Small Soft Tissue Research Articles

760PD - Neuroendocrine Prostate Cancer (Nepc) in Patients (Pts) with Metastatic Castration Resistant Prostate Cancer (Mcrpc) Resistant to Abiraterone (Abi) or Enzalutamide (Enz): Preliminary Results from the Su2C/Pcf/Aacr West Coast Prostate Cancer Dream Team (Wcdt)

ABSTRACT Aim: The mechanisms of resistance to androgen signaling inhibitors such as Abi or Enz are poorly understood. A growing proportion of these pts are developing treatment resistant NEPC. Progressive mCRPC has historically been challenging to biopsy and characterize on a molecular basis because of its bone tropism. As part of the WCDT project, which aims to identify genetic pathways underlying primary and acquired resistance to Abi and Enz, RNA sequencing (RNAseq) was used to develop a NEPC expression signature in mCRPC biopsies. Methods: Following central radiologic review, eligible mCRPC pts underwent a metastasis (met) biopsy at one of 5 WCDT clinical sites, using a uniform biopsy protocol. Tissue was both frozen, and formalin fixed/paraffin embedded (FFPE). Frozen specimens underwent laser capture micro-dissection, RNA isolation, library preparation and RNAseq. Machine learning was used to derive NEPC markers from mCRPC adenocarcinoma and met NEPC RNAseq data. FFPE tissue was evaluated histologically, including NEPC markers. Results: 85 of 300 planned mCRPC pts have undergone a met biopsy. To date, 53 specimens have been evaluated histologically. Histologically identified NEPC was present in 17 (32%) of biopsies overall, 12% of bone biopsies, 64% of lymph nodes, and 27% of liver biopsies. To date RNAseq data are available on 20 pts, including 6 with NEPC. A106 gene signature for met NEPC was developed from this learning set. Conclusions: Genomic sequencing and expression analysis can be accomplished in small bone and soft tissue mCRPC biopsies. The development of NEPC is a common event in mCRPC resistant to ABi or Enz. The majority of liver metastases are not NEPC. A 106 gene signature was derived from this met NEPC learning set and has identified a number of genes that provide insight into the biology and potential treatment of NEPC. Disclosure: All authors have declared no conflicts of interest.

Small soft tissue sarcomas do metastasize: identification of high-risk tumors.

Small (≤5cm) soft tissue sarcomas (STS) of the extremities and the trunk wall generally have a favorable prognosis. However, 1 of 10 patients do develop metastases, and we therefore aimed to determine predictors of metastasis in a population-based cohort of patients with small STSs. In the southern Sweden health care region, 848 adult patients with STS of the extremities or the trunk wall were diagnosed between 1986 and 2010. Of these, 243 STS (29%) were ≤5cm. Prognostic evaluation was performed in 229 patients with localized disease at diagnosis, 181 of whom had histologic high-grade tumors. None of the 48 patients with low-grade tumors developed metastases, whereas 24 of 181 patients with high-grade tumors (13%) tumors did. Presence of either tumor necrosis or vascular invasion predicted development of metastases with a hazard ratio of 2.9 (95% CI, 1.0-7.9), and tumors with both factors had a hazard ratio of 12 (95% CI, 4.1-37) for metastasis (adjusted for size). Our population-based series of STSs ≤5cm demonstrate an overall good prognosis with metastases developing in 13% of the patients with high-grade tumors. Tumor necrosis and vascular invasion were the major predictors of metastatic disease in this subset. Tumors with both these risk factors metastasized in 8 of 18 patients, which corresponds to a 12-fold increased risk of metastasis. These findings suggest that although small STS generally are linked to a good prognosis, necrosis and vascular invasion are features indicating biologically aggressive tumors for which treatment and surveillance should equal that for larger tumors.

