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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]

Objectives: The aim of this study was to compare leukocyte and platelet-rich fibrin (L-PRF) and photobiomodulation (PBM) applications, which have been repeatedly reported to be superior to control groups, in terms of pain, soft tissue and bone healing in tooth extraction sockets. Materials and methods: This double-blind, randomized clinical study was completed with 34 patients, who had an indication for extraction of their bilaterally impacted teeth. The right and left teeth of the patients were randomly divided into L-PRF and PBM groups. L-PRF group was treated with the blood product centrifuged for 12 min at 2700 rpm, and the PBM group was treated with a diode laser at different points for 60 s with a wavelength of 940 nm in repeated sessions. Postoperative pain was evaluated using Visual Analogue Scale (VAS), soft tissue healing with Landry Index (LI), tissue healing in the distal region of mandibular second molar by probing depth measurement, and bone healing via panoramic x-ray using the Image J program. Results: No statistically significant difference was found for any variable compared between the groups. Conclusion: L-PRF and PBM applications provide similar support in the healing of extraction sockets. Nevertheless, the advantages and disadvantages of both methods determine their usage areas. Clinical relevance: While L-PRF is advantageous in the early healing of extraction sockets, PBM may be preferred in terms of bone trabeculation in the long term. [ABSTRACT FROM AUTHOR]

Ultrasound imaging (USI) is the gold standard in the clinical diagnosis of thyroid diseases. Compared with two-dimensional (2D) USI, three-dimensional (3D) USI could provide more structural information. However, the unstable pressure generated by the hand-hold ultrasound probe scanning can cause tissue deformation, especially in soft tissues such as the thyroid. The deformation is manifested as tissue structure being compressed in 2D USI, which results in structural discontinuity in 3D USI. Furthermore, multiple scans apply pressure in different directions to the tissue, which will cause relative displacement between the 3D images obtained from multiple thyroid scans. In this work, we proposed a framework to minimize the influence of the variation of pressure in thyroid 3D USI. To correct pressure artifacts in a single scanning sequence, an adaptive method to smooth the position of the 2D ultrasound (US) image sequence is adopted before performing volumetric reconstruction. To build a whole 3D US image including both sides of the thyroid gland, an iterative closest point (ICP) based registration pipeline is adopted to eliminate the relative displacement caused by different pressure directions. Our proposed method was validated by in vivo experiments, including healthy volunteers and volunteers with thyroid nodules at different grading levels. The thyroid gland and nodule are rendered intelligently in the whole scanning region to facilitate the observation of 3D USI results by the doctor. This work might make a positive contribution to the clinical diagnosis of diseases of the thyroid or other soft tissues. [ABSTRACT FROM AUTHOR]

Mesenchymal tumors may display morphologic and immunohistochemical overlap with melanocytic tumors, presenting a pitfall for misdiagnosis. We report a 62‐year‐old woman who presented with a recurrent dermal and subcutaneous tumor over the Achilles tendon 15 years following complete excision. Both the primary and the recurrent tumors were characterized by nests and sheets of epithelioid and spindle cells with eosinophilic cytoplasm and uniform ovoid nuclei. The tumor was positive for S100, SOX10, HMB45, cathepsin K, and p63 (weak), while negative for Melan‐A, MiTF, smooth muscle actin, and desmin. Gene fusion analysis of the recurrent tumor revealed a NONO::TFE3 fusion which has been recently reported in two similar cutaneous cases. Our case highlights the potential of a NONO::TFE3 cutaneous epithelioid and spindle cell tumor to recur after a prolonged disease‐free interval without evidence of high‐grade transformation or distant metastasis. Our findings support its classification as a cutaneous mesenchymal neoplasm of intermediate malignancy. [ABSTRACT FROM AUTHOR]

Methods of modelling the female torso during physical activity often neglect the position and movement of the breast. This novel investigation compares three female torso modelling approaches that differ in complexity (integrated breast, fixed breast, dynamic breast) to determine the effect on spinal joint moments during running and jumping. The commonly used integrated breast model distributed breast mass within the torso, the fixed breast model attached the mass of the breasts to fixed positions on the anterior of the torso, and a new dynamic breast model enabled relative motion between the breasts and anterior torso. Key findings demonstrated minimal differences in lumbar spine moments (<0.05 Nm/kg; 4%) between integrated breast and fixed breast models but greater differences, up to 0.86 Nm/kg (68%) during running and 0.89 Nm/kg (82%) during jumping, when breast motion was included. Thoracic spine moments revealed similar patterns with minimal differences (<0.05 Nm/kg; 11%) between integrated breast and fixed breast models and greater differences, up to 0.48 Nm/kg (92%) during running and 0.63 Nm/kg (66%) during jumping, with the dynamic breast model. Future female musculoskeletal models should consider including breast mass and motion to avoid mis-representing spinal loading in females during running and jumping. [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]

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]

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]

