Search

Intrahepatic cholangiocarcinoma (ICC)originates from the epithelial cells of the intrahepatic bile ducts, with insidious onset and strong invasiveness, and most of the cases are found in the advanced stage, with extremely poor prognosis. In advanced stages, distant metastases to the lungs, bones, and brain are common, but distant soft tissue (subcutaneous and skeletal muscle) and breast metastases are rare, and simultaneous metastases to all three rare sites had not been reported. We report a 69-year-old woman with right upper abdominal pain who underwent a plain and enhanced CT scan of the upper abdomen, which revealed an intrahepatic space-occupying lesion, as well as subcutaneous and peritoneal nodules in the abdomen. To further evaluate the presence of other metastases, an 18F-FDG PET/CT scan was performed, which showed abnormal FDG uptake in the liver, peritoneum, left upper femur, right breast, subcutaneous tissues of the thoracic and abdominal regions, and skeletal muscle, while the corresponding CT densities of part of the skeletal muscle and the left upper femur did not show any significant abnormality. Pathologic confirmation of ICC with multiple metastases was obtained by puncture biopsy of the liver and subcutaneous nodes. This case demonstrates the advantages of 18F-FDG PET/CT in comprehensively evaluating systemic metastasis of ICC and detecting occult metastases, which is of great significance in its clinical diagnosis and staging. [ABSTRACT FROM AUTHOR]

Background: The nasolabial angle (NLA) is one of the most critical parameters of the soft tissue profile when orthodontic treatment is required. The primary aim of this prospective cohort study was to compare the differences in the evaluation made on lateral photographs and cephalograms. The secondary aim was to evaluate the modifications of the NLA (nasal and labial components) after orthodontic treatment, including upper first premolar extraction. Methods: The pre- and post-treatment lateral radiographs and profile photographs of 60 subjects (18 male and 42 female) treated with upper premolar extraction and fixed orthodontic appliances were evaluated. The nasolabial angle was measured in both investigations, while cephalometric parameters (skeletal, dental, and soft tissue parameters) were evaluated using lateral radiographs. Results: No statistically significant difference was observed between the results of the two types of measurements on the photographs and radiographs. The soft tissue parameters (ULT and UL-e) showed significant changes after orthodontic treatment, with ULT changing from 21.4 mm ± 4.07 mm to 22.9 mm ± 4.06 mm (p = 0.03) and UL-e changing from 8.42 mm ± 4.84 mm to 10.35 mm ± 4.23 mm (p < 0.001). In patients with thinner lips, the upper lip repositioning was more significant (p = 0.001). No statistically significant difference (p = 0.67) was found between the two evaluation methods. Conclusions: Both cephalometric and photographic evaluations of the nasolabial angle were similar. The soft tissue parameters (ULT and UL-e) showed significant changes after the orthodontic treatment. The repositioning of the upper lip was more acute when the lip thickness decreased. [ABSTRACT FROM AUTHOR]

Objective: The surgical team in this study examined the efficacy of a modified reverse sural neurocutaneous flap repair in treating soft tissue defects of the ankle and foot caused by accidents. Methods: This study enrolled 89 patients treated for soft tissue defects of the ankle or foot between January 2007 and December 2023. The patients were divided into two groups: 44 patients underwent a modified reverse sural neurocutaneous flap repair, while 45 received traditional treatment. The modified technique involved repairing various anatomical structures, including fascia, the saphenous nerve, the great saphenous vein, subcutaneous tissue, and skin, with flap sizes ranging from 14 to 152 cm². In the traditional treatment group, the distal perforator of the peroneal artery was identified 5 cm above the lateral malleolus. Island fasciocutaneous flaps were designed along the sural nerve and lesser saphenous vein, elevated subfascially, rotated 180 degrees, and inset without tension. Donor sites were closed with grafts or direct sutures. Results: Of the 44 patients, who underwent the modified technique, 35 were male and 9 were female. Follow-up periods ranged from 2 to 24 weeks to monitor outcomes and recovery. The average size of the affected soft tissue was 71 cm2. Thirty-nine flaps survived completely, while three experienced partial necrosis and two had marginal necrosis. No cases of severe venous congestion were reported. The complication rate was lower with the modified method compared to the traditional repair (p < 0.05). Conclusion: The modified reverse neurocutaneous flap repair is a reliable and structured approach to treating soft tissue defects of the ankle and foot. This method has demonstrated favorable patient outcomes and presents a promising avenue for future studies and clinical practice. [ABSTRACT FROM AUTHOR]

Background: The mechanical properties of biological tissues change over time and with disease progression. Quantifying these mechanical properties can thus be instrumental for medical diagnosis and for evaluation of tissue viability for transplant. However, soft and biological materials are exceptionally challenging to mechanically characterize using conventional testing methods, which are hindered by limitations of sample size, fixturing capabilities, and sample preparation. Objective: We hypothesize that Volume Controlled Cavity Expansion (VCCE) is well-suited to capture subtle mechanical differences in biological tissue. The objective of this work is therefore twofold: first, we seek to quantify how stiffness of liver and gelatin evolve with age. In achieving this understanding, we aim to demonstrate the precision of VCCE in measuring subtle changes in the mechanical properties of biological tissues. Methods: Performing VCCE tests over 15 days in samples of gelatin and liver (porcine and bovine), we track the evolving pressure-volume response and deformation limits of the materials. Results: In both materials, we observed time-dependent variation of the stiffness and fracture thresholds. In gelatin VCCE repeatably captured stiffening over time, which was correlated with a higher fracture stress. This was in contrast to observations in bovine liver, where stiffening corresponded to a lower fracture stress. Porcine liver initially stiffened, then reversed this trend and relaxed. Conclusion: Through this work we show that liver and gelatin stiffen with age, and that this trend is measurable via VCCE. These results highlight the utility of VCCE and call attention to the need for a new class of mechanism based constitutive models that are capable of capturing variations in material over time with a minimal number of parameters. [ABSTRACT FROM AUTHOR]

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]

Copyright of Journal of Prevention & Treatment For Stomatological Diseases is the property of Journal of Prevention & Treatment For Stomatological Diseases Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Chondroblastomas are very rare benign primary bone tumors that typically develop in bones in young adults. Extraosseous chondroblastomas are extremely rare, with a few case reports documented in the literature. The treatment is surgical with a high healing rate. MRI is a key examination for bony forms, and our study has strengthened the MRI description reported in some cases of the extraosseous form. We describe the case of a 40-year-old woman with a chondroblastoma of the soft tissues of the hip more precising in the quadratus femoris muscle and its clinical, radiological, and MRI appearance. The patient underwent complete surgical excision of the mass, and no clinical or MRI signs of recurrence were detected after 18 months of follow-up.

