Soft Tissues In Patients Research Articles

DETERMINATION OF OXYGEN PERFUSION IN THE AREA OF RADIATION-INDUCED FIBROSIS OF THE SKIN IN PATIENTS WITH BREAST CANCER AND ITS ROLE IN PATHOGENESIS OF LATE RADIATION INJURY

Late radiation injury in the form of radiation-induced fibrosis (RIF) is one of the many complications of radiation therapy. The aim was to evaluate oxygen perfusion in the skin in the area of late radiation injury manifested as RIF in patients with breast cancer. Based on our first-hand experience in treating late radiation injures of soft tissues in patients with breast cancer, we measured oxygen perfusion of the skin (tсрО2) in the area of late radiation injury using a transcutaneous monitor (oximeter) TCM 400 (Radiometer, Denmark). Partial oxygen pressure tcpO2in the RIF area in patients with breast cancer didn't show any significant decrease compared to healthy tissue. Mean value of partial oxygen pressure tcpO2in the RIF area was 42.650± 9.178mmHg, in the healthy tissue it was 45.180 ± 8.025mmHg. Maximal difference in tcpO2between the damaged and healthy tissue was 30mmHg. Results of the study suggest that there's no significant difference between oxygen perfusion (tcpO2) in the area of RIF and healthy tissue.

Plastic coverage of the ulcer-necrotic affections of the foot soft tissues in patients, suffering an ischemic form of diabetic foot syndrome

Objective. To improve the results of treatment of the ulcer-necrotic affections of the foot soft tissues in patients, suffering an ischemic form of diabetic foot syndrome (DFS).
 Маterials and methods. The investigated group have consisted of 48 patients, to whom necrectomy was performed, because a tendency for the wounds healing under the influence of standard methods of treatment through two weeks was absent.
 Results. After application of the tactics elaborated a complete healing of the wounds was registered in 89.6%, and a partial one - in 10.4% patients. Of 38 patients of a control group, to whom a standard treatment was conducted, the wounds have healed completely in 11 (28.9%), and partially - in 12 (31.6%) patients.
 Conclusion. Plastic coverage of the foot wounds after necrectomy and early performed revascularization operation for the ischemic form of DFS is indicated to patients, in whom the wounds are lacking a tendency towards healing under the influence of standard methods of treatment through two weeks.

In vivo MRI with Concurrent Excitation and Acquisition using Automated Active Analog Cancellation

Magnetic resonance imaging (MRI) provides excellent cross-sectional images of the soft tissues in patients. Unfortunately, MRI is intrinsically slow, it exposes patients to severe acoustic noise levels, and is limited in the visualization of certain tissues such as bone. These limitations are partly caused by the timing structure of the MRI exam which first generates the MR signal by a strong radio-frequency excitation and later acquires the weak MRI signal. Concurrent excitation and acquisition (CEA) can overcome these limitations, but is extremely challenging due to the huge intensity difference between transmit and receive signal (up to 100 dB). To suppress the strong transmit signals during signal reception, a fully automated analog cancellation unit was designed. On a 3 Tesla clinical MRI system we achieved an on-resonance analog isolation of 90 dB between the transmit and receive path, so that CEA images of the head and the extremities could be acquired with an acquisition efficiency of higher than 90% at sound pressure levels close to background noise. CEA with analog cancellation might provide new opportunities for MRI in tissues with very short T2 relaxation times, and it offers a silent and time-efficient MRI acquisition.

The use of a modified surgical stent in achieving keratinised peri‐implant soft tissues in patients with intra‐oral free flap reconstruction

The use of a modified surgical stent in achieving keratinised peri‐implant soft tissues in patients with intra‐oral free flap reconstruction

A Novel Approach to Improve the Keratinised Peri-Implant Soft Tissues in Patients with Intra-Oral Free Flap Osteocuteanous Reconstruction

A Novel Approach to Improve the Keratinised Peri-Implant Soft Tissues in Patients with Intra-Oral Free Flap Osteocuteanous Reconstruction

New approach to improve the keratinised peri-implant soft tissues in patients with intraoral osteocutaneous reconstruction using a free flap

New approach to improve the keratinised peri-implant soft tissues in patients with intraoral osteocutaneous reconstruction using a free flap

Autologous Fat Grafting in Management of Patients with Progressive Hemifacial Atrophy