Objective: To identify the different uses and modalities of digital technologies to diagnose, plan and monitor peri‐implant soft tissue conditions and aesthetics. Methods: A comprehensive narrative review of pertinent literature was conducted, critically appraising key digital technologies that may assist peri‐implant soft tissue augmentation and assessment. An electronic search on four databases including studies published prior to 1st July 2023 was performed and supplemented by a manual search. Results: Predominantly, tools such as cone beam computed tomography (CBCT), intraoral scanning (iOS), intraoral ultrasonography and digital spectrophotometry were commonly to assess and monitor peri‐implant soft tissues. The main clinical and research applications included: (i) initial assessment of mucosal thickness, supra‐crestal tissue height and keratinized mucosa width, (ii) evaluation of peri‐implant soft tissue health and inflammation, (iii) monitoring profilometric changes and midfacial mucosal margin stability over time and (iv) aesthetic evaluation through colour assessment. While evidence for some digital tools may be limited, the integration of digital technologies into peri‐implant soft tissue management holds great promise. These technologies offer improved precision, comfort and speed in assessment, benefiting both patients and clinicians. Conclusion: As digital technologies progress, their full potential in peri‐implant soft tissue augmentation and their value will become more evident with ongoing research. Embracing these innovations and their potential benefits is recommended to ensure that during progress in implant dentistry, patient care is not hindered. [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]

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. [ABSTRACT FROM AUTHOR]

Aims Methods and Results Conclusion Superficial CD34‐positive fibroblastic tumour (SCD34FT) is an uncommon but distinctive low‐grade neoplasm of the skin and subcutis that shows frequent CADM3 expression by immunohistochemistry (IHC). In this study, prompted by an index case resembling ‘atypical fibrous histiocytoma (FH)’ that was positive for CADM3 IHC, we systematically examined a cohort of tumours previously diagnosed as ‘atypical FH’ by applying CADM3 and fluorescence in situ hybridization (FISH) for PRDM10 rearrangement, to investigate the overlap between these tumour types.Forty cases of atypical FH were retrieved, including CD34‐positive tumours (n = 20) and CD34‐negative tumours (n = 20). All tumours were stained for CADM3. All CADM3‐positive tumours were evaluated by FISH to assess for PRDM10 rearrangement. Eleven CD34‐positive tumours (11/20, 55%) coexpressed CADM3 and were reclassified as SCD34FT. None (0/20) of the CD34‐negative atypical FH were CADM3‐positive. Reclassified SCD34FT (10/11) arose on the lower extremity, with frequent involvement of the thigh (n = 8). Features suggestive of atypical FH were observed in many reclassified cases including variable cellularity, spindled morphology, infiltrative tumour margins, collagen entrapment, epidermal hyperpigmentation, and acanthosis. Variably prominent multinucleate giant cells, including Touton‐like forms, were also present. An informative FISH result was obtained in 10/11 reclassified tumours, with 60% (6/10) demonstrating PRDM10 rearrangement.A significant subset of tumours that histologically resemble atypical FH, and are positive for CD34, coexpress CADM3 and harbour PRDM10 rearrangement, supporting their reclassification as SCD34FT. Awareness of this morphologic overlap and the application of CADM3 IHC can aid the distinction between SCD34FT and atypical FH. [ABSTRACT FROM AUTHOR]

3D bioprinting is a promising technology to fabricate custom geometries for tissue engineering. However, most bioprintable hydrogels are weak and fragile, difficult to handle, and cannot mimic the mechanical behaviors of the native soft elastic tissues. A visible light crosslinked, single‐network, elastic, and biocompatible hydrogel system based on an acrylate triblock copolymer of poly(ethylene glycol) PEG and polycaprolactone (PCL) (PEG‐PCL‐DA) is developed. To enable its application in the bioprinting of soft tissues, the hydrogel system is modified on its printability and biodegradability. Furthermore, it is hypothesized that this elastic material can better transmit pulsatile forces to cells, leading to enhanced cellular response under mechanical stimulation. This central hypothesis is tested using vascular conduits with smooth muscle cells (SMCs) cultured under pulsatile forces in a custom‐made bioreactor. The results show that vascular conduits made of PEG‐PCL‐DA hydrogel faithfully recapitulate the rapid stretch and recoil under the pulsatile pressure from 1 to 3 Hz frequency, which induces a contractile SMC phenotype, consistently upregulating the core contractile transcription factors. In summary, this work demonstrates the potential of elastic hydrogel for 3D bioprinting of soft tissues by fine‐tuning the printability, and biodegradability, while possessing robust elastic properties suitable for manual handling and biomechanical stimulation. [ABSTRACT FROM AUTHOR]

Introduction: Soft tissue sarcomas are a group of malignancies that commonly occur in the extremities. As deep lesions may exist within the confines of the muscular fascia, we postulate that local recurrence rates are higher for superficial soft tissue sarcomas managed by the standard of care. Materials and methods: A retrospective review was performed on 90 patients who underwent surgical resection of soft tissue sarcomas of the extremity from 2007 to 2015. Patients with minimum 2-year follow-up and adequate operative, pathologic, and clinical outcomes data were included. Results: Mean age was 54 ± 18 years with 49 (54.4%) patients being male. Lesions in 77.8% of cases were deep, and 22.2% were superficial to fascia. Following the index surgical resection, a total of 33 (36.7%) patients had positive margins. A total of 17 (18.9%) patients had a local recurrence. Overall, 3-year survival was 92.7%, and 5-year survival was 79.0%. Five-year recurrence-free survival of deep sarcomas was 91.1% versus 58.2% of superficial lesions (p = 0.006). Patients with higher tumor depth had lower odds of experiencing a local recurrence (HR 0.26 [95% CI 0.09–0.72]). Local recurence rates was also associated with positive surgical margins on initial resection (33.3% versus 12.3%) (p = 0.027). Conclusions: In this series, superficial tumor depth was associated with local recurrence of soft tissue sarcomas of the extremity following surgical resection. Positive surgical margins was also associated with local recurrence. [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]