The interaction between the needle and the soft tissue during medical procedures can damage tissue, hindering performance. Reducing tissue damage can improve target accuracy in some procedures, such as biopsies, electrode placement, or drug delivery. This research aims to study the effect of needle speed on tissue damage. For this purpose, we propose a damage model that incorporates the dynamic needle-tissue interaction and the plane strain problem related to the hole left in the tissue after needle extraction. The optimization of the model provides a speed which minimizes tissue damage. A hypodermic needle was inserted into ex vivo turkey breast tissue at different insertion speeds. The size of the tissue hole and the friction stress from the needle-tissue interaction were used to measure damage and develop the damage model. The results revealed significant differences in the hole sizes and the friction stress measurements when different insertion speeds were used. Finally, the damage model was fitted to the experimental data and a speed value that minimizes tissue damage could be obtained.

Objective To explore the changes of periodontal soft and hard tissue parameters of the maxillary central incisors after the distant migration of the maxillary total dentition in adult patients with different periodontal phenotypes, so as to provide a reference for orthodontic treatment. Methods The study was approved by the hospital ethics committee, and the patients signed the informed consent form. Fifty-two adult patients in the orthodontic department of Hefei Stomatological Hospital were selected and divided into thick gingival and thin gingival groups, with 26 cases in each group. The labial and palatal alveolar bone parameters and various periodontal indexes of the maxillary central incisor teeth of the two groups were collected and recorded before and after treatment. SPSS 26.0 statistical software was used to statistically analyze the intra-group and inter-group differences. Results After orthodontic treatment, the differences in sella-nasion-subspinale angle (SNA), sella-nasion-supramental angle (SNB), and subspinale-nasion-supramental angle (ANB) were not statistically significant (P > 0.05). However, the inclination of the upper middle incisor teeth (U1-NA) decreased significantly (P < 0.05), and there was no significant difference in SNA, SNB, ANB, and U1-NA between the two groups after treatment (P > 0.05). The thickness of the labial alveolar bone of the maxillary central incisors in both groups increased at the labial neck 1/3 and labial middle 1/3 (P < 0.05), and decreased at the apical 1/3 (P < 0.05). The thickness of the palatal alveolar bone decreased at the labial neck 1/3 and labial middle 1/3 (P < 0.01), and increased at the apical 1/3 (P < 0.01). In both groups, the height of the lip and palate of the upper jaw decreased to different degrees, and the height of the palatal alveolar bone was lower in the thin gingival group (P < 0.05). There were no significant differences in maxillary central incisor probing depth (PD), lip keratinized tissue width (KTW), or lip gingival recession (GR) between the two groups after treatment (P > 0.05). Conclusion In the process of maxillary central incisor adduction, the labial-palatine alveolar bone remodeling is not uniform, and the alveolar bone of palatine side is mainly absorbed, which should be paid attention to clinically. Palatal alveolar bone height decreased more significantly in patients with thin gingiva after orthodontic treatment, and the risk of bone fenestration and bone dehiscence was greater.

Background: Facial soft tissue trauma cases are often encountered in the emergency room. Soft tissue trauma, especially to the face, is rarely life threatening. It varies in shape, size, and depth and can also affect surrounding organs. The treatment of soft tissue trauma can be complicated and may have a significant impact on facial function and, especially, facial aesthetics. Children are easily injured due to their active nature. Soft tissue trauma to the faces of toddlers is challenging even for experienced surgeons; however, wound debridement and suture management under general anesthesia should be considered. Purpose: The aim of this article is to deliver a thorough overview of the evaluation and treatment of soft tissue injuries in children, covering initial assessments, physical examinations, the application of antimicrobial therapies, and preparation for surgical procedures. Case: An 11-month-old girl went to the emergency department of Hasan Sadikin General Hospital, Bandung, with injuries to her left cheek and upper left lip sustained when she fell, and her face hit the edge of a cement pot at home. There was no history of unconsciousness, nausea and vomiting. The injury was diagnosed as vulnus laceratum of the left face and upper lip region. Case management: Emergency management was carried out by triage, Tetagam injection, and early wound debridement and suture under general anesthesia because the patient was uncooperative. Wounds on the face and lips were primary sutured layer by layer, returning the wound edges to their normal anatomical position. Conclusion: The management of facial soft tissue injuries in toddlers requires general anesthesia for adequate and accurate wound debridement and suture, so that functional and aesthetic effects can be satisfactorily obtained.

Introduction: With the advancements in chemotherapy for malignant bone tumors, the number of patients eligible for limb salvage surgery has increased. Surgeons face a subsequent challenge in limb-sparing resection due to the need for reconstructing soft tissue coverage. The aim of this review is to focus on the present state of the field in these areas, highlighting recent advancements. Methods: A literature research was conducted using keywords such as “soft tissue”, “integration”, “reconstruction”, “megaprosthesis”, and “soft tissue coverage”, on different databases, and following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) criteria, a total of 35 studies were selected. Results: In recent times, there has been a growing emphasis on different techniques such mesh application, allograft-prosthesis composites, allograft reconstruction, a polyethylene terephthalate (PET) tube, prosthesis itself and certain metals utilized for implant coatings are used in soft tissue reconstruction. Conclusion: While tissue-engineered constructs and advancements in biological and cellular approaches have shown potential for enhancing osseointegration and interactions with soft tissues and implants, the actual clinical outcomes have frequently fallen short of expectations. The success of soft tissue integration is crucial for achieving functional outcomes, minimizing complications, and ensuring the long-term stability of orthopedic implants.

Featured Application: This study introduces a 3D-printed capstan-based clamping system that enhances uniaxial tensile testing of tendon tissues by reducing stress concentrations and preventing premature failures at the clamping region, resulting in more reliable biomechanical data. Standardized testing methods for the mechanical characterization of biological soft tissues remain underdeveloped in several domains. Existing clamping methods often induce high stress levels in the clamping region, thereby affecting experimental outcomes. This study introduces a 3D-printed clamping system based on the capstan principle. The capstan system was designed and manufactured using 3D printing technology and optimized to minimize the required gripping pressure while maintaining the natural, non-tapered state of specimens. This optimization helps reduce experimental artifacts and prevents premature tissue failure in the clamping region caused by local stress peaks. Usability trials were conducted using human flexor digitorum profundus (FDP) tendons (n = 15). Results showed that 80% of the tendons failed at the midpoint region, indicating the desired load distribution achieved by the clamping mechanism. The elastic moduli, averaging 316.18 ± 86.73 MPa, and failure load properties, averaging 79.25 ± 19.10 MPa, fell within the range of FDP values reported by other researchers, thereby supporting the validity of the capstan design. Capstan clamping offers a promising add-on for biomechanical testing of soft tissues. Further development is necessary to tailor the clamping design to various tissue geometries and to address issues related to tissue moisture regulation, thereby enhancing the reliability and versatility of the clamping system. [ABSTRACT FROM AUTHOR]

