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Objective: To evaluate the ideal anteroposterior position of incisors in lateral smiling profiles with different chin prominences and to relate these positions to nose and chin landmarks based on the perceptions of orthodontists and laypersons. Methods: A lateral smiling profile image of a female subject was adjusted to create five levels of chin prominence (-6, -3, 0, +3, +6 mm). For each level, the anteroposterior positions of the maxillary incisors were adjusted across five positions (-4, -2, 0, +2, +4 mm). Thirty-six orthodontists and 36 laypersons rated the attractiveness of each profile using a visual analog scale. The maxillary incisor position (U1) was measured relative to the external nose and chin landmarks (E-lines). Differences in perceptions between orthodontists and laypersons were analyzed. Results: For profiles with 6 and 3 mm chin retrusion, the most favored incisor positions were the 2 mm retrusion and unaltered positions, respectively. For the unaltered chin prominence, orthodontists preferred unaltered incisors, while laypersons favored 2 mm protrusion. Conversely, for 3 and 6 mm chin protrusion, both groups preferred 4 and 2 mm protrusion, respectively. The distance between U1 and the E-line is the most attractive images ranged from 8.5 to 11.5 mm. Based on the regression model, an optimal U1-E-line distance of 8.95 mm was recommended. Conclusions: The preferred incisor position is influenced by chin prominence, with the incisor position shifting in the same direction as the chin. The U1 E-line can be a useful clinical tool for determining the proper incisor positioning. Esthetic perceptions were generally consistent between orthodontists and laypersons. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the accuracy of Qlone, Magiscan, and 3dMD with that of direct anthropometry (DA). Methods: The study involved 41 patients. Sixteen facial landmarks, including six individual and five paired points, were marked on each participant's face. Subsequently, 18 linear measurements were assessed using a 3dMD device (multicamera photogrammetry), Qlone, Magiscan smartphone applications (single-camera photogrammetry), and DA. The Qlone and Magiscan images were calibrated using a reference point 10 mm from the nasion during DA to ensure a 1:1 correspondence. Results: Concerning the precision of the digital methods compared to DA, the mean intraclass correlation coefficient values of 3dMD, Qlone and Magiscan were 0.989, 0.980 and 0.982, respectively. Compared with DA, 3dMD achieved excellent trueness with the lowest average absolute differences in the measurements (highest value = 0.95 ± 0.62 mm). The highest values for Qlone and Magiscan were 1.51 ± 1.11 mm and 2.14 ± 1.69 mm, respectively. According to the number of parameters, the ranking of unreliable values (> 2 mm) was Magiscan (n = 46), Qlone (n = 35), and then, 3dMD (n = 4). Furthermore, reliability (less than 1 mm) was the highest for 3dMD (n = 517), followed by Magiscan (n = 457), and then, Qlone (n = 415). Conclusions: The 3dMD achieved excellent trueness with the lowest average absolute differences in the measurements. Based on statistical analysis, the trueness values of Magiscan and Qlone were close to that of 3dMD. To apply these smartphone applications clinically, more studies are necessary. [ABSTRACT FROM AUTHOR]

Fewer than 5 % of soft tissue sarcomas arise in the foot and ankle. It can be difficult to distinguish between benign and malignant lesions which leads to a delay in diagnosis. Initial inappropriate procedures limit options for limb salvage and increasing rates of local recurrence. Our aim is to improve understanding of the presentation and management of these rare tumors to reduce delays in diagnosis and decrease the occurrence of inappropriate or unwarranted procedures. A prospectively maintained database of 376 new referrals to the West of Scotland regional musculoskeletal oncology service for soft tissue lesions of the foot, ankle, and lower leg over a 10-year period was analysed retrospectively. An assessment was made of patient demographics, presentation, anatomical location, diagnosis, classification, management, and outcomes for all patients. Of all new referrals, 53.5 % were diagnosed with primary benign soft tissue tumors and 16 % with primary malignant soft tissue tumors. The most common primary benign tumor in our population was schwannoma (15.9 %) and primary malignant tumor was undifferentiated sarcoma (26.7 %). In the foot alone, soft tissue sarcomas most commonly occurred in the forefoot (44.4 %). The most common presenting complaints were rest pain and focal swelling. Symptoms were present for on average 7 months prior to referral. Death from disease in sarcomas was 41.7 % over a 10 year follow up period, higher than other body areas. Soft tissue sarcomas in the foot and ankle remain a diagnostic challenge. Local biopsies should only be performed following discussion with an oncology surgeon. We have provided a management protocol in order to reduce the number of inappropriate procedures performed in this group and expedite referral to specialist centres, optimising clinical outcomes and reducing the cost of litigation to healthcare services. [ABSTRACT FROM AUTHOR]

Le Fort I (LFI) osteotomy is commonly performed by orthognathic surgeons; however, postoperative changes in nasolabial morphology are of concern. Several factors influence such changes, but it is difficult to accurately predict the postoperative results. This study evaluated the three-dimensional (3D) morphological changes in the nasal region according to the different directions of maxillary movement during LFI osteotomy. Forty-one patients who underwent LFI osteotomies were included. All patients were divided into maxilla-up (Group U: 20 patients) and maxilla-forward (Group F: 21 patients) groups. Soft tissue morphologies were determined preoperatively and 3 or 6 months postoperatively using an optical 3D scanner. All datasets were evaluated in terms of volume changes in nine subregions and changes in linear measurements around the nasal area. Both groups exhibited increased nasal volumes after surgery in the order of the three upper, three central, and three lower subregions. The change in volume of the central nasal region tended to be greater in Group U than that in Group F. We evaluated 3D morphological changes in the nasal region according to the direction of maxillary movement during LFI osteotomy. Group U exhibited a large change in the volume of the central nasal region. [Display omitted] [ABSTRACT FROM AUTHOR]

The analysis of the impact of a 5-min massage session on the gastrocnemius contractile and passive mechanical properties in young adults - a randomized controlled trial. The effect of massage therapy on the muscle properties is unclear. New technologies make investigation more in-depth and reliable. This study examined the effects of a 5-min massage session on the muscle stiffness and tone reduction in healthy young adults. Participants aged between 19 and 24 were randomly assigned to an intervention group (IG) (n = 40) or a control group (CG) (n = 40). The IG participated in a 5-min massage session of the lateral and medial gastrocnemius muscle (LGCM and MGCM respectively). The muscle contractile properties were assessed by tensiomyography (TMG). It measured maximal displacement (Dm), delay time (Td) and contraction time (Tc). Oscillation frequency (F) and stiffness (S) were used to assess muscle passive mechanical properties. These measurements were collected by MytonPro. There were no differences between the groups in the pre-test measurements. The results of mixed-model ANOVA showed significant (p < 0.05) time × group interactions, with greater alteration in the IG compared to the CG in the LGCM for Dm (%diff = 22.5, ƞp2 = 0.41), Td (%diff = 3.63, ƞp2 = 0.02), Tc (%diff = 13.38, ƞp2 = 0.1), F (%diff = 5.55, ƞp2 = 0.07) and in the MGCM for Dm (%diff = −14.34, ƞp2 = 0.06), F (%diff = −7.53, ƞp2 = 0.12). No difference (p > 0.05) was noticed in other variables. A 5-min massage session impacts the contractile and passive mechanical properties of the LGCM and MGCM. The size and direction of changes may depend on the muscle type, its geometry as well as other factors. [ABSTRACT FROM AUTHOR]

