of soft-tissue gain.Monobloc advancement by distraction osteogenesis using internal devices resulted in increased volumetric soft-tissue changes, which remained stable at 1 year. The positive linear correlation between soft-tissue increments and bony advancement can be incorporated during the planning of osteotomies to achieve optimum surgical outcomes with monobloc distraction.

Soft-Tissue Reconstruction of the Complicated Knee Arthroplasty: Principles and Predictors of Salvage.

PubMed

Colen, David L; Carney, Martin J; Shubinets, Valeriy; Lanni, Michael A; Liu, Tiffany; Levin, L Scott; Lee, Gwo-Chin; Kovach, Stephen J

2018-04-01

Total knee arthroplasty is a common orthopedic procedure in the United States and complications can be devastating. Soft-tissue compromise or joint infection may cause failure of prosthesis requiring knee fusion or amputation. The role of a plastic surgeon in total knee arthroplasty is critical for cases requiring optimization of the soft-tissue envelope. The purpose of this study was to elucidate factors associated with total knee arthroplasty salvage following complications and clarify principles of reconstruction to optimize outcomes. A retrospective review of patients requiring soft-tissue reconstruction performed by the senior author after total knee arthroplasty over 8 years was completed. Logistic regression and Fisher's exact tests determined factors associated with the primary outcome, prosthesis salvage versus knee fusion or amputation. Seventy-three knees in 71 patients required soft-tissue reconstruction (mean follow-up, 1.8 years), with a salvage rate of 61.1 percent, mostly using medial gastrocnemius flaps. Patients referred to our institution with complicated periprosthetic wounds were significantly more likely to lose their knee prosthesis than patients treated only within our system. Patients with multiple prior knee operations before definitive soft-tissue reconstruction had significantly decreased rates of prosthesis salvage and an increased risk of amputation. Knee salvage significantly decreased with positive joint cultures (Gram-negative greater than Gram-positive organisms) and particularly at the time of definitive reconstruction, which also trended toward an increased risk of amputation. In revision total knee arthroplasty, prompt soft-tissue reconstruction improves the likelihood of success, and protracted surgical courses and contamination increase failure and amputations. The authors show a benefit to involving plastic surgeons early in the course of total knee arthroplasty complications to optimize genicular soft tissues. Therapeutic, III.

Soft tissue volume augmentation at dental implant sites using a volume stable three-dimensional collagen matrix - histological outcomes of a preclinical study.

PubMed

Thoma, Daniel S; Naenni, Nadja; Benic, Goran I; Hämmerle, Christoph H F; Jung, Ronald E

2017-02-01

The aim of this study was to test whether or not soft tissue augmentation with a collagen matrix (VCMX) leads to a similar increase in ridge width around dental implants compared to the use of an autogenous subepithelial connective tissue graft (SCTG). In 12 dogs, immediate dental implants were placed with simultaneous guided bone regeneration. Three months later, soft tissue volume augmentation was performed by randomly allocating three treatment modalities to these sites [VCMX, SCTG, sham-operated group (control)]. Dogs were sacrificed at 1 (n = 4), 2 (n = 4) or 6 months (n = 4). Descriptive histology and histomorphometric measurements for soft tissue thickness were performed on non-decalcified sections. The horizontal soft tissue thickness was maximal at the most coronal level (alveolar crest) at 1 month (VCMX: 2.1 ± 1.6 mm; SCTG: 2.5 ± 1.7 mm; p = 0.877) and decreased until 6 months. At 6 months, the greatest mucosal thickness was at a level 3.5 mm below the crest (VCMX: 0.8 ± 0.3 mm; SCTG: 0.7 ± 0.2 mm) (p = 0.754). Control sites revealed no relevant soft tissue augmentation at any level and any time-point. Tissue integration for VCMX and SCTG were favourable with minimal inflammatory reactions. Soft tissue volume augmentation at implant sites was obtained to a similar extent using VCMX and SCTG up to 2 months. Thereafter, degradation and remodelling processes were enhanced leading to a minimal increase in soft tissue thickness at 6 months for VCMX and SCTG. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

X-Ray Spectral Variability Signatures of Flares in BL Lac Objects

NASA Technical Reports Server (NTRS)

Boettcher, Markus; Chiang, James; White, Nicholas E. (Technical Monitor)

2002-01-01

We are presenting a detailed parameter study of the time-dependent electron injection and kinematics and the self-consistent radiation transport in jets of intermediate and low-frequency peaked BL Lac objects. Using a time-dependent, combined synchrotron-self-Compton and external-Compton jet model, we study the influence of variations of several essential model parameters, such as the electron injection compactness, the relative contribution of synchrotron to external soft photons to the soft photon compactness, the electron- injection spectral index, and the details of the time profiles of the electron injection episodes giving rise to flaring activity. In the analysis of our results, we focus on the expected X-ray spectral variability signatures in a region of parameter space particularly well suited to reproduce the broadband spectral energy distributions of intermediate and low-frequency peaked BL Lac objects. We demonstrate that SSC- and external-Compton dominated models for the gamma-ray emission from blazars are producing significantly different signatures in the X-ray variability, in particular in the soft X-ray light curves and the spectral hysteresis at soft X-ray energies, which can be used as a powerful diagnostic to unveil the nature of the high-energy emission from BL Lac objects.

Silk Based Bioinks for Soft Tissue Reconstruction Using 3-Dimensional (3D) Printing with in vitro and in vivo Assessments

PubMed Central

Rodriguez, María J.; Brown, Joseph; Giordano, Jodie; Lin, Samuel J.; Omenetto, Fiorenzo G.; Kaplan, David L.

2016-01-01

In the field of soft tissue reconstruction, custom implants could address the need for materials that can fill complex geometries. Our aim was to develop a material system with optimal rheology for material extrusion, that can be processed in physiological and non-toxic conditions and provide structural support for soft tissue reconstruction. To meet this need we developed silk based bioinks using gelatin as a bulking agent and glycerol as a non-toxic additive to induce physical crosslinking. We developed these inks optimizing printing efficacy and resolution for patient-specific geometries that can be used for soft tissue reconstruction. We demonstrated in vitro that the material was stable under physiological conditions and could be tuned to match soft tissue mechanical properties. We demonstrated in vivo that the material was biocompatible and could be tuned to maintain shape and volume up to three months while promoting cellular infiltration and tissue integration. PMID:27940389

Silk based bioinks for soft tissue reconstruction using 3-dimensional (3D) printing with in vitro and in vivo assessments.

PubMed

Rodriguez, María J; Brown, Joseph; Giordano, Jodie; Lin, Samuel J; Omenetto, Fiorenzo G; Kaplan, David L

2017-02-01

In the field of soft tissue reconstruction, custom implants could address the need for materials that can fill complex geometries. Our aim was to develop a material system with optimal rheology for material extrusion, that can be processed in physiological and non-toxic conditions and provide structural support for soft tissue reconstruction. To meet this need we developed silk based bioinks using gelatin as a bulking agent and glycerol as a non-toxic additive to induce physical crosslinking. We developed these inks optimizing printing efficacy and resolution for patient-specific geometries that can be used for soft tissue reconstruction. We demonstrated in vitro that the material was stable under physiological conditions and could be tuned to match soft tissue mechanical properties. We demonstrated in vivo that the material was biocompatible and could be tuned to maintain shape and volume up to three months while promoting cellular infiltration and tissue integration. Copyright © 2016 Elsevier Ltd. All rights reserved.

Semianalytical Solution for the Deformation of an Elastic Layer under an Axisymmetrically Distributed Power-Form Load: Application to Fluid-Jet-Induced Indentation of Biological Soft Tissues.

PubMed

Lu, Minhua; Huang, Shuai; Yang, Xianglong; Yang, Lei; Mao, Rui

2017-01-01

Fluid-jet-based indentation is used as a noncontact excitation technique by systems measuring the mechanical properties of soft tissues. However, the application of these devices has been hindered by the lack of theoretical solutions. This study developed a mathematical model for testing the indentation induced by a fluid jet and determined a semianalytical solution. The soft tissue was modeled as an elastic layer bonded to a rigid base. The pressure of the fluid jet impinging on the soft tissue was assumed to have a power-form function. The semianalytical solution was verified in detail using finite-element modeling, with excellent agreement being achieved. The effects of several parameters on the solution behaviors are reported, and a method for applying the solution to determine the mechanical properties of soft tissues is suggested.

Effects of soft tissue augmentation procedures on peri-implant health or disease: A systematic review and meta-analysis.

PubMed

Thoma, Daniel S; Naenni, Nadja; Figuero, Elena; Hämmerle, Christoph H F; Schwarz, Frank; Jung, Ronald E; Sanz-Sánchez, Ignacio

2018-03-01

To review the dental literature in terms of soft tissue augmentation procedures and their influence on peri-implant health or disease in partially and fully edentulous patients. A MEDLINE search from 1966 to 2016 was performed to identify controlled clinical studies comparing soft tissue grafting versus no soft tissue grafting (maintenance) or two types of soft tissue grafting procedures at implant sites. The soft tissue grafting procedures included either an increase of keratinized tissue or an increase of the thickness of the peri-implant mucosa. Studies reporting on the peri-implant tissue health, as assessed by bleeding or gingival indices, were included in the review. The search was complemented by an additional hand search of all selected full-text articles and reviews published between 2011 and 2016. The initial search yielded a total number of 2,823 studies. Eligible studies were selected based on the inclusion criteria (finally included: four studies on gain of keratinized tissue; six studies on gain of mucosal thickness) and quality assessments conducted. Meta-analyses were applied whenever possible. Soft tissue grafting procedures for gain of keratinized tissue resulted in a significantly greater improvement of gingival index values compared to maintenance groups (with or without keratinized tissue) [n = 2; WMD = 0.863; 95% CI (0.658; 1.067); p < .001]. For final marginal bone levels, statistically significant differences were calculated in favor of an apically positioned flap (APF) plus autogenous grafts versus all control treatments (APF alone; APF plus a collagen matrix; maintenance without intervention [with or without residual keratinized tissue]) [n = 4; WMD = -0.175 mm; 95% CI: (-0.313; -0.037); p = .013]. Soft tissue grafting procedures for gain of mucosal thickness did not result in significant improvements in bleeding indices over time, but in significantly less marginal bone loss over time [WMD = 0.110; 95% CI: 0.067; 0.154; p < .001] and a borderline significance for marginal bone levels at the study endpoints compared to sites without grafting. Within the limitations of this review, it was concluded that soft tissue grafting procedures result in more favorable peri-implant health: (i) for gain of keratinized mucosa using autogenous grafts with a greater improvement of bleeding indices and higher marginal bone levels; (ii) for gain of mucosal thickness using autogenous grafts with significantly less marginal bone loss. © 2018 The Authors. Clinical Oral Implants Research Published by John Wiley & Sons Ltd.

Guided bone generation in a rabbit mandible model after periosteal expansion with an osmotic tissue expander.

PubMed

Abrahamsson, Peter; Isaksson, Sten; Andersson, Gunilla

2011-11-01

To evaluate the space-maintaining capacity of titanium mesh covered by a collagen membrane after soft tissue expansion on the lateral border of the mandible in rabbits, and to assess bone quantity and quality using autogenous particulate bone or bone-substitute (Bio-Oss(®) ), and if soft tissue ingrowth can be avoided by covering the mesh with a collagen membrane. In 11 rabbits, a self-inflatable soft tissue expander was placed under the lateral mandibular periosteum via an extra-oral approach. After 2 weeks, the expanders were removed and a particulated onlay bone graft and deproteinized bovine bone mineral (DBBM) (Bio-Oss(®) ) were placed in the expanded area and covered by a titanium mesh. The bone and DBBM were separated in two compartments under the mesh with a collagen membrane in between. The mesh was then covered with a collagen membrane. After 3 months, the animals were sacrificed and specimens were collected for histology. The osmotic soft tissue expander created a subperiosteal pocket and a ridge of new bone formed at the edges of the expanded periosteum in all sites. After the healing period of 3 months, no soft tissue dehiscence was recorded. The mean bone fill was 58.1±18% in the bone grafted area and 56.9±13.7% in the DBBM area. There was no significant difference between the autologous bone graft and the DDBM under the titanium mesh with regard to the total bone area or the mineralized bone area. Scanning electron microscopy showed that new bone was growing in direct contact with the DBBM particles and the titanium mesh. There is a soft tissue ingrowth even after soft tissue expansion and protection of the titanium mesh with a collagen membrane. This study confirms that an osmotic soft tissue expander creates a surplus of periosteum and soft tissue, and that new bone can subsequently be generated under a titanium mesh with the use of an autologous bone graft or DBBM. © 2011 John Wiley & Sons A/S.

Surgical hazards posed by marine and freshwater animals in Florida.

PubMed

Howard, R J; Burgess, G H

1993-11-01

Marine and freshwater animals can cause injury to humans by biting, stinging, being poisonous to eat, and causing infections. Biting aquatic animals in Florida include sharks, barracudas, alligators, and moray eels. Devitalized tissue should be débrided, and vascular, neurologic, and tendinous injuries should be repaired. Radiographs should be obtained to examine the injury sit for fractures and retained foreign bodies (teeth). The spines of stingrays and marine catfish can cause soft tissue injury and infection. The spine has a recurved, serrated shape that may cause further injury and break if it is pulled out. The venom may cause local tissue necrosis requiring débridement. Soft tissue infections with marine Vibrio bacteria can occur after eating raw oysters or receiving even minor injuries from marine animals. Thirty-one individuals developed soft tissue infections, 49 developed sepsis, and 23 developed both sepsis and soft tissue infection with marine Vibrio species during a 12-year period. Sixteen patients developed necrotizing soft tissue infections. Treatment is with antibiotics and débridement when necrosis occurs.

Outcomes of acute Achilles tendon rupture repair with bone marrow aspirate concentrate augmentation.

PubMed

Stein, Benjamin E; Stroh, David Alex; Schon, Lew C

2015-05-01

Optimal treatment of acute Achilles tendon ruptures remains controversial. Positive results using stem-cell-bearing concentrates have been reported with other soft-tissue repairs, but no studies exist on outcomes of bone marrow aspirate concentrate (BMAC) augmentation in primary Achilles tendon repair. We reviewed patients with sport-related Achilles tendon ruptures treated via open repair augmented with BMAC injection from 2009 to 2011. Data on operative complications, strength, range of motion, rerupture, calf circumference and functional improvement through progressive return to sport and the Achilles tendon Total Rupture Score (ATRS) were analysed. A total of 27 patients (28 tendons) treated with open repair and BMAC injection were identified (mean age 38.3 ± 9.6 years). At mean follow-up of 29.7 ± 6.1 months, there were no reruptures. Walking without a boot was at 1.8 ± 0.7 months, participation in light activity was at 3.4 ± 1.8 months and 92% (25 of 27) of patients returned to their sport at 5.9 ± 1.8 months. Mean ATRS at final follow-up was 91 (range 72-100) points. One case of superficial wound dehiscence healed with local wound care. No soft-tissue masses, bone formation or tumors were observed in the operative extremity. Excellent results, including no re-ruptures and early mobilisation, were observed in this small cohort with open Achilles tendon repair augmented by BMAC. No adverse outcomes of biologic treatment were observed with this protocol. The efficacy of BMAC in the operative repair of acute Achilles tendon ruptures warrants further study. IV - Therapeutic.

Soft Tissue Regeneration Incorporating 3-Dimensional Biomimetic Scaffolds.

PubMed

Shah, Gaurav; Costello, Bernard J

2017-02-01

Soft tissue replacement and repair is crucial to the ever-developing field of reconstructive surgery as trauma, pathology, and congenital deficits cannot be adequately restored if soft tissue regeneration is deficient. Predominant approaches were sometimes limited to harvesting autografts, but through regenerative medicine and tissue engineering, the hope of fabricating custom constructs is now a feasible and fast-approaching reality. The breadth of this field includes tissues ranging from skin, mucosa, muscle, and fat and hopes to not only provide construct to replace a tissue but also to replace its function. Copyright © 2016 Elsevier Inc. All rights reserved.

Randomized controlled clinical study evaluating effectiveness and safety of a volume-stable collagen matrix compared to autogenous connective tissue grafts for soft tissue augmentation at implant sites.

PubMed

Thoma, Daniel S; Zeltner, Marco; Hilbe, Monika; Hämmerle, Christoph H F; Hüsler, Jürg; Jung, Ronald E

2016-10-01

To test whether or not the use of a collagen matrix (VCMX) results in short-term soft tissue volume increase at implant sites non-inferior to an autogenous subepithelial connective tissue graft (SCTG), and to evaluate safety and tissue integration of VCMX and SCTG. In 20 patients with a volume deficiency at single-tooth implant sites, soft tissue volume augmentation was performed randomly allocating VCMX or SCTG. Soft tissue thickness, patient-reported outcome measures (PROMs), and safety were assessed up to 90 days (FU-90). At FU-90 (abutment connection), tissue samples were obtained for histological analysis. Descriptive analysis was computed for both groups. Non-parametric tests were applied to test non-inferiority for the gain in soft tissue thickness at the occlusal site. Median soft tissue thickness increased between BL and FU-90 by 1.8 mm (Q1:0.5; Q3:2.0) (VCMX) (p = 0.018) and 0.5 mm (-1.0; 2.0) (SCTG) (p = 0.395) (occlusal) and by 1.0 mm (0.5; 2.0) (VCMX) (p = 0.074) and 1.5 mm (-2.0; 2.0) (SCTG) (p = 0.563) (buccal). Non-inferiority with a non-inferiority margin of 1 mm could be demonstrated (p = 0.020); the difference between the two group medians (1.3 mm) for occlusal sites indicated no relevant, but not significant superiority of VCMX versus SCTG (primary endpoint). Pain medication consumption and pain perceived were non-significantly higher in group SCTG up to day 3. Median physical pain (OHIP-14) at day 7 was 100% higher for SCTG than for VCMX. The histological analysis revealed well-integrated grafts. Soft tissue augmentation at implant sites resulted in a similar or higher soft tissue volume increase after 90 days for VCMX versus SCTG. PROMs did not reveal relevant differences between the two groups. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Soft tissue hemangioma with osseous extension: a case report and review of the literature.