Rheological behaviour of reconstructed skin

Reconstructed skins have been developed to replace skin when the integrity of tissue has been compromised following severe injury, and to provide alternative methods validating the innocuousness and effectiveness of dermatological and cosmetic products. However the functional properties of tissue substitutes have not been well characterised, mainly since mechanical measurement devices have not been designed to test cell culture materials in vitro. From the mechanical standpoint, reconstructed skin is a heterogeneous multi-layer viscoelastic material. To characterise the time-dependent behaviour of reconstructed skin, spherical indentation load-relaxation tests were performed with a specific original device adapted to measure small soft tissue samples. Load-relaxation indentation tests were performed on a standard reconstructed skin model and on sub-components of the reconstructed skin (3D-scaffold alone and dermal equivalent). Generalised Maxwell and Kelvin–Voigt rheological models are proposed for analysing the mechanical behaviour of each biological tissue. The results indicated a modification of the rheological behaviour of the samples tested as a function of their biological structure. The 3D-scaffold was modelled using the one-branch Maxwell model, while the dermis equivalent and the reconstructed skin were modeled using a one-branch and a two-branch Kelvin–Voigt model, respectively. Finally, we demonstrated that skin cells contribute to global mechanical behaviour through an increase of the instantaneous relaxation function, while the 3D-scaffold alone influences the mechanical response of long relaxation times.

Intraoral Reconstruction with “Thinned” Peroneal Artery Perforator Flaps: An Alternative to Classic Donor Areas in Comorbid Patients

Introduction: Free fasciocutaneous flaps are extensively used for intraoral soft tissue reconstruction. The free radial forearm flap (RFFF), offers thin, pliable skin with long vessels of high caliber, and historically, has been the most commonly used option for small soft tissue defects of the intraoral cavity. Recently, the anterolateral thigh (ALT) flap has come forward for intraoral soft tissue reconstruction. However, certain conditions exist where use of either flap is either not warranted or available.

Small Animal Soft Tissue Surgery ‐ Edited by Eric Monnet

Journal of Small Animal PracticeVolume 55, Issue 1 p. E2-E3 BOOK REVIEW Small Animal Soft Tissue Surgery - Edited by Eric Monnet Robert N White BSc (Hons) BVetMed CertVA DSAS (Soft Tissue) DipECVS MRCVS, Robert N White BSc (Hons) BVetMed CertVA DSAS (Soft Tissue) DipECVS MRCVSSearch for more papers by this author Robert N White BSc (Hons) BVetMed CertVA DSAS (Soft Tissue) DipECVS MRCVS, Robert N White BSc (Hons) BVetMed CertVA DSAS (Soft Tissue) DipECVS MRCVSSearch for more papers by this author First published: 06 January 2014 https://doi.org/10.1111/jsap.12045Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume55, Issue1January 2014Pages E2-E3 RelatedInformation

Reconstruction of small soft tissue nasal defects.

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

Vascular Tumor in Metal-on-polyethylene THA Requiring Hemipelvectomy

Total hip arthroplasty with metal-on-polyethylene implants and metal-on-metal articulations have been an area of recent interest. This article describes a patient with a persistent small soft tissue mass on the anterior groin following total hip arthroplasty with negative findings on infection workup, including blood work and aspiration. Subsequent biopsy findings were consistent with organizing thrombus and necrosis. It then developed into an expansile soft tissue groin mass with significant femoral and pelvic bony destruction and soft tissue infiltration. Metallosis, the formation of a pseudocapsule, and aseptic lymphocyte vasculitis-associated lesions have also been an area of interest following adult hip reconstruction. Occasionally, the formation of subsequent lesions make revision surgery impossible to perform due to bony destruction and soft tissue limitations. Although few in number, most studies or cases that have linked metal-on-metal implants to pseudotumors have been treated with revision surgery and replacement of articulating surfaces. This case highlights a metal-on-polyethylene total hip arthroplasty with a mass presenting with pseudotumor-like characteristics. However, final histology demonstrated fibroadipose tissue with fat necrosis and fibrosis, thickened vascular vessels, and diffuse chronic inflammation with lymphocytic infiltrates, which are more consistent with an atypical inflammatory vascular tumor. The current case illustrates treatment difficulties and provides surgical options for when this event occurs. Although aseptic lymphocyte vasculitis-associated lesions have been observed with metal-on-polyethylene articulations, the multiorgan involvement in this case is unique. In this case, radical excision with hemipelvectomy and complex flap closure was a last resort treatment solution that staved off the prospect of patient mortality.