Elbow dislocation is frequently associated with bony and osteochondral posterolateral capitellar lesions that are often under-reported. We aim to examine the radiologic signs of posterolateral lesions on computed tomography (CT). A retrospective analysis of CT scans was performed. Patients were classified into 4 groups: (1) simple elbow dislocation, (2) elbow dislocation with a fracture of the coronoid tip, (3) elbow dislocation with coronoid tip fracture and a radial head fracture inferior or equal to the anterior third, and (4) terrible triad defined as elbow dislocation with concomitant coronoid and radial head fracture with a more important involvement. Patients with a more complex fracture pattern were excluded. The presence of POsteroLateral Engagement of Soft Tissue And Radial head (POLESTAR) patterns was analyzed and subclassified as impaction type or fragmentation type. Fifty-one CT scans met the inclusion criteria. POLESTAR lesions were identified in 48 cases (94%): 46% impaction-type and 54% fragmentation-type POLESTAR. Analyzing patients from grade 1 to 4, impaction-type POLESTAR was found, respectively, from 40% to 57%, whereas fragmentation type was present from 60% to 43%. This study shows a high incidence of POLESTAR lesions (94%) that can be present as impaction type or fragmentation type. Based on our preliminary results, impaction type is more common in grades 3 and 4, whereas fragmentation type is more frequent in grades 1 and 2. [ABSTRACT FROM AUTHOR]

Ultrasonography (US) has been suggested as a valuable complement to clinical and radiologic examinations in elbow trauma. Magnetic resonance imaging (MRI) has been the method of choice, despite fair to moderate inter-rater reliability (IRR). US has potential advantages but is assessor dependent and the IRR scarcely examined. The primary aim of the present study was to investigate IRR for US and secondarily interobserver agreement (IOA) between US and MRI in the acute phase after elbow trauma. Acute phase was defined as 2 weeks and, if applicable, the following weekend. The hypothesis was that US reliability would be at least substantial for complete muscle or ligament lesions. A total of 116 patients (50 men, median age 47 [range 19-87] years) who had an elbow trauma with dislocation and/or fracture were included. Exclusion criteria were prior injury to the same elbow, and US and/or MRI not possible within 16 days. During US, the condition of muscle origins at the epicondyles and collateral and annular ligament complexes was recorded in a predesigned protocol, with the alternatives intact, partially or completely torn. Seventy-two patients had a second US examination the same day by an independent upper extremity surgeon, and 58 of the 116 patients underwent an MRI before or after the US, evaluated by 2 radiologists using the same protocol. IOA and IRR between assessors and modalities were analyzed with kappa statistics and interpreted according to Landis and Koch. Perfect agreement (PA) was reported in percentages. US examination within 2 weeks was feasible with tolerable discomfort. Defining muscle origins and ligaments as intact or completely torn, the US IRR ranged from substantial to near perfect (kappa 0.63-1, PA 93%-100%). Intact tissues vs. tear (partial and complete tear combined) or intact vs. partial vs. complete tear resulted in kappa values from moderate to substantial and PA 74%-96% with lowest reliability for the muscle origins. The IOA between MRI and US ranged from fair to near perfect for no tear vs. complete tear (kappa 0.25-1, PA 65%-100%). Agreement between no tear and tear (partial and complete together) ranged from fair to substantial (0.25-0.66, PA 63%-89%) and no tear vs. partial or complete tear ranged from fair to moderate (0.25-0.53, PA 50%-79%). US in the acute setting is suitable and reliable for diagnosis of ligament injuries in the elbow and is in addition fast, cheap, and easily accessible. The agreement with MRI seems to vary with the structure assessed and severity of the lesions, ranging from fair to near perfect. [ABSTRACT FROM AUTHOR]

Magnetic resonance elastography (MRE) and diffusion-weighted imaging (DWI) are complementary imaging techniques that detect disease based on viscoelasticity and water mobility, respectively. However, the relationship between viscoelasticity and water diffusion is still poorly understood, hindering the clinical translation of combined DWI-MRE markers. We used DWI-MRE to study 129 biomaterial samples including native and cross-linked collagen, glycosaminoglycans (GAGs) with different sulfation levels, and decellularized specimens of pancreas and liver, all with different proportions of solid tissue, or solid fractions. We developed a theoretical framework of the relationship between mechanical loss and tissue-water mobility based on two parameters, solid and fluid viscosity. These parameters revealed distinct DWI-MRE property clusters characterizing weak, moderate, and strong water-network interactions. Sparse networks interacting weakly with water, such as collagen or diluted decellularized tissue, resulted in marginal changes in water diffusion over increasing solid viscosity. In contrast, dense networks with larger solid fractions exhibited both free and hindered water diffusion depending on the polarity of the solid components. For example, polar and highly sulfated GAGs as well as native soft tissues hindered water diffusion despite relatively low solid viscosity. Our results suggest that two fundamental properties of tissue networks, solid fraction and network polarity, critically influence solid and fluid viscosity in biological tissues. Since clinical DWI and MRE are sensitive to these viscosity parameters, the framework we present here can be used to detect tissue remodeling and architectural changes in the setting of diagnostic imaging. The viscoelastic properties of biological tissues provide a wealth of information on the vital state of cells and host matrix. Combined measurement of viscoelasticity and water diffusion by medical imaging is sensitive to tissue microarchitecture. However, the relationship between viscoelasticity and water diffusion is still poorly understood, hindering full exploitation of these properties as a combined clinical biomarker. Therefore, we analyzed the parameter space accessible by diffusion-weighted imaging (DWI) and magnetic resonance elastography (MRE) and developed a theoretical framework for the relationship between water mobility and mechanical parameters in biomaterials. Our theory of solid material properties related to particle motion can be translated to clinical radiology using clinically established MRE and DWI. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Glomus tumors are benign mesenchymal tumors of the neuromyoarterial glomus bodies. They are generally localized at the subungual area of the fingers. Extradigital or non-subungual glomus tumors are less common. Their diagnosis can be challenging because of their lower incidence, nonspecific symptoms, and the fact that they can be missed during the physical examination. The aim of this case series is to provide an overview of non-subungual glomus tumors, including the patients' epidemiology characteristics, tumor localization and size, their varied imaging manifestations in ultrasound and magnetic resonance imaging, differential diagnosis and histopathological features. Our report included 64 patients with the diagnosis of non-subungual glomus tumor in the Pathology Department at the La Paz University Hospital in Madrid from January 1966 to September 2022. There were 44 men and 20 women (mean age, 55.8 years; range, 8–85 years). The tumors had a mean size of 1 cm and were located in the lower limbs in most cases (59.3%). In 17 cases (27%) a diagnostic imaging test was performed (US, MRI or both). The radiological appearance of a glomus tumor on ultrasound was in most cases a circumscribed hypoechoic oval nodule located in the subcutaneous layer. Spectral Doppler can demonstrate both venous and arterial intralesional flow and in some cases a "Vascular stalk sign,'' seen in 4/9 cases. MRI assists in providing a more detailed characterization of these lesions, which present as T2-weighted hyperintense nodules with avid enhancement. Short conclusion: Glomus tumors are considered rare neoplasms, accounting for a small percentage of all tumors. Our report brings together the most up-to-date information available regarding the imaging findings and differential diagnosis of this entity. Although ultrasound images are not specific, they are crucial for early diagnosis, provide precise location information, and serve as a guide for tumor excision. MRI study helps to better characterize these tumors. The diagnosis is mostly clinical, with confirmation in the histopathologic study. [ABSTRACT FROM AUTHOR]