PubMed

Daoud, Alexander; Olivieri, Brandon; Feinberg, Daniel; Betancourt, Michel; Bockelman, Brian

2015-04-01

Soft tissue hemangiomas are commonly encountered lesions, accounting for 7-10 % of all benign soft tissue masses (Mitsionis et al. J Foot Ankle Surg 16(2):27-9, 2010). While the literature describes the great majority of hemangiomas as asymptomatic and discovered only as incidental findings, they do have the potential to induce reactive changes in neighboring structures (Pastushyn et al. Surg Neurol 50(6):535-47, 1998). When these variants occur in close proximity to bone, they may elicit a number of well-documented reactive changes in osseous tissue (Mitsionis et al. J Foot Ankle Surg 16(2):27-9, 2010; DeFilippo et al. Skelet Radiol 25(2):174-7, 1996; Ly et al. AJR Am J Roentgenol 180(6):1695-700, 2003; Sung et al. Skelet Radiol 27(4):205-10, 1998). However, instances of direct extension into bone by soft tissue hemangiomas--that is, infiltration of the mass's vascular components into nearby osseous tissue--are currently undocumented in the literature. In these cases, imaging plays an important role in differentiating hemangiomas from malignant lesions (Mitsionis et al. J Foot Ankle Surg 16(2):27-9, 2010; Sung et al. Skelet Radiol 27(4):205-10, 1998; Pourbagher, Br J Radiol 84(1008):1100-8, 2011). In this article, we present such a case that involved the sacral spine. Imaging revealed a soft tissue mass with direct extension of vascular components into osseous tissue of the adjacent sacral vertebrae. Biopsy and subsequent histopathologic examination led to definitive diagnosis of soft tissue hemangioma. While MRI is widely regarded as the gold standard imaging modality for evaluating hemangiomas, in this report we describe how CT can aid in narrowing the differential diagnosis when one encounters a vascular lesion with adjacent osseous changes. Furthermore, we review the literature as it pertains to the imaging of soft tissue hemangiomas that occur in proximity to osseous tissue, as well as correlate this case to current theories on the pathogenesis of hemangiomas. Radiologists should be aware that benign soft tissue hemangiomas demonstrate a spectrum of imaging findings, including aggressive-appearing changes to adjacent bone.

Fatigue Damage of Collagenous Tissues: Experiment, Modeling and Simulation Studies

PubMed Central

Martin, Caitlin; Sun, Wei

2017-01-01

Mechanical fatigue damage is a critical issue for soft tissues and tissue-derived materials, particularly for musculoskeletal and cardiovascular applications; yet, our understanding of the fatigue damage process is incomplete. Soft tissue fatigue experiments are often difficult and time-consuming to perform, which has hindered progress in this area. However, the recent development of soft-tissue fatigue-damage constitutive models has enabled simulation-based fatigue analyses of tissues under various conditions. Computational simulations facilitate highly controlled and quantitative analyses to study the distinct effects of various loading conditions and design features on tissue durability; thus, they are advantageous over complex fatigue experiments. Although significant work to calibrate the constitutive models from fatigue experiments and to validate predictability remains, further development in these areas will add to our knowledge of soft-tissue fatigue damage and will facilitate the design of durable treatments and devices. In this review, the experimental, modeling, and simulation efforts to study collagenous tissue fatigue damage are summarized and critically assessed. PMID:25955007

Next Generation Tissue Engineering of Orthopedic Soft Tissue-to-Bone Interfaces.

PubMed

Boys, Alexander J; McCorry, Mary Clare; Rodeo, Scott; Bonassar, Lawrence J; Estroff, Lara A

2017-09-01

Soft tissue-to-bone interfaces are complex structures that consist of gradients of extracellular matrix materials, cell phenotypes, and biochemical signals. These interfaces, called entheses for ligaments, tendons, and the meniscus, are crucial to joint function, transferring mechanical loads and stabilizing orthopedic joints. When injuries occur to connected soft tissue, the enthesis must be re-established to restore function, but due to structural complexity, repair has proven challenging. Tissue engineering offers a promising solution for regenerating these tissues. This prospective review discusses methodologies for tissue engineering the enthesis, outlined in three key design inputs: materials processing methods, cellular contributions, and biochemical factors.

Next Generation Tissue Engineering of Orthopedic Soft Tissue-to-Bone Interfaces

PubMed Central

Boys, Alexander J.; McCorry, Mary Clare; Rodeo, Scott; Bonassar, Lawrence J.; Estroff, Lara A.

2017-01-01

Soft tissue-to-bone interfaces are complex structures that consist of gradients of extracellular matrix materials, cell phenotypes, and biochemical signals. These interfaces, called entheses for ligaments, tendons, and the meniscus, are crucial to joint function, transferring mechanical loads and stabilizing orthopedic joints. When injuries occur to connected soft tissue, the enthesis must be re-established to restore function, but due to structural complexity, repair has proven challenging. Tissue engineering offers a promising solution for regenerating these tissues. This prospective review discusses methodologies for tissue engineering the enthesis, outlined in three key design inputs: materials processing methods, cellular contributions, and biochemical factors. PMID:29333332

Tissue Anisotropy Modeling Using Soft Composite Materials.

PubMed

Chanda, Arnab; Callaway, Christian

2018-01-01

Soft tissues in general exhibit anisotropic mechanical behavior, which varies in three dimensions based on the location of the tissue in the body. In the past, there have been few attempts to numerically model tissue anisotropy using composite-based formulations (involving fibers embedded within a matrix material). However, so far, tissue anisotropy has not been modeled experimentally. In the current work, novel elastomer-based soft composite materials were developed in the form of experimental test coupons, to model the macroscopic anisotropy in tissue mechanical properties. A soft elastomer matrix was fabricated, and fibers made of a stiffer elastomer material were embedded within the matrix material to generate the test coupons. The coupons were tested on a mechanical testing machine, and the resulting stress-versus-stretch responses were studied. The fiber volume fraction (FVF), fiber spacing, and orientations were varied to estimate the changes in the mechanical responses. The mechanical behavior of the soft composites was characterized using hyperelastic material models such as Mooney-Rivlin's, Humphrey's, and Veronda-Westmann's model and also compared with the anisotropic mechanical behavior of the human skin, pelvic tissues, and brain tissues. This work lays the foundation for the experimental modelling of tissue anisotropy, which combined with microscopic studies on tissues can lead to refinements in the simulation of localized fiber distribution and orientations, and enable the development of biofidelic anisotropic tissue phantom materials for various tissue engineering and testing applications.

Tissue Anisotropy Modeling Using Soft Composite Materials

PubMed Central

Callaway, Christian

2018-01-01

Soft tissues in general exhibit anisotropic mechanical behavior, which varies in three dimensions based on the location of the tissue in the body. In the past, there have been few attempts to numerically model tissue anisotropy using composite-based formulations (involving fibers embedded within a matrix material). However, so far, tissue anisotropy has not been modeled experimentally. In the current work, novel elastomer-based soft composite materials were developed in the form of experimental test coupons, to model the macroscopic anisotropy in tissue mechanical properties. A soft elastomer matrix was fabricated, and fibers made of a stiffer elastomer material were embedded within the matrix material to generate the test coupons. The coupons were tested on a mechanical testing machine, and the resulting stress-versus-stretch responses were studied. The fiber volume fraction (FVF), fiber spacing, and orientations were varied to estimate the changes in the mechanical responses. The mechanical behavior of the soft composites was characterized using hyperelastic material models such as Mooney-Rivlin's, Humphrey's, and Veronda-Westmann's model and also compared with the anisotropic mechanical behavior of the human skin, pelvic tissues, and brain tissues. This work lays the foundation for the experimental modelling of tissue anisotropy, which combined with microscopic studies on tissues can lead to refinements in the simulation of localized fiber distribution and orientations, and enable the development of biofidelic anisotropic tissue phantom materials for various tissue engineering and testing applications. PMID:29853996

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.

Palaeoneurological clues to the evolution of defining mammalian soft tissue traits

PubMed Central

Benoit, J.; Manger, P. R.; Rubidge, B. S.

2016-01-01

A rich fossil record chronicles the distant origins of mammals, but the evolution of defining soft tissue characters of extant mammals, such as mammary glands and hairs is difficult to interpret because soft tissue does not readily fossilize. As many soft tissue features are derived from dermic structures, their evolution is linked to that of the nervous syutem, and palaeoneurology offers opportunities to find bony correlates of these soft tissue features. Here, a CT scan study of 29 fossil skulls shows that non-mammaliaform Prozostrodontia display a retracted, fully ossified, and non-ramified infraorbital canal for the infraorbital nerve, unlike more basal therapsids. The presence of a true infraorbital canal in Prozostrodontia suggests that a motile rhinarium and maxillary vibrissae were present. Also the complete ossification of the parietal fontanelle (resulting in the loss of the parietal foramen) and the development of the cerebellum in Probainognathia may be pleiotropically linked to the appearance of mammary glands and having body hair coverage since these traits are all controlled by the same homeogene, Msx2, in mice. These suggest that defining soft tissue characters of mammals were already present in their forerunners some 240 to 246 mya. PMID:27157809

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.

Paraspinal Transposition Flap for Reconstruction of Sacral Soft Tissue Defects: A Series of 53 Cases from a Single Institute

PubMed Central

Chattopadhyay, Debarati; Agarwal, Akhilesh Kumar; Guha, Goutam; Bhattacharya, Nirjhar; Chumbale, Pawan K; Gupta, Souradip; Murmu, Marang Buru

2014-01-01

Study Design Case series. Purpose To describe paraspinal transposition flap for coverage of sacral soft tissue defects. Overview of Literature Soft tissue defects in the sacral region pose a major challenge to the reconstructive surgeon. Goals of sacral wound reconstruction are to provide a durable skin and soft tissue cover adequate for even large sacral defects; minimize recurrence; and minimize donor site morbidity. Various musculocutaneous and fasciocutanous flaps have been described in the literature. Methods The flap was applied in 53 patients with sacral soft tissue defects of diverse etiology. Defects ranged in size from small (6 cm×5 cm) to extensive (21 cm×10 cm). The median age of the patients was 58 years (range, 16-78 years). Results There was no flap necrosis. Primary closure of donor sites was possible in all the cases. The median follow up of the patients was 33 months (range, 4-84 months). The aesthetic outcomes were acceptable. There has been no recurrence of pressure sores. Conclusions The authors conclude that paraspinal transposition flap is suitable for reconstruction of large sacral soft tissue defects with minimum morbidity and excellent long term results. PMID:24967044

Deformation of Soft Tissue and Force Feedback Using the Smoothed Particle Hydrodynamics

PubMed Central

Liu, Xuemei; Wang, Ruiyi; Li, Yunhua; Song, Dongdong

2015-01-01

We study the deformation and haptic feedback of soft tissue in virtual surgery based on a liver model by using a force feedback device named PHANTOM OMNI developed by SensAble Company in USA. Although a significant amount of research efforts have been dedicated to simulating the behaviors of soft tissue and implementing force feedback, it is still a challenging problem. This paper introduces a kind of meshfree method for deformation simulation of soft tissue and force computation based on viscoelastic mechanical model and smoothed particle hydrodynamics (SPH). Firstly, viscoelastic model can present the mechanical characteristics of soft tissue which greatly promotes the realism. Secondly, SPH has features of meshless technique and self-adaption, which supply higher precision than methods based on meshes for force feedback computation. Finally, a SPH method based on dynamic interaction area is proposed to improve the real time performance of simulation. The results reveal that SPH methodology is suitable for simulating soft tissue deformation and force feedback calculation, and SPH based on dynamic local interaction area has a higher computational efficiency significantly compared with usual SPH. Our algorithm has a bright prospect in the area of virtual surgery. PMID:26417380

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 vascular reanastomosis in the recipient site, the engineered products successful regenerated large-scale fat tissue in vivo. This approach may provide a translatable platform for composite soft tissue free flap engineering for microsurgical reconstruction. Copyright © 2016 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

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.

Screening paediatric rectal forms of azithromycin as an alternative to oral or injectable treatment.

PubMed

Kauss, Tina; Gaudin, Karen; Gaubert, Alexandra; Ba, Boubakar; Tagliaferri, Serena; Fawaz, Fawaz; Fabre, Jean-Louis; Boiron, Jean-Michel; Lafarge, Xavier; White, Nicholas J; Olliaro, Piero L; Millet, Pascal

2012-10-15

The aim of this study was to identify a candidate formulation for further development of a home or near-home administrable paediatric rectal form of a broad-spectrum antibiotic - specially intended for (emergency) use in tropical rural settings, in particular for children who cannot take medications orally and far from health facilities where injectable treatments can be given. Azithromycin, a broad-spectrum macrolide used orally or intravenously for the treatment of respiratory tract, skin and soft tissue infections, was selected because of its pharmacokinetic and therapeutic properties. Azithromycin in vitro solubility and stability in physiologically relevant conditions were studied. Various pharmaceutical forms, i.e. rectal suspension, two different rectal gels, polyethylene glycol (PEG) suppository and hard gelatin capsule (HGC) were assessed for in vitro dissolution and in vivo bioavailability in the rabbit. Azithromycin PEG suppository appears to be a promising candidate. Copyright © 2012 Elsevier B.V. All rights reserved.

Screening paediatric rectal forms of azithromycin as an alternative to oral or injectable treatment

PubMed Central

Kauss, Tina; Gaudin, Karen; Gaubert, Alexandra; Ba, Boubakar; Tagliaferri, Serena; Fawaz, Fawaz; Fabre, Jean-Louis; Boiron, Jean-Michel; Lafarge, Xavier; White, Nicholas J.; Olliaro, Piero L.; Millet, Pascal

2012-01-01

The aim of this study was to identify a candidate formulation for further development of a home or near-home administrable paediatric rectal form of a broad-spectrum antibiotic – specially intended for (emergency) use in tropical rural settings, in particular for children who cannot take medications orally and far from health facilities where injectable treatments can be given. Azithromycin, a broad-spectrum macrolide used orally or intravenously for the treatment of respiratory tract, skin and soft tissue infections, was selected because of its pharmacokinetic and therapeutic properties. Azithromycin in vitro solubility and stability in physiologically relevant conditions were studied. Various pharmaceutical forms, i.e. rectal suspension, two different rectal gels, polyethylene glycol (PEG) suppository and hard gelatin capsule (HGC) were assessed for in vitro dissolution and in vivo bioavailability in the rabbit. Azithromycin PEG suppository appears to be a promising candidate. PMID:22868232

Iatrogenic non-clostridial gas gangrene - a case report.

PubMed

Sh, Jayanth; Yp, Girish Chandra; J, Ramkumar

2016-03-01

Skin and soft tissue infections of the lower limbs are quite common and can at times progress rapidly to become both limb and life-threatening infections. Muscular infections usually occur in areas of the body that have been compromised or injured by a foreign body, trauma, ischaemia, injection of illicit drugs, malignancy or surgery. Gas gangrene is one such limb-threatening infection. The gas-forming infection can be clostridial or non-clostridial. Clostridia are the main causative organism of the gas gangrene. Non-clostridial gas gangrene is a rare condition and is known to be associated with high mortality. Here, we report one such rare case where a middle-aged man succumbed to non-clostridial gas gangrene after he was administered an intramuscular injection. The case was registered as a suspicious death by the police and the body was subjected to medico legal autopsy. © The Author(s) 2015.

Analysis of Anthrax Immune Globulin Intravenous with Antimicrobial Treatment in Injection Drug Users, Scotland, 2009-2010.

PubMed

Cui, Xizhong; Nolen, Leisha D; Sun, Junfeng; Booth, Malcolm; Donaldson, Lindsay; Quinn, Conrad P; Boyer, Anne E; Hendricks, Katherine; Shadomy, Sean; Bothma, Pieter; Judd, Owen; McConnell, Paul; Bower, William A; Eichacker, Peter Q

2017-01-01

We studied anthrax immune globulin intravenous (AIG-IV) use from a 2009-2010 outbreak of Bacillus anthracis soft tissue infection in injection drug users in Scotland, UK, and we compared findings from 15 AIG-IV recipients with findings from 28 nonrecipients. Death rates did not differ significantly between recipients and nonrecipients (33% vs. 21%). However, whereas only 8 (27%) of 30 patients at low risk for death (admission sequential organ failure assessment score of 0-5) received AIG-IV, 7 (54%) of the 13 patients at high risk for death (sequential organ failure assessment score of 6-11) received treatment. AIG-IV recipients had surgery more often and, among survivors, had longer hospital stays than did nonrecipients. AIG-IV recipients were sicker than nonrecipients. This difference and the small number of higher risk patients confound assessment of AIG-IV effectiveness in this outbreak.

Effects on craniofacial growth and development of unilateral botulinum neurotoxin injection into the masseter muscle.

PubMed

Tsai, Chi-Yang; Chiu, Wan Chi; Liao, Yi-Hsuan; Tsai, Chih-Mong

2009-02-01

The effects of botulinum neurotoxin type A (BoNT/A) on masseter muscles, when injected for cosmetic purposes (volumetric reduction) or treatment of excessive muscle activity (bruxism), have been investigated. However, the full anatomic effects of treatment are not known, particularly with respect to the mandible and relevant anthropometric measurements. The intent of this study was to use unilaterial BoNT/A injections to induce localized masseter atrophy and paresis and then to measure the effects of muscle influence on craniofacial growth and development. Growing male Wistar rats, 30 days old, were studied. The experimental group consisted of 8 rats. One side of the masseter muscle was injected with BoNT/A and the other side of the masseter muscle was injected with saline. The side with BoNT/A belonged to 1 group and the side with saline was the sham group. Three rats without injections was the control. After 45 days, the masseter muscles were dissected and weighed. Dry skulls were prepared, and anthropometric measurements determined. One-way ANOVA showed that the animals maintained their weight in both groups; however, the muscles injected with BoNT/A were smaller than the sham or control muscles. Anthropometric measurements of the bony structures attached to the masseter muscle showed a significant treatment effect. After localized masseter muscle atrophy induced by BoNT/A injection, alterations of craniofacial bone growth and development were seen. The results agree with the functional matrix theory that soft tissues regulate bone growth.

Genome-wide discovery of novel M1T1 group A streptococcal determinants important for fitness and virulence during soft-tissue infection

PubMed Central

Sundar, Ganesh S.; Islam, Emrul; Shirtliff, Mark E.

2017-01-01

The Group A Streptococcus remains a significant human pathogen causing a wide array of disease ranging from self-limiting to life-threatening invasive infections. Epithelium (skin or throat) colonization with progression to the subepithelial tissues is the common step in all GAS infections. Here, we used transposon-sequencing (Tn-seq) to define the GAS 5448 genetic requirements for in vivo fitness in subepithelial tissue. A near-saturation transposon library of the M1T1 GAS 5448 strain was injected subcutaneously into mice, producing suppurative inflammation at 24 h that progressed to prominent abscesses with tissue necrosis at 48 h. The library composition was monitored en masse by Tn-seq and ratios of mutant abundance comparing the output (12, 24 and 48 h) versus input (T0) mutant pools were calculated for each gene. We identified a total of 273 subcutaneous fitness (scf) genes with 147 genes (55 of unknown function) critical for the M1T1 GAS 5448 fitness in vivo; and 126 genes (53 of unknown function) potentially linked to in vivo fitness advantage. Selected scf genes were validated in competitive subcutaneous infection with parental 5448. Two uncharacterized genes, scfA and scfB, encoding putative membrane-associated proteins and conserved among Gram-positive pathogens, were further characterized. Defined scfAB mutants in GAS were outcompeted by wild type 5448 in vivo, attenuated for lesion formation in the soft tissue infection model and dissemination to the bloodstream. We hypothesize that scfAB play an integral role in enhancing adaptation and fitness of GAS during localized skin infection, and potentially in propagation to other deeper host environments. PMID:28832676

3D MRI Modeling of Thin and Spatially Complex Soft Tissue Structures without Shrinkage: Lamprey Myosepta as an Example.