Ultrasound (US) is the imaging modality of choice for evaluation of superficial palpable lesions. A large proportion of these lesions have characteristic sonographic appearance and can be confidently diagnosed with US without the need for biopsy or other intervention. The Society of Radiologists in Ultrasound (SRU) recently published a Consensus Conference Statement on superficial soft tissue masses. The goal of this manuscript is (a) to serve as a sonographic pictorial review for palpable lesions based on the SRU statement, (b) present the typical sonographic features of palpable lesions that can be confidently diagnosed with US, and (c) provide an overview of other palpable lesions with a framework to interpret the US studies and advise on appropriate further management. [ABSTRACT FROM AUTHOR]

Musculoskeletal hydatid disease is rare and can be located anywhere but most commonly the bone and muscles of the spine, pelvis, then the lower limbs. Imaging is essential for its diagnosis, performing the pre-therapeutic assessment, guiding possible percutaneous treatments, and providing post-therapeutic follow-up. Musculoskeletal hydatidosis can take several forms that may suggest other infections and tumors or pseudotumors. MRI and CT are superior for its diagnosis but ultrasound and radiography remain the most accessible examinations in developing countries where this parasitosis is endemic. In this review, we provide an overview of this disease and describe its different imaging patterns in soft tissue and bone involvement that should be sought to support the diagnosis. [ABSTRACT FROM AUTHOR]

Objectives: Ecogeographic variation in human nasal anatomy has historically been analyzed on skeletal morphology and interpreted in the context of climatic adaptations to respiratory air‐conditioning. Only a few studies have analyzed nasal soft tissue morphology, actively involved in air‐conditioning physiology. Materials and Methods: We used in vivo computer tomographic scans of (N = 146) adult individuals from Cambodia, Chile, Russia, and Spain. We conducted (N = 438) airflow simulations during inspiration using computational fluid dynamics to analyze the air‐conditioning capacities of the nasal soft tissue in the inflow, functional, and outflow tract, under three different environmental conditions: cold–dry; hot–dry; and hot–humid. We performed statistical comparisons between populations and sexes. Results: Subjects from hot–humid regions showed significantly lower air‐conditioning capacities than subjects from colder regions in all the three conditions, specifically within the isthmus region in the inflow tract, and the anterior part of the internal functional tract. Posterior to the functional tract, no differences were detected. No differences between sexes were found in any of the tracts and under any of the conditions. Discussion: Our statistical analyses support models of climatic adaptations of anterior nasal soft tissue morphology that fit with, and complement, previous research on dry skulls. However, our results challenge a morpho‐functional model that attributes air‐conditioning capacities exclusively to the functional tract located within the nasal cavity. Instead, our findings support studies that have suggested that both, the external nose and the intra‐facial soft tissue airways contribute to efficiently warming and humidifying air during inspiration. This supports functional interpretations in modern midfacial variation and evolution. [ABSTRACT FROM AUTHOR]

Anterior ankle impingement is a frequent cause of chronic ankle pain and swelling. A pathological examination has been reclassified as “anterior ankle impingement syndrome.” Soft tissue impingement is prevalent in the anterolateral compartment of the ankle, while a bony spur often causes impingement in the anteromedial compartment. Although open surgery has yielded good outcomes historically, it is associated with several complications. On the other hand, the development of ankle arthroscopy has reduced these risks significantly and has been used effectively in numerous studies to treat impingements caused by anterior bony spurs or soft tissue. An accurate preoperative clinical diagnosis and diagnostic imaging are critical for surgical planning, particularly for identifying bony spurs in front of the ankle. Narrowing joint space, large bone fragments, and other factors can influence the surgical outcomes. Computed tomography scans precisely evaluate the bony spur size, while magnetic resonance imaging scans help assess soft tissue lesions. Therefore, understanding diagnosis and treatment is important, and an accurate understanding of patient prognostic factors, such as osteoarthritis and degenerative osteoarthritis, eventually affects patient outcomes. This paper discusses the clinical symptoms, causes, diagnosis, surgical method, and postoperative rehabilitation of anteromedial and anterolateral ankle impingement syndrome and reports the results of arthroscopic surgery. [ABSTRACT FROM AUTHOR]

Scaffold-guided breast tissue regeneration (SGBTR) can transform both reconstructive and cosmetic breast surgery. Implant-based surgery is the most common method. However, there are inherent limitations, as it involves replacement of tissue rather than regeneration. Regenerating autologous soft tissue has the potential to provide a more like-for-like reconstruction with minimal morbidity. Our SGBTR approach regenerates soft tissue by implanting additively manufactured bioresorbable scaffolds filled with autologous fat graft. A pre-clinical large animal study was conducted by implanting 100 mL breast scaffolds (n = 55) made from medical-grade polycaprolactone into 11 minipigs for 12 months. Various treatment groups were investigated where immediate or delayed autologous fat graft, as well as platelet rich plasma, were added to the scaffolds. Computed tomography and magnetic resonance imaging were performed on explanted scaffolds to determine the volume and distribution of the regenerated tissue. Histological analysis was performed to confirm the tissue type. At 12 months, we were able to regenerate and sustain a mean soft tissue volume of 60.9 ± 4.5 mL (95% CI) across all treatment groups. There was no evidence of capsule formation. There were no immediate or long-term post-operative complications. In conclusion, we were able to regenerate clinically relevant soft tissue volumes utilizing SGBTR in a pre-clinical large animal model. [ABSTRACT FROM AUTHOR]