There are different kinds of benign and malignant lesions in the oral cavity. Clinically, definite diagnosis can be confirmed only by doing adequate surgical biopsy and subsequent histopathological examination. Inadequate biopsy technique, unsuitable selection of the location for biopsy, inappropriate tissue handling and record of patients' information may lead to artifacts and misdiagnosis by the oral pathologists. Soft tissue stabilization is a challenge during oral surgery procedures. It needs the cooperation of operator, assistants, and patients to overcome the difficulty and ensure the successful outcome. In this article, we reviewed the procedures for clinical surgical biopsy, and raised three current tissue stabilization methods including fingers and gauze stabilization, stabilization with chalazion forceps and adapted instruments, and stabilization with retraction sutures. Moreover, some limitations were also presented. Clinician should examine the clinical characteristics of the oral lesion, the surrounding anatomical structures, and their own clinical experience and preference to select the appropriate tool. More understanding of these biopsy and tissue stabilization methods can effectively improve the biopsy procedures and obtain adequate tissues for histopathological examination and subsequent issue of an accurate pathological report. [ABSTRACT FROM AUTHOR]

Soft tissue sarcomas are a rare group of heterogenous entities which affect the tissues supporting, connecting and/or surrounding body structures and organs. Factors such as patient age and tumour location can influence how soft tissue sarcomas manifest with biological and clinical behaviour ranging from less aggressive to highly malignant. Recent advances in both diagnosis and treatment have led to new insights into the pathologic, histologic and genomic characterisation of sarcomas and these insights have diversified subtyping. One subtype, small round (blue) cell tumours (SRBCT), constitutes a divergent group of tumours which occur most commonly in the paediatric and young adult population. The clinical characteristics, prognostics and therapeutic approaches regarding these tumours differ greatly. Despite this variation the relative histomorphological uniformity of SRBCTs poses the histopathologist a diagnostic challenge. This challenge is being ameliorated by advances in molecular genetic profiling which is revolutionising diagnosis and providing insight into both biomarkers and therapeutic targets. The following review aims to address the pertinent morphological, immunohistochemical and molecular features of some of the more common SRBCTs, including variants, and hopes to provide the histopathologist with a diagnostic approach focussed upon the key diagnostic features. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to review the literature on current surface modification strategies used to improve the binding efficiency of an emerging biological material, polyetheretherketone (PEEK), with bone and soft tissues. Study selection: This review was based on articles retrieved from PubMed, Google Scholar, Web of Science, and ScienceDirect databases. The main keywords used during the search were "polyetheretherketone (PEEK)," "implant," "surface modification," "biomaterials," "bone," "osseointegration," and "soft tissue.". Results: The suitability of PEEK surface modification strategies has been critically analyzed and summarized here. Many cell and in vivo experiments in small animals have shown that the use of advanced modification technologies with appropriate surface modification strategies can effectively improve the surface inertness of PEEK, thereby improving its binding efficiency with bone and soft tissues. Conclusions: Surface modifications of PEEK have revealed new possibilities for implant treatment; however, most results are based on in vitro or short-term in vivo evaluations in small animals. To achieve a broad application of PEEK in the field of oral implantology, more in vivo experiments and long-term clinical evaluations are needed to investigate the effects of various surface modifications on the tissue integration ability of PEEK to develop an ideal implant material. [ABSTRACT FROM AUTHOR]

To develop a coupled-lines system to determine the anteroposterior position of maxillary central incisors (U1) for smiling profile esthetics. Thirty Asian females with ordinary and good facial harmony were selected as the study sample and the control sample, respectively. Three-dimensional facial images and 45°- and 90°-angled profiles were collected. The anteroposterior relationships between U1 and upper- and mid-facial soft tissue landmarks were measured. By morphing photos of the study sample, two artificial images were created to represent the well-balanced 45°- and 90°-angled profiles and were further processed with combined variations of soft tissue subnasale (SSn)–Glabella and the mid-point of facial axial points of the bilateral central incisor (mFA)–SSn distances. Esthetic assessments were performed on these images by layperson (n = 94) and orthodontist (n = 94) raters. Both upper- and mid-facial soft tissue landmarks were indispensable in assessing anteroposterior positions of U1 for well-balanced smiling profiles. As assessed in 45°- and 90°-angled profiles, the most esthetically sensitive parameters were mFA-Glabella and mFA-SSn distances. A coupled-lines system was constructed, comprising the Glabella and SSn vertical lines. In smiling profiles with optimal esthetics, the mFA point was at 2 to 5 mm posterior to the Glabella vertical and concomitantly 4 to 7 mm posterior to the SSn vertical, as perceived by orthodontists. Laypersons gave a wider range for mFA-Glabella distances, at 2 to 6 mm. The coupled-lines system could serve as a reliable reference for determining esthetically optimal anteroposterior positions of U1 for female facial profiles. [ABSTRACT FROM AUTHOR]

Non-Diagnostic (ND) biopsies are occasionally encountered during the investigation of soft tissue sarcoma. We performed a retrospective review of all ND soft tissue biopsies discussed at our regional Multi-Disciplinary Team (MDT) meeting between 2004 & 2014 with the aim of establishing the incidence of ND biopsies, identifying predictive factors for repeat biopsies and evaluating the effectiveness of MDT decisions. We identified 80 ND out of 3233 biopsies. Diagnostic Yield (DY) was 97.5%, 76.0% and 77.8% for the first, second and third successive biopsy respectively. With an MDT approach utilising radiological and clinical information, the diagnostic success rate achieved was 98.5%, 82.0% and 77.8% for the first, second and third biopsies respectively. Malignant tumours (sarcoma & carcinoma) were 19 times more likely to undergo an increasing number of biopsies compared to benign lesions (p < 0.01), while repeat biopsies were less useful for suspected benign lesion. Although a repeat biopsy was only performed in 63% of cases, there were no patients originally diagnosed with a benign lesion that re-presented with the same lesion subsequently being malignant throughout the study period. Our study shows that a specialist MDT approach leads to high diagnostic rates and is a safe and effective method of preventing unnecessary, repeat biopsies where the initial biopsy is ND. [ABSTRACT FROM AUTHOR]

Conventional teaching in the management of partial hand amputations prioritizes residual limb length, often through local, regional, or distant flaps. While multiple options exist to provide durable soft tissue coverage, only a few flaps are thin and pliable enough to match that of the dorsal hand skin. Despite debulking, excessive soft tissues from previous flap reconstructions can interfere with residual limb function, prosthesis fit, and surface electrode recording for myoelectric prostheses. With rapid advances in prosthetic technology and nerve transfer techniques, patients can achieve very high levels of function following prosthetic rehabilitation that rival, or even outpace, traditional soft tissue reconstruction. Therefore, our reconstruction algorithm for partial hand amputations has evolved to the thinnest coverage possible, providing adequate durability. This evolution has provided our patients with faster and more secure prosthesis fitting with better surface electrode detection, enabling earlier and improved use of simple and advanced partial hand prostheses. [ABSTRACT FROM AUTHOR]