PubMed

Wood, Bradley M; Jia, Guang; Carmichael, Owen; McKlveen, Kevin; Homberger, Dominique G

2018-05-12

3D imaging techniques enable the non-destructive analysis and modeling of complex structures. Among these, MRI exhibits good soft tissue contrast, but is currently less commonly used for non-clinical research than x-ray CT, even though the latter requires contrast-staining that shrinks and distorts soft tissues. When the objective is the creation of a realistic and complete 3D model of soft tissue structures, MRI data are more demanding to acquire and visualize and require extensive post-processing because they comprise non-cubic voxels with dimensions that represent a trade-off between tissue contrast and image resolution. Therefore, thin soft tissue structures with complex spatial configurations are not always visible in a single MRI dataset, so that standard segmentation techniques are not sufficient for their complete visualization. By using the example of the thin and spatially complex connective tissue myosepta in lampreys, we developed a workflow protocol for the selection of the appropriate parameters for the acquisition of MRI data and for the visualization and 3D modeling of soft tissue structures. This protocol includes a novel recursive segmentation technique for supplementing missing data in one dataset with data from another dataset to produce realistic and complete 3D models. Such 3D models are needed for the modeling of dynamic processes, such as the biomechanics of fish locomotion. However, our methodology is applicable to the visualization of any thin soft tissue structures with complex spatial configurations, such as fasciae, aponeuroses, and small blood vessels and nerves, for clinical research and the further exploration of tensegrity. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

Components of soft tissue deformations in subjects with untreated angle's Class III malocclusions: thin-plate spline analysis.

PubMed

Singh, G D; McNamara, J A; Lozanoff, S

1998-01-01

While the dynamics of maxillo-mandibular allometry associated with treatment modalities available for the management of Class III malocclusions currently are under investigation, developmental aberration of the soft tissues in untreated Class III malocclusions requires specification. In this study, lateral cephalographs of 124 prepubertal European-American children (71 with untreated Class III malocclusion; 53 with Class I occlusion) were traced, and 12 soft-tissue landmarks digitized. Resultant geometries were scaled to an equivalent size and mean Class III and Class I configurations compared. Procrustes analysis established statistical difference (P < 0.001) between the mean configurations. Comparing the overall untreated Class III and Class I configurations, thin-plate spline (TPS) analysis indicated that both affine and non-affine transformations contribute towards the deformation (total spline) of the averaged Class III soft tissue configuration. For non-affine transformations, partial warp 8 had the highest magnitude, indicating large-scale deformations visualized as a combination of columellar retrusion and lower labial protrusion. In addition, partial warp 5 also had a high magnitude, demonstrating upper labial vertical compression with antero-inferior elongation of the lower labio-mental soft tissue complex. Thus, children with Class III malocclusions demonstrate antero-posterior and vertical deformations of the maxillary soft tissue complex in combination with antero-inferior mandibular soft tissue elongation. This pattern of deformations may represent gene-environment interactions, resulting in Class III malocclusions with characteristic phenotypes, that are amenable to orthodontic and dentofacial orthopedic manipulations.

Reverse radial artery flap for soft tissue defects of hand in pediatric age group.

PubMed

Cheema, Saeed Ashraf; Talaat, Nabeela

2009-01-01

To highlight the usefulness of reverse radial artery flap in covering various soft tissue defects of hand in paediatric age group. A total of 16 reverse radial artery flaps were utilized in a period of three years to cover various soft tissue defects of hand for paediatric age group patients. The age ranged from 5-18 years. The two common causes of soft tissue defects in this series were mechanical trauma and fireworks trauma with five cases in each group. Three of the cases were burn victims and other two presented with earth quake injuries. One patient had wound because of road traffic accident. Soft tissue defects of palm were covered with this flap in eight cases while in three cases it was wrapped around the thumb. First web space defects were covered with this flap in two cases. Two cases required coverage of amputation stump at transmetacarpal level and yet another required a big flap to cover the soft tissue defects at palm, dorsum and thumb. Donor site was covered with split skin graft in all cases but one, which was closed primarily. We had partial loss of flap in one case. Grafted donor sites healed uneventfully and were quite acceptable to the patients in due course of time. Reverse radial artery flap has a quite long arc of rotation which brings it great ease to cover the soft tissue defects of various areas of hand like palm, dorsum, first web space and thumb.

Myoepithelial carcinoma on the right shoulder: Case report with published work review.

PubMed

Yokose, Chiharu; Asai, Jun; Kan, Saori; Nomiyama, Tomoko; Takenaka, Hideya; Konishi, Eiichi; Goto, Keisuke; Ansai, Shin-Ichi; Katoh, Norito

2016-09-01

Myoepithelial carcinoma is a malignant tumor that can differentiate towards myoepithelial cells and commonly occur in the salivary glands. There have been only a few reports of primary cutaneous myoepithelial carcinoma; however, most cases showed subcutaneous involvement and could also be diagnosed as soft tissue myoepithelial carcinoma arising from the subcutis with dermal involvement. It may thus be impossible to distinguish a primary cutaneous from a soft tissue myoepithelial carcinoma. Herein, we describe a case of myoepithelial carcinoma on the shoulder in an 85-year-old Japanese woman. The tumor was located in the whole dermis and subcutis; therefore, it could be diagnosed as either a cutaneous or soft tissue myoepithelial carcinoma. We reviewed previous cases of primary cutaneous and soft tissue myoepithelial carcinomas and compared their clinical and immunohistological features. We found no obvious differences in anatomical distribution or immunohistochemical findings. However, the recurrence rate of cutaneous myoepithelial carcinomas seems to be lower than that of soft tissue carcinomas. Such a difference may be attributable to the adequate surgical margin in cutaneous carcinomas compared with the deep-seated soft tissue carcinomas. The metastatic frequency did not significantly differ between the two types. Although we could summarize from only a small number of cases, these results indicate the difficulty in distinguishing between cutaneous and soft tissue myoepithelial carcinomas; furthermore, it may not be suitable to distinguish them on the basis of aggressive behavior. © 2016 Japanese Dermatological Association.

Xenogeneic collagen matrix versus connective tissue graft for buccal soft tissue augmentation at implant site. A randomized, controlled clinical trial.

PubMed

Cairo, Francesco; Barbato, Luigi; Tonelli, Paolo; Batalocco, Guido; Pagavino, Gabriella; Nieri, Michele

2017-07-01

Peri-implant soft tissue may be critical to prevent inflammation and promote gingival margin stability. The purpose of this randomized clinical trial (RCT) is to compare xenogeneic collagen matrix (XCM) versus connective tissue graft (CTG) to increase buccal soft tissue thickness at implant site. Soft tissue augmentation with XCM (test) or CTG (control) was performed at 60 implants in 60 patients at the time of implant uncovering. Measurements were performed by a blinded examiner at baseline, 3 and 6 months. Outcome measures included buccal soft tissue thickness (GT), apico-coronal keratinized tissue (KT), chair time and post-operative discomfort. Visual Analogue Scale (VAS) was used to evaluate patient satisfaction. After 6 months, the final GT increase was 0.9 ± 0.2 in the XCM group and 1.2 ± 0.3 mm in the CTG group, with a significant difference favouring the control group (0.3 mm; p = .0001). Both procedures resulted in similar final KT amount with no significant difference between treatments. XCM was associated with significant less chair-time (p < .0001), less post-operative pain (p < .0001), painkillers intake (p < .0001) and higher final satisfaction than CTG (p = .0195). CTG was more effective than XCM to increase buccal peri-implant soft tissue thickness. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Comparative anatomy and histology of xenarthran osteoderms.

PubMed

Hill, Robert V

2006-12-01

Reconstruction of soft tissues in fossil vertebrates is an enduring challenge for paleontologists. Because inferences must be based on evidence from hard tissues (typically bones or teeth), even the most complete fossils provide only limited information about certain organ systems. Osteoderms ("dermal armor") are integumentary bones with high fossilization potential that hold information about the anatomy of the skin in many extant and fossil amniotes. Their importance for functional morphology and phylogenetic research has recently been recognized, but studies have focused largely upon reptiles, in which osteoderms are most common. Among mammals, osteoderms occur only in members of the clade Xenarthra, which includes armadillos and their extinct relatives: glyptodonts, pampatheres, and, more distantly, ground sloths. Here, I present new information on the comparative morphology and histology of osteoderms and their associated soft tissues in 11 extant and fossil xenarthrans. Extinct mylodontid sloths possessed simple, isolated ossicles, the presence of which is likely plesiomorphic for Xenarthra. More highly derived osteoderms of glyptodonts, pampatheres, and armadillos feature complex articulations and surface ornamentation. Osteoderms of modern armadillos are physically associated with a variety of soft tissues, including nerve, muscle, gland, and connective tissue. In some cases, similar osteological features may be caused by two or more different tissue types, rendering soft-tissue inferences for fossil osteoderms equivocal. Certain osteological structures, however, are consistently associated with specific soft-tissue complexes and therefore represent a relatively robust foundation upon which to base soft-tissue reconstructions of extinct xenarthrans. Copyright 2006 Wiley-Liss, Inc.

Intra-oral soft tissue expansion and volume stability of onlay bone grafts.

PubMed

Abrahamsson, Peter

2011-01-01

Insufficient regeneration of missing bone and soft-tissue may present aesthetic or functional problems in patients indicated for dental implant surgery. Several techniques such as bone grafts, bone substitutes and guided tissue regeneration (GTR) have been described to rebuild a compromised alveolar ridge. Adequate soft-tissue coverage of grafted bone and titanium-mesh is important to avoid exposure which may result in loss of the bone graft. The general aim of this thesis was to evaluate use of an osmotic tissue expander for expanding intra-oral soft tissue--creating a surplus of soft tissue-- in preparation for onlay bone grafting. An experimental rabbit model was used in studies (I), (II) and (III). In (I) an osmotic soft-tissue expander was placed bilaterally on the lateral wall of the mandible via an extra-oral approach. After two weeks of expansion the rabbits were killed and specimens were collected for histology. No inflammatory reaction and no resorbtion of the cortical bone occured. The periosteum was expanded and new bone formation was seen in the edges of the expander. In (II) and (III) the expander was placed under the periosteum in the same way as in (I): bilaterally in 13 rabbits in (II) and unilaterally in 11 rabbits in (III). After two weeks of expansion the expander was identified and removed. In (II) particulated bone was placed at the recipient site protected by a titanium mesh in one site and a bio-resorbable mesh on the other site. In (III), DBBM particles and bone particles collected from the lateral border of the mandible separated by a collagen membrane was placed at the recipient site. The graft was protected by a pre-bent titanium mesh covered by a collagen membrane. After a healing period of 3 months specimens were collected for histological and SEM examination. New bone was growing in direct contact with the titanium mesh and bio resorbable mesh. The newly formed bone had the same calcium content as the mature bone in the base of the mandible. In the clinical study (IV) 20 patients were consecutively recruited and randomised into two groups. The experimental group (ten patients) had an osmotic soft tissue expander implanted. After two weeks of expansion the expander was removed and a particulated bone graft protected by a titanium mesh and a collagen membrane was fixed to the recipient site. Titanium implants were installed after a healing period of 6 months. The patients in the reference group had a bone block grafted from the anterior ramus fixated to the recipient site with one or two titanium mini screws. Implants were installed after a healing period of 6 months. A three dimensional optical measuring device was used to measure alterations in the soft tissue profile before each surgical procedure. The three-dimensional changes were then analysed on a PC. The results from the clinical study in patients confirmed the results from the experimental rabbit studies. The osmotic tissue expander expanded the soft tissue. Expander perforations of the soft tissue occurred in two patients. The optical measurements demonstrated a positive volume gain after soft tissue expansion and bone grafting. The expanded tissue could be used to cover a bone graft. There still was a risk of mesh exposure, even after soft tissue expansion, which occurred in two patients. In both groups, implants could be installed in the grafted bone in positions that would allow the crowns to fit aesthetically into the dental arch.

A new method of fabricating a blend scaffold using an indirect three-dimensional printing technique.

PubMed

Jung, Jin Woo; Lee, Hyungseok; Hong, Jung Min; Park, Jeong Hun; Shim, Jung Hee; Choi, Tae Hyun; Cho, Dong-Woo

2015-11-03

Due to its simplicity and effectiveness, the physical blending of polymers is considered to be a practical strategy for developing a versatile scaffold having desirable mechanical and biochemical properties. In the present work, an indirect three-dimensional (i3D) printing technique was proposed to fabricate a 3D free-form scaffold using a blend of immiscible materials, such as polycaprolactone (PCL) and gelatin. The i3D printing technique includes 3D printing of a mold and a sacrificial molding process. PCL/chloroform and gelatin/water were physically mixed to prepare the blend solution, which was subsequently injected into the cavity of a 3D printed mold. After solvent removal and gelatin cross-linking, the mold was dissolved to obtain a PCL-gelatin (PG) scaffold, with a specific 3D structure. Scanning electron microscopy and Fourier transform infrared spectroscopy analysis indicated that PCL masses and gelatin fibers in the PG scaffold homogenously coexisted without chemical bonding. Compression tests confirmed that gelatin incorporation into the PCL enhanced its mechanical flexibility and softness, to the point of being suitable for soft-tissue engineering, as opposed to pure PCL. Human adipose-derived stem cells, cultured on a PG scaffold, exhibited enhanced in vitro chondrogenic differentiation and tissue formation, compared with those on a PCL scaffold. The i3D printing technique can be used to blend a variety of materials, facilitating 3D scaffold fabrication for specific tissue regeneration. Furthermore, this convenient and versatile technique may lead to wider application of 3D printing in tissue engineering.

Impact of timing on soft tissue augmentation during implant treatment: A systematic review and meta-analysis.

PubMed

Lin, Cho-Ying; Chen, Zhaozhao; Pan, Whei-Lin; Wang, Hom-Lay

2018-05-01

To achieve a predictable esthetic and functional outcome, soft tissue augmentation has become popular in implant treatment. The aim of this systematic review and meta-analysis was to assess the influence of different timing for soft tissue augmentation during implant treatment on soft tissue conditions and its stability. Electronic and manual searches for articles written in English up to September 2017 were performed by two independent reviewers. Human clinical studies with the purpose of evaluating outcomes (at least 3-month follow-up) of autogenous soft tissue graft for augmentation during implant treatment, either simultaneous or after implant placement (staged), were included. Cumulative changes of keratinized tissue width (KTW), soft tissue thickness (STT), and mid-buccal mucosal recession (MR) data were analyzed with a random-effects model to compare the postoperative outcomes. Twenty-nine human studies (eight randomized clinical trials, six cohort studies, and 15 case series) that met the inclusion criteria were included. For the overall data, the weighted mean STT gain (1 year after surgery) was 1.03 mm (95% CI: 0.78-1.29 mm), among which the simultaneous group was 1.12 mm (95% CI: 0.75-1.49 mm) and staged group (3-6 months after implant placement) was 0.95 mm (95% CI: 0.58-1.31 mm). There was no statistically significant difference in KTW and MR between 3 months and more than 3 months after surgery. This review revealed that the stability of soft tissue, in terms of KTW and mid-buccal MR, can be obtained 3 months after surgery. There is no difference between simultaneous and staged soft tissue augmentation during implant treatment, and both procedures significantly enhance KTW and STT. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

3D map of theranostic nanoparticles distribution in mice brain and liver by means of X-ray Phase Contrast Tomography

NASA Astrophysics Data System (ADS)

Longo, E.; Bravin, A.; Brun, F.; Bukreeva, I.; Cedola, A.; Fratini, M.; Le Guevel, X.; Massimi, L.; Sancey, L.; Tillement, O.; Zeitoun, P.; de La Rochefoucauld, O.

2018-01-01

The word "theranostic" derives from the fusion of two terms: therapeutic and diagnostic. It is a promising research field that aims to develop innovative therapies with high target specificity by exploiting the therapeutic and diagnostic properties, in particular for metal-based nanoparticles (NPs) developed to erase cancer. In the framework of a combined research program on low dose X-ray imaging and theranostic nanoparticles (NPs), high resolution Phase-Contrast Tomography images of mice organs injected with gadolinium and gold-NPs were acquired at the European Synchrotron Radiation Facility (ESRF). Both compounds are good X-ray contrast agents due to their high attenuation coefficient with respect to biological tissues, especially immediately above K-edge energy. X-ray tomography is a powerful non-invasive technique to image the 3D vasculature network in order to detect abnormalities. Phase contrast methods provide more detailed anatomical information with higher discrimination among soft tissues. We present the images of mice liver and brain injected with gold and gadolinium NPs, respectively. We discuss different image processing methods used aiming at enhancing the accuracy on localizing nanoparticles.

Multi organ failure following intravenous gasoline for suicide: a case report.

PubMed

Mahmoodpoor, Ata; Soleimanpour, Hassan; Hamishehkar, Hadi

2012-01-01

Hydrocarbons are ubiquitous in daily life and include plant and animal fats, alcohols, solvents, natural gas, petroleum derivates. Majority of intoxication reports of hydrocarbons are due to inhalation or ingestion, but there is few reports about intravenous injection of gasoline. We report a 58 year-old man who injected gasoline intravenously for suicide. He developed soft tissue necrosis of forearm and bilateral pulmonary infiltration. He underwent fasciotomy and extensive debridement of necrotic tissues, at the operation room. He was intubated and mechanically ventilated because of acute lung injury. He developed acute kidney injury after 2 days. These symptoms seem to be due to extravasation of gasoline from vessels which lead to inflammation, cell damage and organ failure. The patient developed multi organ failure which unfortunately did not respond to our treatment and he died at day 21. Management of gasoline intoxication depends on the rout of exposure. Like other types of toxications, intravenous toxication has pulmonary involvement, however in this case we had multiple organ involvement. It seems that in such cases we should consider early end organ targeted therapy to stop the future organ failure. © 2012 Tehran University of Medical Sciences. All rights reserved.

Summaries of Research - Fiscal Year 1985.

DTIC Science & Technology

1986-01-01

emergencies, not trauma-related, 2) diagnosis of dental emergencies, trauma-related, 3) differential diagnosis of soft tissue lesions, 4) definitions of terms...on 49 different soft tissue lesions. Preliminary validation was accomplished by a variety of dentists who input over 200 simulated emergencies. The...non-specific opsonin, that promotes adhesion of fibroblasts to collagen, and influences the attachment of bacteria to soft tissues . As a first step

Soft tissue recurrence of giant cell tumor of the bone: Prevalence and radiographic features.