Background: Progressive hemi facial atrophy or Romberg disease is a rare neurocutaneous syndrome characterized by slow progressive atrophy on one side of face involving skin, subcutaneous and connective tissue. Various methods have been described for soft tissue augmentation in patients with progressive hemi facial atrophy. Autologous fat, dermofat, fascial grafts have been used for grade 1,2 and 3 atrophy. Free flaps, cartilage and bone grafts are described for grade 3 and 4 atrophy. Aims and objectives: To study efficacy of autologous fat graft in patients with grade 1, 2 and 3 hemi facial atrophy. Strategies to reduce fat absorption and to calculate approximate amount of fat required required by facial mask template. Observations: It is a prospective study conducted in Department of plastic surgery, Bangalore Medical college and Research Institute, Bangalore in 10 patients with grade 2 and 3 Progressive hemi facial atrophy. All patients with stable non-progressive atrophy were graded for severity of disease and face-mask templates were prepared by pro-sthodontists to know approximate amount of fat required for injection. Fat was aspirated by low-pressure small suction cannulas manually and infiltrated at multiple points and in multiple planes after sedimentation and separation of fat. Five of the patients with grade 2 and 3 of patients with grade 3 atrophy were satisfied with symmetric face and with emotional betterment. Two patients needed repeat fat grafting after 2 years of follow-up. Conclusion: Autologous fat grafting is a simple and safe method for augmentation of soft tissue in patients with grade 1, 2 and 3 Progressive hemi facial atrophy. Aspiration of fat with low-pressure small cannulas and infiltrating in multiple planes improves fat survival. Preparing face-mask templates gives an idea of approximate volume of fat required. Keywords: Progressive hemifacial atrophy, Autologous fat grafting, Face-mask templates, Strategies for decreased fat absorption.

The Role of CT Arthrography in Shoulder Instability

Computerized Tomography (CT) and CT arthrography are useful tools in evaluating both the osseous structures and the soft tissues in patients with shoulder instability. A variety of osseous injuries can be accurately depicted, such as Hill-Sachs lesions, glenoid rim fractures, or glenoid bone loss. CT arthrography further allows precise evaluations of labral and chondral defects. Further, CT is a simple modality for performing anatomical measurements in the shoulder such as glenoid version or for the assessment of osseous deficiencies of the posterior glenoid. Finally, CT is also be beneficial for assessing patients in the postoperative situation.

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

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

Role of Diffusion Weighted Imaging in Differentiating Benign from Malignant Head and Neck Tumors

Head and neck mass is considered to be a relatively common finding in adult and pediatric patients and can present a difficult diagnostic challenge. Differentiation of benign head and neck tumors from malignant lesions are important for treatment strategy as well as for predicting prognosis of malignant tumors. The aim of this work is to review the role of diffusion MRI scan in differentiation between benign and malignant head and neck masses This study was performed on 72 patients (30 men and 42 women aged from 13 years to 85 years, mean age of 51 years) with head and neck mass, in the period from September 2012 until May 2014. We found that DWI is a reliable noninvasive imaging tool to help in differentiation between malignant and benign head and neck lesions and also to identify the tumor-free soft tissue in patients with head and neck neoplasms. It could be performed with conventional MR systems in few minutes time, Further studies on larger number of patients is required to assess if such a technique should be implemented routinely with conventional MRI scan.

Implant therapy in the esthetic zone-surgical considerations

Implant placement in the esthetic zone is a complex procedure and requires a restoration-driven approach. Proper selection of patients and implant together with individual assessment of the risk of esthetic complications are very important. Correct 3D-implant positioning and sufficient bone volume should provide long-term esthetic and function. Esthetic region is a zone in which expectations and possibilities collide. Clinician should bring the important decision on the appropriate time of implant placement. Immediate implant placement is particularly challenging in the esthetic zone. Patient desire for reduced treatment time should be weighed against the possible risk factors. Protocol of immediate implant placement in conditions of unfavourable gingival biotypes, the lack of bone or soft tissue in patients with a high smile line lead to esthetic failure which is very important in the esthetic region.

Three-dimensional analysis of hard and soft tissue changes in patients with facial asymmetry undergoing 2-jaw surgery

We studied 3-dimensionally how hard and soft tissues of patients with facial asymmetry were changed by 2-jaw surgery. Nine patients diagnosed with mandibular prognathism and facial asymmetry who underwent 2-jaw surgery were enrolled. Three-dimensional (3-D) computed tomographic images taken before and after surgery were superimposed by 3-D imaging software. Linear and angular measurements of hard and soft tissues were performed and compared before and after surgery. Along with improved roll rotations of the hard and soft tissues of the facial structures by surgery, both hard and soft tissue mentons were moved toward the nonshifted side. Only the hard tissue mentons, however, were important for improving the roll rotation of the mandible. Variations in the wing of the nose and lip were significant for shaping the maxilla. The 3-D analysis in this study enabled us to understand hard and soft tissues quantitatively, thereby providing helpful information for treatment planning.