The evaluation of soft tissue biomechanical properties is of paramount importance not only for a comprehensive understanding of human physiology and physiopathology, but also in the research and development of bio-compatible artificial tissues with viscoelastic properties. Contrarily to standard tensile testing devices, a system intended for biomaterials testing should consider low stress and high strain ranges, characteristic of human tissues; moreover, such a system should enable the ex vivo simulation of biological environmental conditions. Commercial solutions address these challenges, although they are expensive for most academic and research institutions. This study presents a low-cost open-source design solution for soft tissue tensile testing, offering an affordable solution, yet without compromising the high quality and precision of the results. The proposed uniaxial tensile system allows for sample testing at room temperature as well as in a temperature-controlled liquid environment. Moreover, custom clamps ensure the fixation of tissue samples without slipping or tearing. System validation is performed using the tensile testing of springs and 3D-printed soft polymeric samples, demonstrating accurate results compared to the available data. The system is suitable for educational, research, and development applications. [ABSTRACT FROM AUTHOR]

Background: Facial soft tissue trauma cases are often encountered in the emergency room. Soft tissue trauma, especially to the face, is rarely life threatening. It varies in shape, size, and depth and can also affect surrounding organs. The treatment of soft tissue trauma can be complicated and may have a significant impact on facial function and, especially, facial aesthetics. Children are easily injured due to their active nature. Soft tissue trauma to the faces of toddlers is challenging even for experienced surgeons; however, wound debridement and suture management under general anesthesia should be considered. Purpose: The aim of this article is to deliver a thorough overview of the evaluation and treatment of soft tissue injuries in children, covering initial assessments, physical examinations, the application of antimicrobial therapies, and preparation for surgical procedures. Case: An 11-month-old girl went to the emergency department of Hasan Sadikin General Hospital, Bandung, with injuries to her left cheek and upper left lip sustained when she fell, and her face hit the edge of a cement pot at home. There was no history of unconsciousness, nausea and vomiting. The injury was diagnosed as vulnus laceratum of the left face and upper lip region. Case management: Emergency management was carried out by triage, Tetagam injection, and early wound debridement and suture under general anesthesia because the patient was uncooperative. Wounds on the face and lips were primary sutured layer by layer, returning the wound edges to their normal anatomical position. Conclusion: The management of facial soft tissue injuries in toddlers requires general anesthesia for adequate and accurate wound debridement and suture, so that functional and aesthetic effects can be satisfactorily obtained. [ABSTRACT FROM AUTHOR]

Recent advancements in biotechnology forged the path for clinical trials in dish (CTiDs) to advance as a popular method of experimentation in biomedicine. CTiDs play a fundamental role in translational research through technologies such as induced pluripotent stem cells, whole genome sequencing, and organs-on-a-chip. In this review, we explore advancements that enable these CTiD biotechnologies and their applications in animal testing, disease modeling, and space radiation technologies. Furthermore, this review dissects the advantages and disadvantages of CTiDs, as well as their regulatory considerations. Lastly, we evaluate the challenges that CTiDs pose and the role of CTiDs in future experimentation. [ABSTRACT FROM AUTHOR]

Introduction: With the advancements in chemotherapy for malignant bone tumors, the number of patients eligible for limb salvage surgery has increased. Surgeons face a subsequent challenge in limb-sparing resection due to the need for reconstructing soft tissue coverage. The aim of this review is to focus on the present state of the field in these areas, highlighting recent advancements. Methods: A literature research was conducted using keywords such as "soft tissue", "integration", "reconstruction", "megaprosthesis", and "soft tissue coverage", on different databases, and following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) criteria, a total of 35 studies were selected. Results: In recent times, there has been a growing emphasis on different techniques such mesh application, allograft-prosthesis composites, allograft reconstruction, a polyethylene terephthalate (PET) tube, prosthesis itself and certain metals utilized for implant coatings are used in soft tissue reconstruction. Conclusion: While tissue-engineered constructs and advancements in biological and cellular approaches have shown potential for enhancing osseointegration and interactions with soft tissues and implants, the actual clinical outcomes have frequently fallen short of expectations. The success of soft tissue integration is crucial for achieving functional outcomes, minimizing complications, and ensuring the long-term stability of orthopedic implants. [ABSTRACT FROM AUTHOR]

Regeneration of soft tissues, especially those requiring complex vascularization, is a major challenge in the field of tissue engineering. The current types of tissue engineering scaffolds include sponges, electric spinning silk, hydrogels, and 3D printed biomaterials. Among them, hydrogels have the unique property of mimicking extracellular matrix (ECM), which can provide a relatively stable microenvironment for cellular activities and facilitate cell adhesion, proliferation, and differentiation; thus, have become a promising scaffold. In this paper, we present a review of the commonly used types of natural hydrogels and their applications as scaffolds in tissue vascularization. First, we enumerate the importance and advantages of several types of commonly used hydrogels of natural origin in terms of fabricating vascularized tissues or organs. Second, we discuss two different formation modalities of blood vessels, as well as natural hydrogel-based vascularization strategies, including carrying growth factors, stem cell delivery, special scaffold structures and pharmaceutical-enhanced strategy. In addition, we describe the crosslinking strategies of hydrogels as scaffolds for regeneration of vascularized soft tissues, as well as the factors affecting it. Finally, new insights are provided for the development of natural hydrogel-based vascularized soft tissue regeneration research. [ABSTRACT FROM AUTHOR]

Purpose: High-energy heavy ions generated by accelerators utilized in industrial and medical uses. Ar, C, and He heavy ions have been used in the treatment of cancer. In this research, it was tried to calculate the radioactive elements production in healthy tissues around tumors by heavy ions spallation process in the direct usage of highenergy ions for the treatment of cancerous tumors. Materials and Methods: The radioactive elements production in body tissues irradiated with heavy ions was calculated by Monte Carlo N Particle X-version (MCNPX) code based on the Monte Carlo method. The F8 tally card with FT8 command was utilized to derive the activation and spallation data in the range of Z1 to Z2 atomic numbers. Results: A wide range of radioactive elements was created in healthful tissues in Ne, C, Ar, and He heavy ions therapy. Results show that 10Be,14C, 26Al, 36Cl, 39Ar, 40K, 39Ar, 32Si, 22Na, and 36Cl radioactive materials were produced for high-energy heavy ions spallation in healthy soft tissue. Conclusion: The results of this research show that due to using directly high-energy ions to treat internal tumors, healthy soft tissue is activated. Also, by irradiated Ne, C, Ar, and He ions, the radioactive elements are produced with high gains and long half-lives. Therefore, in the therapy of cancerous tumors with high-energy ions, due to the production of radioactive agents, healthy tissues are at high risk. [ABSTRACT FROM AUTHOR]