PubMed

Xu, Leilei; Jin, Jing; Hu, Annan; Xiong, Jin; Wang, Dongmei; Sun, Qi; Wang, Shoufeng

2017-11-01

Recurrence of giant cell tumor of bone (GCTB) in the soft tissue is rarely seen in the clinical practice. This study aims to determine the prevalence of soft tissue recurrence of GCTB, and to characterize its radiographic features. A total of 291 patients treated by intralesional curettage for histologically diagnosed GCTB were reviewed. 6 patients were identified to have the recurrence of GCTB in the soft tissue, all of whom had undergone marginal resection of the lesion. Based on the x-ray, CT and MRI imaging, the radiographic features of soft tissue recurrence were classified into 3 types. Type I was defined as soft tissue recurrence with peripheral ossification, type II was defined as soft tissue recurrence with central ossification, and type III was defined as pure soft tissue recurrence without ossification. Demographic data including period of recurrence and follow-up duration after the second surgery were recorded for these 6 patients. Musculoskeletal Tumor Society (MSTS) scoring system was used to evaluate functional outcomes. The overall recurrence rate was 2.1% (6/291). The mean interval between initial surgery and recurrence was 11.3 ± 4.1 months (range, 5-17). The recurrence lesions were located in the thigh of 2 patients, in the forearm of 2 patients and in the leg of the other 2 patients. According to the classification system mentioned above, 2 patients were classified with type I, 1 as type II and 3 as type III. After the marginal excision surgery, all patients were consistently followed up for a mean period of 13.4 ± 5.3 months (range, 6-19), with no recurrence observed at the final visit. All the patients were satisfied with the surgical outcome. According to the MSTS scale, the mean postoperative functional score was 28.0 ± 1.2 (range, 26-29). The classification of soft tissue recurrence of GCTB may be helpful for the surgeon to select the appropriate imaging procedure to detect the recurrence. In addition, the marginal resection can produce a favorable outcome for the patients.

SU-E-J-203: Investigation of 1.5T Magnetic Field Dose Effects On Organs of Different Density

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, H; Rubinstein, A; Ibbott, G

2015-06-15

Purpose: For the combined 1.5T/6MV MRI-linac system, the perpendicular magnetic field to the radiation beam results in altered radiation dose distributions. This Monte Carlo study investigates the change in dose at interfaces for common organs neighboring soft tissue. Methods: MCNP6 was used to simulate the effects of a 1.5T magnetic field when irradiating tissues with a 6 MV beam. The geometries used in this study were not necessarily anatomically representative in size in order to directly compare quantitative dose effects for each tissue at the same depths. For this purpose, a 512 cm{sup 3} cubic material was positioned at themore » center of a 2744 cm{sup 3} cubic soft tissue material phantom. The following tissue materials and their densities were used in this study: lung (0.296 g/cm{sup 3}), fat (0.95), spinal cord (1.038), soft tissue (1.04), muscle (1.05), eye (1.076), trabecular bone (1.40), and cortical bone (1.85). Results: The addition of a 1.5T magnetic field caused dose changes of +46.5%, +2.4%, −0.9%, −0.8%, −1.5%, −6.5%, and −8.8% at the entrance interface between soft tissue and lung, fat, spinal cord, muscle, eye, trabecular bone, and cortical bone tissues respectively. Dose changes of −39.4%, −4.1%, −0.8%, −0.8%, +0.5%, +6.7%, and +10.9% were observed at the second interface between the same tissues respectively and soft tissue. On average, the build-up distance was reduced by 0.6 cm, and a dose increase of 62.7% was observed at the exit interface between soft tissue and air of the entire phantom. Conclusion: The greatest changes in dose were observed at interfaces containing lung and bone tissues. Due to the prevalence and proximity of bony anatomy to soft tissues throughout the human body, these results encourage further examination of these tissues with anatomically representative geometries using multiple beam configurations for safe treatment using the MRI-linac system.« less

Possible role of mechanical force in regulating regeneration of the vascularized fat flap inside a tissue engineering chamber.

PubMed

Ye, Yuan; Yuan, Yi; Lu, Feng; Gao, Jianhua

2015-12-01

In plastic and reconstructive surgery, adipose tissue is widely used as effective filler for tissue defects. Strategies for treating soft tissue deficiency, which include free adipose tissue grafts, use of hyaluronic acid, collagen injections, and implantation of synthetic materials, have several clinical limitations. With the aim of overcoming these limitations, researchers have recently utilized tissue engineering chambers to produce large volumes of engineered vascularized fat tissue. However, the process of growing fat tissue in a chamber is still relatively limited, and can result in unpredictable or dissatisfactory final tissue volumes. Therefore, detailed understanding of the process is both necessary and urgent. Many studies have shown that mechanical force can change the function of cells via mechanotransduction. Here, we hypothesized that, besides the inflammatory response, one of the key factors to control the regeneration of vascularized fat flap inside a tissue engineering chamber might be the balance of mechanical forces. To test our hypothesis, we intend to change the balance of forces by means of measures in order to make the equilibrium point in favor of the direction of regeneration. If those measures proved to be feasible, they could be applied in clinical practice to engineer vascularized adipose tissue of predictable size and shape, which would in turn help in the advancement of tissue engineering. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Magnetic resonance imaging in facial injuries and digital fusion CT/MRI].

PubMed

Kozakiewicz, Marcin; Olszycki, Marek; Arkuszewski, Piotr; Stefańczyk, Ludomir

2006-01-01

Magnetic resonance images [MRI] and their digital fusion with computed tomography [CT] data, observed in patients affected with facial injuries, are presented in this study. The MR imaging of 12 posttraumatic patients was performed in the same plains as their previous CT scans. Evaluation focused on quality of the facial soft tissues depicting, which was unsatisfactory in CT. Using the own "Dental Studio" programme the digital fusion of the both modalities was performed. Pathologic dislocations and injures of facial soft tissues are visualized better in MRI than in CT examination. Especially MRI properly reveals disturbances in intraorbital soft structures. MRI-based assessment is valuable in patients affected with facial soft tissues injuries, especially in case of orbita/sinuses hernia. Fusion CT/MRI scans allows to evaluate simultaneously bone structure and soft tissues of the same region.

Soft Tissue Grafting Around Teeth and Implants.

PubMed

Deeb, George R; Deeb, Janina Golob

2015-08-01

The presence of healthy attached tissue at the tooth and implant soft tissue interface correlates with long-term success and stability in function and esthetics. There are several soft tissue grafting procedures that increase the volume of keratinized tissue and provide coverage on both teeth and implants. Many of these techniques can be used in conjunction with implant placement, or after placement as a means of salvage. This article describes the techniques for augmentation of keratinized tissue as well as root and implant coverage. These tools should be in the armamentarium of oral and maxillofacial surgeons providing implant services. Copyright © 2015 Elsevier Inc. All rights reserved.

Randomised, prospective, non-blinded pilot study comparing the effect of intramuscular steroid injections and intralesional steroid injections in the management of tennis elbow

PubMed Central

Tahir, Hasan; Biro, Izolda; Donnelly, Simon; Greenwood, Mandy

2016-01-01

Background Tennis elbow is an overuse injury affecting people performing repetitive forearm movements. It is a soft tissue disorder that causes significant disability and pain. The aim of the study was to establish that an intramuscular steroid injection is effective in the short-term pain relief and functional improvement of tennis elbow. The severity of pain at the injection site was monitored to determine whether the intramuscular injection is better tolerated than the intralesional injection. Methods and results 19 patients, who had no treatment for tennis elbow in the preceding 3 months, were recruited from Whipps Cross University Hospital, London, and were randomised to receive either 80 mg of intramuscular Depo-Medrone or 40 mg of intralesional Depo-Medrone injection. Blinding proved difficult as the injection sites differed and placebo arms were not included in the study. A Patient-Rated Tennis Elbow Evaluation (PRTEE) Questionnaire and a 10-point Likert scale were used to assess primary outcome. Six weeks after the treatment, there was a reduction in pain, improvement in function and total PRTEE scores in both intramuscular and intralesional groups (p=0.008) using a 95% CI for mean treatment difference of −26 to +16 points. A statistically significant result (p=0.001) in favour of intramuscular causing less pain at the injection site was noted. Conclusion Non-inferiority of intramuscular to intralesional injections was not confirmed; however, the intramuscular injection proved to be effective in reducing tennis elbow-related symptoms and was found less painful at the site of injection at the time of administration. Trial registration number EUDRACT Number: 2010-022131-11. REC Number: 10/H0718/76 (NRES, Central London REC 1). PMID:28879024

Autologous platelet-rich plasma as an adipocyte in vivo delivery system: case report.

PubMed

Azzena, Bruno; Mazzoleni, Francesco; Abatangelo, Giovanni; Zavan, Barbara; Vindigni, Vincenzo

2008-01-01

Tissue engineering has emerged as a promising alternative to current clinical treatments for restoration of soft tissue defects. A key element in the process of tissue engineering is an ideal implant that provides structural support and a favorable environment for growing cells. The authors hypothesized that autologous platelet-rich plasma (APRP) could be used as an in vivo adipocyte delivery system to favor cell survival and to stimulate early recruitment of microcapillaries to the site of implantation. Autologous fat was included in APRP and injected as a gel into a subcutaneous pocket created to correct a painful, adherent scar at the shoulder level in a 75-year-old woman. The surgical outcome was evaluated by histologic and immunohistochemical analysis as well as by ecography before and after surgery. The results were satisfactory, showing fat survival 1 year after surgery. The characteristics of this new material should stimulate research into future clinical applications for such cell constructs in plastic and reconstructive surgery.

Real-time three-dimensional ultrasound-assisted axillary plexus block defines soft tissue planes.

PubMed

Clendenen, Steven R; Riutort, Kevin; Ladlie, Beth L; Robards, Christopher; Franco, Carlo D; Greengrass, Roy A

2009-04-01

Two-dimensional (2D) ultrasound is commonly used for regional block of the axillary brachial plexus. In this technical case report, we described a real-time three-dimensional (3D) ultrasound-guided axillary block. The difference between 2D and 3D ultrasound is similar to the difference between plain radiograph and computer tomography. Unlike 2D ultrasound that captures a planar image, 3D ultrasound technology acquires a 3D volume of information that enables multiple planes of view by manipulating the image without movement of the ultrasound probe. Observation of the brachial plexus in cross-section demonstrated distinct linear hyperechoic tissue structures (loose connective tissue) that initially inhibited the flow of the local anesthesia. After completion of the injection, we were able to visualize the influence of arterial pulsation on the spread of the local anesthesia. Possible advantages of this novel technology over current 2D methods are wider image volume and the capability to manipulate the planes of the image without moving the probe.

Injectional anthrax at a Scottish district general hospital.

PubMed

Inverarity, D J; Forrester, V M; Cumming, J G R; Paterson, P J; Campbell, R J; Brooks, T J G; Carson, G L; Ruddy, J P

2015-04-01

This retrospective, descriptive case-series reviews the clinical presentations and significant laboratory findings of patients diagnosed with and treated for injectional anthrax (IA) since December 2009 at Monklands Hospital in Central Scotland and represents the largest series of IA cases to be described from a single location. Twenty-one patients who fulfilled National Anthrax Control Team standardized case definitions of confirmed, probable or possible IA are reported. All cases survived and none required limb amputation in contrast to an overall mortality of 28% being experienced for this condition in Scotland. We document the spectrum of presentations of soft tissue infection ranging from mild cases which were managed predominantly with oral antibiotics to severe cases with significant oedema, organ failure and coagulopathy. We describe the surgical management, intensive care management and antibiotic management including the first description of daptomycin being used to treat human anthrax. It is noted that some people who had injected heroin infected with Bacillus anthracis did not develop evidence of IA. Also highlighted are biochemical and haematological parameters which proved useful in identifying deteriorating patients who required greater levels of support and surgical debridement.

Towards endoscopic ultrafast laser microsurgery of vocal folds

NASA Astrophysics Data System (ADS)

Hoy, Christopher L.; Everett, W. Neil; Yildirim, Murat; Kobler, James; Zeitels, Steven M.; Ben-Yakar, Adela

2012-03-01

Vocal fold scarring is a predominant cause of voice disorders yet lacks a reliable treatment method. The injection of soft biomaterials to improve mechanical compliance of the vocal folds has emerged as a promising treatment. Here, we study the use of precise femtosecond laser microsurgery to ablate subsurface voids, with a goal of eventually creating a plane in dense subepithelial scar tissue into which biomaterials can be injected for their improved localization. Specifically, we demonstrate the ablation of small subepithelial voids in porcine vocal fold tissue up to 120 µm below the surface such that larger voids in the active area of vocal fold mucosa (~3×10 mm2) can eventually be ablated in about 3 min. We use sub-µJ, 776-nm pulses from a compact femtosecond fiber laser system operating at a 500-kHz repetition rate. The use of relatively high repetition rates, with a small number of overlapping pulses, is critical to achieving ablation in a very short time while still avoiding significant heat deposition. Additionally, we use the same laser for nonlinear optical imaging to provide visual feedback of tissue structure and to confirm successful ablation. The ablation parameters, including pulse duration, pulse energy, spot size, and scanning speed, are comparable to the specifications in our recently developed miniaturized femtosecond laser surgery probes, illustrating the feasibility of developing an ultrafast laser surgical instrument.

Practical use of imaging technique for management of bone and soft tissue tumors.

PubMed

Miwa, Shinji; Otsuka, Takanobu

2017-05-01

Imaging modalities including radiography, computed tomography (CT), and magnetic resonance imaging (MRI) are necessary for the diagnosis of bone and soft tissue tumors. The history of imaging began with the discovery of X-rays in the 19th century. The development of CT, MRI, ultrasonography, and positron emission tomography (PET) have improved the management of bone and soft tissue tumors. X-ray imaging and CT scans enable the evaluation of bone destruction, periosteal reaction, sclerotic changes in lesions, condition of cortical bone, and ossification. MRI enables the assessment of tissue characteristics, tumor extent, and the reactive areas. Functional imaging modalities including 201 thallium ( 201 Tl) scintigraphy can be used to differentiate benign lesions from malignant lesions and to assess chemotherapeutic effects. Real-time assessment of soft tissue tumors by ultrasonography enables accurate and safe performance of surgery and biopsy. This article describes useful imaging modalities and characteristic findings in the management of bone and soft tissue tumors. Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

'Care and Prevent': rationale for investigating skin and soft tissue infections and AA amyloidosis among people who inject drugs in London.

PubMed

Harris, M; Brathwaite, R; McGowan, Catherine R; Ciccarone, D; Gilchrist, G; McCusker, M; O'Brien, K; Dunn, J; Scott, J; Hope, V

2018-05-08

Skin and soft tissue infections (SSTIs) are a leading cause of morbidity and mortality among people who inject drugs (PWID). International data indicate up to one third of PWID have experienced an SSTI within the past month. Complications include sepsis, endocarditis and amyloid A (AA) amyloidosis. AA amyloidosis is a serious sequela of chronic SSTI among PWID. Though there is a paucity of literature reporting on AA amyloidosis among PWID, what has been published suggests there is likely a causal relationship between AA amyloidosis and injecting-related SSTI. If left untreated, AA amyloidosis can lead to renal failure; premature mortality among diagnosed PWID is high. Early intervention may reverse disease. Despite the high societal and individual burden of SSTI among PWID, empirical evidence on the barriers and facilitators to injecting-related SSTI prevention and care or the feasibility and acceptability of AA amyloidosis screening and treatment referral are limited. This study aims to fill these gaps and assess the prevalence of AA amyloidosis among PWID. Care and Prevent is a UK National Institute for Health Research-funded mixed-methods study. In five phases (P1-P5), we aim to assess the evidence for AA amyloidosis among PWID (P1); assess the feasibility of AA amyloidosis screening, diagnostic and treatment referral among PWID in London (P2); investigate the barriers and facilitators to AA amyloidosis care (P3); explore SSTI protection and risk (P4); and co-create harm reduction resources with the affected community (P5). This paper describes the conceptual framework, methodological design and proposed analysis for the mixed-methods multi-phase study. We are implementing the Care and Prevent protocol in London. The systematic review component of the study has been completed and published. Care and Prevent will generate an estimate of AA amyloidosis prevalence among community recruited PWID in London, with implications for the development of screening recommendations and intervention implementation. We aim to recruit 400 PWID from drug treatment services in London, UK. Care and Prevent is the first study to assess screening feasibility and the prevalence of positive proteinuria, as a marker for AA amyloidosis, among PWID accessing drug treatment services. AA amyloidosis is a serious, yet under-recognised condition for which early intervention is available but not employed.

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

Tracheo-bronchial soft tissue and cartilage resonances in the subglottal acoustic input impedance.

PubMed

Lulich, Steven M; Arsikere, Harish

2015-06-01

This paper offers a re-evaluation of the mechanical properties of the tracheo-bronchial soft tissues and cartilage and uses a model to examine their effects on the subglottal acoustic input impedance. It is shown that the values for soft tissue elastance and cartilage viscosity typically used in models of subglottal acoustics during phonation are not accurate, and corrected values are proposed. The calculated subglottal acoustic input impedance using these corrected values reveals clusters of weak resonances due to soft tissues (SgT) and cartilage (SgC) lining the walls of the trachea and large bronchi, which can be observed empirically in subglottal acoustic spectra. The model predicts that individuals may exhibit SgT and SgC resonances to variable degrees, depending on a number of factors including tissue mechanical properties and the dimensions of the trachea and large bronchi. Potential implications for voice production and large pulmonary airway tissue diseases are also discussed.

Characterization of focal muscle compression under impact loading

NASA Astrophysics Data System (ADS)

Butler, B. J.; Sory, D. R.; Nguyen, T.-T. N.; Proud, W. G.; Williams, A.; Brown, K. A.

2017-01-01

In modern wars over 70% of combat wounds are to the extremities. These injuries are characterized by disruption and contamination of the limb soft tissue envelope. The extent of this tissue trauma and contamination determine the outcome of the extremity injury. In military injury, common post-traumatic complications at amputation sites include heterotopic ossification (formation of bone in soft tissue), and severe soft tissue and bone infections. We are currently developing a model of soft tissue injury that recreates pathologies observed in combat injuries. Here we present characterization of a controlled focal compression of the rabbit flexor carpi ulnaris (FCU) muscle group. The FCU was previously identified as a suitable site for studying impact injury because its muscle belly can easily be mobilized from the underlying bone without disturbing anatomical alignment in the limb. We show how macroscopic changes in tissue organization, as visualized using optical microscopy, can be correlated with data from temporally resolved traces of loading conditions.

Soft Tissue Closure of Grafted Extraction Sockets in the Anterior Maxilla: A Modified Palatal Pedicle Connective Tissue Flap Technique.

PubMed

El Chaar, Edgard; Oshman, Sarah; Cicero, Giuseppe; Castano, Alejandro; Dinoi, Cinzia; Soltani, Leila; Lee, Yoonjung Nicole

Localized ridge resorption, the consequence of socket collapse, following tooth extraction in the anterior maxilla can adversely affect esthetics, function, and future implant placement. Immediate grafting of extraction sockets may help preserve natural ridge contours, but a lack of available soft tissue can compromise the final esthetic outcome. The presented modified rotated palatal pedicle connective tissue flap is a useful technique for simultaneous soft tissue coverage and augmentation of grafted sockets to improve esthetic outcome. This article delineates its advantages through the presentation of a four-case series using this new technique.