Background: The tunnel technique (TUN) preserves the integrity of the papilla by creating envelope flaps that allow for the insertion of a connective tissue graft, and/or biomaterials. Methods: (1) A comprehensive overview of tunneling flap procedures in the treatment of gingival recessions (GRs) for soft tissue coverage is presented and (2) A classification system for soft and hard tissue anatomy of GR sites which may aid the clinician in determining the surgical complexity is being introduced. Results: A novel clinical classification system is proposed to illustrate complexity levels determined by soft and hard tissue anatomy of GR sites such as the mucogingival junction proximity to the gingival margin, bone morphotype, and mucosal margin thickness. Conclusions: TUN is highly effective in treating single/multiple GRs. Its limitations are related to variability in surgical site anatomy and operator expertise. A classification system based on anatomical soft and hard tissue variations has been proposed to help identify complexity levels encountered during tunneling procedures. Key points: Site‐related factors directly impact the surgical variables related to tissue trauma, flap tension, soft tissue management, muscle pull, and wound stability during the healing of gingival recessions (GRs).The achievement of expedited and favorable wound healing is crucial to obtaining quantitative and qualitative success in the treatment of GR and the long‐term stability of root coverage.A classification system based on anatomical soft and hard tissue variations has been proposed to facilitate tunneling procedures while respecting surgical principles. [ABSTRACT FROM AUTHOR]

This case report introduces an innovative approach for tissue regeneration post-total excision of basal cell carcinoma utilizing a xenogeneic collagen matrix coupled with injectable platelet-rich fibrin. The clinical outcome underscores the efficacy and predictability of this protocol in soft tissue regeneration. While further investigation on a larger patient cohort is warranted to fully elucidate its effects and advantages, this technique holds promise in streamlining surgical procedures following excision of extraoral neoplasms. Notably, its simple handling, minimal resource requirements, and potential to mitigate donor site morbidity and patient comorbidities post-surgery signify its value in clinical practice. [ABSTRACT FROM AUTHOR]

Soft tissue is an important operation object in robot-assisted surgery and its mechanical response is of great significance to the precision of surgical operation. Accurate prediction of soft tissue mechanical properties can effectively avoid the potential damage of biological tissue caused by excessive operating force. In this paper, three typical mechanical responses of soft tissue were obtained by no-slip compression experiments of liver tissue. Second, the prediction model of soft tissue mechanical response based on gray prediction was established, and the influence of key parameters of the model on the precision of mechanical response prediction was analyzed. The results show that the gray prediction model can accurately predict the mechanical response of soft tissue, and the prediction accuracy is the highest when the number of historical data is 7. The prediction method of soft tissue mechanical response proposed in this paper will provide important data reference for accurate operation of surgery. [ABSTRACT FROM AUTHOR]

Autotransplanted teeth in the maxillary anterior region should be restored or reshaped as soon as possible for functional and esthetic reasons as well as the well‐being of the patient. However, such tooth restorations are frequently not carried out immediately after tooth transplantation because the process could have a negative impact on the healing process. The development of a simple, immediate, and atraumatic esthetic interim restoration would be of great benefit to both the clinician and patient and address all the concerns caused by immediately preparing the tooth postoperatively and cementing a permanent restoration. This report describes the use of CAD‐CAM technology to create poly (methyl methacrylate) veneers preoperatively that can be cemented extraorally on the extracted donor tooth for the immediate and interim recontouring of autotransplanted anterior teeth. [ABSTRACT FROM AUTHOR]

Background: Angiosarcoma of the adrenal gland is a very rare malignant vascular neoplasm. The clinical symptoms are atypical or completely absent. Angiosarcomas of the adrenal gland are therefore often discovered incidentally, and the diagnosis is made histologically after resection. Case presentation: A 46-year-old white Spanish male who was a previous smoker and nondrinker and was slightly overweight (92 kg, 176 cm, body mass index 29.7 kg/m2) with no relevant medical history presented to the internal medicine emergency department of our hospital with an unclear 12 cm tumor of the right adrenal gland. Prior to the computed tomography scan, he had had persistent evening fevers for 4 months and unintentional weight loss of 5 kg. The laboratory results showed anemia and an elevated C-reactive protein, but no hormone production. We performed an open adrenalectomy of the right adrenal gland. Finally, the histologic findings revealed an angiosarcoma of the adrenal gland. Conclusion: Even though angiosarcomas of the adrenal gland are rare, the differential diagnosis of an angiosarcoma should be considered if a malignant tumor of the adrenal gland is suspected. Treatment decisions should be made on an interdisciplinary basis and preferably in a specialized center. Owing to the rarity of angiosarcomas of the adrenal gland, it is necessary to continue to share clinical experience to gain a better understanding of this particular tumor entity. [ABSTRACT FROM AUTHOR]

Background: Bone-anchored maxillary protraction (BAMP) aims to correct midfacial deficiencies, with proven positive skeletal changes without potential unwanted side effects. However, the influence of BAMP treatment on facial soft tissues, particularly in subjects with complete unilateral cleft lip, alveolus, and palate (CUCLAP), remains unclear. Methods: This single-center longitudinal cohort study examined the effects of 1.5 years of BAMP treatment on facial soft tissues in growing subjects with complete unilateral cleft lip, alveolus, and palate. The sample consisted of 25 patients, age range 9.7 to 12.6 years. Three-dimensional surface models derived from CBCT scans were superimposed on stable structures of the anterior cranial base and on the occipital area posterior of the foramen magnum to assess three-dimensional changes due to growth and BAMP therapy. Results: The results revealed a moderate positive correlation (Pearson's correlation coefficient from 0.203 to 0.560) between changes in hard tissue and soft tissue; some correlations were found to be weak (<0.300). Linear changes in soft tissue following BAMP were in the same direction as skeletal changes, showing downward, forward, and outward displacement. The only exception was in the vertical dimension. The lower facial third showed a slight but significant reduction, mainly in lip length (−1.2 mm), whereas the middle facial third showed a small increase (1.1 mm). Conclusions: It was concluded that during BAMP, soft tissue changes occur in the same direction as skeletal changes, although with a larger variability and less pronounced effects. [ABSTRACT FROM AUTHOR]