This study aimed to assess clinical and radiographic outcomes, including implant survival, marginal bone loss, and patient satisfaction, in individuals with severe bone atrophy treated using a newly developed system of short and extra-short implants. A total of 44 implants (37 short and 7 extra-short) were placed with immediate loading in 11 patients. The patients were followed up at between 6 and 24 months. Bone changes, keratinized mucosa, bleeding on probing, probing depth, crown-to-implant ratio, and patient satisfaction were evaluated. An implant survival and success rate of 100% was observed. The peri-implant bone condition showed no significant associations between marginal bone loss (MBL) and gingival recession. In extra-short implants, the crown-to-implant ratio did not affect MBL in the evaluated times. However, short implants showed a statistically significant inverse correlation between mesial measurement and crown-to-implant ratio (p = 0.006) and between distal measurement and crown-to-implant ratio (p = 0.004) over six months. Plaque was present in the mesiobuccal regions in 38.64% of the implants, with extra-short implants having the highest relative frequency (71.4%). Bleeding was observed in 18.9% of the short implants in the mesiolingual region and 14.3% of the extra-short implants. There was a statistically significant association between bleeding on probing in the mesiobuccal region and the type of implant (p = 0.026). The analysis of probing depth showed no difference between the types of implants. Within the limits of this study, short and extra-short implants presented similar clinical and radiographic behavior of soft and hard tissues in the evaluated times. [ABSTRACT FROM AUTHOR]

Myoepithelioma is an exceptionally rare tumor, primarily arising in glandular tissues but occasionally found in soft tissues, including the hand. Its occurrence in the hand is particularly uncommon, presenting unique clinical challenges due to the limited number of documented cases and the unusual location. We conducted a literature review in June 2024, with the aim to evaluate the current understanding of hand myoepithelioma, recent diagnostic advances, treatment options, and the diverse presentations of this neoplasm. Articles confirmed that patients present with a painless, slow-growing mass in the hand, often misdiagnosed as more common soft tissue tumors like lipomas or fibromas. Imaging, particularly MRI and ultrasound, aids in assessing the tumor, but definitive diagnosis relies on histopathology, including immunophenotyping. Managing spindle cell myoepithelioma in the hand requires a multidisciplinary approach, with surgical excision being the primary treatment. Achieving clear margins is critical yet challenging due to the hand's complex anatomy. In some cases, adjuvant therapies such as radiation or chemotherapy may be necessary. The prognosis depends on factors like tumor size, location, and the success of surgical removal, with complete excision typically leading to a favorable outcome. [ABSTRACT FROM AUTHOR]

Intrahepatic cholangiocarcinoma (ICC)originates from the epithelial cells of the intrahepatic bile ducts, with insidious onset and strong invasiveness, and most of the cases are found in the advanced stage, with extremely poor prognosis. In advanced stages, distant metastases to the lungs, bones, and brain are common, but distant soft tissue (subcutaneous and skeletal muscle) and breast metastases are rare, and simultaneous metastases to all three rare sites had not been reported. We report a 69-year-old woman with right upper abdominal pain who underwent a plain and enhanced CT scan of the upper abdomen, which revealed an intrahepatic space-occupying lesion, as well as subcutaneous and peritoneal nodules in the abdomen. To further evaluate the presence of other metastases, an 18F-FDG PET/CT scan was performed, which showed abnormal FDG uptake in the liver, peritoneum, left upper femur, right breast, subcutaneous tissues of the thoracic and abdominal regions, and skeletal muscle, while the corresponding CT densities of part of the skeletal muscle and the left upper femur did not show any significant abnormality. Pathologic confirmation of ICC with multiple metastases was obtained by puncture biopsy of the liver and subcutaneous nodes. This case demonstrates the advantages of 18F-FDG PET/CT in comprehensively evaluating systemic metastasis of ICC and detecting occult metastases, which is of great significance in its clinical diagnosis and staging.

An 84-year-old lady presented with 1 day history of sudden onset generalized abdominal pain, fevers, and peritonism. Computed tomography was suggestive of a mid-small bowel perforation associated with a distal ovoid soft tissue density structure without pneumobilia. An urgent laparotomy demonstrated two areas of jejunal diverticula necrosis and perforation associated with a 3 cm luminal mass in the proximal ileum, and proximal small bowel dilatation. A 100 cm small bowel resection incorporating the mass and perforated jejunal diverticula and primary stapled anastomosis were performed. Histopathology surprisingly demonstrated cholelithiasis consistent with a gallstone ileus and necrotic, perforated jejunal diverticulitis. The patient had no recurrent symptoms at 6 weeks follow-up. The authors report an uncommon and unexpected occurrence of small bowel diverticulitis perforation as a rare complication of gallstone ileus. [ABSTRACT FROM AUTHOR]

A 27-year-old male with insidious right arm swelling was diagnosed with a hematoma secondary to a partial biceps tear, later identified as a rhabdomyosarcoma. Soft tissue sarcomas (STS) may present with misleading patient histories and nonspecific symptoms, resulting in misdiagnosis and delayed treatment. One of the classic masqueraders of soft tissue sarcomas is hematomas secondary to trauma. Obtaining a prudent history with careful scrutiny of appropriate imaging often helps establish the correct diagnosis. Ultimately, tissue biopsy can resolve any ambiguous cases and prevent delays in diagnosis and treatment.

ObjectivesTo evaluate the performance of machine learning-augmented MRI-based radiomics models for predicting response to neoadjuvant chemotherapy (NAC) in soft tissue sarcomas.MethodsForty-four subjects were identified retrospectively from patients who received NAC at our institution for pathologically proven soft tissue sarcomas. Only subjects who had both a baseline MRI prior to initiating chemotherapy and a post-treatment scan at least 2 months after initiating chemotherapy and prior to surgical resection were included. 3D ROIs were used to delineate whole-tumor volumes on pre- and post-treatment scans, from which 1708 radiomics features were extracted. Delta-radiomics features were calculated by subtraction of baseline from post-treatment values and used to distinguish treatment response through univariate analyses as well as machine learning-augmented radiomics analyses.ResultsThough only 4.74% of variables overall reached significance at p ≤ 0.05 in univariate analyses, Laws Texture Energy (LTE)-derived metrics represented 46.04% of all such features reaching statistical significance. ROC analyses similarly failed to predict NAC response, with AUCs of 0.40 (95% CI 0.22-0.58) and 0.44 (95% CI 0.26-0.62) for RF and AdaBoost, respectively.ConclusionOverall, while our result was not able to separate NAC responders from non-responders, our analyses did identify a subset of LTE-derived metrics that show promise for further investigations. Future studies will likely benefit from larger sample size constructions so as to avoid the need for data filtering and feature selection techniques, which have the potential to significantly bias the machine learning procedures.