Limb salvage after gas gangrene: a case report and review of the literature

PubMed Central

2011-01-01

Gas gangrene is a necrotic infection of soft tissue associated with high mortality, often necessitating amputation in order to control the infection. Herein we present a case of gas gangrene of the arm in an intravenous drug user with a history of intramuscular injections with normal saline in the shoulder used to provoke pain for recovery after drug induced coma. The patient was early treated with surgery and antibiotics rendering possible the preservation of the limb and some of its function. Additionally, a review of the literature regarding case reports of limb salvage after gas gangrene is presented. PMID:21846405

Regeneration of soft and hard tissue periodontal defects.

PubMed

Caffesse, Raúl G; de la Rosa, Manuel; Mota, Luis F

2002-10-01

Periodontitis is characterized by the formation of periodontal pockets and bone loss. Although the basic treatment emphasizes the control of bacterial plaque, the clinician is confronted with the need to correct soft and/or hard tissue defects that develop as a consequence of the disease. This article reviews the current status of regenerative approaches in treating soft and hard tissue defects (based mainly on findings from our own laboratory) and assessed the global applicability of these procedures. Many different techniques have been suggested to treat those defects with, in general, a high degree of success. From the present knowledge it can be concluded that periodontal soft and hard tissue regeneration is possible. Treatment of areas with localized gingival recession or insufficient keratinized gingiva can be achieved with soft tissue grafts or pedicle flaps, as well as with the use of dermal allografts. The treatment of hard tissue defects around teeth and implants can be approached using different types of bone grafts, guided tissue or bone regeneration, or a combination of these. The predictability of many of these therapies, however, still needs to be improved. Since most of these techniques are sensitive, specific, and expensive, their present universal application is limited.

Soft-Tissue Infections and Their Imaging Mimics: From Cellulitis to Necrotizing Fasciitis.

PubMed

Hayeri, Mohammad Reza; Ziai, Pouya; Shehata, Monda L; Teytelboym, Oleg M; Huang, Brady K

2016-10-01

Infection of the musculoskeletal system can be associated with high mortality and morbidity if not promptly and accurately diagnosed. These infections are generally diagnosed and managed clinically; however, clinical and laboratory findings sometimes lack sensitivity and specificity, and a definite diagnosis may not be possible. In uncertain situations, imaging is frequently performed to confirm the diagnosis, evaluate the extent of the disease, and aid in treatment planning. In particular, cross-sectional imaging, including computed tomography and magnetic resonance imaging, provides detailed anatomic information in the evaluation of soft tissues due to their inherent high spatial and contrast resolution. Imaging findings of soft-tissue infections can be nonspecific and can have different appearances depending on the depth and anatomic extent of tissue involvement. Although many imaging features of infectious disease can overlap with noninfectious processes, imaging can help establish the diagnosis when combined with the clinical history and laboratory findings. Radiologists should be familiar with the spectrum of imaging findings of soft-tissue infections to better aid the referring physician in managing these patients. The aim of this article is to review the spectrum of soft-tissue infections using a systematic anatomic compartment approach. We discuss the clinical features of soft-tissue infections, their imaging findings with emphasis on cross-sectional imaging, their potential mimics, and clinical management. © RSNA, 2016.

Facial soft-tissue fillers conference: assessing the state of the science.

PubMed

Rohrich, Rod J; Hanke, C William; Busso, Mariano; Carruthers, Alastair; Carruthers, Jean; Fagien, Steven; Fitzgerald, Rebecca; Glogau, Richard; Greenberger, Phyllis E; Lorenc, Z Paul; Marmur, Ellen S; Monheit, Gary D; Pusic, Andrea; Rubin, Mark G; Rzany, Berthold; Sclafani, Anthony; Taylor, Susan; Weinkle, Susan; McGuire, Michael F; Pariser, David M; Casas, Laurie A; Collishaw, Karen J; Dailey, Roger A; Duffy, Stephen C; Edgar, Elizabeth Jan; Greenan, Barbara L; Haenlein, Kelly; Henrichs, Ronald A; Hume, Keith M; Lum, Flora; Nielsen, David R; Poulsen, Lisle; Shoaf, Lori; Schoaf, Lori; Seward, William; Begolka, Wendy Smith; Stanton, Robert G; Svedman, Katherine J; Thomas, J Regan; Sykes, Jonathan M; Wargo, Carol; Weiss, Robert A

2011-04-01

: The American Society of Plastic Surgeons and the American Academy of Dermatology, with the support of other sister societies, conducted the Facial Soft-Tissue Fillers: Assessing the State of the Science conference in December of 2009. The American Society of Plastic Surgeons and the American Academy of Dermatology established a panel of leading experts in the field of soft-tissue fillers-from researchers to clinicians-and other stakeholders for the conference to examine and discuss issues of patient safety, efficacy, and effectiveness in relation to the approved and off-label use of soft-tissue fillers, and other factors, including the training and level of experience of individuals administering fillers. This report represents the systematic literature review that examines comprehensively the available evidence and gaps in the evidence related to soft-tissue fillers, to inform and support the work of the state-of-the-science conference panel. This evidence-based medicine review will serve as the foundation for future evidence-based medicine reports in this growing field.

Ultrasound screening of periarticular soft tissue abnormality around metal-on-metal bearings.

PubMed

Nishii, Takashi; Sakai, Takashi; Takao, Masaki; Yoshikawa, Hideki; Sugano, Nobuhiko

2012-06-01

Although metal hypersensitivity or pseudotumors are concerns for metal-on-metal (MoM) bearings, detailed pathologies of patterns, severity, and incidence of periprosthetic soft tissue lesions are incompletely understood. We examined the potential of ultrasound for screening of periarticular soft tissue lesions around MoM bearings. Ultrasound examinations were conducted in 88 hips (79 patients) with MoM hip resurfacings or MoM total hip arthroplasties with a large femoral head. Four qualitative ultrasound patterns were shown, including normal pattern in 69 hips, joint-expansion pattern in 11 hips, cystic pattern in 5 hips, and mass pattern in 3 hips. Hips with the latter 3 abnormal patterns showed significantly higher frequency of clinical symptoms, without significant differences of sex, duration of implantation, head sizes, and cup abduction/anteversion angles, compared with hips with normal pattern. Ultrasound examination provides sensitive screening of soft tissue reactions around MoM bearings and may be useful in monitoring progression and defining treatment for periarticular soft tissue abnormalities. Copyright © 2012 Elsevier Inc. All rights reserved.

Soft tissue reconstruction of the oral cavity: a review of current options.

PubMed

Rigby, Matthew H; Taylor, S Mark

2013-08-01

This article provides an overview of the principles of soft tissue reconstruction of the oral cavity, and reviews the recent clinical outcomes for described options. For small defects of the oral cavity, healing by secondary intention and primary closure are both excellent options and may provide functionally superior results. In defects where a split-thickness skin graft is appropriate, acellular dermis may provide results that are at least as good at lower cost. Free flaps, particularly the radial forearm and the anterolateral thigh, have become the mainstays of oral cavity soft tissue reconstruction for larger defects. Recent clinical series suggest that relatively novel regional flaps provide a reasonable alternative to free flap reconstructions for moderate and some large soft tissue defects. Soft tissue reconstruction of the oral cavity is a complex task with significant functional implications. There are a large number of reconstructive options available. Systematic appraisal of the defect and options allows the reconstructive surgeon to optimize functional potential by choosing the most appropriate reconstructive option.

Soft tissue-based surgical techniques for treatment of posterior shoulder instability.

PubMed

Castagna, Alessandro; Conti, Marco; Garofalo, Raffaele

2017-01-01

Posterior shoulder instability is a rare clinical condition that encompasses different degrees of severity including various possible pathologies involving the labrum, capsule, bony lesions, and even locked posterior dislocation. When focusing on soft tissue involvement, the diagnosis of posterior instability may be difficult to make because frequently patients report vague symptoms not associated with a clear history of traumatic shoulder dislocation. Pathological soft tissue conditions associated with posterior instability in most cases are related to posterior labral tear and/or posterior capsular detensioning/tear. The diagnosis can be facilitated by physical examination using specific clinical tests (i. e., jerk test, Kim test, and reinterpreted O'Brien test) together with appropriate imaging studies (i. e., magnetic resonance arthrography). Arthroscopy may help in a complete evaluation of the joint and allows for the treatment of soft tissue lesions in posterior instability. Caution is warranted in the case of concomitant posterior glenoid chondral defect as a potential cause of poor outcome after soft tissue repair in posterior instability.

Long-term stability of soft tissue changes in anterior open bite adults treated with zygomatic miniplate-anchored maxillary posterior intrusion.

PubMed

Marzouk, Eiman S; Kassem, Hassan E

2018-03-01

To evaluate soft tissue changes and their long-term stability in skeletal anterior open bite adults treated by maxillary posterior teeth intrusion using zygomatic miniplates and premolar extractions. Lateral cephalograms of 26 patients were taken at pretreatment (T1), posttreatment (T2), 1 year posttreatment (T3), and 4 years posttreatment (T4). At the end of treatment, the soft tissue facial height and profile convexity were reduced. The lips increased in length and thickness, with backward movement of the upper lip and forward movement of the lower lip. The total relapse rate ranged from 20.2% to 31.1%. At 4 years posttreatment, 68.9% to 79.8% of the soft tissue treatment effects were stable. The changes in the first year posttreatment accounted for approximately 70% of the total relapse. Soft tissue changes following maxillary posterior teeth intrusion with zygomatic miniplates and premolar extractions appear to be stable 4 years after treatment.

Arthroscopic debridement for soft tissue ankle impingement.

PubMed

Brennan, S A; Rahim, F; Dowling, J; Kearns, S R

2012-06-01

To assess the response to treatment in patients with soft tissue impingement of the ankle managed with arthroscopic debridement. Forty-one ankle arthroscopies were performed for soft tissue impingement between April 2007 and April 2009. There were 26 men and 15 women and the mean age was 30.1 years. Arthroscopy was performed on an average of 21 months after injury. The Visual-Analogue-Scale Foot and Ankle (VASFA) score and Meislin's criteria were used to assess the response to treatment. The mean pre-operative VASFA score was 44.5. This increased to 78.3 postoperatively (p < 0.0001). According to Meislin's criteria, there were 34 good or excellent results, five fair and two poor results. Pre-operative magnetic resonance imaging was useful in detecting tears of the anterior talofibular ligament and excluding osteochondral defects; however, synovitis and soft tissue impingement was under-reported. Arthroscopy is an effective method for the diagnoses and treatment of soft tissue impingement of the ankle joint. This condition is under-reported on MRI.

Use of a porcine collagen matrix as an alternative to autogenous tissue for grafting oral soft tissue defects.

PubMed

Herford, Alan S; Akin, Lee; Cicciu, Marco; Maiorana, Carlo; Boyne, Philip J

2010-07-01

Soft tissue grafting is often required to correct intraoral mucosal deficiencies. Autogenous grafts have disadvantages including an additional harvest site with its associated pain and morbidity and, sometimes, poor quality and limited amount of the graft. Porcine collagen matrices have the potential to be helpful for grafting of soft tissue defects. Thirty consecutive patients underwent intraoral grafting to re-create missing soft tissue. Defects ranged in size from 50 to 900 mm(2). Porcine collagen matrices were used to reconstruct missing tissue. Indications included preprosthetic (22), followed by tumor removal (5), trauma (2), and release of cheek ankylosis (1). The primary efficacy parameters evaluated were the degree of lateral and/or alveolar extension and the evaluation of re-epithelialization and shrinkage of the grafted area. Overall, the percentage of shrinkage of the graft was 14% (range, 5%-20%). The amount of soft tissue extension averaged 3.4 mm (range, 2-10 mm). The secondary efficacy parameters included hemostatic effect, pain evaluation, pain and discomfort, and clinical evaluation of the grafted site. All patients reported minimal pain and swelling associated with the grafted area. No infections were noted. This porcine collagen matrix provides a biocompatible surgical material as an alternative to an autogenous transplant, thus obviating the need to harvest soft tissue autogenous grafts from other areas of the oral cavity. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Correlation between histological and ultrasonographic findings of soft tissue tumors: To verify the possibility of cell-like resolution in ultrasonography.

PubMed

Wu, Ching-Lan; Lai, Yi-Chen; Wang, Hsin-Kai; Chen, Paul Chih-Hsueh; Chiou, Hong-Jen

2017-11-01

The purpose of this study is to test the possibility of obtained cell-like resolution in soft tissue tumors on the basis of ultrasound echotexture. This is a prospective study consisting of 57 patients (29 females and 28 males, age range: 9-83 years, average age: 44.5 years) with palpable soft tissue mass, referred from the Departments of Orthopedics and Oncology for ultrasound (US)-guided biopsy. The study was approved by the institutional review board (IRB) of our hospital. Ultrasonographic images were recorded by still imaging in the biopsy tract in each biopsy session. Equipment included curvilinear and linear array probes. After biopsy, a radiologist and a pathologist correlated the US image and the observations regarding the histology of the tissue specimen in low-power (40 × magnification) and high-power (100-400 × magnification) fields. The histologic results included 22 benign and 35 malignant lesions. The echotexture of the soft tissue tumors correlated well with the cellular distribution and arrangement: the greater the number of cells and the more regular their arrangement as seen histologically, the greater is the hypoechogenicity on the ultrasound. The echogenicity of the soft tissue tumor also correlated well with the presence of fat cells, hemorrhage, cartilage, and osteoid tissue, all of which cause an increase in echogenicity. This study showed that the echotexture of soft tissue tumors can predict some details of cellular histology. Copyright © 2017. Published by Elsevier Taiwan LLC.

Soft tissue response in orthognathic surgery patients treated by bimaxillary osteotomy: cephalometry compared with 2-D photogrammetry.

PubMed

Rustemeyer, Jan; Martin, Alice

2013-03-01

Since improvement of facial aesthetics after orthognathic surgery moves increasingly into the focus of patients, prediction of soft tissue response to hard tissue movement becomes essential for planning. The aim of this study was to assess the facial soft tissue response in skeletal class II and III patients undergoing orthognathic surgery and to compare the potentials of cephalometry and two-dimensional (2-D) photogrammetry for predicting soft tissue changes. Twenty-eight patients with class II relationship and 33 with class III underwent bimaxillary surgery. All subjects had available both a traced lateral cephalogram and a traced lateral photogram taken pre- and postsurgery in natural head position (median follow-up, 9.4 ± 0.6 months). Facial convexity and lower lip length were highly correlated with hard tissue movements cephalometrically in class III patients and 2-D photogrammetrically in both classes. In comparison, cephalometric correlations for class II patients were weak. Correlations of hard and soft tissue movements between pre- and postoperative corresponding landmarks in horizontal and vertical planes were significant for cephalometry and 2-D photogrammetry. No significant difference was found between cephalometry and 2-D photogrammetry with respect to soft to hard tissue movement ratios. This study revealed that cephalometry is still a feasible standard for evaluating and predicting outcomes in routine orthognathic surgery cases. Accuracy could be enhanced with 2-D photogrammetry, especially in class II patients.

Facial Soft Tissue Trauma

PubMed Central

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

2010-01-01

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

Complicated acute appendicitis presenting as a rapidly progressive soft tissue infection of the abdominal wall: a case report.

PubMed

Beerle, Corinne; Gelpke, Hans; Breitenstein, Stefan; Staerkle, Ralph F

2016-12-01

We report a case of a rare complication of acute appendicitis with perforation through the abdominal wall. The case points out that an intraabdominal origin should be considered in patients presenting with rapidly spreading soft tissue infections of the trunk. A 58-year-old European woman presented to our hospital with a 1-week history of severe abdominal pain accompanied by rapidly spreading erythema and emphysema of the lower abdomen. On admission, the patient was in septic shock with leukocytosis and elevation of C-reactive protein. Among other diagnoses, necrotizing fasciitis was suspected. Computed tomography showed a large soft tissue infection with air-fluid levels spreading through the lower abdominal wall. During the operation, we found a perforated appendicitis breaking through the fascia and causing a rapidly progressive soft tissue infection of the abdominal wall. Appendicitis was the origin of the soft tissue infection. The abdominal wall was only secondarily involved. Even though perforated appendicitis as an etiology of a rapidly progressive soft tissue infection of the abdominal wall is very rare, it should be considered in the differential diagnosis of abdominal wall cellulitis. The distinction between rapidly spreading subcutaneous infection with abscess formation and early onset of necrotizing fasciitis is often difficult and can be confirmed only by surgical intervention.

Soft tissue waxup and mock-up as key factors in a treatment plan: case presentation.

PubMed

Viana, Pedro Couto; Correia, André; Neves, Manuel; Kovacs, Zsolt; Neugbauer, Rudiger

2012-01-01

Rehabilitation of edentulous spaces in esthetic areas is a challenge to the clinician due to the loss of soft tissues. In these clinical situations, it would be desirable to evaluate and predict the gingival architecture to recover in the oral rehabilitation. To fulfill this need, the diagnostic wax should anticipate the final rehabilitation with the integration of hard and soft tissue. Thus, it is essential to produce a diagnostic waxup that integrates these two components that are simultaneously seeking to recreate the harmony of white and pink esthetic. This diagnostic waxup will be the basis for the creation of the provisional prosthesis and a soft tissue mock-up. After placing the provisional prosthesis in the mouth, the soft tissue mock-up can be applied to assess its esthetic impact at facial and intraoral level. Dentist and patient should objectively assess the appearance of the final result. After approval of this rehabilitation concept, the virtual surgical planning can be performed and the surgical guide can be designed, allowing the treatment to take place. This protocol allows the development of a rigorous treatment plan based on the integration of teeth and gingiva component. The waxup and the soft tissue mock-up play a significant role, since they allow an earlier evaluation of the esthetic result, better prosthetic and surgical planning, and it allows us to anticipate the need for gingiva-colored ceramics use. The authors present a clinical case report of the importance of the wax-up and soft tissue mock-up in the treatment plan.

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.

The Pedicled Latissimus Dorsi Flap Provides Effective Coverage for Large and Complex Soft Tissue Injuries Around the Elbow.

PubMed

Hacquebord, Jacques H; Hanel, Douglas P; Friedrich, Jeffrey B

2017-08-01

The pedicled latissimus flap has been shown to provide effective coverage of wounds around the elbow with an average size of 100 to 147 cm 2 but with complication rates of 20% to 57%. We believe the pedicled latissimus dorsi flap is an effective and safe technique that provides reliable and durable coverage of considerably larger soft tissue defects around the elbow and proximal forearm. A retrospective review was performed including all patients from Harborview Medical Center between 1998 and 2012 who underwent coverage with pedicled latissimus dorsi flap for defects around the elbow. Demographic information, injury mechanism, soft tissue defect size, complications (minor vs major), and time to surgery were collected. The size of the soft tissue defect, complications, and successful soft tissue coverage were the primary outcome measures. A total of 18 patients were identified with variable mechanisms of injury. Average defect size around the elbow was 422 cm 2 . Three patients had partial necrosis of the distal most aspect of the flap, which was treated conservatively. One patient required a secondary fasciocutaneous flap, and another required conversion to a free latissimus flap secondary to venous congestion. Two were lost to follow-up after discharge from the hospital. In all, 88% (14 of 16) of the patients had documented (>3-month follow-up) successful soft tissue coverage with single-stage pedicled latissimus dorsi flap. The pedicled latissimus dorsi flap is a reliable option for large and complex soft tissue injuries around the elbow significantly larger than previous reports. However, coverage of the proximal forearm remains challenging.