Ultrasonographic Assessment of Soft Tissues in Patients With Acromegaly

Objectives: This study aims to investigate ultrasound examination findings of cartilage, tendon and nerve structures in patients with acromegaly and assess whether imaging findings have any association with the clinical and laboratory features of the patients. Patients and methods: The study included 38 diagnosed acromegaly patients (18 males, 20 females; mean age 45.6±10.4 years; range 28 to 63 years) and 21 control subjects (8 males, 13 females; mean age; 43.1±7.4 years; range 29 to 58 years) similar for age, sex and body mass index. Patients’ clinical characteristics and laboratory parameters were recorded. The cross sectional area of median nerve, flexor pollicis longus and Achilles tendon, and humeral cartilage thickness were bilaterally assessed by ultrasound. Results: Arthralgia was present in 13 patients (34.9%) and 11 (28.9%) had paresthesia in the hands. Thickness of humeral cartilage and the cross sectional area of median nerve, flexor pollicis longus tendon and Achilles tendon was significantly higher in acromegaly patients compared with controls (p<0.001). While measurements performed with ultrasound were correlated among themselves, no significant correlation was present between ultrasound measurements and growth hormone and insulin-like growth factor-1. When acromegaly patients were analyzed as active (n=22) and inactive (n=16), no significant difference was determined in the parameters with the exception of median nerve measurements. Conclusion: Ultrasound examination revealed significantly different cartilage, tendon and nerve parameters in acromegaly patients compared to the control group. Median nerve cross sectional area was significantly greater in active patients compared to inactive patients.

Additive effect of autologous platelet concentrates in treatment of intrabony defects: a systematic review and meta-analysis.

The aim of the present review is to systematically evaluate the additive effect of autologous platelet concentrates (APCs) in treatment of intrabony defects when used along with other regenerative procedures and when used alone in terms of clinical and radiological outcomes. A search was performed in electronic databases (i.e., MEDLINE and the Cochrane Central Register of Controlled Trials) in order to identify randomized clinical trials (RCTs) assessing the additive efficacy of APCs for healing and regeneration of hard and soft tissues in patients undergoing regenerative surgical procedures for the treatment of intrabony defects, having a follow-up of at least 9months. Included studies underwent risk of bias assessment and data extraction. The main variables evaluated for efficacy were: pocket depth (PD), clinical attachment level (CAL), radiographic bone filling, and postoperative pain. The effect of APCs adjunct was evaluated for the following procedures: open flap debridement (OFD) alone, OFD plus grafting of the defect with autogenous bone or bone substitutes, and grafting in combination with a covering membrane for guided tissue regeneration (GTR). Platelet-rich fibrin (PRF) has a significant additive effect when used along with OFD. Platelet-rich plasma (PRP) has a significant additive effect when used along with bone grafts. Conversely, PRP was found to be ineffective when used in combination with GTR procedures. No study evaluated the effect of APCs on postoperative pain. Platelet-rich plasma may be used advantageously as an adjunct to grafting materials, but not in combination with GTR, for treatment of intrabony defects. Moreover, PRF can be effective as a sole regenerative material, in combination with OFD. There is still a lack of evidence regarding the effect of PRF in combination with grafting materials and GTR, the effect of other types of APCs such as plasma rich in growth factors, and the effect of APCs on postoperative pain.

SP0076 Proteasome as A Therapeutic Target in Osteoarthritis?

Osteoarthritis (OA) is a common chronic joint disorder affecting approximately 10% of the population today. Pain is the predominant symptom in patients with OA followed by changes in articular cartilage,...

Proteomics analysis of the peritoneal dialysate effluent reveals the presence of calcium-regulation proteins and acute inflammatory response.

BackgroundPeritoneal dialysis (PD) is a form of renal replacement used for advanced chronic kidney disease. PD effluent holds a great potential for biomarker discovery for diagnosis and prognosis. In this study a novel approach to unravelling the proteome of PD effluent based-on dithiothreitol depletion followed by 2D-SDS-PAGE and protein identification using tandem mass spectrometry is proposed.ResultsA total of 49 spots were analysed revealing 25 proteins differentially expressed, among them many proteins involved in calcium regulation.ConclusionsRemarkably, a group of proteins dealing with calcium metabolism and calcium regulation has been found to be lost through peritoneal dialysate effluent, giving thus a potential explanation to the calcification of soft tissues in patients subjected to peritoneal dialysis and kidney injury. Comparison of literature dealing with PD is difficult due to differences in sample treatment and analytical methodologies.