Soft tissue elasticity is directly related to different stages of diseases and can be used for tissue identification during minimally invasive procedures. By palpating a tissue with a robot in a minimally invasive fashion force-displacement curves can be acquired. However, force-displacement curves strongly depend on the tool geometry which is often complex in the case of medical tools. Hence, a tool calibration procedure is desired to directly map force-displacement curves to the corresponding tissue elasticity.We present an experimental setup for calibrating medical tools with a robot. First, we propose to estimate the elasticity of gelatin phantoms by spherical indentation with a state-of-the-art contact model. We estimate force-displacement curves for different gelatin elasticities and temperatures. Our experiments demonstrate that gelatin elasticity is highly dependent on temperature, which can lead to an elasticity offset if not considered. Second, we propose to use a more complex material model, e.g., a neural network, that can be trained with the determined elasticities. Considering the temperature of the gelatin sample we can represent different elasticities per phantom and thereby increase our training data.We report elasticity values ranging from 10 to 40 kPa for a 10% gelatin phantom, depending on temperature.

Abstract Ballistic impacts on human thorax without penetration can produce severe injuries or even death of the carrier. Soft tissue finite element models must capture the non-linear elasticity and strain-rate dependence to accurately estimate the dynamic human mechanical response. The objective of this work is the calibration of a visco-hyperelastic model for soft tissue simulants. Material model parameters have been calculated by fitting experimental stress–strain relations obtained from the literature using genetic algorithms. Several parametric analyses have been carried out during the definition of the optimization algorithm. In this way, we were able to study different optimization strategies to improve the convergence and accuracy of the final result. Finally, the genetic algorithm has been applied to calibrate two different soft tissue simulants: ballistic gelatin and styrene–ethylene–butylene–styrene. The algorithm is able to calculate the constants for visco-hyperelastic constitutive equations with high accuracy. Regarding synthetic stress–strain curves, a short computational time has been shown when using the semi-free strategy, leading to high precision results in stress–strain curves. The algorithm developed in this work, whose code is included as supplementary material for the reader use, can be applied to calibrate visco-hyperelastic parameters from stress–strain relations under different strain rates. The semi-free relaxation time strategy has shown to obtain more accurate results and shorter convergence times than the other strategies studied. It has been also shown that the understanding of the constitutive models and the complexity of the stress–strain objective curves is crucial for the accuracy of the method.

Introduction: Foreign body (FB) injuries constitute an important part of admission to emergency and orthopedic clinics in daily practice. The localization and removal of FBs can be difficult. Ultrasound (USG) plays an important role in the localization of FBs. In this study, we aimed to present the results of patients who underwent US-guided FB extraction. Methods: Fifty-seven patients who were admitted to the emergency service and orthopedic outpatient clinic due to FB trauma to soft tissue were retrospectively evaluated. USG-guided removal was performed under local anesthesia. The number, size, shape, structure, distance to the skin, and integrity of the FB were determined using USG guidance. Patient satisfaction was evaluated with Roles-Maudsley score. Results: The mean duration of surgery was 7 min (range; 5 to 20 minutes), and the mean incision size was 11 mm (range; 5 to 25 mm). Forty-seven of the patients underwent an outpatient procedure and were discharged on the same day. No postoperative complications were observed. Fifty one of 57 (89.5%) were very satisfied with the surgery. Conclusion: Consequently, USG-guided FB extraction is a safe, fast, and comfortable option for the patient and the physician. Orthopedic physicians should receive USG training starting from their assistantship, and its use in daily practice should be increased.

Soft tissue myxomas are benign mesenchymal neoplasms typically found in the intramuscular components of the proximal extremities. However, soft tissue myxomas in the chest wall are rare. We report the case of a 41-year-old woman with soft tissue myxoma who presented with a slowly growing, palpable lump on her left anterior chest wall that has been present for several years. Mammography revealed an oval, circumscribed, and hyperdense mass in the retromammary fat layer of the upper inner quadrant of the left breast. Ultrasonography revealed an oval, circumscribed, and hypoechoic mass with internal echoes and multiple microcystic spaces. A triangular hyperechoic area adjacent to the pole of the mass and peripheral hyperechoic rim were also detected. The patient underwent surgical excision and was diagnosed with soft tissue myxoma with subcutaneous manifestation.

Ossifying fibromyxoid tumor (OFMT) is a rare mesenchymal tumor of uncertain histogenesis with intermediate malignant potential presenting commonly in the fifth to sixth decade in the proximal limb and limb girdle. A 65-year-old male patient presented with a slow-growing gluteal mass. Wide local excision performed showed a well-defined tumor in the subcutaneous plane with a partially hard outer shell. Microscopy showed a moderately cellular tumor having cords and nests of round to ovoid cells with moderate cytoplasm and bland nuclei embedded in a myxo-hyaline matrix. An incomplete peripheral rim of ossification was seen. Pleomorphism/high cellularity was not seen. Mitosis was

ABSTRACT Background Methods Results Conclusion The treatment of the medial infraorbital region also termed the tear trough has become increasingly popular by the use of soft tissue fillers in a minimally invasive approach using a cannula.A total of 246 tear troughs were injected and investigated originating from 123 study participants. The clinical outcome was evaluated 6 months after the treatment by independent observers based on standardized frontal images and the procedure was documented by ultrasound imaging.On average, 0.26 (0.1) cc [range: 0.08–0.32] of soft tissue filler material was injected per tear trough. Tear trough depth was before the treatment rated as 2.12 (0.4), whereas after the treatment it was 1.15 (0.4) (p < 0.001). Hyperpigmentation score was 2.19 (0.4) before the treatment, whereas after the treatment it was 1.31 (0.5) (p < 0.001). Intraorbital fat pseudo‐prolapse severity was rated before the treatment 1.88 (0.7), whereas it was rated after the treatment 1.14 (0.3) (p < 0.001). Wrinkle severity of the lower eyelid was rated before the treatment 1.51 (0.6), whereas it was rated after the treatment 1.12 (0.3) (p < 0.001).The results of this retrospectively investigated case series revealed that the conducted injection technique for treating the tear trough for medial infraorbital hollowing with a cannula provided statistically significant clinical improvement with a limited adverse events profile. The technique utilized an injection approach which was perpendicularly oriented to the longitudinal axis of the tear trough thereby “bridging the gap instead of filling the entire valley.” [ABSTRACT FROM AUTHOR]