Metastatic sarcomas to pleural effusion are extremely rare, accounting for <1% of all malignant pleural effusions. We aim to present our experience with pleural effusion specimens containing metastatic sarcomas over a 10-year period. We performed a 10-year retrospective search of cytopathology archives to identify all pleural effusions that were involved by metastatic sarcoma. All available cytopathology and surgical pathology specimens were retrieved and reviewed. Twenty-eight pleural fluids from 22 patients with metastatic sarcoma were identified in our search. The patients' ages ranged from 12 to 73 years. The pleural fluid volumes ranged from 10 to 1500 ml. Rhabdomyosarcoma was the most commonly encountered metastatic sarcoma to pleural effusion (n = 7). Other metastatic sarcomas were as follows: epithelioid angiosarcoma (n = 4), Ewing sarcoma (n = 3), clear cell sarcoma (n = 2), high grade conventional osteosarcoma (n = 2), undifferentiated pleomorphic sarcoma (n = 1), epithelioid sarcoma, proximal type (n = 1), dedifferentiated liposarcoma (n = 1), and conventional chondrosarcoma (n = 1). The time between initial diagnosis and effusion varied from 3 months to 25 years. Two patients are alive with disease at 6 and 21 months of follow-up. All other patients were dead of disease and the survival after a malignant pleural effusion ranged from <1 month to 18 months. Metastatic bone and soft tissue sarcomas to pleural effusions are rare and their cytologic features can be mistaken for carcinoma, melanoma, or mesothelioma. Careful review of the patient's medical history, comparison of the previous pathology and the use of ancillary studies are crucial for the evaluation of pleural effusions involved by metastatic sarcomas. • Metastatic sarcomas to pleural effusion are extremely rare. • Rhabdomyosarcoma is the most common sarcoma encountered in pleural effusion. • The cytologic features of sarcomas in pleural effusion can be mistaken for carcinoma, melanoma, or mesothelioma. • Careful review of the patient's medical history, comparison of previous pathology, and use of ancillary studies are helpful for the diagnosis of metastatic sarcomas to effusion. • Metastatic sarcomas to pleural effusion portend a dismal prognosis. [ABSTRACT FROM AUTHOR]

Soft tissue material properties are vital to human body models that evaluate interactions between the human body and its environment. Such models evaluate internal stress/strain responses in soft tissues to investigate issues like pressure injuries. Numerous constitutive models and parameters have been used to represent mechanical behavior of soft tissues in biomechanical models under quasi-static loading. However, researchers reported that generic material properties cannot accurately represent specific target populations due to large inter-individual variability. Two challenges that exist are experimental mechanical characterization and constitutive modeling of biological soft tissues and personalization of constitutive parameters using non-invasive, non-destructive bedside testing methods. It is imperative to understand the scope and appropriate applications for reported material properties. Thus, the goal of this paper was to compile studies from which soft tissue material properties were obtained and categorize them by source of tissue samples, methods used to quantify deformation, and material models used to describe tissues. The collected studies displayed wide ranges of material properties, and factors that affected the properties included whether tissue samples were in vivo or ex vivo , from humans or animals, the body region tested, body position during in vivo studies, deformation measurements, and material models used to describe tissues. Because of the factors that affected reported material properties, it is clear that much progress has been made in understanding soft tissue responses to loading, yet there is a need to broaden the scope of reported soft tissue material properties and better match reported properties to appropriate human body models. • Soft tissue properties were collected from animals and humans, in-vivo and ex-vivo. • Sample source, body region and position, and testing conditions affected properties. • Models and tissue properties should match to ensure realistic approximations. • Guidelines for reporting uncertainty in models depend on material characterization. • Growing efforts in personalized soft tissue properties may reduce uncertainty. [ABSTRACT FROM AUTHOR]

Imaging should be performed in patients with a suspected soft tissue mass that cannot be clinically confirmed as benign. Imaging provides essential information necessary for diagnosis, local staging, and biopsy planning. Although the modalities available for imaging of musculoskeletal masses have undergone progressive technological advancements in recent years, their overall purpose in the setting of a soft tissue mass remains unchanged. This document identifies the most common clinical scenarios related to soft tissue masses and the most appropriate imaging for their assessment on the basis of the current literature. It also provides general guidance for those scenarios that are not specifically addressed. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation. [ABSTRACT FROM AUTHOR]

The human patellar tendon contains distinct fascicle bundles across its mediolateral and anteroposterior regions. Studies have suggested region-specific behaviour during in vivo actions, but it is unclear whether such regional differences result from localized variation in composition and mechanical properties within the tendon itself. Furthermore, the viscoelastic properties of any region of the human patellar tendon have not been well described previously. Here, a comprehensive investigation of the composition and material properties of six regions (three mediolateral × two anteroposterior) of the human patellar tendon was performed on tendons harvested from eight cadaver knees. Thorough viscoelastic (stress relaxation and sinusoidal) and elastic (failure) mechanical tests were conducted on dumbbell-shaped samples. Uronic acid (proteoglycan), hydroxyproline (collagen), and water contents were measured from the samples after mechanical testing. No systematic between-region differences were found for any measured biomechanical or biochemical parameter. However, the phase difference between stress and strain decreased as a function of increasing sinusoidal frequency (from 0.1 Hz to 5 Hz), suggesting the human patellar tendon behaves more elastically at higher strain rates. These results indicate the human patellar tendon is a homogenous material at its mid-substance and that other factors, such as geometrical constraints, enthesis properties, and insertion points, may be responsible for any region-specific behaviour in vivo. Additionally, the more elastic behaviour of the human patellar tendon as strain rate increases likely supports improved joint control and enhanced movement economy during fast actions such as sprinting. [Display omitted] [ABSTRACT FROM AUTHOR]

The fine-needle aspiration (FNA) cytopathology of pleomorphic hyalinizing angiectatic tumor (PHAT) is the subject of a very limited number of reports. We undertook a review of our FNA experience with this neoplasm. A search was made of our files for PHAT FNA cases with histopathologic confirmation. FNA biopsy smears and cell blocks were performed and examined using standard techniques. Two primary cases of histologically proven PHAT [both male, ages 56 and 60 years] met study inclusion. FNA sites included buttock and foot. A misdiagnosis of sarcoma was made in each case. Ancillary immunohistochemical testing performed in 1 case suggested angiosarcoma. Cytologic smears showed only modest cellularity with a dual population of bland spindle cells and isolated large pleomorphic cells, many harboring nuclear pseudoinclusions. Smear background was clean, and mitoses absent. The imitative cytopathology of PHAT with a pleomorphic sarcoma remains a pitfall in FNA specimens. Awareness of this entity and its lack of hypercellularity, necrosis, and cohesive groups of atypical cells in smears should assist the cytopathologist in avoiding a misdiagnosis of malignancy. • Pleomorphic hyalinizing angiectatic tumor (PHAT) has only rarely been the subject of single fine-needle aspiration (FNA) biopsy cytology reports. • Due to the presence of large pleomorphic cells and unlike whole tissue sections the inability to recognize ectatic blood vessel clusters in smears, FNA of PHAT is typically mistaken for a sarcoma. • The lack of distinctive cytomorphology and a specific immunoprofile precludes a specific interpretation unless molecular testing for TGFBR3 and/or MGEA5 gene rearrangements are performed. • The imitative cytopathology of PHAT with pleomorphic sarcomas remains a pitfall in FNA specimens. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate facial soft and hard tissue changes, individually and relative to each other, in patients with skeletal class III deformity after bimaxillary surgery using three-dimensional (3D) photos obtained by white light scanning. Thirty patients with skeletal class III deformity who underwent bimaxillary surgery were selected. Each patient underwent white light scanning and spiral computed tomography (CT) within two weeks before (T0) and six months after surgery (T1). The 3D photos were registered with CT soft tissue models for T0 and T1, and the skeletal area unaffected by treatment (cranial base) was used to register T0 and T1. Then, the 3D colour-coded map was analysed to assess both skeletal and soft tissue changes between T0 and T1. Changes in the 3D coordinates of each anatomical landmark were analysed using the Student's t -test. Maxillary advancement by 2–3 mm and mandibular recession by 5–6 mm were observed; the mandible was shortened in the vertical direction. Compared with the preoperative values, the nasal columella was 0.51 mm shorter, the upper lip was 0.71 mm longer, the base of the alar cartilage was 1.38 mm wider, and the nasolabial angle became larger. The ratio of change in the position of soft tissue point Sn to hard tissue point A was 0.73:1, and that of soft tissue point Pg to hard tissue point Pog was 0.86:1. Images obtained by structured white light scanning registered with CT can be used as an alternative to study facial changes after orthognathic surgery. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Glucose-6-phosphate dehydrogenase (G6PD) deficiency, Thalassemia (THL), and Sickle cell anemia (SCA) are the most common inherited hematologic diseases globally. It is important to understand the skeletal and dental manifestations in orthodontic treatment. This study aimed at assessing and comparing skeletal and dental manifestations of G6PD deficiency, THL, and SCA patients with healthy controls in Saudi Arabia. SUBJECTS AND METHODS: This is a retrospective study of G6PD deficient, THL, and SCA patients’ cephalometric records in Saudi Arabia. This study included 136 subjects (G6PD=34, THL=34, SCA=34, and healthy control=34), aged between 18-32 years. 17 skeletal, dental, and soft tissue cephalometric measurements obtained from the G6PD, THL, and SCA were compared to control measurements using ANOVA and Tukey’s HSD post-hoc test. RESULTS: Intra-class correlation ranged between (ICC: 0.971-0.996), indicating excellent reliability of measurements. A statistically significant difference in skeletal, dental, and soft tissue measurements between each condition and controls was observed, except for Wits, PP-MP, Y-axis, UI-SN, NLA, and LI-E line in SCA, FMA, ANS-Me, UI-SN, and LI-A Pog in G6PD and Wits, Y-axis, UI-SN, UI-NA, LI-MP, LI-Apog and UI-E line in THL group (p>0.05). CONCLUSIONS: SCA and THL patients showed class II skeletal patterns, while class III skeletal relationship was evident in patients with G6PD deficiency. [ABSTRACT FROM AUTHOR]