Prevalence and Significance of Perivascular Soft Tissue Surrounding the Hepatic Artery After Liver Transplantation

The objective of this study was to determine the prevalence and significance of perivascular soft tissue surrounding the hepatic artery on computed tomography (CT) after liver transplantation. A total of 119 consecutive patients who underwent liver transplantation were retrospectively identified from a search of electronic medical records. Fourteen patients had histologic proof of posttransplant lymphoproliferative disease (PTLD). For each patient, the initial CT scan after transplantation, and the most recent CT scan if available, was analyzed for the presence of soft tissue in the porta hepatis region, particularly surrounding the transplanted hepatic artery. The hepatic artery was identified, and the maximum diameter of the soft tissue surrounding the vessel was measured and classified using the following scale: grade 0, none; grade 1, mild; grade 2, moderate; grade 3, moderate-large; and grade 4, large. Prevalence of perivascular soft tissue was 93% in the initial CT scans and follow-up studies. Comparing the initial and follow-up soft tissue measurements, 34% decreased, 62% were unchanged, and 4% increased. Using the Fisher exact test and a Mann-Whitney test, there was no statistically significant difference in the prevalence or diameter of perivascular soft tissue when comparing patients with pathologically proven PTLD and patients with no PTLD. Twenty-nine of the 119 patients underwent 68 positron emission tomography/CT scans in the time interval analyzed. Ninety percent of these patients had no abnormal fluorodeoxyglucose activity in the porta hepatis and portacaval regions. The presence of isolated perivascular soft tissue in patients after liver transplantation is a common finding and is not associated with lymphoproliferative disease.

Metastatic Calcification of the Finger in a Chronic Renal Failure Patient

Metastatic calcification is defined as ectopic calcification of soft tissues in patients with a systemic mineral imbalance, and dystrophic calcification or heterotopic ossification is distinct from that disease. The authors encountered a metastatic calcification of the finger in a patient with chronic renal failure, the lesion disappeared spontaneously during the observation period. We report on a case of metastatic calcification of the finger with a review of the literature.

Three-dimensional Assessment of Facial Soft Tissue after Orthognathic Surgery in Patients with Skeletal Class III and Asymmetry

Purpose: The purpose of this study was to perform three-dimensional (3D) assessment of facial soft tissue in patients with skeletal Class III and mandibular asymmetry after orthognathic surgery. Methods: Samples consisted of 3D facial images obtained from five patients with A point-nasion-B point angle less than 2 degrees, and more than 5 mm of menton deviation. All patients had been treated at Gangneung-Wonju National University Dental Hospital from 2009 to 2012. They had undergone orthognathic surgery of Lefort I, and sagittal split osteotomy for correction of skeletal deformity, and orthodontic treatment. Facial scanning was performed before treatment (T1) and post-surgical orthodontic treatment (T2). Linear and angle variables of soft tissue landmarks, antero-posterior facial depth, and facial volume were measured. Results: No significant differences in width of the alar base, mouth width, and nasal canting were observed between T1 and T2. However, lip deviation, menton deviation, alar canting, lip canting, and menton deviation angle were significantly reduced at T2. Antero-posterior facial depth on the axial plane parallel to the left cheilion was significantly reduced on the deviated side and significantly increased on the non-deviated side at T2. Volume of the lower lateral and lower medial parts of the face was reduced on the deviated side, and volume of upper lateral and lower lateral parts on the non-deviated side was significantly increased at T2. Conclusion: After orthognathic surgery, facial asymmetry of soft tissue was improved following skeletal changes, especially the mandibular region. Although the length of the alar base and mouth width did not change, lip and soft tissue menton were displaced to the medial side after treatment. Facial depth also became symmetric after treatment. Facial volume showed a decrease on the lower part of the deviated side and that on lateral parts of the non-deviated side showed an increase after treatment.

Soft-tissue masses as presentation of non-Hodgkin's lymphoma in AIDS patients

Primary soft tissue Non-Hodgkin lymphomas are very rare and account only for 0.1 % of the cases. Generally, Non-Hodgkin lymphomas of the soft tissue present as large subcutaneous masses without evidence of nodal or skin involvement. We describe four cases of primary Non-Hodgkin lymphomas of the soft tissue in patients infected with the human immunodeficiency virus. The most common site of involvement was the chest wall in all the patients; histopathological and immunophenotypic examination of the biopsy smears revealed two cases of plasmablastic lymphomas, one Burkitt and one diffuse large B-cell lymphoma. Non-Hodgkin lymphomas should be included in the differential diagnosis of soft tissue masses in human immunodeficiency virus - seropositive patients.