Assessment of image quality in soft tissue and bone visualization tasks for a dedicated extremity cone-beam CT system.

PubMed

Demehri, S; Muhit, A; Zbijewski, W; Stayman, J W; Yorkston, J; Packard, N; Senn, R; Yang, D; Foos, D; Thawait, G K; Fayad, L M; Chhabra, A; Carrino, J A; Siewerdsen, J H

2015-06-01

To assess visualization tasks using cone-beam CT (CBCT) compared to multi-detector CT (MDCT) for musculoskeletal extremity imaging. Ten cadaveric hands and ten knees were examined using a dedicated CBCT prototype and a clinical multi-detector CT using nominal protocols (80 kVp-108mAs for CBCT; 120 kVp- 300 mAs for MDCT). Soft tissue and bone visualization tasks were assessed by four radiologists using five-point satisfaction (for CBCT and MDCT individually) and five-point preference (side-by-side CBCT versus MDCT image quality comparison) rating tests. Ratings were analyzed using Kruskal-Wallis and Wilcoxon signed-rank tests, and observer agreement was assessed using the Kappa-statistic. Knee CBCT images were rated "excellent" or "good" (median scores 5 and 4) for "bone" and "soft tissue" visualization tasks. Hand CBCT images were rated "excellent" or "adequate" (median scores 5 and 3) for "bone" and "soft tissue" visualization tasks. Preference tests rated CBCT equivalent or superior to MDCT for bone visualization and favoured the MDCT for soft tissue visualization tasks. Intraobserver agreement for CBCT satisfaction tests was fair to almost perfect (κ ~ 0.26-0.92), and interobserver agreement was fair to moderate (κ ~ 0.27-0.54). CBCT provided excellent image quality for bone visualization and adequate image quality for soft tissue visualization tasks. • CBCT provided adequate image quality for diagnostic tasks in extremity imaging. • CBCT images were "excellent" for "bone" and "good/adequate" for "soft tissue" visualization tasks. • CBCT image quality was equivalent/superior to MDCT for bone visualization tasks.

The Lateral Proximal Phalanx Flap for Contractures and Soft Tissue Defects in the Proximal Interphalangeal Joint

PubMed Central

Beltrán, Aldo G.; Romero, Camilo J.

2016-01-01

Background: The management of contractures and soft tissue defects in the proximal interphalangeal (PIP) finger joint remains a challenge. We report a transposition flap from the lateral skin of the proximal phalanx that is based on perforating branches of the digital arteries and can be used safely for both palmar and dorsal cover defects. Methods: We first completed an anatomic study, dissecting 20 fingers in fresh cadavers with arterial injections and made the new flap in patients with dorsal or palmar defects in PIP joints. Results: In cadavers, we can reveal 4 constant branches from each digital artery in the proximal phalanx, with the more distal just in the PIP joint constituting the flap pedicle. Between February 2010 and February 2015, we designed 33 flaps in 29 patients, 7 for dorsal and 26 for palmar defects, with no instances of flap necrosis and 4 distal epidermolysis. The patients were between 4 and 69 years with no major complications, and all of the skin defects in the PIP joint were resolved satisfactorily without any relevant sequelae at the donor site. Conclusions: This flap procedure is an easy, reliable, versatile, and safe technique, and could be an important tool for the management of difficult skin defects and contractures at the PIP joint level. PMID:28082850

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.

Imunohistological aspects of the tissue around dental implants

NASA Astrophysics Data System (ADS)

Nimigean, Victor; Nimigean, Vanda R.; Sǎlǎvǎstru, Dan I.; Moraru, Simona; BuÅ£incu, Lavinia; Ivaşcu, Roxana V.; Poll, Alexandru

2016-03-01

Objectives: study of soft and hard tissues around implants. Material and methods: For the immunohistochemical and histological study of the implant/soft tissue interface, we examined pieces of peri-implant mucosa harvested from 35 patients. The implant/bone interface was assessed using histologic and histomorphometric examination of hard tissues around unloaded, early loaded or delayed loaded dental implants with pre-established design, with a sandblasted and acid-etched surface, placed both in extraction sockets, or after bone healing following tooth removal. This study was performed on 9 common race dogs. Results: The histological study of the implant/soft tissue interface showed regenerative modifications and moderate chronic subepithelial inflammatory reactions. Immunohistochemical evaluation of the soft tissue biopsies revealed the presence of specific immunocompetent cells and proteins of the matrix metalloproteinase (MMP) expression. Bone-implants contacts were more obvious in the apical half of the implants and at the edges of the threads, than between them. A mature, lamelliform bone containing lacunae with osteocytes and lack of connective tissue were noticed around implants that were late placed and loaded. The new-formed bone was also abundant in the crestal zone, not only in the apical part of the implants. Conclusions: A thorough understanding of the microstructure of dental implant/soft and hard tissue interface will improve the longevity of osseointegrated implants.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nguyen, Thao D.; Grazier, John Mark; Boyce, Brad Lee

Biological tissues are uniquely structured materials with technologically appealing properties. Soft tissues such as skin, are constructed from a composite of strong fibrils and fluid-like matrix components. This was the first coordinated experimental/modeling project at Sandia or in the open literature to consider the mechanics of micromechanically-based anisotropy and viscoelasticity of soft biological tissues. We have exploited and applied Sandia's expertise in experimentation and mechanics modeling to better elucidate the behavior of collagen fibril-reinforced soft tissues. The purpose of this project was to provide a detailed understanding of the deformation of ocular tissues, specifically the highly structured skin-like tissue inmore » the cornea. This discovery improved our knowledge of soft/complex materials testing and modeling. It also provided insight into the way that cornea tissue is bio-engineered such that under physiologically-relevant conditions it has a unique set of properties which enhance functionality. These results also provide insight into how non-physiologic loading conditions, such as corrective surgeries, may push the cornea outside of its natural design window, resulting in unexpected non-linear responses. Furthermore, this project created a clearer understanding of the mechanics of soft tissues that could lead to bio-inspired materials, such as highly supple and impact resistant body armor, and improve our design of human-machine interfaces, such as micro-electrical-mechanical (MEMS) based prosthetics.« less

Breathing life into dinosaurs: tackling challenges of soft-tissue restoration and nasal airflow in extinct species.

PubMed

Bourke, Jason M; Porter, W M Ruger; Ridgely, Ryan C; Lyson, Tyler R; Schachner, Emma R; Bell, Phil R; Witmer, Lawrence M

2014-11-01

The nasal region plays a key role in sensory, thermal, and respiratory physiology, but exploring its evolution is hampered by a lack of preservation of soft-tissue structures in extinct vertebrates. As a test case, we investigated members of the "bony-headed" ornithischian dinosaur clade Pachycephalosauridae (particularly Stegoceras validum) because of their small body size (which mitigated allometric concerns) and their tendency to preserve nasal soft tissues within their hypermineralized skulls. Hypermineralization directly preserved portions of the olfactory turbinates along with an internal nasal ridge that we regard as potentially an osteological correlate for respiratory conchae. Fossil specimens were CT-scanned, and nasal cavities were segmented and restored. Soft-tissue reconstruction of the nasal capsule was functionally tested in a virtual environment using computational fluid dynamics by running air through multiple models differing in nasal soft-tissue conformation: a bony-bounded model (i.e., skull without soft tissue) and then models with soft tissues added, such as a paranasal septum, a scrolled concha, a branched concha, and a model combining the paranasal septum with a concha. Deviations in fluid flow in comparison to a phylogenetically constrained sample of extant diapsids were used as indicators of missing soft tissue. Models that restored aspects of airflow found in extant diapsids, such as appreciable airflow in the olfactory chamber, were judged as more likely. The model with a branched concha produced airflow patterns closest to those of extant diapsids. These results from both paleontological observation and airflow modeling indicate that S. validum and other pachycephalosaurids could have had both olfactory and respiratory conchae. Although respiratory conchae have been linked to endothermy, such conclusions require caution in that our re-evaluation of the reptilian nasal apparatus indicates that respiratory conchae may be more widespread than originally thought, and other functions, such as selective brain temperature regulation, could be important. © 2014 Wiley Periodicals, Inc.

Bone-Patellar Tendon-Bone Versus Soft-Tissue Allograft for Anterior Cruciate Ligament Reconstruction: A Systematic Review.

PubMed

Joyce, Christopher D; Randall, Kyle L; Mariscalco, Michael W; Magnussen, Robert A; Flanigan, David C

2016-02-01

To describe the outcomes of bone-patellar tendon-bone (BPTB) and soft-tissue allografts in anterior cruciate ligament (ACL) reconstruction with respect to graft failure risk, physical examination findings, instrumented laxity, and patient-reported outcomes. A search of the PubMed, Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature) Complete, Cochrane Collaboration, and SPORTDiscus databases was performed. English-language studies with outcome data on primary ACL reconstruction with nonirradiated BPTB and soft-tissue allografts were identified. Outcome data included failure risk, physical examination findings, instrumented laxity measurements, and patient-reported outcome scores. Seventeen studies met the inclusion criteria. Of these studies, 11 reported on BPTB allografts exclusively, 5 reported on soft-tissue allografts exclusively, and 1 compared both types. The comparative study showed no difference in failure risk, Lachman grade, pivot-shift grade, instrumented laxity, or overall International Knee Documentation Committee score between the 2 allograft types. Data from all studies yielded a failure risk of 10.3% (95% confidence interval [CI], 4.5% to 18.1%) in the soft-tissue group and 15.2% (95% CI, 11.3% to 19.6%) in the BPTB group. The risk of a Lachman grade greater than 5 mm was 6.4% (95% CI, 1.7% to 13.7%) in the soft-tissue group and 8.6% (95% CI, 6.3% to 11.2%) in the BPTB group. The risk of a grade 2 or 3 pivot shift was 1.4% (95% CI, 0.3% to 3.3%) in the soft-tissue group and 4.1% (95% CI, 1.9% to 7.2%) in the BPTB group. One comparative study showed no difference in results after ACL reconstruction with nonirradiated BPTB and soft-tissue allografts. Inclusion of case series in the analysis showed qualitatively similar outcomes with the 2 graft types. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Distal chevron osteotomy with lateral soft tissue release for moderate to severe hallux valgus decided using intraoperative varus stress radiographs.

PubMed

Kim, Hyong-Nyun; Park, Yoo-Jung; Kim, Gab-Lae; Park, Yong-Wook

2013-01-01

The purpose of the present study was to investigate the outcomes of distal chevron osteotomy with lateral soft tissue release for moderate to severe hallux valgus. The patients were selected using criteria that included the degree of lateral soft tissue contracture and metatarsocuneiform joint flexibility. The contracture and flexibility were determined from intraoperative varus stress radiographs. From April 2007 to May 2009, 56 feet in 51 consecutive patients with moderate to severe hallux valgus had undergone distal chevron osteotomy with lateral soft tissue release. This was done when the lateral soft tissue contracture was not so severe that passive correction of the hallux valgus deformity was not possible and when the metatarsocuneiform joint was flexible enough to permit additional correction of the first intermetatarsal angle after lateral soft tissue release. The mean patient age was 45.2 (range 23 to 54) years, and the duration of follow-up was 27.5 (range 24 to 46) months. The mean hallux abductus angle decreased from 33.5° ± 3.1° to 11.6° ± 3.3°, and the first intermetatarsal angle decreased from 16.4° ± 2.7° to 9.7° ± 2.1°. The mean American Orthopaedic Foot and Ankle Society hallux-interphalangeal scores increased from 66.6° ± 10.7° to 92.6° ± 9.4° points, and 46 of the 51 patients (90%) were either very satisfied or satisfied with the outcome. No recurrence of deformity or osteonecrosis of the metatarsal head occurred. When lateral soft tissue contracture is not severe and when the metatarsocuneiform joint is flexible enough, distal chevron osteotomy with lateral soft tissue release can be a useful and effective choice for moderate to severe hallux valgus deformity. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Socket Preservation using Enzyme-treated Equine Bone Granules and an Equine Collagen Matrix: A Case Report with Histological and Histomorphometrical Assessment.

PubMed

Leonida, Alessandro; Todeschini, Giovanni; Lomartire, Giovanni; Cinci, Lorenzo; Pieri, Laura

2016-11-01

To histologically assess the effectiveness of a socket-preservation technique using enzyme-treated equine bone granules as a bone-graft material in combination with an equine collagen matrix as a scaffold for soft-tissue regeneration. Enzyme-treated equine bone granules and equine collagen matrix recently have been developed to help overcome alveolar bone deficiencies that develop in the wake of edentulism. The patient had one mandibular molar extracted and the socket grafted with equine bone granules. The graft was covered with the equine collagen matrix, placed in a double layer. No flap was prepared, and the gingival margins were stabilized with a single stitch, leaving the matrix partially exposed and the site to heal by secondary intention. The adjacent molar was extracted 1 month later, and that socket was left to heal by secondary intention without any further treatment. Three months after each surgery, an implant was placed and a biopsy was collected. The two biopsies underwent histological processing and qualitative evaluation. Histomorphometric analysis was also performed to calculate the percentage of newly formed bone (NFB) in the two cores. Healing at both sites was uneventful, and no inflammation or other adverse reactions were observed in the samples. Soft-tissue healing by secondary intention appeared to occur faster at the grafted site. The corresponding core showed a marked separation between soft and hard tissue that was not observed in the core from the nongrafted site, where soft-tissue hypertrophy could be observed. Newly formed bone at the grafted and nongrafted sites was not significantly different (27.2 ± 7.1 and 29.4 ± 6.2% respectively, p = 0.45). The surgical technique employed in this case appeared to facilitate postextraction soft-tissue healing by second intention and simplify soft-tissue management. Using a collagen-based matrix to cover a postextraction grafted site may facilitate second intention soft-tissue healing and proper soft-tissue growth.

Palatal approach of anterior superior alveolar injection technique may not be potentially useful in periodontal procedures.

PubMed

Bhat, Pragathi Raghavendra; Acharya, Anirudh Balakrishna; Thakur, Srinath Lakshman

2016-01-01

The palatal approach of anterior superior alveolar (P-ASA) using WAND injection was reported to effectively provide a profound bilateral maxillary anesthesia of the soft tissue of anterior one-third of the palate and facial gingivae extending from canine to canine which lasted for more than an hour thus making it ideal for scaling root planing and minor periodontal procedures in the anterior maxilla. Our study suggests that the conventional P-ASA injection is of very short duration and the extent of anesthesia was not profound and consistent. This has not been reported earlier in the literature. Thirty-five cases (20 males and 15 females), who underwent scaling, root planing and minor periodontal surgical procedures such as abscess drainage, gingivectomy, and frenectomy in the maxillary anterior region in the age range of 19-45 years was assessed for the efficacy of the P-ASA injection. After the administration of the P-ASA injection, the subjective and the objective symptoms were used to evaluate the extent and duration of the anesthesia at 10, 15, and 20 min. This study suggests that the conventional P-ASA injection technique does not provide anesthesia for more than 20 min. Wilcoxon matched pairs test was used to compare the effect of anesthesia at the different time intervals and the results were found to be statistically significant ( P < 0.05). The conventional P-ASA injection technique is of very short duration and does not demonstrate effectiveness in periodontal surgery of the anterior maxilla.

Soft tissue wound healing around teeth and dental implants.

PubMed

Sculean, Anton; Gruber, Reinhard; Bosshardt, Dieter D

2014-04-01

To provide an overview on the biology and soft tissue wound healing around teeth and dental implants. This narrative review focuses on cell biology and histology of soft tissue wounds around natural teeth and dental implants. The available data indicate that: (a) Oral wounds follow a similar pattern. (b) The tissue specificities of the gingival, alveolar and palatal mucosa appear to be innately and not necessarily functionally determined. (c) The granulation tissue originating from the periodontal ligament or from connective tissue originally covered by keratinized epithelium has the potential to induce keratinization. However, it also appears that deep palatal connective tissue may not have the same potential to induce keratinization as the palatal connective tissue originating from an immediately subepithelial area. (d) Epithelial healing following non-surgical and surgical periodontal therapy appears to be completed after a period of 7–14 days. Structural integrity of a maturing wound between a denuded root surface and a soft tissue flap is achieved at approximately 14-days post-surgery. (e) The formation of the biological width and maturation of the barrier function around transmucosal implants requires 6–8 weeks of healing. (f) The established peri-implant soft connective tissue resembles a scar tissue in composition, fibre orientation, and vasculature. (g) The peri-implant junctional epithelium may reach a greater final length under certain conditions such as implants placed into fresh extraction sockets versus conventional implant procedures in healed sites. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Soft tissue volume alterations after connective tissue grafting at teeth: the subepithelial autologous connective tissue graft versus a porcine collagen matrix - a pre-clinical volumetric analysis.

PubMed

Schmitt, Christian M; Matta, Ragai E; Moest, Tobias; Humann, Julia; Gammel, Lisa; Neukam, Friedrich W; Schlegel, Karl A

2016-07-01

This study evaluates a porcine collagen matrix (CM) for soft tissue thickening in comparison to the subepithelial connective tissue graft (SCTG). In eight beagle dogs, soft tissue thickening was performed at the buccal aspects of the upper canines (SCTG and CM). Impressions were taken before augmentation (i1), after surgery (i2), after one (i3), three (i4) and ten month (i5). Casts were optically scanned with a 3D scanner and each augmented region (unit of analysis) evaluated (primary outcome variable: volume increase in mm(3) ; secondary outcome variables: volume increase in percent, mean and maximum thickness increases in mm). 3D tissue measurements after surgery revealed a significant higher volume increase in the CM (86.37 mm(3)  ± 35.16 mm(3) ) than in the SCTG group (47.65 mm(3)  ± 17.90 mm(3) ). After 10 months, volume increase was non-significant between groups (SCTG:11.36 mm(3)  ± 9.26 mm(3) ; CM: 8.67 mm(3)  ± 13.67 mm(3) ). Maximum soft tissue thickness increase (i1-i5) was 0.66 mm ± 0.29 mm (SCTG) and 0.79 mm ± 0.37 mm (CM) with no significant difference. Ten months after soft tissue thickening, the CM is statistically non-inferior to the SCTG in terms of soft tissue volume and thickness increase. Further 3D studies are needed to confirm the data. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Epidemiological characteristics and mortality risk factors in patients admitted in hospitals with soft tissue infections. A multicentric STIMG (Soft Tissue Infections Malacitan Group) study results].