Simple Summary: Radiation-associated sarcomas pose a significant clinical challenge due to their complexity, aggressiveness, and poor prognosis. Our retrospective study is one of the largest descriptions of radiation-associated sarcomas, aiming to shed light on their clinicopathologic characteristics and highlight treatment approaches. Our research found a significant association between high radiation-associated sarcoma histologic grade and inferior clinical outcomes. We also found that localized radiation-associated sarcoma patients who underwent margin-negative resections lived significantly longer than their counterparts. Our analysis thus confirms the paramount role of tumor grade and the central importance of margin-negative oncologic resection in determining clinical outcomes for radiation-associated sarcomas. Radiation-associated sarcomas (RASs) are rare tumors with limited contemporary data to inform prognostication and management. We sought to identify the clinical presentation, patterns of care, and prognostic factors of RASs. RAS patients treated at a single institution from 2015 to 2021 were retrospectively reviewed for clinicopathologic variables, treatment strategies, and outcomes. Thirty-eight patients were identified with a median follow-up of 30.5 months. The median age at RAS diagnosis was 68.4 years (27.9–85.4), with a median latency from index radiotherapy (RT) of 9.1 years (3.7–46.3). RAS histologies included angiosarcoma (26%), undifferentiated pleomorphic sarcoma (21%), and osteosarcoma (18%). Most were high-grade (76%). Genomic profiling revealed low tumor mutational burden, frequent inactivating TP53 mutations (44%), CDKN2A deletions (26%), and MYC amplifications (22%), particularly in breast angiosarcomas. Of 38 patients, 33 presented with localized disease, 26 of whom were treated with curative intent. Overall, the median progression-free survival (PFS) was 9.5 months (1.4–34.7), and the overall survival (OS) was 11.1 months (0.6–31.6). Patients with localized vs. metastatic RASs had a longer PFS (HR, 3.0 [1.1–8.5]; p = 0.03) and OS (HR, 3.0 [1.04–8.68]; p = 0.03). Among localized RAS patients, high grade was associated with shorter OS (HR, 4.6 [1.04–20.30]; p = 0.03) and resection with longer OS (mean 58.8 vs. 6.1 months, HR, 0.1 [0.03–0.28]; p < 0.001). Among patients undergoing resection, negative margins were associated with improved OS (mean 71.0 vs. 15.5 months, HR, 5.1 [1.4–18.2]; p = 0.006). Patients with localized disease, particularly those undergoing R0 resection, demonstrated significantly better outcomes. Novel strategies are urgently needed to improve treatment outcomes in this challenging group of diseases. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the upper incisors (U1), lower incisors (L1), and soft tissue profiles of bimaxillary protrusion (BM) adult patients among skeletal Class I (BM1), II (BM2) and III (BM3). Understanding these characteristics would be useful for incisor and lip diagnostics in different skeletal classifications. Fourteen linear and twelve angular variables of the incisors and lips were evaluated in 214 lateral cephalograms (BM1 = 91, BM2 = 84, BM3 = 39). ANOVA and Bonferroni tests compared the measurements. BM1 and BM3 exhibited a greater U1 position and U1 inclination than the norms, while BM2 presented only a greater U1 position than the norms but normal U1 inclination. BM1 and BM3 had a significantly greater U1 position than BM2. BM1 and BM2 demonstrated a greater L1 position and L1 inclination than the norms, whereas BM3 displayed only a greater L1 position than the norms but normal L1 inclination. BM2 had the most anterior L1 position, whereas BM3 had the least anterior position. Only BM2 had a longer anterior dental height (ADH) than the norms, while BM1 and BM3 had a normal ADH and the significantly shortest ADH, respectively. Only BM1 had a normal upper incisor display at rest (U1R), while BM2 and BM3 displayed an increased and decreased U1R, respectively, with significant differences among the three groups. The most significantly protruded upper and lower lips were presented in BM2, but these were exhibited the least in BM3. The most significant acute nasolabial angle (NLA) was found in BM3, whereas BM2 presented the least acute NLA. A normal lip–chin–throat angle (LCTA) was observed in BM1 and BM3, while only BM2 had a greater LCTA than the norms. The most significant obtuse LCTA was found in BM2, while BM3 had the least obtuse LCTA. Therefore, both U1 and L1 in all groups presented protrusion and proclination, except for U1 in BM2, while L1 in BM3 exhibited normal inclination. The ADH and U1R were increased in BM2 but decreased in BM3. The most acute NLA was found in BM3, whereas the least acute was found in BM2. The most obtuse LCTA was in BM2, while the least was in BM3. [ABSTRACT FROM AUTHOR]

In this paper, a sliding mode control method based on improved intelligent decision (IID-SMC) algorithm is proposed to improve the accuracy of the puncture needle to reach the target and reduce the time required in the puncture process. First of all, around the straight line of the puncture needle and the direction of the rotation of the needle, the independent control law is designed to realise the mutual decoupling and reduce the mutual interference. Secondly, the error range of this method in the process of puncture is analysed, and the upper bound of the error in the process of puncture is given. Finally, the method is verified by simulation and experiment platform. [ABSTRACT FROM AUTHOR]