Complications after thoracic surgery: don't (necessarily) blame it on the approach

Complications after thoracic surgery: don't (necessarily) blame it on the approach

Accuracy of Off-Line Bioluminescence Imaging to Localize Targets in Preclinical Radiation Research

In this study, we investigated the accuracy of using off-line bioluminescence imaging (BLI) and tomography (BLT) to guide irradiation of small soft tissue targets on a small animal radiation research platform (SARRP) with on-board cone beam CT (CBCT) capability. A small glass bulb containing BL cells was implanted as a BL source in the abdomen of 11 mouse carcasses. Bioluminescence imaging and tomography were acquired for each carcass. Six carcasses were setup visually without immobilization and 5 were restrained in position with tape. All carcasses were setup in treatment position on the SARRP where the centroid position of the bulb on CBCT was taken as "truth". In the 2D visual setup, the carcass was setup by aligning the point of brightest luminescence with the vertical beam axis. In the CBCT assisted setup, the pose of the carcass on CBCT was aligned with that on the 2D BL image for setup. For both 2D setup methods, the offset of the bulb centroid on CBCT from the vertical beam axis was measured. In the BLT-CBCT fusion method, the 3D torso on BLT and CBCT was registered and the 3D offset of the respective source centroids was calculated. The setup results were independent of the carcass being immobilized or not due to the onset of rigor mortis. The 2D offset of the perceived BL source position from the CBCT bulb position was 2.3 mm ± 1.3 mm. The 3D offset between BLT and CBCT was 1.5 mm ± 0.9 mm. Given the rigidity of the carcasses, the setup results represent the best that can be achieved with off-line 2D BLI and 3D BLT. The setup uncertainty would require the use of undesirably large margin of 4-5 mm. The results compel the implementation of on-board BLT capability on the SARRP to eliminate setup error and to improve BLT accuracy.

The application of Chinese Visible Human dataset

The objective of the study was to establish the Chinese Visible Human (CVH) dataset and to explore its application on clinical field and basic research.We have achieved five CVH dataset up to 2003. The CVH project achieved greater integrity of images, easier blood vessel identification, and free of organic lesion. The establish of CVH dataset was done in a low temperature laboratory, which contributed to prevention of small structures from falling off of the milling surface and better integrity of images.We're taking our step toward application by acquiring new data sets, performing segmentation and setting up a platform of computer‐assisted medicine. We have established the three‐dimensional (3D) digital model for transjugular intrahepatic portosystemic shunt pathway and model for the craniocervical junction region by using the serial sectional images from CVH dataset. These models correctly reflected the complicated anatomic structural characteristics and spatial adjacency relationships for diagnostics and interventional therapy. We also use the dataset to display anatomic features of the superior mediastinal and the left extraperitoneal space for diagnostic imaging, which is better than CT image at visualizing the small soft tissue structures. In additionally, the CVH dataset was used to construct Chinese adult anatomical models for evaluation of radio frequency electromagnetic field exposures. Further more, we use the CVH sectional image and the Duel‐Sources CT image to establish the 3D visible model of heart to display the third‐level branch of the coronary artery, and combine with the echocardiogram to diagnose the coronary heart disease by Beta ultrasound. Our study on the clinical application of CVH dataset will go on.

An Integrated X-Ray/Optical Tomography System for Pre-clinical Radiation Research.

The current Small Animal Radiation Research Platform (SARRP) is poor for localizing small soft tissue targets for irradiation or tumor models growing in a soft tissue environment. Therefore, an imaging method complementary to x-ray CT is required to localize the soft tissue target's Center of Mass (CoM) to within 1 mm. In this paper, we report the development of an integrated x-ray/bioluminescence imaging/tomography (BLI/BLT) system to provide a pre-clinical, high resolution irradiation system. This system can be used to study radiation effects in small animals under the conebeam computed tomography (CBCT) imaging guidance by adding the bioluminescence imaging (BLI) system as a standalone system which can also be docked onto the SARRP. The proposed system integrates two robotic rotating stages and an x-ray source rated at maximum 130 kVp and having a small variable focal spot. A high performance and low noise CCD camera mounted in a light-tight housing along with an optical filter assembly is used for multi-wavelength BL tomography. A three-mirror arrangement is implemented to eliminate the need of rotating the CCD camera for acquiring multiple views. The mirror system is attached to a motorized stage to capture images in angles between 0-90° (for the standalone system). Camera and CBCT calibration are accomplished.