PubMed

Salgado Ordóñez, F; Villar Jiménez, J; Hidalgo Conde, A; Villalobos Sánchez, A; de la Torre Lima, J; Aguilar García, J; da Rocha Costa, I; García Ordóñez, M A; Nuño Alvarez, E; Ramos Cantes, C; Martín Pérez, M

2006-07-01

To describe the characteristics of patients admitted in hospitals with soft tissue infections, and analyse the variables whose died, in order to define risk groups. retrospective analysis of medical reports of all patient admitted during 2002 year for soft tissue infections in public malacitans hospitals. We excluded the patient with soft tissue infections associated with burns, surgery, pressure ulcers, and orbit cellulitis. We analysed clinical, biochemical variables and indications for yields and imaging tests, so the empiric antibiotic treatment established and its correlations with practice guidelines. We analysed 391 admissions of 374 patients. Cellulitis was the most frequent diagnosis (69.3%). We did imaging tests in 51.6%. In 94.3% of cases were treated with empirics antibiotics. The most prescribed drug was amoxiciline plus clavulanate (39%). 27 patients died, 40.7% of them for septic cause. All deceased patients had chronic diseases. The only biochemical parameters associated with mortality were serum proteins and albumina (55 +/- 9 g/L vs. 63 +/- 8 g/L; p = 0.0231) and (22 +/- 7 g/L vs. 29 +/- 7 g/L; p = 0.0125) respectively. Cellullitis are the most frequent soft tissue infections that requires admissions in hospitals. We overuse imaging test and don t follow the practice guidelines recommendations in antibiotic therapy. Primary soft issue infection s mortality is low and it s restricted to people with chronic illness, deep infections and bad nutritional status.

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.

In vivo soft tissue differentiation by diffuse reflectance spectroscopy: preliminary results

NASA Astrophysics Data System (ADS)

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

Remote laser surgery does not provide haptic feedback to operate layer by layer and preserve vulnerable anatomical structures like nerve tissue or blood vessels. The aim of this study is identification of soft tissue in vivo by diffuse reflectance spectroscopy to set the base for a feedback control system to enhance nerve preservation in oral and maxillofacial laser surgery. Various soft tissues can be identified by diffuse reflectance spectroscopy in vivo. The results may set the base for a feedback system to prevent nerve damage during oral and maxillofacial laser surgery.

Ultrasound Shear Wave Simulation of Breast Tumor Using Nonlinear Tissue Elasticity

PubMed Central

Park, Dae Woo

2016-01-01

Shear wave elasticity imaging (SWEI) can assess the elasticity of tissues, but the shear modulus estimated in SWEI is often less sensitive to a subtle change of the stiffness that produces only small mechanical contrast to the background tissues. Because most soft tissues exhibit mechanical nonlinearity that differs in tissue types, mechanical contrast can be enhanced if the tissues are compressed. In this study, a finite element- (FE-) based simulation was performed for a breast tissue model, which consists of a circular (D: 10 mm, hard) tumor and surrounding tissue (soft). The SWEI was performed with 0% to 30% compression of the breast tissue model. The shear modulus of the tumor exhibited noticeably high nonlinearity compared to soft background tissue above 10% overall applied compression. As a result, the elastic modulus contrast of the tumor to the surrounding tissue was increased from 0.46 at 0% compression to 1.45 at 30% compression. PMID:27293476

Phase contrast imaging of cochlear soft tissue.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smith, S.; Hwang, M.; Rau, C.

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 imagingmore » and tomographic techniques hold promise to noninvasively image cochlear structures at an unprecedented cellular level.« less

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.

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

Temozolomide, Cixutumumab, and Combination Chemotherapy in Treating Patients With Metastatic Rhabdomyosarcoma

ClinicalTrials.gov

2017-07-31

Adult Rhabdomyosarcoma; Childhood Alveolar Rhabdomyosarcoma; Childhood Embryonal Rhabdomyosarcoma; Metastatic Childhood Soft Tissue Sarcoma; Stage IV Adult Soft Tissue Sarcoma; Untreated Childhood Rhabdomyosarcoma

Tooth Eruption Results from Bone Remodelling Driven by Bite Forces Sensed by Soft Tissue Dental Follicles: A Finite Element Analysis

PubMed Central

Sarrafpour, Babak; Swain, Michael; Li, Qing; Zoellner, Hans

2013-01-01

Intermittent tongue, lip and cheek forces influence precise tooth position, so we here examine the possibility that tissue remodelling driven by functional bite-force-induced jaw-strain accounts for tooth eruption. Notably, although a separate true ‘eruptive force’ is widely assumed, there is little direct evidence for such a force. We constructed a three dimensional finite element model from axial computerized tomography of an 8 year old child mandible containing 12 erupted and 8 unerupted teeth. Tissues modelled included: cortical bone, cancellous bone, soft tissue dental follicle, periodontal ligament, enamel, dentine, pulp and articular cartilage. Strain and hydrostatic stress during incisive and unilateral molar bite force were modelled, with force applied via medial and lateral pterygoid, temporalis, masseter and digastric muscles. Strain was maximal in the soft tissue follicle as opposed to surrounding bone, consistent with follicle as an effective mechanosensor. Initial numerical analysis of dental follicle soft tissue overlying crowns and beneath the roots of unerupted teeth was of volume and hydrostatic stress. To numerically evaluate biological significance of differing hydrostatic stress levels normalized for variable finite element volume, ‘biological response units’ in Nmm were defined and calculated by multiplication of hydrostatic stress and volume for each finite element. Graphical representations revealed similar overall responses for individual teeth regardless if incisive or right molar bite force was studied. There was general compression in the soft tissues over crowns of most unerupted teeth, and general tension in the soft tissues beneath roots. Not conforming to this pattern were the unerupted second molars, which do not erupt at this developmental stage. Data support a new hypothesis for tooth eruption, in which the follicular soft tissues detect bite-force-induced bone-strain, and direct bone remodelling at the inner surface of the surrounding bony crypt, with the effect of enabling tooth eruption into the mouth. PMID:23554928

Tooth eruption results from bone remodelling driven by bite forces sensed by soft tissue dental follicles: a finite element analysis.

PubMed

Sarrafpour, Babak; Swain, Michael; Li, Qing; Zoellner, Hans

2013-01-01

Intermittent tongue, lip and cheek forces influence precise tooth position, so we here examine the possibility that tissue remodelling driven by functional bite-force-induced jaw-strain accounts for tooth eruption. Notably, although a separate true 'eruptive force' is widely assumed, there is little direct evidence for such a force. We constructed a three dimensional finite element model from axial computerized tomography of an 8 year old child mandible containing 12 erupted and 8 unerupted teeth. Tissues modelled included: cortical bone, cancellous bone, soft tissue dental follicle, periodontal ligament, enamel, dentine, pulp and articular cartilage. Strain and hydrostatic stress during incisive and unilateral molar bite force were modelled, with force applied via medial and lateral pterygoid, temporalis, masseter and digastric muscles. Strain was maximal in the soft tissue follicle as opposed to surrounding bone, consistent with follicle as an effective mechanosensor. Initial numerical analysis of dental follicle soft tissue overlying crowns and beneath the roots of unerupted teeth was of volume and hydrostatic stress. To numerically evaluate biological significance of differing hydrostatic stress levels normalized for variable finite element volume, 'biological response units' in Nmm were defined and calculated by multiplication of hydrostatic stress and volume for each finite element. Graphical representations revealed similar overall responses for individual teeth regardless if incisive or right molar bite force was studied. There was general compression in the soft tissues over crowns of most unerupted teeth, and general tension in the soft tissues beneath roots. Not conforming to this pattern were the unerupted second molars, which do not erupt at this developmental stage. Data support a new hypothesis for tooth eruption, in which the follicular soft tissues detect bite-force-induced bone-strain, and direct bone remodelling at the inner surface of the surrounding bony crypt, with the effect of enabling tooth eruption into the mouth.

Age-related changes in dynamic compressive properties of trochanteric soft tissues over the hip.

PubMed

Choi, W J; Russell, C M; Tsai, C M; Arzanpour, S; Robinovitch, S N

2015-02-26

Hip fracture risk increases dramatically with age, and 90% of fractures are due to falls. During a fall on the hip, the soft tissues overlying the hip region (skin, fat, and muscle) act as shock absorbers to absorb energy and reduce the peak force applied to the underlying bone. We conducted dynamic indentation experiments with young women (aged 19-30; n=17) and older women (aged 65-81; n=17) to test the hypothesis that changes occur with age in the stiffness and damping properties of these tissues. Tissue stiffness and damping were derived from experiments where subjects lay sideways on a bed with the greater trochanter contacting a 3.8cm diameter indenter, which applied sinusoidal compression between 5 to 30Hz with a peak-to-peak amplitude of 1mm. Soft tissue thickness was measured using ultrasound. On average, stiffness was 2.9-fold smaller in older than young women (5.7 versus 16.8kN/m, p=0.0005) and damping was 3.5-fold smaller in older than young women (81 versus 282Ns/m, p=0.001). Neither parameter associated with soft tissue thickness. Our results indicate substantial age-related reductions in the stiffness and damping of soft tissues over the hip region, which likely reduce their capacity to absorb and dissipate energy (before "bottoming out") during a fall. Strategies such as wearable hip protectors or compliant flooringmay compensate for age-related reductions in the shock-absorbing properties of soft tissues and decrease the injury potential of falls. Copyright © 2014 Elsevier Ltd. All rights reserved.

Modeling Soft Tissue Damage and Failure Using a Combined Particle/Continuum Approach.

PubMed

Rausch, M K; Karniadakis, G E; Humphrey, J D

2017-02-01

Biological soft tissues experience damage and failure as a result of injury, disease, or simply age; examples include torn ligaments and arterial dissections. Given the complexity of tissue geometry and material behavior, computational models are often essential for studying both damage and failure. Yet, because of the need to account for discontinuous phenomena such as crazing, tearing, and rupturing, continuum methods are limited. Therefore, we model soft tissue damage and failure using a particle/continuum approach. Specifically, we combine continuum damage theory with Smoothed Particle Hydrodynamics (SPH). Because SPH is a meshless particle method, and particle connectivity is determined solely through a neighbor list, discontinuities can be readily modeled by modifying this list. We show, for the first time, that an anisotropic hyperelastic constitutive model commonly employed for modeling soft tissue can be conveniently implemented within a SPH framework and that SPH results show excellent agreement with analytical solutions for uniaxial and biaxial extension as well as finite element solutions for clamped uniaxial extension in 2D and 3D. We further develop a simple algorithm that automatically detects damaged particles and disconnects the spatial domain along rupture lines in 2D and rupture surfaces in 3D. We demonstrate the utility of this approach by simulating damage and failure under clamped uniaxial extension and in a peeling experiment of virtual soft tissue samples. In conclusion, SPH in combination with continuum damage theory may provide an accurate and efficient framework for modeling damage and failure in soft tissues.

Modeling Soft Tissue Damage and Failure Using a Combined Particle/Continuum Approach

PubMed Central

Rausch, M. K.; Karniadakis, G. E.; Humphrey, J. D.

2016-01-01

Biological soft tissues experience damage and failure as a result of injury, disease, or simply age; examples include torn ligaments and arterial dissections. Given the complexity of tissue geometry and material behavior, computational models are often essential for studying both damage and failure. Yet, because of the need to account for discontinuous phenomena such as crazing, tearing, and rupturing, continuum methods are limited. Therefore, we model soft tissue damage and failure using a particle/continuum approach. Specifically, we combine continuum damage theory with Smoothed Particle Hydrodynamics (SPH). Because SPH is a meshless particle method, and particle connectivity is determined solely through a neighbor list, discontinuities can be readily modeled by modifying this list. We show, for the first time, that an anisotropic hyperelastic constitutive model commonly employed for modeling soft tissue can be conveniently implemented within a SPH framework and that SPH results show excellent agreement with analytical solutions for uniaxial and biaxial extension as well as finite element solutions for clamped uniaxial extension in 2D and 3D. We further develop a simple algorithm that automatically detects damaged particles and disconnects the spatial domain along rupture lines in 2D and rupture surfaces in 3D. We demonstrate the utility of this approach by simulating damage and failure under clamped uniaxial extension and in a peeling experiment of virtual soft tissue samples. In conclusion, SPH in combination with continuum damage theory may provide an accurate and efficient framework for modeling damage and failure in soft tissues. PMID:27538848

Will a single periarticular lidocaine-corticosteroid injection improve the clinical efficacy of intraarticular hyaluronic acid treatment of symptomatic knee osteoarthritis?

PubMed

Ertürk, Cemil; Altay, Mehmet Akif; Altay, Nuray; Kalender, Ali Murat; Öztürk, İbrahim Avşin

2016-11-01

A local injection of corticosteroid-lidocaine into the periarticular soft tissue structures is used commonly for rapid pain relief. It is hypothesized that knee pain associated with knee osteoarthritis would be relieved quickly and effectively in patients receiving intraarticular hyaluronic acid combined with a periarticular lidocaine-corticosteroid injection. To test this hypothesis, the clinical effect of the combined treatment with hyaluronic acid injection alone in patients with symptomatic knee osteoarthritis as compared in this prospective single-blinded randomized trial. This study included 70 patients. Group 1 (n = 35) received intraarticular hyaluronic acid injections only, whereas group 2 (n = 35) received intraarticular hyaluronic acid injections combined with a single local injection of corticosteroid-lidocaine. Injections were administered to the most painful areas of the anterior or posterior medial condyle of the femur or tibia. The outcome was measured by independent assessors (blinded to treatment) using a linear VAS pain scale and WOMAC and HSS knee scores. Assessments were performed at baseline and at 1, 3, 6, 12, 26, and 52 weeks. During the first 3 weeks, group 2 patients showed significantly better all scores than did group 1 patients (p < 0.01). However, no significant differences were detected at 6, 12, 26 or 52 weeks (n.s.). The combined treatment may lead to earlier pain relief compared with intraarticular hyaluronic acid alone in patients with knee osteoarthritis and can be considered a useful adjunctive treatment modality. This combined method may provide early return to patient's daily activity. Therapeutic study, Level I.

An improved parameter estimation and comparison for soft tissue constitutive models containing an exponential function.

PubMed

Aggarwal, Ankush

2017-08-01

Motivated by the well-known result that stiffness of soft tissue is proportional to the stress, many of the constitutive laws for soft tissues contain an exponential function. In this work, we analyze properties of the exponential function and how it affects the estimation and comparison of elastic parameters for soft tissues. In particular, we find that as a consequence of the exponential function there are lines of high covariance in the elastic parameter space. As a result, one can have widely varying mechanical parameters defining the tissue stiffness but similar effective stress-strain responses. Drawing from elementary algebra, we propose simple changes in the norm and the parameter space, which significantly improve the convergence of parameter estimation and robustness in the presence of noise. More importantly, we demonstrate that these changes improve the conditioning of the problem and provide a more robust solution in the case of heterogeneous material by reducing the chances of getting trapped in a local minima. Based upon the new insight, we also propose a transformed parameter space which will allow for rational parameter comparison and avoid misleading conclusions regarding soft tissue mechanics.

Single-stage soft tissue reconstruction and orbital fracture repair for complex facial injuries.

PubMed

Wu, Peng Sen; Matoo, Reshvin; Sun, Hong; Song, Li Yuan; Kikkawa, Don O; Lu, Wei

2017-02-01

Orbital fractures with open periorbital wounds cause significant morbidity. Timing of debridement with fracture repair and soft tissue reconstruction is controversial. This study focuses on the efficacy of early single-stage repair in combined bony and soft tissue injuries. Retrospective review. Twenty-three patients with combined open soft tissue wounds and orbital fractures were studied for single-stage orbital reconstruction and periorbital soft tissue repair. Inclusion criteria were open soft tissue wounds with clinical and radiographic evidence of orbital fractures and repair performed within 48 h after injury. Surgical complications and reconstructive outcomes were assessed over 6 months. The main outcome measures were enophthalmos, pre- and post-CT imaging of orbits, scar evaluation, presence of diplopia, and eyelid position. Enophthalmos was corrected in 16/19 cases and improved in 3/19 cases. 3D reconstruction of CT images showed markedly improved orbital alignment with objective measurements of the optic foramen to cornea distance (mm) in reconstructed orbits relative to intact orbits of 0.66, 95% confidence interval [CI] (lower 0.33, upper 0.99) mm. The mean baseline of Stony Brook Scar Evaluation Scale was 0.6, 95%CI (0.30-0.92), and for 6 months, the mean score was 3.4, 95%CI (3.05-3.73). Residual diplopia in secondary gazes was present in two patients; one patient had ectropion. Complications included one case of local wound infection. An early single-stage repair of combined soft tissue and orbital fractures yields satisfactory functional and aesthetic outcomes. Complications are low and likely related to trauma severity. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Influence of soft tissue in the assessment of the primary fixation of acetabular cup implants using impact analyses.

PubMed

Bosc, Romain; Tijou, Antoine; Rosi, Giuseppe; Nguyen, Vu-Hieu; Meningaud, Jean-Paul; Hernigou, Philippe; Flouzat-Lachaniette, Charles-Henri; Haiat, Guillaume

2018-06-01

The acetabular cup (AC) implant primary stability is an important determinant for the success of cementless hip surgery but it remains difficult to assess the AC implant fixation in the clinic. A method based on the analysis of the impact produced by an instrumented hammer on the ancillary has been developed by our group (Michel et al., 2016a). However, the soft tissue thickness present around the acetabulum may affect the impact response, which may hamper the robustness of the method. The aim of this study is to evaluate the influence of the soft tissue thickness (STT) on the acetabular cup implant primary fixation evaluation using impact analyses. To do so, different AC implants were inserted in five bovine bone samples. For each sample, different stability conditions were obtained by changing the cavity diameter. For each configuration, the AC implant was impacted 25 times with 10 and 30 mm of soft tissues positioned underneath the sample. The averaged indicator I m was determined based on the amplitude of the signal for each configuration and each STT and the pull-out force was measured. The results show that the resonance frequency of the system increases when the value of the soft tissue thickness decreases. Moreover, an ANOVA analysis shows that there was no significant effect of the value of soft tissue thickness on the values of the indicator I m (F = 2.33; p-value = 0.13). This study shows that soft tissue thickness does not appear to alter the prediction of the acetabular cup implant primary fixation obtained using the impact analysis approach, opening the path towards future clinical trials. Copyright © 2018 Elsevier Ltd. All rights reserved.

Analysis of the microcirculation after soft tissue reconstruction of the outer ear with burns in patients with severe burn injuries.

PubMed

Medved, Fabian; Medesan, Raluca; Rothenberger, Jens Martin; Schaller, Hans-Eberhard; Schoeller, Thomas; Manoli, Theodora; Weitgasser, Lennart; Naumann, Aline; Weitgasser, Laurenz

2016-07-01

Reconstruction of soft tissue defects of the ear with burns remains one of the most difficult tasks for the reconstructive surgeon. Although numerous reconstructive options are available, the results are often unpredictable and worse than expected. Besides full and split skin grafting, local random pattern flaps and pedicled flaps are frequently utilized to cover soft tissue defects of the outer auricle. Because of the difficulty and unpredictable nature of outer ear reconstruction after burn injury, a case-control study was conducted to determine the best reconstructive approach. The microcirculatory properties of different types of soft tissue reconstruction of the outer ear with burns in six severely burned Caucasian patients (three men and three women; mean age, 46 years (range, 22-70)) were compared to those in the healthy tissue of the outer ear using the O2C device (Oxygen to See; LEA Medizintechnik, Gießen, Germany). The results of this study revealed that the investigated microcirculation parameters such as the median values of blood flow (control group: 126 AU), relative amount of hemoglobin (control group: 59.5 AU), and tissue oxygen saturation (control group: 73%) are most similar to those of normal ear tissue when pedicled flaps based on the superficial temporal artery were used. These findings suggest that this type of reconstruction is superior for soft tissue reconstruction of the outer ear with burns in contrast to random pattern flaps and full skin grafts regarding the microcirculatory aspects. These findings may improve the knowledge on soft tissue viability and facilitate the exceptional and delicate process of planning the reconstruction of the auricle with burns. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

A finite element evaluation of mechanical function for 3 distal extension partial dental prosthesis designs with a 3-dimensional nonlinear method for modeling soft tissue.