Herein, state‐of‐the‐art multiscale modeling methods have been described. This research includes notable molecular, micro‐, meso‐, and macroscale models for hard (polymer, metal, yarn, fiber, fiber‐reinforced polymer, and polymer matrix composites) and soft (biological tissues such as brain white matter [BWM]) composite materials. These numerical models vary from molecular dynamics simulations to finite‐element (FE) analyses and machine learning/deep learning surrogate models. Constitutive material models are summarized, such as viscoelastic hyperelastic, and emerging models like fractional viscoelastic. Key challenges such as meshing, data variability and material nonlinearity‐driven uncertainty, limitations in terms of computational resources availability, model fidelity, and repeatability are outlined with state‐of‐the‐art models. Latest advancements in FE modeling involving meshless methods, hybrid ML and FE models, and nonlinear constitutive material (linear and nonlinear) models aim to provide readers with a clear outlook on futuristic trends in composite multiscale modeling research and development. The data‐driven models presented here are of varying length and time scales, developed using advanced mathematical, numerical, and huge volumes of experimental results as data for digital models. An in‐depth discussion on data‐driven models would provide researchers with the necessary tools to build real‐time composite structure monitoring and lifecycle prediction models. [ABSTRACT FROM AUTHOR]

Soft tissue injuries are common in the military, generally producing simple hematomas without the need for intensive evaluation and management. In certain situations, a shearing effect between fascial planes whereby a disruption of the vasculature and lymphatic systems creates a "closed degloving injury" is more generally referred to as a Morel-Lavallée Lesion (MLL). With a consistent pool of blood, lymph, and pieces of soft tissue, an M7LL can cause significant poor cosmesis, chronic pain, and risk secondary infection if left undetected and untreated. Proper diagnosis can be made through the effective use of ultrasound and, if detected early enough, through conservative measures to include needle aspiration and compression sleeves. Prior cases describe chronic MLLs existing for extended periods of time, in some cases years, requiring operative intervention, and in some cases poor outcomes. We present two cases of active duty soldiers presenting with seemingly innocuous injuries found on closer evaluation to have MLL, treated in one case with needle aspiration and compression, in the other with operative management. [ABSTRACT FROM AUTHOR]

Giant cell-rich lesions of bone represent a heterogeneous group of entities which classically include giant cell tumor of bone, aneurysmal bone cyst, nonossifying fibroma, and Brown tumor of hyperparathyroidism. A recently described subset of giant cell-rich tumors involving bone and soft tissue has been characterized by recurrent HMGA2::NCOR2 fusions and keratin expression. The overlapping clinical, radiographic, and morphological features of these giant cell-rich lesions provide a unique diagnostic challenge, particularly on biopsy. We present 2 additional cases of keratin-positive giant cell-rich tumor of bone with HMGA2::NCOR2 fusions, including 1 patient who developed metastatic disease. [ABSTRACT FROM AUTHOR]

Sport injuries, including the anterior crucial ligament rupture (ACLR) seem to be related to complex genetic backgrounds, including the genes responsible for inflammatory response. This review and meta-analysis investigated the contribution of the polymorphisms of genes encoding inflammatory cytokines and their receptors to the risk of ACLR. The scientific databases Science Direct, EBSCO host, Scopus, PubMed, and Google Scholar were screened (completed on 14 June 2023) according to the established inclusion/exclusion criteria (only fully accessible, original, human case–control studies written in English concerning the effect of interleukin genes' polymorphisms on the occurrence of ACL injury were included) and statistical meta-analysis using R version 4.0.3 was performed. The PRISMA methodology was used to review articles. The review protocol was registered under the number CRD42024514316 in the Prospero database. Eighty-nine studies were identified and narrowed down to three original case–control studies used for the meta-analysis. The studies analyzed Polish, South African, and Swedish cohorts, altogether 1282 participants. The candidate polymorphisms indicated in the studies involved IL6 rs1800795, IL6R rs2228145 and IL1B rs16944. The systematic review showed the relationships between IL6 rs1800795 polymorphism and ACLR in the Polish subpopulation, and IL6R rs2228145 and IL1B rs16944 in the South African subpopulations. The meta-analysis revealed that the IL6 rs1800795 CG genotype was over-represented (OR = 1.30, 95% CI 1.02–1.66), while the CC genotype was under-represented (OR = 0.75, 95% CI 0.54–1.03) in ACLR subjects, but no significant impact of IL6R rs2228145 was shown. Additionally, a tendency of the IL1B rs16944 CT genotype to be protective (OR 0.89, 95% CI 0.70–1.14), while the TT to be a risk genotype (OR 1.19, 95% CI 0.84–1.68) was observed. Thus, the relationship between the interleukin receptor IL6R rs2228145 and ACLR risk was not confirmed. However, the impact of genes coding pleiotropic IL6 rs1800795 on the incidences of ACLR was clear and the effect of pro-inflammatory IL1B rs16944 was possible. [ABSTRACT FROM AUTHOR]

Case: A 40-year-old man was evaluated for a painful mass on his right calf, and a 36-year-old woman presented with a painless mass on her right foot. Final pathology revealed marked nuclear atypia and positivity for S100/SOX10 and AE1/AE3 confirming diagnoses of myoepithelial carcinoma. Both patients underwent surgical resection and are without evidence of local recurrence or metastatic disease at 1-year follow-up. Conclusion: Soft-tissue tumors presenting in the extremities warrant careful evaluation and timely histopathologic diagnosis. Myoepithelial carcinomas are rare, aggressive tumors with a propensity for local recurrence and metastasis. Treatment of these tumors should be discussed by a multidisciplinary tumor team. [ABSTRACT FROM AUTHOR]