Context: Children sustain facial skeletal and soft-tissue injuries, which are often seen in the preschool age; however, severe facial injuries involving facial bones occur in ages above 11 years. There have been several postulated reasons for the reduction in the incidence of skeletal fractures in children. These include sutural pliability of pediatric facial bones, increased subcutaneous fat, and a greater ratio of cranial to facial bones. Aims: The study aimed to report our institutional experience of the pattern of presentation in pediatric maxillofacial trauma and report its main etiologies. Methods and Materials: Clinical and demographic information was retrieved from the maxillofacial registers, day clinics, and pathology registers. The etiology of the trauma and associated injuries were also noted. Statistical Analysis: Descriptive statistics were performed on demographic variables such as age, gender, and location of trauma. Categorical variables were analyzed in frequencies and proportions. Association analyses across variables were done using student t -test, ANOVA, and Pearson's Chi-square after normality test had been conducted. Dunn's test and Tukey's post-hoc analysis were conducted after significant observations. Results: The mean age observed in the study was 7.3 years ± 5.3 SD (range: 2.6 months–16 years). There was a slight male predilection with 58.6%. Falls were the most common etiology in the ≤5-years group. RTC accounted for most injuries in children above 11 years. Soft-tissue-only injuries were observed in 51.4% of all cases. In facial bone fractures, mandibular fractures accounted for 40% of all cases. Conclusion: Male children experienced the greatest impact from maxillofacial trauma. The primary factor contributing to this was falls among preschool children. Soft-tissue injuries were found to be more prevalent among preschool children, whereas the incidence of facial fractures increased as age advanced. [ABSTRACT FROM AUTHOR]

Background: Trabectedin is an antineoplastic drug approved for patients (pts) with advanced soft tissue sarcomas (STS). Interestingly, the radiological evaluation of response during trabectedin therapy is peculiar. Methods: The aim of this single-center retrospective study is to analyze the concordance of response assessment according to RECIST compared with Choi criteria in patients with STS treated with trabectedin between 2009 and 2020 at Regina Elena National Cancer Institute in Rome. Results: We present the preliminary data collected in the last 2 months (mos) on 37 pts who received the diagnosis between 2015 and 2020, with a median age of 52.5 years (range 32–78). The median number of trabectedin cycles administered was four (range 2–50) for a median follow up of 5.83 months (range 1–60). Histological subtypes of STS were five (13.5%) leiomyosarcoma, 14 (37.8%) liposarcoma, nine (24.3%) undifferentiated pleomorphic sarcoma, three (8.1%) synovial sarcoma, and six (16.2%) other rare histological subtypes. Eight pts (21.6%) received trabectedin in the first line setting, 21 (56.8%) in the second line, and seven (18.9%) received it in subsequent lines. One pt received trabectedin as neoadjuvant therapy in a clinical trial (ISG-STS 1001). Median progression-free survival was 3.6 months (CI95% 2.7–4.6); median overall survival was 34.3 months (CI95% 0–75.4). The radiological responses were evaluated with both RECIST and Choi criteria; responses matched in 33 pts (89.2%) but not in four (10.8%). The best responses obtained according to RECIST criteria were two (5.4%) partial response (PR), 13 (35.1%) stable disease (SD), and 22 (59.5%) progressive disease (PD). Instead, two (5.4%), 13 (35.1%), and 22 (59.5%) pts obtained PR, SD, and PD respectively, according to Choi criteria. Cohen’s kappa coefficient of concordance was 0.792 (p-value <0.002). A specialized radiologist performed all imaging examinations using a dedicated workstation in the same center. Conclusion: In this first analysis, the concordance between RECIST and Choi assessments demonstrates no statistically significant difference. Responses did not match for four pts. We are expanding the analysis to all pts included in the original cohort to confirm or deny these initial results. [ABSTRACT FROM AUTHOR]

In minimally invasive surgery, the tendency for human tissue to adhere to the electrosurgical scalpel can complicate procedures and elevate the risk of medical accidents. Consequently, the development of an electrosurgical scalpel with an anti-sticking coating is critically important. Drawing inspiration from nature, we identified that the leaves of Setaria Virids exhibit exceptional non-stick properties. Utilizing this natural surface texture as a model, we designed and fabricated a specialized anti-sticking surface for electrosurgical scalpels. Employing nanosecond laser direct writing ablation technology, we created a micro-nano textured surface on the high-frequency electrosurgical scalpel that mimics the structure found on Setaria Virids leaves. Subsequently, a TiO2 coating was deposited onto the ablated scalpel surface via magnetron sputtering, followed by plasma-induced hydrophobic modification and treatment with octadecyltrichlorosilane (OTS) to enhance the surface's affinity for silicone oil, thereby constructing a self-lubricating and anti-sticking surface. The spreading behavior of deionized water, absolute ethanol, and dimethyl silicone oil on this textured surface is investigated to confirm the effectiveness of the self-lubrication mechanism. Furthermore, the sticking force and quality are compared between the anti-sticking electrosurgical scalpel and a standard high-frequency electrosurgical scalpel to demonstrate the efficacy of the nanosecond laser-ablated micro-nano texture in preventing sticking. The findings indicate that the self-lubricating anti-sticking surface fabricated using this texture exhibits superior anti-sticking properties. [ABSTRACT FROM AUTHOR]

Background/Aim: Benign and tumor-like lesions of the hindfoot and ankle are common, whereas malignant entities are rare. Accurate evaluation and timely management of these lesions can be challenging, making it crucial to understand their incidence and anatomic localization. This study retrospectively analyzed the distribution of benign and malignant bone and soft tissue tumors in the hindfoot and ankle. Patients and Methods: This study included patient data from a single center, such as age, sex, histologic diagnosis, and anatomic location over a 12.5 year period. Results: Of the 105 cases reviewed, 19 cases (18.1%) were osseous lesions and 86 cases (81.9%) were soft tissue lesions. The latter were divided into 77 benign and 9 malignant cases, resulting in an overall malignancy rate of 8.6%. The most common osseous lesion was the intraosseous ganglion (n=12). The majority of benign soft tissue lesions (75.3%) were located in the hindfoot, with TGCT, schwannoma, and ganglion cysts being the most common types. The nine malignant cases were distributed among seven entities and were evenly distributed among both regions and sexes. Malignant cases had a higher mean age (59.2 years) compared to benign cases (40.8 years; p=0.001). Conclusion: Tumors, tumor-like lesions, and pseudotumors represent an important aspect of ankle pathology. The majority of focal masses and swellings are benign soft tissue or osseous lesions, but malignant entities can occur and may be mistaken for benign conditions. Preoperative imaging and histopathologic examination are essential, and preoperative presentation to a multidisciplinary tumor board is recommended in unclear cases. [ABSTRACT FROM AUTHOR]

Experimental protocols are fundamental for quantifying the mechanical behaviour of soft tissue. These data are crucial for advancing the understanding of soft tissue mechanics, developing and calibrating constitutive models, and informing the development of more accurate and predictive computational simulations and artificial intelligence tools. This paper offers a comprehensive review of experimental tests conducted on soft aortic tissues, employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, based on the Scopus, Web of Science, IEEE, Google Scholar and PubMed databases. This study includes a detailed overview of the test method protocols, providing insights into practical methodologies, specimen preparation and full-field measurements. The review also briefly discusses the post-processing methods applied to extract material parameters from experimental data. In particular, the results are analysed and discussed providing representative domains of stress–strain curves for both uniaxial and biaxial tests on human aortic tissue. [ABSTRACT FROM AUTHOR]