Background: Esthetic complications of dental implants in the esthetic zone can have a major negative impact on patients' quality of life and perception of implant therapy. The aim of the present study was to evaluate the prevalence of peri-implant soft tissue dehiscence (PSTD) and the clinical and ultrasonographic risk indicators for this condition.Methods: Subjects with ≥1 healthy single dental implants in the esthetic area were identified and recruited. Clinical and ultrasonographic measurements, including PSTD class and subclass, probing depth, keratinized mucosa width (KMW), mucosal thickness (MT) at 1 mm and 3 mm, buccal bone distance (BBD) and buccal bone thickness, were evaluated in healthy implants and implants with PSTD.Results: A total of 153 subjects with a total of 176 dental implants were included. The prevalence of PSTD was 54.2% and 56.8% on a patient and implant level, respectively. The most frequent type of PSTD was the one characterized by having both an implant-supported crown longer than the clinical crown of the homologous tooth and a visible abutment/implant fixture exposed to the oral cavity. The multivariate analysis showed that the presence of an adjacent implant, a longer time of the implant in function, limited MT, reduced KMW, and increased BBD were significantly associated with the presence of PSTD.Conclusions: PSTDs are common findings in the esthetic region. Several risk indicators for this condition, such as presence of an adjacent implant, increased time in function of the implant, higher BBD, lower KMW, and MT were identified. [ABSTRACT FROM AUTHOR]

Soft tissue reconstruction currently relies on two main approaches, one involving the implantation of external biomaterials and the second one exploiting surgical autologous tissue displacement. While both methods have different advantages and disadvantages, successful long-term solutions for soft tissue repair are still limited. Specifically, volume retention over time and local tissue regeneration are the main challenges in the field. In this study the performance of a recently developed elastic porous injectable (EPI) biomaterial based on crosslinked carboxymethylcellulose is analyzed. Nearly quantitative volumetric stability, with over 90% volume retention at 6 months, is observed, and the pore space of the material is effectively colonized with autologous fibrovascular tissue. A comparative analysis with hyaluronic acid and collagen-based clinical reference materials is also performed. Mechanical stability, evidenced by a low-strain elastic storage modulus (G') approaching 1kPa and a yield strain of several tens of percent, is required for volume retention in-vivo. Macroporosity, along with in-vivo persistence of at least several months, is instead needed for successful host tissue colonization. This study demonstrates the importance of understanding material design criteria and defines the biomaterial requirements for volume retention and tissue colonization in soft tissue regeneration. We present the design of an elastic, porous, injectable (EPI) scaffold suspension capable of inducing a precisely defined, stable volume of autologous connective tissue in situ. It combines volume stability and vascularized tissue induction capacity known from bulk scaffolds with the ease of injection in shear yielding materials. By comparative study with a series of clinically established biomaterials including a wound healing matrix and dermal fillers, we establish design rules regarding rheological and compressive mechanical properties as well as degradation characteristics that rationally underpin the volume stability and tissue induction in a high-performance biomaterial. These design rules should allow to streamline the development of new colonizable injectables. [Display omitted] [ABSTRACT FROM AUTHOR]

Objectives: Compensatory is a mechanism that preserve a proportional and harmonious facial pattern in patients with Class III skeletal pattern. There are two major treatments for this type of patient which are orthodontic surgery and fixed orthodontic appliances. The objective of this study is to assess dentoalveolar and soft tissue compensation in Class III skeletal pattern in relation to normal occlusion. Methods: Pre-operative lateral cephalometric radiograph of 30 patients each from Class I and Class III skeletal pattern were selected for this study. The cephalometric parametric such as sagittal jaw relationship, occlusal plane angulation, chin thickness, distance of lips toward aesthetic line, incisors inclination were measured. Results: The result shows significant difference in DL' (p = 0.019), ANB (p = 0.000), SN-AB (p = 0.004), SN-L1 (p = 0.001), SNB (p = 0.037), L1A (p = 0.000) and DU' (p = 0.001). There are no significant differences in other sagittal jaw relationship, upper incisor proclination, distance of upper lip to aesthetic line and thickness of chin. Conclusion: In summary, the dentoalveolar compensation in Class III skeletal pattern is by retroclination of the lower incisors meanwhile the soft tissue compensation is achieved by the change of the distance of the upper and lower lips towards the aesthetic line, in response to the inclination of the incisors. [ABSTRACT FROM AUTHOR]

Despite being one of the most common mesenchymal benign tumors in the body, lipomas in the oral cavity constitute only 1-4% of all benign neoplasm. Buccal mucosa is the most common anatomic site within the oral cavity which is followed by tongue, lips, floor of the mouth, palate, vestibule, retromolar area and gingiva. The average tumor size ranges from 10 to 30mm. We present a rare case of unusually large sub-mucosal lipoma in lower buccal vestibule measuring about 52×29×22mm at its greatest dimension. [ABSTRACT FROM AUTHOR]