PubMed

Nakamura, Yoshinori; Kanbara, Ryo; Ochiai, Kent T; Tanaka, Yoshinobu

2014-10-01

The mechanical evaluation of the function of partial removable dental prostheses with 3-dimensional finite element modeling requires the accurate assessment and incorporation of soft tissue behavior. The differential behaviors of the residual ridge mucosa and periodontal ligament tissues have been shown to exhibit nonlinear displacement. The mathematic incorporation of known values simulating nonlinear soft tissue behavior has not been investigated previously via 3-dimensional finite element modeling evaluation to demonstrate the effect of prosthesis design on the supporting tissues. The purpose of this comparative study was to evaluate the functional differences of 3 different partial removable dental prosthesis designs with 3-dimensional finite element analysis modeling and a simulated patient model incorporating known viscoelastic, nonlinear soft tissue properties. Three different designs of distal extension removable partial dental prostheses were analyzed. The stress distributions to the supporting abutments and soft tissue displacements of the designs tested were calculated and mechanically compared. Among the 3 dental designs evaluated, the RPI prosthesis demonstrated the lowest stress concentrations on the tissue supporting the tooth abutment and also provided wide mucosa-borne areas of support, thereby demonstrating a mechanical advantage and efficacy over the other designs evaluated. The data and results obtained from this study confirmed that the functional behavior of partial dental prostheses with supporting abutments and soft tissues are consistent with the conventional theories of design and clinical experience. The validity and usefulness of this testing method for future applications and testing protocols are shown. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Iodine-enhanced micro-CT imaging: methodological refinements for the study of the soft-tissue anatomy of post-embryonic vertebrates.

PubMed

Gignac, Paul M; Kley, Nathan J

2014-05-01

The now widespread use of non-destructive X-ray computed tomography (CT) and micro-CT (µCT) has greatly augmented our ability to comprehensively detail and quantify the internal hard-tissue anatomy of vertebrates. However, the utility of X-ray imaging for gaining similar insights into vertebrate soft-tissue anatomy has yet to be fully realized due to the naturally low X-ray absorption of non-mineralized tissues. In this study, we show how a wide diversity of soft-tissue structures within the vertebrate head-including muscles, glands, fat deposits, perichondria, dural venous sinuses, white and gray matter of the brain, as well as cranial nerves and associated ganglia-can be rapidly visualized in their natural relationships with extraordinary levels of detail using iodine-enhanced (i-e) µCT imaging. To date, Lugol's iodine solution (I2 KI) has been used as a contrast agent for µCT imaging of small invertebrates, vertebrate embryos, and certain isolated parts of larger, post-embryonic vertebrates. These previous studies have all yielded promising results, but visualization of soft tissues in smaller invertebrate and embryonic vertebrate specimens has generally been more complete than that for larger, post-embryonic vertebrates. Our research builds on these previous studies by using high-energy µCT together with more highly concentrated I2 KI solutions and longer staining times to optimize the imaging and differentiation of soft tissues within the heads of post-embryonic archosaurs (Alligator mississippiensis and Dromaius novaehollandiae). We systematically quantify the intensities of tissue staining, demonstrate the range of anatomical structures that can be visualized, and generate a partial three-dimensional reconstruction of alligator cephalic soft-tissue anatomy. © 2014 Wiley Periodicals, Inc.

Congruence of Imaging Estimators and Mechanical Measurements of Viscoelastic Properties of Soft Tissues

PubMed Central

Zhang, Man; Castaneda, Benjamin; Wu, Zhe; Nigwekar, Priya; Joseph, Jean V.; Rubens, Deborah J.; Parker, Kevin J.

2007-01-01

Biomechanical properties of soft tissues are important for a wide range of medical applications, such as surgical simulation and planning and detection of lesions by elasticity imaging modalities. Currently, the data in the literature is limited and conflicting. Furthermore, to assess the biomechanical properties of living tissue in vivo, reliable imaging-based estimators must be developed and verified. For these reasons we developed and compared two independent quantitative methods – crawling wave estimator (CRE) and mechanical measurement (MM) for soft tissue characterization. The CRE method images shear wave interference patterns from which the shear wave velocity can be determined and hence the Young’s modulus can be obtained. The MM method provides the complex Young’s modulus of the soft tissue from which both elastic and viscous behavior can be extracted. This article presents the systematic comparison between these two techniques on the measurement of gelatin phantom, veal liver, thermal-treated veal liver, and human prostate. It was observed that the Young’s moduli of liver and prostate tissues slightly increase with frequency. The experimental results of the two methods are highly congruent, suggesting CRE and MM methods can be reliably used to investigate viscoelastic properties of other soft tissues, with CRE having the advantages of operating in nearly real time and in situ. PMID:17604902

Estimating zero strain states of very soft tissue under gravity loading using digital image correlation⋆,⋆⋆,★

PubMed Central

Gao, Zhan; Desai, Jaydev P.

2009-01-01

This paper presents several experimental techniques and concepts in the process of measuring mechanical properties of very soft tissue in an ex vivo tensile test. Gravitational body force on very soft tissue causes pre-compression and results in a non-uniform initial deformation. The global Digital Image Correlation technique is used to measure the full field deformation behavior of liver tissue in uniaxial tension testing. A maximum stretching band is observed in the incremental strain field when a region of tissue passes from compression and enters a state of tension. A new method for estimating the zero strain state is proposed: the zero strain position is close to, but ahead of the position of the maximum stretching band, or in other words, the tangent of a nominal stress-stretch curve reaches minimum at λ ≳ 1. The approach, to identify zero strain by using maximum incremental strain, can be implemented in other types of image-based soft tissue analysis. The experimental results of ten samples from seven porcine livers are presented and material parameters for the Ogden model fit are obtained. The finite element simulation based on the fitted model confirms the effect of gravity on the deformation of very soft tissue and validates our approach. PMID:20015676

Using Digital Image Correlation to Characterize Local Strains on Vascular Tissue Specimens.

PubMed

Zhou, Boran; Ravindran, Suraj; Ferdous, Jahid; Kidane, Addis; Sutton, Michael A; Shazly, Tarek

2016-01-24

Characterization of the mechanical behavior of biological and engineered soft tissues is a central component of fundamental biomedical research and product development. Stress-strain relationships are typically obtained from mechanical testing data to enable comparative assessment among samples and in some cases identification of constitutive mechanical properties. However, errors may be introduced through the use of average strain measures, as significant heterogeneity in the strain field may result from geometrical non-uniformity of the sample and stress concentrations induced by mounting/gripping of soft tissues within the test system. When strain field heterogeneity is significant, accurate assessment of the sample mechanical response requires measurement of local strains. This study demonstrates a novel biomechanical testing protocol for calculating local surface strains using a mechanical testing device coupled with a high resolution camera and a digital image correlation technique. A series of sample surface images are acquired and then analyzed to quantify the local surface strain of a vascular tissue specimen subjected to ramped uniaxial loading. This approach can improve accuracy in experimental vascular biomechanics and has potential for broader use among other native soft tissues, engineered soft tissues, and soft hydrogel/polymeric materials. In the video, we demonstrate how to set up the system components and perform a complete experiment on native vascular tissue.

Experience with Proctectomy to Manage Combat Casualties Sustaining Catastrophic Perineal Blast Injury Complicated by Invasive Mucor Soft-Tissue Infections

DTIC Science & Technology

2014-03-01

Complicated by Invasive Mucor Soft-Tissue Infections MAJ Jonathan B. Lundy, MC USA; MAJ Ian R. Driscoll, MC USA ABSTRACT Catastrophic pelviperineal injuries...invasive Mucor species infection. The purpose of this report is to describe two catastrophi- cally injured combat casualties with pelviperineal blast...loss of anal sphincter complex, invasive Mucor species pelvic soft- tissue infection, and continued soilage of perineal wounds. Combat Casualty 1 A 25

Stress fields in soft material induced by injection of highly-focused microjets

NASA Astrophysics Data System (ADS)

Miyazaki, Yuta; Endo, Nanami; Kawamoto, Sennosuke; Kiyama, Akihito; Tagawa, Yoshiyuki

2017-11-01

Needle-free drug injection systems using high-speed microjets are of great importance for medical innovations since they can solve problems of the conventional needle injection systems. However, the mechanical stress acting on the skin/muscle of patients during the penetration of liquid-drug microjets had not been clarified. In this study we investigate the stress caused by the penetration of microjets into soft materials, which is compared with the stress induced by the penetration of needles. In order to capture high-speed temporal evolution of the stress field inside the material, we utilized a high-speed polarized camera and gelatin that resembles human skin. Remarkably we find clear differences in the stress fields induced by microjets and needles. On one hand, high shear stress induced by the microjets is attenuated immediately after the injection, even though the liquid stays inside the soft material. On the other hand, high-shear stress induced by the needles stays and never decays unless the needles are entirely removed from the material. JSPS KAKENHI Grant Numbers 26709007 and 17H01246.

A device for characterising the mechanical properties of the plantar soft tissue of the foot.

PubMed

Parker, D; Cooper, G; Pearson, S; Crofts, G; Howard, D; Busby, P; Nester, C

2015-11-01

The plantar soft tissue is a highly functional viscoelastic structure involved in transferring load to the human body during walking. A Soft Tissue Response Imaging Device was developed to apply a vertical compression to the plantar soft tissue whilst measuring the mechanical response via a combined load cell and ultrasound imaging arrangement. Accuracy of motion compared to input profiles; validation of the response measured for standard materials in compression; variability of force and displacement measures for consecutive compressive cycles; and implementation in vivo with five healthy participants. Static displacement displayed average error of 0.04 mm (range of 15 mm), and static load displayed average error of 0.15 N (range of 250 N). Validation tests showed acceptable agreement compared to a Houndsfield tensometer for both displacement (CMC > 0.99 RMSE > 0.18 mm) and load (CMC > 0.95 RMSE < 4.86 N). Device motion was highly repeatable for bench-top tests (ICC = 0.99) and participant trials (CMC = 1.00). Soft tissue response was found repeatable for intra (CMC > 0.98) and inter trials (CMC > 0.70). The device has been shown to be capable of implementing complex loading patterns similar to gait, and of capturing the compressive response of the plantar soft tissue for a range of loading conditions in vivo. Copyright © 2015. Published by Elsevier Ltd.

Digital dissection - using contrast-enhanced computed tomography scanning to elucidate hard- and soft-tissue anatomy in the Common Buzzard Buteo buteo.

PubMed

Lautenschlager, Stephan; Bright, Jen A; Rayfield, Emily J

2014-04-01

Gross dissection has a long history as a tool for the study of human or animal soft- and hard-tissue anatomy. However, apart from being a time-consuming and invasive method, dissection is often unsuitable for very small specimens and often cannot capture spatial relationships of the individual soft-tissue structures. The handful of comprehensive studies on avian anatomy using traditional dissection techniques focus nearly exclusively on domestic birds, whereas raptorial birds, and in particular their cranial soft tissues, are essentially absent from the literature. Here, we digitally dissect, identify, and document the soft-tissue anatomy of the Common Buzzard (Buteo buteo) in detail, using the new approach of contrast-enhanced computed tomography using Lugol's iodine. The architecture of different muscle systems (adductor, depressor, ocular, hyoid, neck musculature), neurovascular, and other soft-tissue structures is three-dimensionally visualised and described in unprecedented detail. The three-dimensional model is further presented as an interactive PDF to facilitate the dissemination and accessibility of anatomical data. Due to the digital nature of the data derived from the computed tomography scanning and segmentation processes, these methods hold the potential for further computational analyses beyond descriptive and illustrative proposes. © 2013 The Authors. Journal of Anatomy published by John Wiley & Sons Ltd on behalf of Anatomical Society.

Relationship between severity of shoulder subluxation and soft-tissue injury in hemiplegic stroke patients.

PubMed

Huang, Shih-Wei; Liu, Sen-Yung; Tang, Hao-Wei; Wei, Ta-Sen; Wang, Wei-Te; Yang, Chao-Pin

2012-09-01

The aims of this study were: (i) to determine whether the severity of post-hemiplegic shoulder subluxation in stroke patients correlates with soft-tissue injury; and (ii) to determine the shoulder subluxation measurement cut-off points that are indications for further ultrasound examination for soft-tissue injuries in these patients. Cross-sectional study. A total of 39 stroke patients with shoulder subluxation. Shoulder subluxation was evaluated by physical examination, radiography and ultrasound. Soft-tissue injuries were assessed by ultrasound. Subluxation parameters were entered into stepwise logistic regression analyses to predict biceps and supraspinatus tendonitis. With the assumption that shoulder subluxation can be a predisposing factor for tendonitis, receiver operating characteristic curves for shoulder subluxation parameters of the affected side were used to determine cut-off points for optimal sensitivity and specificity of biceps and supraspinatus tendonitis. Shoulder subluxation lateral distance, measured by physical examination, is a predictor for supraspinatus tendonitis (odds ratio = 34.9, p = 0.036). Further ultrasound investigation for soft-tissue injury is indicated when subluxation lateral distance, measured by physical examination is ≥ 2.25 cm or, measured by radiographic examination, ≥ 3.18 cm for lateral distance, ≥ 3.08 cm for vertical distance, or ≥ 2.65 cm for horizontal distance. When post-hemiplegic shoulder subluxation measurements exceed the above-mentioned cut-off points in physical or radiographic examinations, further ultrasound evaluation for soft-tissue injury is recommended.

The extent of soft tissue and musculoskeletal injuries after earthquakes; describing a role for reconstructive surgeons in an emergency response.

PubMed

Clover, A J P; Jemec, B; Redmond, A D

2014-10-01

Earthquakes are the leading cause of natural disaster-related mortality and morbidity. Soft tissue and musculoskeletal injuries are the predominant type of injury seen after these events and a major reason for admission to hospital. Open fractures are relatively common; however, they are resource-intense to manage. Appropriate management is important in minimising amputation rates and preserving function. This review describes the pattern of musculoskeletal and soft-tissue injuries seen after earthquakes and explores the manpower and resource implications involved in their management. A Medline search was performed, including terms "injury pattern" and "earthquake," "epidemiology injuries" and "earthquakes," "plastic surgery," "reconstructive surgery," "limb salvage" and "earthquake." Papers published between December 1992 and December 2012 were included, with no initial language restriction. Limb injuries are the commonest injuries seen accounting for 60 % of all injuries, with fractures in more than 50 % of those admitted to hospital, with between 8 and 13 % of these fractures open. After the first few days and once the immediate lifesaving phase is over, the management of these musculoskeletal and soft-tissue injuries are the commonest procedures required. Due to the predominance of soft-tissue and musculoskeletal injuries, plastic surgeons as specialists in soft-tissue reconstruction should be mobilised in the early stages of a disaster response as part of a multidisciplinary team with a focus on limb salvage.

Evaluation of sample holders designed for long-lasting X-ray micro-tomographic scans of ex-vivo soft tissue samples

NASA Astrophysics Data System (ADS)

Dudak, J.; Zemlicka, J.; Krejci, F.; Karch, J.; Patzelt, M.; Zach, P.; Sykora, V.; Mrzilkova, J.

2016-03-01

X-ray microradiography and microtomography are imaging techniques with increasing applicability in the field of biomedical and preclinical research. Application of hybrid pixel detector Timepix enables to obtain very high contrast of low attenuating materials such as soft biological tissue. However X-ray imaging of ex-vivo soft tissue samples is a difficult task due to its structural instability. Ex-vivo biological tissue is prone to fast drying-out which is connected with undesired changes of sample size and shape producing later on artefacts within the tomographic reconstruction. In this work we present the optimization of our Timepix equipped micro-CT system aiming to maintain soft tissue sample in stable condition. Thanks to the suggested approach higher contrast of tomographic reconstructions can be achieved while also large samples that require detector scanning can be easily measured.

Early Reconstructions of Complex Lower Extremity Battlefield Soft Tissue Wounds

PubMed Central

Ebrahimi, Ali; Nejadsarvari, Nasrin; Ebrahimi, Azin; Rasouli, Hamid Reza

2017-01-01

BACKGROUND Severe lower extremity trauma as a devastating combat related injury is on the rise and this presents reconstructive surgeons with significant challenges to reach optimal cosmetic and functional outcomes. This study assessed early reconstructions of complex lower extremity battlefield soft tissue wounds. METHODS This was a prospective case series study of battled field injured patients which was done in the Department of Plastic Surgery, Baqiyatallah University of Medical Sciences hospitals, Tehran, Iran between 2013-2015. In this survey, 73 patients were operated for reconstruction of lower extremity soft tissue defects due to battlefield injuries RESULTS Seventy-three patients (65 men, 8 womens) ranging from 21-48 years old (mean: 35 years) were enrolled. Our study showed that early debridement and bone stabilization and later coverage of complex battlefields soft tissue wounds with suitable flaps and grafts of lower extremity were effective method for difficult wounds managements with less amputation and infections. CONCLUSION Serial debridement and bone stabilization before early soft tissue reconstruction according to reconstructive ladder were shown to be essential steps. PMID:29218283

[Skin and Soft Tissue Infections Due to Corynebacterium ulcerans - Case Reports].

PubMed

Jenssen, Christian; Schwede, Ilona; Neumann, Volker; Pietsch, Cristine; Handrick, Werner

2017-10-01

History and clinical findings  We report on three patients suffering from skin and soft tissue infections of the legs due to toxigenic Corynebacterium ulcerans strains. In all three patients, there was a predisposition due to chronic diseases. Three patients had domestic animals (cat, dog) in their households. Investigations and diagnosis  A mixed bacterial flora including Corynebacterium ulcerans was found in wound swab samples. Diphtheric toxin was produced by the Corynebacterium ulcerans strains in all three cases. Treatment and course  In all three patients, successful handling of the skin and soft tissue infections was possible by combining local treatment with antibiotics. Diphtheria antitoxin was not administered in any case. Conclusion  Based on a review of the recent literature pathogenesis, clinical symptoms and signs, diagnostics and therapy of skin and soft tissue infections due to Corynebacterium ulcerans are discussed. Corynebacterium ulcerans should be considered as a potential cause of severe skin and soft tissue infections. Occupational or domestic animal contacts should be evaluated. © Georg Thieme Verlag KG Stuttgart · New York.