Objective: Increasing aesthetic demands require that the color and contour of the peri‐implant soft tissues be in harmony with the neighboring teeth. Recession, migration toward the apical, is a frequent clinical finding. Its presence can lead to inflammation and increased marginal bone loss. These complications, in addition to affecting the aesthetic results of our treatment, are difficult to treat and can threaten the survival of the implant. There are fewer studies showing the outcome of treatment of soft‐tissue defects around implants. The aim of this article is to describe the treatment of a soft‐tissue defect around an implant‐supported prosthesis treatment, performed on two neighboring implants, in the esthetic zone in a patient with a high smile and to evaluate both the coverage achieved and the patient's esthetic satisfaction. Clinical Considerations: This study showed that a mucogingival approach, using a surgical technique designed for the treatment of alveolar ridge defects, together with tissue management with temporaries and a new restoration, achieved an optimal result. Conclusions: The case has been closely followed up, for 10 years, and the authors have been able to confirm the long‐term stability of the result. Clinical Significance: The following paper shows the result of an innovative approach. Connective tissue platform technique, usually performed for soft‐tissue augmentation, was used for a defect in soft‐tissue dehiscence. The authors followed the results for 10 years, and the results achieved were satisfactory in terms of esthetic. [ABSTRACT FROM AUTHOR]

Non-rhabdomyosarcoma soft-tissue sarcoma ("RMS-like" and "non-RMS-like" tumours-NRSTS) of childhood is a highly heterogeneous group of tumours. Within the subgroup of undifferentiated sarcomas (UDS), new entities have been described based on molecular markers found through increasingly available genetic analysis in the new 2020 classification of the World Health Organization (WHO). In recent years, the importance of genetic analysis and the detection of molecular tumour markers has been growing due to the possibility of targeted therapy application and the determination of prognosis or disease course. We will present two patients with soft tissue sarcoma and neurotrophic tyrosine receptor kinase (NTRK) gene rearrangement, focusing on excellent therapeutic response to NTRK inhibitor targeted therapy with good drug tolerance. [ABSTRACT FROM AUTHOR]

We report the case of a 34-year-old female who was evaluated for a right lower extremity soft-tissue mass, found to be a large cystic lesion bound by fibrous tissue containing innumerable, freely mobile nodules of fat. Her presentation suggested the diagnosis of nodular cystic fat necrosis (NCFN), a rare entity that likely represents a morphological subset of fat necrosis potentially caused by vascular insufficiency secondary to local trauma. Her lesion was best visualized using MRI, which revealed characteristic imaging features of NCFN including nodular lipid-signal foci that suppress on fat-saturated sequences, intralesional fluid with high signal intensity on T2-weighted imaging, and a contrast-enhancing outer capsule with low signal intensity on T1-weighted imaging. Ultrasound imaging offered the advantage of showing mobile hyperechogenic foci within the anechoic cystic structure, and the lesion was otherwise visualized on radiography as a nonspecific soft-tissue radiopacity. She was managed with complete surgical excision with pathologic evaluation demonstrating, similar to the radiologic features, innumerable free-floating, 1–5 mm, smooth, nearly uniform spherical nodules of mature fat with widespread necrosis contained within a thick fibrous pseudocapsule. Follow-up imaging revealed no evidence of remaining or recurrent disease on postoperative follow-up MRI. The differential diagnosis includes lipoma with fat necrosis, lipoma variant, atypical lipomatous tumor, and a Morel-Lavallée lesion. There is overlap in the imaging features between fat necrosis and both benign and malignant adipocytic tumors, occasionally making this distinction based solely on imaging findings challenging. To our knowledge, this is the largest example of NCFN ever reported. [ABSTRACT FROM AUTHOR]

Low-grade fibromyxoid sarcoma is a rare mesenchymal neoplasm with distinctive histopathological features. Although it typically arises in the deep soft tissues of the trunk and extremities, its occurrence in the head and neck region is exceedingly rare. We present the first documented case of low-grade fibromyxoid sarcoma in the laryngopharynx, expanding the spectrum of this rare tumor's anatomical localization. The clinical, radiological, and histopathological features of this unique case are discussed, highlighting the diagnostic challenges and therapeutic considerations associated with this uncommon presentation. [ABSTRACT FROM AUTHOR]

Objectives: Patellar instability is one of the most common pathologies in children and adolescents. The objective of this study is to present the functional and diagnostic results after performing modified Roux-Goldthwait procedure for habitual patellar dislocation in pediatric population. Materials & methods: A retrospective analysis was performed on 17 patients, under the age of 18 years, from September 2007 to March 2023. For diagnostic results were evaluated congruence angle, sulcus angle and Caton-Deschamps index. Functional results were evaluated by modified Lysholm score and Cox grading system. Results: Excellent and good results were reported for 82%, fair and poor results for 18%. No statistical significance was reported on the topic of congruence angle and sulcus angle. Conclusions: Modified Roux-Goldthwait procedure for habitual patellar dislocation in pediatric population is safe and effective as it is entirely soft tissue operation that leaves the growth plate intact. [ABSTRACT FROM AUTHOR]