[Display omitted] Understanding the response of skin to superphysiological temperatures is critical to the diagnosis and prognosis of thermal injuries, and to the development of temperature-based medical therapeutics. Unfortunately, this understanding has been hindered by our incomplete knowledge about the nonlinear coupling between skin temperature and its mechanics. In Part I of this study we experimentally demonstrated a complex interdependence of time, temperature, direction, and load in skin's response to superphysiological temperatures. In Part II of our study, we test two different models of skin's thermo-mechanics to explain our observations. In both models we assume that skin's response to superphysiological temperatures is governed by the denaturation of its highly collageneous microstructure. Thus, we capture skin's native mechanics via a microstructurally-motivated strain energy function which includes probability distributions for collagen fiber orientation and waviness. In the first model, we capture skin's response to superphysiological temperatures as a transition between two states that link the kinetics of collagen fiber denaturation to fiber coiling and to the transformation of each fiber's constitutive behavior from purely elastic to viscoelastic. In the second model, we capture skin's response to superphysiological temperatures instead via three states in which a sequence of two reactions link the kinetics of collagen fiber denaturation to fiber coiling, followed by a state of fiber damage. Given the success of both models in qualitatively and quantitatively capturing our observations, we expect that our work will provide guidance for future experiments that could probe each model's assumptions toward a better understanding of skin's coupled thermo-mechanics and that our work will be used to guide the engineering design of heat treatment therapies. Quantifying and modeling skin thermo-mechanics is critical to our understanding of skin physiology, pathophysiology, as well as heat-based treatments. This work addresses a lack of theoretical and computational models of the coupled thermo-mechanics of skin. Our model accounts for skin microstructure through modeling the probability of fiber orientation and fiber stress-free states. Denaturing induces changes in the stress-free configuration of collagen, as well as changes in fiber stiffness and viscoelastic properties. We propose two competing models that fit all of our experimental observations. These models will enable future developments of thermal-therapeutics, prevention and management of skin thermal injuries, and set a foundation for improved mechanistic models of skin thermo-mechanics. [ABSTRACT FROM AUTHOR]

This review explores the evolution of the use of hydrogels for craniofacial soft tissue engineering, ranging in complexity from acellular injectable fillers to fabricated, cell-laden constructs with complex compositions and architectures. Addressing both in situ and ex vivo approaches, tissue restoration secondary to trauma or tumor resection is discussed. Beginning with relatively simple epithelia of oral mucosa and gingiva, then moving to more functional units like vocal cords or soft tissues with multilayer branched structures, such as salivary glands, various approaches are presented toward the design of function-driven architectures, inspired by native tissue organization. Multiple tissue replacement paradigms are presented here, including the application of hydrogels as structural materials and as delivery platforms for cells and/or therapeutics. A practical hierarchy is proposed for hydrogel systems in craniofacial applications, based on their material and cellular complexity, spatial order, and biological cargo(s). This hierarchy reflects the regulatory complexity dictated by the Food and Drug Administration (FDA) in the United States prior to commercialization of these systems for use in humans. The wide array of available biofabrication methods, ranging from simple syringe extrusion of a biomaterial to light-based spatial patterning for complex architectures, is considered within the history of FDA-approved commercial therapies. Lastly, the review assesses the impact of these regulatory pathways on the translational potential of promising pre-clinical technologies for craniofacial applications. While many commercially available hydrogel-based products are in use for the craniofacial region, most are simple formulations that either are applied topically or injected into tissue for aesthetic purposes. The academic literature previews many exciting applications that harness the versatility of hydrogels for craniofacial soft tissue engineering. One of the most exciting developments in the field is the emergence of advanced biofabrication methods to design complex hydrogel systems that can promote the functional or structural repair of tissues. To date, no clinically available hydrogel-based therapy takes full advantage of current pre-clinical advances. This review surveys the increasing complexity of the current landscape of available clinical therapies and presents a framework for future expanded use of hydrogels with an eye toward translatability and U.S. regulatory approval for craniofacial applications. [Display omitted] [ABSTRACT FROM AUTHOR]

Soft tissue myoepithelioma (STM), a rare mesenchymal neoplasm morphologically analogous to its more common salivary gland (SG) counterpart, is the subject of single case reports regarding its fine-needle aspiration (FNA) biopsy. To our knowledge, ours is the first case series of STM. A search was made of our pathology databases for cases diagnosed as STM. FNA biopsy smears and cell blocks were performed using standard techniques. Seven cases were retrieved from 4 men and 3 women (M:F = 1.3:1; age range: 25-79 years, x = 54 years). All but 1 presented as a primary neoplasm. Six aspirates were from the extremities, and 1 from the abdominal wall. Mean tumor size was 5.7 cm. Cytologic diagnosis of STM or suspicious for STM was made in 3 cases (43%). Remaining FNA diagnoses were spindle cell neoplasm/lesion (2), spindle cell sarcoma (1), and extraskeletal myxoid chondrosarcoma (1). Three cases were composed primarily or solely of uniform spindle cells, 3 primarily of uniform epithelioid cells with plasmacytoid features, and 1 case a mixture of these 2 cell types. Myxoid/chondromyxoid stroma was relatively abundant except in the single hypocellular example. Immunohistochemical (IHC) testing performed in 71% was nonspecific, but positive with S-100 in 4 of 5, EMA in 3 of 3, calponin in 2 of 2, and keratin in 1 of 3 examples. FNA biopsy smears of STM are remarkably similar cytomorphologically to their SG equivalent. However, STM can be misidentified principally as extraskeletal myxoid chondrosarcoma, thus requiring a relatively broad IHC panel for a specific diagnosis. • A series of 7 fine-needle aspiration (FNA) biopsy cases of soft tissue myoepithelioma (STM) is presented. • Correct FNA diagnosis was suggested in 43% of cases. • STM cytomorphology is composed of spindle and epithelioid cells, but 1 cell type is usually predominant. • STM FNA cytopathology imitates its salivary gland counterpart. • Extraskeletal myxoid chondrosarcoma is a close mimic of STM in FNA smears. [ABSTRACT FROM AUTHOR]

In this study, we aimed to evaluate soft tissue generated by periosteal distraction. Management of soft tissue defects represents a challenge in dentistry. Previous periosteal distraction studies documented partial fill of the distraction space with newly-generated bone and fibrous connective tissue. Titanium meshes were inserted in subperiosteal tunnels in the calvaria of 20 rats through coronal incision. The devices were immediately activated after insertion by elevation of one side at 1 mm/day for 3 days. Rats were then divided into two groups (n = 10). Animals were sacrificed after 2 weeks (Group 1) and after 4 weeks (Group 2). Distraction sites specimens were embedded in paraffin and analyzed histologically and histomorphometrically. In both groups, new periosteum was regenerated and covered the original bone surface in the distraction site. Distraction spaces showed a predomination of hyper-vascularized connective tissue and little new bone formation near to the stable end of the device. The 4-week findings showed more organized collagen fibers with less vascularity compared to the 2-week findings. The periosteal distraction technique can effectively regenerate connective tissue. It may open a new modality in the guided tissue regeneration for soft tissue augmentation. [ABSTRACT FROM AUTHOR]

Background: In pediatric patients, soft tissue masses encompass a wide heterogeneous group of benign and malignant lesions. MRI is a powerful diagnostic tool in the workup of soft tissue tumors in children, and it helps in characterization of lesion and evaluation of the extent of the lesion. However, conventional MRI techniques are not specific in differentiating benign from malignant lesions. So to improve characterization of tumors, DWI was added to MRI techniques as it increases sensitivity and specificity by detecting the micro-diffusion changes of water into intra- and extracellular spaces. The aim of this work was to highlight the diagnostic value of DWI in detection and characterization of different musculoskeletal soft tissue masses in pediatrics. Results: There was a statistically significant difference regarding the mean ADC value of benign and malignant masses (P value = 0.001*). The mean ADC value for all benign masses (n = 41) was 1.495 ± 0.55 SD × 10–3 mm2/s, while the mean ADC value for all malignant masses (n = 21) was 0.449 ± 0.27 SD × 10–3 mm2/s. The cutoff ADC value between benign and malignant masses was 0.88 × 10–3 mm2/s. This cutoff ADC value has sensitivity of 100.0%, specificity of 92.3%, PPV of 66.7%, NPV of 100.0% and diagnostic accuracy of 93.3%. Conclusion: In pediatric patients, DWI is an innovative valuable noninvasive imaging technique for characterization of musculoskeletal soft tissue masses and discrimination between benign and malignant masses. [ABSTRACT FROM AUTHOR]