Manual of Small Animal Soft Tissue Surgery ‐ by Karen M. Tobias

Journal of Small Animal PracticeVolume 54, Issue 3 p. 165-165 BOOK REVIEW Manual of Small Animal Soft Tissue Surgery - by Karen M. Tobias Rachel Hattersley, Rachel HattersleySearch for more papers by this author Rachel Hattersley, Rachel HattersleySearch for more papers by this author First published: 04 March 2013 https://doi.org/10.1111/j.1748-5827.2013.01276.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume54, Issue3March 2013Pages 165-165 RelatedInformation

One-Stage Integra Coverage for Fingertip Injuries

We hypothesize that one-stage Integra skin coverage is an effective treatment modality for the treatment of fingertip defects. Nine patients who sustained fingertip injuries were treated with one-stage Integra coverage. In all cases, Integra was placed directly on bone. Static two-point discrimination and the Semmes-Weinstein Monofilament Test (SWMFT) were used to determine the sensations of the affected and opposite unaffected digit. The QuickDASH, Cold Intolerance Symptom Severity (CISS), visual analog scale (VAS), and a 0-10-point pain scale were administered to assess patient function, satisfaction, and pain levels. The mean age was 53.1years (39-61). There were 8 males and 1 female. The average area covered was 2.3cm(2) (1.0-3.2). The mean follow-up duration was 16months (8-46). The median QuickDASH, CISS score, VAS patient satisfaction, and 0-10 pain score were 9.1 (2.3-40.9), 18 (4-30), 10 (most satisfied) (7-10), and 0 (0-3), respectively. Five patients were evaluated for their digital sensory perception. The mean static two-point discrimination was 9.6mm for the affected digit and 4.6mm for the opposite unaffected digit. The median SWMFT was 4.31 for the affected digit and 3.61 for the opposite unaffected digit. For small soft tissue and bone defects involving the fingertip, the use of Integra without further skin grafting appears to be effective, avoids the morbidity of the donor site, and avoids a second surgery. Despite mild sensory deficits, patients were satisfied with the results and fully functional during short-term follow-up.

Accuracy of Off-Line Bioluminescence Imaging to Localize Targets in Preclinical Radiation Research.

In this study, we investigated the accuracy of using off-line bioluminescence imaging (BLI) and tomography (BLT) to guide irradiation of small soft tissue targets on a small animal radiation research platform (SARRP) with on-board cone beam CT (CBCT) capability. A small glass bulb containing BL cells was implanted as a BL source in the abdomen of 11 mouse carcasses. Bioluminescence imaging and tomography were acquired for each carcass. Six carcasses were setup visually without immobilization and 5 were restrained in position with tape. All carcasses were setup in treatment position on the SARRP where the centroid position of the bulb on CBCT was taken as "truth". In the 2D visual setup, the carcass was setup by aligning the point of brightest luminescence with the vertical beam axis. In the CBCT assisted setup, the pose of the carcass on CBCT was aligned with that on the 2D BL image for setup. For both 2D setup methods, the offset of the bulb centroid on CBCT from the vertical beam axis was measured. In the BLT-CBCT fusion method, the 3D torso on BLT and CBCT was registered and the 3D offset of the respective source centroids was calculated. The setup results were independent of the carcass being immobilized or not due to the onset of rigor mortis. The 2D offset of the perceived BL source position from the CBCT bulb position was 2.3 mm ± 1.3 mm. The 3D offset between BLT and CBCT was 1.5 mm ± 0.9 mm. Given the rigidity of the carcasses, the setup results represent the best that can be achieved with off-line 2D BLI and 3D BLT. The setup uncertainty would require the use of undesirably large margin of 4-5 mm. The results compel the implementation of on-board BLT capability on the SARRP to eliminate setup error and to improve BLT accuracy.