Background: The diagnostic work-up of musculoskeletal tumors is a multifactorial process. During the early phase, differential diagnoses are made using basic radiological imaging. In this phase, part of the decision making is based on the patient's age, as well as the incidence and predilection sites of different entities. Unfortunately, this information is based on older and fragmented data. In this study, we retrospectively evaluated all soft-tissue and bone tumors around the knee in children treated at our tertiary center in the last 20 years, with the aim of verifying the data used today. Methods: In this retrospective study, the databank of our tertiary center was used to give an overview of treated tumors around the knee in children. Results: We were able to include 224 children with bone and soft-tissue tumors around the knee. The cohort consisted of 184 bone tumors, of which 144 were benign and 40 malignant. The 40 soft-tissue tumors comprised 30 benign and 10 malignant masses. The most common lesions were osteochondromas (88) in the bone and tenosynovial giant-cell tumors (12) in the soft tissue. Conclusions: With this original work, we were able to verify and supplement earlier studies, as well as deepen our insight into these very rare diseases. [ABSTRACT FROM AUTHOR]

Tessier number 10 cleft is one of the rarest facial clefts. Surgical treatment of this type of cleft is challenging due to the complexity of periorbital and temporal soft tissue deformities. A 23-year-old male patient presented with typical facial deformities of Tessier number 10 cleft. The surgical procedure involved using a free anterolateral thigh flap to reconstruct the eye socket, while the superficial temporal artery pedicle scalp flap was used to reconstruct the eyebrow deformity. The patient had no complications and 16 months after surgery, the patient had good aesthetic results. A hair-bearing scalp flap with a pedicle of the frontal branch of the superficial temporal artery combined with an anterolateral thigh-free flap can effectively resolve most soft tissue deformities of Tessier number 10 cleft and reconstruct the orbital socket in a single surgery. At the same time, it augments the soft tissue of the frontotemporal area and provides good aesthetic results. [ABSTRACT FROM AUTHOR]

Ballistic impacts on human thorax without penetration can produce severe injuries or even death of the carrier. Soft tissue finite element models must capture the non-linear elasticity and strain-rate dependence to accurately estimate the dynamic human mechanical response. The objective of this work is the calibration of a visco-hyperelastic model for soft tissue simulants. Material model parameters have been calculated by fitting experimental stress–strain relations obtained from the literature using genetic algorithms. Several parametric analyses have been carried out during the definition of the optimization algorithm. In this way, we were able to study different optimization strategies to improve the convergence and accuracy of the final result. Finally, the genetic algorithm has been applied to calibrate two different soft tissue simulants: ballistic gelatin and styrene–ethylene–butylene–styrene. The algorithm is able to calculate the constants for visco-hyperelastic constitutive equations with high accuracy. Regarding synthetic stress–strain curves, a short computational time has been shown when using the semi-free strategy, leading to high precision results in stress–strain curves. The algorithm developed in this work, whose code is included as supplementary material for the reader use, can be applied to calibrate visco-hyperelastic parameters from stress–strain relations under different strain rates. The semi-free relaxation time strategy has shown to obtain more accurate results and shorter convergence times than the other strategies studied. It has been also shown that the understanding of the constitutive models and the complexity of the stress–strain objective curves is crucial for the accuracy of the method. [ABSTRACT FROM AUTHOR]

PURPOSE. The objective of the study was to analyze the impact of cement, bonding pretreatment, and ceramic abutment material on the overall color results of CAD-CAM ceramic crowns bonded to titanium-based hybrid abutments. MATERIALS AND METHODS. For single implant restoration of a maxillary lateral incisor a total of 51 CAD-CAM-fabricated monolithic lithium disilicate crowns were fabricated and subsequently bonded onto 24 lithium disilicate Ti-base abutments, 24 zirconia Ti-base abutments and 3 resin abutment replicas as a control group. The 48 copings were cemented with three definitive and one provisional cement on both grit-blasted and non-blasted Ti-bases. The color of each restoration and surrounding artificial gingiva was measured spectrophotometrically at predefined measuring points and the CIELAB (ΔEab) color scale values were recorded. RESULTS. The color outcome of ceramic crowns bonded to hybrid abutments and soft tissues was affected differently by cements of different brands. Grit-blasting of Ti-bases prior to cementing CAD-CAM copings affected the color results of allceramic crowns. There was a significant difference ( P = .038) for the median ΔE value between blasted and non-blasted reconstructions at the cervical aspect of the crown. Full-ceramic crowns on zirconia Ti-base abutments exhibited significantly lower ΔE values below the threshold of visibility (ΔE 1.8). In all subcategories tested, the use of a highly opaque temporary cement demonstrated the lowest median ΔE for both the crown and the artificial gingiva. CONCLUSION. Various cements, core ceramic materials and airborne particle abrasion prior to bonding can adversely affect the color of Ti-base supported ceramic crowns and peri-implant soft tissue. However, zirconia CAD-CAM copings and an opaque cement can effectively mask this darkening. [ABSTRACT FROM AUTHOR]

Medical image analysis gains huge advancements with deep learning approaches which boosts the computational capability and accurate prediction. An expert in the field analyzes the feature representation, and an intelligent model helps to categorize and forecast diseases. The MRI images from cancer imaging archives are used to give a novel learning approach for soft tissue diagnosis. This work suggests a Type-2 fuzzy model that chooses local and maximum absolute value to handle the data. According to the experimental investigation, the predicted model works better than several current strategies. Deep convolutional neural networks built on the VGG-16 architecture and the Adam optimizers are used to pre-train the proposed model. The classification accuracy is anticipated based on the experimentation, demonstrating the need for complementary information for learning systems. The goal is to forecast the depth of knowledge extraction by boosting pre-trained CNN's ability to be fine-tuned by improving the accuracy of soft tissue classification. The proposed model improves performance and validates the significance of the network model by categorizing the tissues as benign or cancerous. The proposed model attains 96.8% accuracy and 9% for depths of 5 and 8 mm and 93% for 10 mm. Similarly, the model attains 96.8% without inclusion, 100% with inclusion and an average outcome of 99%. [ABSTRACT FROM AUTHOR]