The aim of this retrospective study was to compare three-dimensional (3D) soft tissue and hard tissue changes between orthodontics-first approach (OFA) and surgery-first approach (SFA) after mandibular setback surgery. All patients underwent bilateral sagittal split osteotomy, and were examined by lateral cephalograms and 3D optical scanner before surgery (T0) and 1 (T1), 3 (T2), and 12 (T3) months after surgery. Three standard angles (FMA, U1 to FH, IMPA) were measured as hard tissue change and the 2 sets of 3D data were superimposed, and volumetric differences were calculated as soft tissue change. Statistical analyses were performed by using unpaired t -tests. Differences with P < 0.05 were considered significant. A total of 39 patients with mandibular prognathism were included in this study. The OFA group consisted of 24 patients and the SFA group of 15 patients. The SFA group exhibited more labial inclination from T1 to T2 (p = 0.008) and T2 to T3 (p = 0.003) than did the OFA group. There were no significant changes at maxilla and mandible at each term of T0, T1, T2 and T3 (p > 0.05), but compared to before surgery, mandibular volume in SFA group significant increased at 1year (p = 0.049) after surgery. We found that the soft tissue changes after the SFA differed significantly from those after the OFA; thus, soft tissue predictions require more care. An analysis of our data compared with OFA and SFA for the patient with mandibular prognathism confirm that the mandibular soft tissue changes by postoperative orthodontic treatment and occlusal relationship in SFA. [ABSTRACT FROM AUTHOR]

The study refers to the application of a type of artificial neural network called the Self-Organising Map (SOM) for the identification of areas of the human abdominal wall that behave in a similar mechanical way. The research is based on data acquired during in vivo tests using the digital image correlation technique (DIC). The mechanical behaviour of the human abdominal wall is analysed during changing intra-abdominal pressure. SOM allow to study simultaneously three variables in four time/load steps. The variables refer to the principal strains and their directions. SOM classifies all the abdominal surface data points into clusters that behave similarly in accordance with the 12 variables. The analysis of the clusters provides a better insight into abdominal wall deformation and its evolution under pressure than when observing a single mechanical variable. The presented results may provide a better understanding of the mechanics of the living human abdominal wall. It might be particularly useful when selecting proper implants as well as for the design of surgical meshes for the treatment of abdominal hernias, which would be mechanically compatible with identified regions of the human anterior abdominal wall, and possibly open the way for patient-specific solutions. [Display omitted] [ABSTRACT FROM AUTHOR]

To systematically assess the current literature on soft-tissue response associated with osseous movement following orthognathic surgery in patients with facial asymmetry. Six electronic databases (PubMed, EMBASE (via Ovid), Medline (via Ovid), Cochrane Library, Scopus, and Web of Science) and gray literature were searched for studies evaluating hard- and soft-tissue responses three-dimensionally after orthognathic surgery, using MeSH terms and keywords. The methodological quality and level of evidence of the included studies were analyzed using EPHPP and GRADE , respectively. The primary search yielded 125 articles, and 10 articles that satisfied the predefined inclusion criteria were finally included. All the included articles evaluated soft-tissue response, with six of them additionally investigating the magnitude of this response. Soft tissues move with hard tissues horizontally and anteroposteriorly; however, soft-tissue movement is less than hard tissue movement. In addition, soft tissue movement is more pronounced in the lower central facial region. Six articles were judged as having 'strong' methodological quality, while the evidence was found to be of 'low' quality for the soft-tissue response and the magnitude of this response. Despite a low level of evidence, the review substantiates a favorable three-dimensional soft-tissue response following osseous surgery. The soft-tissue response is more pronounced horizontally, anteroposteriorly, and in the lower central facial region. Nevertheless, well-designed prospective studies with a higher level of evidence are needed. [ABSTRACT FROM AUTHOR]

The primary aim of this study was to explore patients' perceptions regarding the impact of 3D prediction planning (3D PP) of facial soft tissue changes following orthognathic surgery. The study was carried out on 30 patients who were shown photorealistic 3D soft tissue prediction planning before undergoing orthognathic surgery to demonstrate the expected facial changes. Distraction osteogenesis and cleft deformities were excluded from the study before consenting to surgery. Following surgery, the included patients were asked to complete a standard questionnaire to explore their perceptions regarding the impact, accuracy, and value of 3D prediction planning. The majority of the 30 participants perceived 3D PP to be beneficial in reducing their presurgical anxiety, increasing their motivation to undergo surgery, improving the accuracy of their surgical expectations, and enhancing doctor–patient communication. Most of the patients perceived their surgical soft tissue changes to be better than the predictions. Significant positive correlations were detected between satisfaction with the delivered service and the facility of seeing 3D PP (r s = 0.4; p = 0.034). Similarly, 3D PP improved patients' confidence in the surgical decision (r s = 0.4; p = 0.031), as well as increasing their motivation to undergo surgery (r s = 0.5; p = 0.010). 3D PP was found to be effective in improving the quality of orthognathic surgical care. [ABSTRACT FROM AUTHOR]

Solitary fibrous tumor (SFT), a fibroblastic neoplasm characterized by a specific genetic alteration (NAB2-STAT6 fusion) and relatively specific immunohistochemical profile (STAT6/CD34 positivity), is seldom the subject of cytopathology data. We report our experience with scrape smears and fine-needle aspiration (FNA) biopsies of SFT in a large patient cohort. A search was made of our cytopathology and surgical pathology databases for cases diagnosed as solitary fibrous tumor (SFT). FNA biopsy smears, imprint smears, and cell blocks were performed and examined using standard technique. Thirty-four cases from 30 patients (M:F = 1.1:1; age range: 24-86 years, x = 58 years) met inclusion criteria for this study. All patients had prior or subsequent tissue confirmation of SFT. Twenty-seven (79%) specimens were FNAs, and 7 (21%) were scrape smears. Most cases (29, 85%) represented primary tumors, 4 (12%) were metastatic deposits, and 1 (3.5%) was a locally recurrent neoplasm. Sites included: pleura/lung 9 (26%), head/neck 8 (24%), lower extremity 7 (21%), trunk 4 (12%), intra-abdominal 3 (9%), upper extremity 2 (7%), and mediastinum 1 (4%). Mean tumor size was 7.2 cm (range: 1.5-19 cm). Three (9%) cases were diagnosed specifically as SFT. Remaining diagnoses were spindle cell neoplasm/proliferation 14 (41%), nondiagnostic 5 (15%), specific type of sarcoma 3 (9%), malignant round cell tumor 2 (6%), sarcoma 2 (6%), malignant tumor 2 (6%) and single cases of melanoma, pleomorphic adenoma, and mesenchymal tumor. Immunohistochemical (IHC) testing was performed in 7 of 27 (26%) cell blocks. SFT FNA cytopathology is morphologically ambiguous, overlapping with a broad array of other spindle cell proliferations. A specific diagnosis is only possible with added staining of STAT6 coupled with a set of other IHC markers. • Analysis of a large cytologic series of solitary fibrous tumors (SFT) showed a correct and specific diagnosis in only 9% of cases. • The most common interpretation in this series of SFT was spindle cell neoplasm/spindle cell proliferation. • SFT imitates a broad category of spindle cell lesions due to its undistinguishable cytomorphology that is similar in pleural and extrapleural locations. • Positive STAT6 immunostaining is required to definitively recognize SFT using the cytologic method. [ABSTRACT FROM AUTHOR]