Cutaneous paraneoplastic syndrome in a cat with thymoma

Feline cutaneous paraneoplastic syndrome is a rare disorder associated mainly with pancreatic carcinoma and thymoma. In this report the authors describe the case of a 12-year-old cat with paraneoplastic exfoliative dermatitis associated with thymoma. Lateral radiographic examination of the chest showed a small subtle soft tissue density in the ventral part of the first and second intercostal space, which together with skin changes suggested thymoma. Because of pain associated with the skin condition, costs of treatment and the risk associated with surgical treatment, the owner chose euthanasia of the cat. Post-mortem examination revealed a tumour which was diagnosed as thymoma by histopathological examination.

Merkel Cell Carcinoma Masquerading as Small Blue Round Cell Soft Tissue Sarcoma: A Case Report With Review of Literature

Merkel Cell Carcinoma Masquerading as Small Blue Round Cell Soft Tissue Sarcoma: A Case Report With Review of Literature

Distinguishing Benign Notochordal Cell Tumor from Chordoma

Benign notochordal remnants have been reported in the nucleus pulposus and as small extraosseous soft tissue masses, ecchordosis physalifora. Similar entities have been found in vertebrae, but only recently well characterized. They appear to be more prevalent than originally recognized and are thought to possibly be precursors to chordoma. Terminology has varied; they are now referred to as giant notochordal rests or benign notochordal cell tumors (BNCT). Histopathologically, they have morphological features distinct from the notochordal cells found in disks and from chordomas, however, differentiating between these can be difficult.

Small animal soft tissue surgery edited by DAYool. CABI Publishing, Oxfordshire, 2012. 394 pages. Price US$99.95. ISBN 978 1 84593 821 5.

Australian Veterinary JournalVolume 90, Issue 9 p. 369-369 BOOK REVIEW Small animal soft tissue surgery edited by DA Yool. CABI Publishing, Oxfordshire, 2012. 394 pages. Price US$99.95. ISBN 978 1 84593 821 5. John Culvenor, John CulvenorSearch for more papers by this author John Culvenor, John CulvenorSearch for more papers by this author First published: 28 August 2012 https://doi.org/10.1111/j.1751-0813.2012.00965.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume90, Issue9September 2012Pages 369-369 RelatedInformation

The platysma myocutaneous flap (PMF) for head and neck reconstruction: A retrospective and multicentric analysis of 91 T1–T2 patients

The platysma myocutaneous flap (PMF) was first applied to intraoral reconstructions in 1978. PMF is not only an alternative to microvascular flaps but it also represents an excellent reconstructive choice especially in cases where free tissue transfer cannot be carried out.Failure and complications rate have been described as varying from 18 to 45% and this is why this flap should not be used in specific cases such as in the presence of cervical metastases and in cases of mandibulectomy and simultaneous reconstruction with alloplastic materials.The purpose of this study is to examine the experience and results obtained in three different and independent institutes where PMF has been adopted in 91 patients for head and neck cancer reconstructions.The authors report their departments’ separate but simultaneous experiences with PMF for small and middle-size soft tissue defects in a 10-year period.

Comparative study of thin sectional anatomical images from Chinese Visible Human data set and computed tomography images of superior mediastinum

The structures of superior mediastinum and their spatial relationships are complex and difficult to master. This study aimed to compare visualization of the superior mediastinum based on computed tomography (CT) images and on the thin sections of the Chinese visible human (CVH) data set to provide a sectional anatomical basis for diagnostic imaging of superior mediastinal pathology. CVH sections of the mediastinum of a 35-year old male were compared with plain and enhanced CT images of a 45-year old male without apparent abnormalities in the upper chest. In addition, a three-dimensional model based on the CVH sections was compared with a model based on CT images. Although CT imaging is noninvasive and can be carried out in many individuals, its weakness is clearly the visualization of small soft tissue structures. In this respect, the sectional anatomical approach of the CVH images is complementary, as it visualizes these small soft tissue structures due to the higher resolution in the plain of sectioning and the color of the different structures in the section. Three-dimensional surface and volume rendering of reconstructions of the CVH data set can help medical students and less experienced thoracic surgeons to familiarize themselves with the topographic anatomy of the superior mediastinal structures and their spatial relationships, and thus with interpreting CT images of patients.