Simple Summary: Programmed death-ligand 1 (PD-L1) on the tumor cell surface binds to its receptor, programmed death-1 (PD-1), on T cells and inhibits their activity. Immunotherapy involving PD-L1 and PD-1 inhibition has provided a remarkable innovation in cancer therapy. Recently, the soluble form of PD-L1 (sPD-L1) has attracted attention for systemic immune suppression. In this study, we successfully showed that sarcoma cells can release functional exosomal PD-L1, one of the forms of sPD-L1. Furthermore, the release of exosomal PD-L1 derived from normal and sarcoma cells was shown to be induced by irradiation. These findings demonstrate that radiated cells, including normal cells and sarcoma cells, induce the systemic release of exosomal PD-L1, and combination therapy with anti-PD-1/PD-L1 antibody may block the immune activity of exosomal PD-L1. (1) Background: Exosomal PD-L1 has garnered attention owing to its role in instigating systemic immune suppression. The objective of this study is to elucidate whether bone and soft tissue sarcoma cells possess the capacity to secrete functionally active exosomal PD-L1 and whether radiotherapy (RT) induces the exosomal PD-L1 release. (2) Methods: Human osteosarcoma cell line 143B and human fibrosarcoma cell line HT1080 were utilized. Exosomes were isolated from the culture medium and blood via ultracentrifugation. The expression of PD-L1 on both tumor cells and exosomes was evaluated. The inhibitory effect on PBMC was employed to assess the activity of exosomal PD-L1. Post radiotherapy, changes in PD-L1 expression were compared. (3) Results: Exosomal PD-L1 was detected in the culture medium of tumor cells but was absent in the culture medium of PD-L1 knockout cells. Exosomal PD-L1 exhibited an inhibitory effect on PBMC activation. In tumor-bearing mice, human-derived exosomal PD-L1 was detected in the bloodstream. Following radiotherapy, tumor cells upregulated PD-L1, and human-derived exosomal PD-L1 were detected in the bloodstream. (4) Conclusions: Exosomal PD-L1 emanates from bone and soft tissue sarcoma cells and is disseminated into the circulatory system. The levels of PD-L1 in tumor cells and the release of exosomal PD-L1 were augmented after irradiation with RT. [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]

Copyright of Revista Facultad de Medicina de la Universidad Nacional de Colombia is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Personal care robots are assumed to be frequent contact with humans. Thus, the limitation of mechanical inputs should be clarified for the development of safety standards on human-personal care robot interactions. In our previous studies, in vivo impact tests has been conducted using anesthetized pigs in order to obtain the injury resistance threshold caused by human-robot interactions. The impact points in this tests were selected the porcine chest and extremities. As a result, the bleeding threshold value of the porcine extremities was lower than that of the chest. However, the bleeding threshold of the porcine extremities has not been clarified yet. In this study, to investigate the threshold value for bleeding of the porcine extremities, we performed in vivo impact tests under the low impact energy conditions. Moreover, in vivo impact tests were simulated using a finite element model at the part of porcine thigh based on CT images to identify the tissue-level injury resistance evaluation index and the threshold value for bleeding. As a result, when the maximum stress based on the maximum impact force and contact area was used as the injury resistance evaluation index, the injury resistance threshold value for bleeding was 1.16 MPa in the in vivo impact test. The part of first principal stress concentration in the finite element analysis was in good agreement with the bleeding point obtained from in vivo impact tests. Moreover, when the first principal stress was used as the tissue-level injury resistance evaluation index, the threshold value for bleeding was 0.74～0.80 MPa.

Multilayered skin, subcutaneous tissue, and skeletal muscle exhibit complex mechanical behavior. Deformation of surrounding tissues affects superficial venous circulation, but the deformation behavior of these tissues has not been determined in relation to skin surface shear. This study investigated the effect of shear on the deformation of soft tissues surrounding superficial veins. Motion analysis of five subjects in their 20s was conducted to quantify the deformation of forearm soft tissues with a cephalic vein of about 3 mm in luminal height by ultrasound video imaging with application of shear to the skin surface. Selected points near the skin surface and the top and bottom of the vein were traced on video images. When the top of the vein was at a depth of 2 mm (four subjects; body mass index (BMI) 17–22), the point near the top of the vein moved by almost the same amount as the point near the skin surface, whereas the point near the bottom of the vein moved by only a small amount (three subjects) or by the same amount as the top of the vein (one subject). In one case where the top of the vein was at a depth of 4 mm (one subject, BMI 26; grade 1 overweight according to the World Health Organization classification), the points near the top and bottom of the vein in the thick subcutaneous tissue moved by half the displacement of the skin surface. Finite element analyses were conducted for typical cases of subcutaneous tissue thickness above the vein. The results reproduced the experimental deformation behaviors, with the exception of substantial sliding below the vein. They indicated that BMI category, venous depth, and the sliding mechanism in subcutaneous tissue determine the motion of the vein and surrounding soft tissues under shear.

BackgroundSarcomas are rare malignancies, accounting for approximately 1% of all cancers. Pulmonary metastases are the most preferential site for distant metastasis in malignant soft tissue sarcomas. Despite the lack of evidence from large randomized trials to support treatment guidelines, surgical resection of resectable metastatic tumors remains the current standard of care. This study aimed to explore the survival status of patients with soft tissue sarcoma after resection of pulmonary metastases.MethodsThis study is a retrospective analysis of patients who mestastasectomy by means of lobar or sublobar resections at National Taiwan University Hospital and its branches. The statistical and investigation period was from February 2007 to December 2020.ResultsAmong 110 samples during the investigation period, the overall 5-year survival rate was 62.9%, which was higher than the 15%–50.9% reported previously. A disease-free interval of more than 12 months and the occurrence of local recurrence of sarcoma at the time of resection of pulmonary metastases are associated with overall survival. Most of the samples were treated with minimally invasive surgery (VATS), and therefore, most patients had a shorter hospital stay and better postoperative recovery.ConclusionFor pulmonary metastatic sarcoma, pulmonary metastasectomy is a relatively safe treatment method with short hospital stay and short ICU stay. The results of this study suggest that VATS is preferred over thoracotomy, but further observations are needed to confirm these findings.

Purpose: Primary bone tumors of the fibula are rare. Distal fibular resection has a significant impact on ankle biomechanics and gait, possibly leading to complications such as ankle instability, valgus deformity, and degenerative changes. Question: Is there a need for reconstructive surgery after distal fibular resection, and what reconstructive procedures are available? Materials and methods: The review is registered with the PROSPERO International Register of Systematic Reviews. Inclusion criteria consisted of all levels of evidence, human studies, patients of all ages and genders, publication in English, and resection of the distal portion of the fibula due to tumor pathology. The reviewers defined four different categories of interest by method of treatment. Additional articles of interest during full-text review were also added. Results: The initial search resulted with a total of 2958 records. After screening, a total of 50 articles were included in the study. Articles were divided into ‘No reconstruction’, ‘Soft tissue reconstruction’, ‘Bone and soft tissue reconstruction’, and ‘Arthrodesis, arthroplasty or other reconstruction options’ groups. Conclusion: Limb salvage surgery should be followed by reconstruction in order to avoid complications. Soft tissue reconstructions should always be considered to stabilize the joint after fibular resection. Bone reconstruction with reversed vascularized fibula is the preferred technique in young patients and in cases of bone defects more than 3 cm, while arthrodesis should be considered in adult patients. Whenever possible for oncologic reason, if a residual peroneal malleolus could be preserved, we prefer augmentation with a sliding ipsilateral fibular graft.