This cross-sectional study compared and contrasted the morphological characteristics of Class I, II and III malocclusions in an adolescent Saudi population. Adolescent Saudis with Angle's Class I, II and III malocclusions were selected from orthodontic patients' records. Angular and linear measurements were compared between the three groups. Cephalometric analysis was performed using the VistadentOC® software. Multifactorial ANOVA for angular and linear measurements between and within groups. Orthodontic records of 300 patients were included. There was no significant difference between and within groups in age and distribution of Angle's classification, p > 0.05. Multifactorial ANOVA showed that there were significant interactions between gender and malocclusions in skeletal, dental and soft tissue measurements, p < 0.05. There were significant differences in the sagittal and vertical skeletal measurements between groups, p < 0.05. The dental measurements were also significantly different in most of the measurements (p < 0.05). Moreover, there were significantly different readings among the groups in the soft tissue analysis. Morphological characteristics of adolescent Saudis show unique differences between gender and malocclusions, more so in Class III malocclusions. Class II and III malocclusions also show skeletal differences amongst the groups. [ABSTRACT FROM AUTHOR]

The accurate diagnosis of musculoskeletal neoplasms is difficult but a pattern-based approach combined with ancillary testing has been shown to improve diagnostic accuracy. The pattern-based approach is particularly appropriate for myxoid lesions. The authors reviewed their personal experience of over 3 decades of diagnosing myxoid neoplasms of musculoskeletal lesions. The authors found that myxoid lesions can be accurately classified based on cell type, nuclear atypia, presence of blood vessel fragments, as well as the results of immunohistochemical and molecular testing. Musculoskeletal lesions with a prominence of myxoid or chondroid material in the background can be accurately diagnosed using pattern analysis and ancillary testing. • This paper is a comprehensive description of the cytomorphology of myxoid lesions of the soft tissues. • This paper describes ancillary immunocytochemical and molecular diagnostic features. • This paper discusses the differential diagnoses for each lesion. [ABSTRACT FROM AUTHOR]

Investigations on the internal anatomy of stalked jellyfishes (Staurozoa) are crucial for species descriptions and systematic studies on this taxon. Contrast-enhanced X-ray micro computed tomography (micro-CT) has increased the opportunities for morphological descriptions of soft-bodied invertebrates in the last decade, but only few studies have focused on cnidarian taxa so far. We performed a micro-CT-based morphological study on the staurozoan Craterolophus convolvulus (Johnston, 1835) including the juvenile stage of the species for the first time. Virtual sections allowed for the analysis of specific anatomical details and revealed stage specific differences. For example, the peduncle length was longer in relation to the calyx length, the arrangement of arms in pairs was more pronounced, and the number of secondary tentacles and adhesive pads was lower in the juvenile specimen. Longitudinal virtual sections revealed the internal septa (claustra) with triangular lower edges in the adult and semicircular lower edges in the juvenile specimen. The primary tentacles, only present in the juvenile stage, had distinct distal swellings and adhesive pads at their stem bases. For both stages, our results revealed an internal canal system at the tip of the arms previously described as "intertentacular lobules". Virtual sections also clarified the organization of gonads in densely folded gonad bands, which form sac-like pouches with small pathways. Even though our micro-CT data allowed for the discrimination of different tissues such as epidermis, gastrodermis, mesoglea, gonads, and muscles, their resolution was not sufficient to depict micro-anatomical details of gametes and nematocysts, which can be relevant for morphological studies on stauromedusae. Thus, micro-CT cannot replace histological standard techniques, but allow for a better spatial understanding of anatomical details and morphological features, facilitating taxonomic and phylogenetic studies on Staurozoa and other soft-bodied cnidarians. [ABSTRACT FROM AUTHOR]

Soft tissue lesions of the head and neck encompass a broad range of pathological entities associated with different prognoses and requiring different treatments. All pathologists will encounter a wide range of soft tissue tumours in whatever specialist area they practice. Getting the diagnosis 'right the first time' is critical for patients to be offered optimal treatment. Molecular testing can help reach the correct diagnoses and this arena is developing fast. However, pathologists should not rely unquestioningly on special tests, whether it is immunohistochemistry or whole genome sequencing as no test is entirely specific or sensitive. Pathologists should provide a diagnosis in the context of all tests including the histology along with medical imaging and the patient's symptoms, signs and family history. This article reviews key clinical, pathological and histologic features of tumours most commonly presenting in the head and neck region, including those most recently described. [ABSTRACT FROM AUTHOR]

[Display omitted] The human Achilles tendon (AT) is a hierarchical structure macroscopically composed of three subtendons originating from the soleus (SOL) and gastrocnemius (GL, GM) muscles. According to recent reports, the divisible structure of the AT together with diverse material properties of its subtendons are suspected as a probable cause of non-homogeneous stress and strain distribution occurring in loaded AT. Despite numerous investigations on human AT, there is still relatively little knowledge regarding mechanical properties of subtendon-level hierarchy, which is crucial in fully understanding the multiscale relationship which governs tendon mechanics. In this paper we present the first ex vivo study conducted on SOL, GL, and GM subtendons of human AT. We investigate differences in viscoelastic properties of SOL, GM, and GL subtendons in terms of tensile modulus, mechanical hysteresis as well as stress relaxation observed at two different values of strain. Our results show that the most significant differences in mechanical properties exist between subtendon attached to the soleus muscle (SOL) and subtendons originating from the two heads of the gastrocnemius muscle (GM and GL). We used our experimental results to calibrate three different constitutive models: the hyperelastic Yeoh model with power-law flow, the microstructurally motivated Holzapfel-Gasser-Ogden model enhanced with strain-dependent Berström-Boyce flow and the phenomenological elasto-viscoplastic Arruda-Boyce-based model with strain-dependent Berström-Boyce flow supplemented with component representing matrix response. All calibrated models may be applied to commercial FEA software as a sufficient solution for rapid mechanical response modeling of human AT subtendons or for the purpose of future development of comprehensive patient-specific models of human lower limbs. The divisible structure of the Achilles tendon together with diverse material properties of its subtendons are suspected as a probable cause of non-homogeneous stress and strain distribution occurring in loaded Achilles tendon. Despite numerous investigations on mechanical properties of Achilles tendon, there is still relatively little knowledge regarding mechanical properties of subtendon-level hierarchy, which is crucial in fully understanding the multiscale relationship which governs tendon mechanics. This study is the first reported ex vivo investigation conducted on SOL, GL, and GM human Achilles subtendons. We investigate differences in the viscoelastic properties of individual subtendons and demonstrate that the observed differences should be considered as muscle-dependent. Our experimental research is supported with a modeling study in which we calibrate three different constitutive models. [ABSTRACT FROM AUTHOR]

Aggressive or Desmoid fibromatosis (AF) is a benign fibrous soft tissue tumor that consists of dense masses of fibroblasts and myofibroblasts with marked collagen production. The lesions are considered to be aggressive and non-metastasizing but invade locally and recur frequently after surgical excision. Although the head and neck are not an unusual site of involvement, very few cases of fibromatosis of the cheek are reported till date. We report a case of fibromatosis of cheek in an adult female that was managed successfully by surgical intervention and to discuss the review of literature on this subject. [ABSTRACT FROM AUTHOR]