Aim To investigate whether the use of ion resonance and bromelain- vitamin C or bromelain-vitamin C is the best to prevent ankle complications in post operative bimalleolar surgery. Methods A total of 61 patients treated with bimalleolar surgery were enrolled. The patients were divided into three groups: the first group (n=22) treated only with the surgery, the second group (n=18) treated by ion resonance and bromelain-vitamin C, and the third group (n=21) was treated with bromelain-vitamin C. All patients in the second and third group underwent adjuvant therapy for 50 days. The criteria to evaluate the three groups during the clinical and radiological follow-up were as follows: complications and soft tissue status. Bone healing measured by the Radiographic Union Score Ankle (RUSA), and functional results were evaluated according to the American Foot & Ankle Score (AFAS). Results In the first group nine (out of 22; 40.90%) patients developed complications, in the second group three (out of 18; 16.67%) and in the third group seven (out of 21; 33.33%) presented complications. There is no statistical difference between the three groups regarding the type of fractures, mean age, gender ratio. The worst radiographic and stiffness results in the first group were found (p=0.006). The second group showed better bone healing (p=0.049), better performance in functional recovery measured by AFAS (p=0.039). Conclusion Ion resonance and bromelain-vitamin C group showed better outcomes to improve the functional outcome; it allows reduction of complications, consequently, an early return to quality life, and a corresponding improvement of the quality of life. [ABSTRACT FROM AUTHOR]

Introduction: Prosthodontic rehabilitation after reconstruction with microvascular revascularized free flaps following ablative tumor surgery is challenging due to the altered anatomical and functional conditions. The aim of this retrospective study was to determine whether the type of graft and the type of peri‐implant tissue have an effect on peri‐implant inflammatory parameters and implant survival. Materials and Methods: Patients who received a free flap reconstruction with subsequent implant‐prosthetic rehabilitation between 2010 and 2022 were retrospectively included. The primary outcome variable was the probing depth (PPD) at a minimum of 1 year after completion of prosthetic restoration. Predictive variables were type of free flap, emergence profile, and history of radiation. Results: Seventy‐one patients after free flap reconstruction were included in the analysis. At a minimum of 24 months after implant insertion the primary outcome, PPD showed no clinically relevant differences between the types of free flaps used. The emergence profile through a skin island resulted in an increase in BOP compared to native mucosa in the descriptive analysis (p‐value >.05). The analysis showed a 5‐year implant survival of 96.2% (95% CI: 0.929–0.996) in cases without irradiation and 87.6% (95% CI: 0.810–0.948) with irradiation of the region evaluated (p‐value.034). Conclusion: Flap and associated soft tissue type had no significant effect on 5‐year implant survival or peri‐implant inflammatory parameters. However, the large heterogeneity of the patient population indicates that further prolonged studies are required for a more differentiated assessment of the long‐term success. [ABSTRACT FROM AUTHOR]

A 50-year-old man presented for evaluation of a periscapular mass. Biopsy suggested a low-grade chondrosarcoma; however, the resected specimen revealed a grade 2 chondrosarcoma with a low-grade dedifferentiated mesenchymal component. The mass multiply recurred as chondrosarcoma without a dedifferentiated component before the patient developed lung metastases of chondrosarcoma without a dedifferentiated component 11 years after the initial diagnosis and died of disease. This is one of the first reported cases of a dedifferentiated chondrosarcoma with low-grade dedifferentiated component. While overall prognosis may be better than in typical dedifferentiated chondrosarcoma, this tumor demonstrated numerous local recurrences as well as metastasis. [ABSTRACT FROM AUTHOR]

Objectives Lefamulin is a pleuromutilin antibiotic approved for the treatment of community-acquired bacterial pneumonia (CABP). Its spectrum of activity, good penetration into soft tissues and low rates of cross-resistance also make lefamulin a potentially valuable option for treatment of acute bacterial skin and skin structure infections (ABSSSIs). A Phase 2 trial of lefamulin for ABSSSI indicated similar efficacy of 100 and 150 mg q12h IV dosing regimens. In the present study, the potential of lefamulin for this indication was further evaluated from a translational pharmacokinetic/pharmacodynamic perspective. Methods PTA was determined for various dosages using Monte Carlo simulations of a population pharmacokinetic model of lefamulin in ABSSSI patients and preclinical exposure targets associated with bacteriostasis and a 1-log reduction in bacterial count. Overall target attainment against MSSA and MRSA was calculated using lefamulin MIC distributions. Results Overall attainment of the bacteriostasis target was 94% against MSSA and 84% against MRSA for the IV dosage approved for CABP (150 mg q12h). Using the same target, for the 100 mg q12h regimen, overall target attainment dropped to 68% against MSSA and 50% against MRSA. Using the 1-log reduction target, overall target attainment for both regimens was <40%. Conclusions Lefamulin at the currently approved IV dosage covers most Staphylococcus aureus isolates when targeting drug exposure associated with bacteriostasis, suggesting potential of lefamulin for the treatment of ABSSSIs. Lefamulin may not be appropriate in ABSSSI when rapid bactericidal activity is warranted. [ABSTRACT FROM AUTHOR]

Background Fine needle aspiration cytology is a simple, inexpensive method for obtaining a tissue diagnosis of disease site. FNAC has become a well-established diagnostic component in the medical field. It has become an accepted technique for the preoperative diagnosis of palpable and radiographically detected lesions at a wide variety of body sites. The technique is relatively painless, produces a speedy result and is inexpensive. In experienced hands its accuracy can approach that of histopathology in arriving at a definite diagnosis. Method The present retrospective study included total number of 768 fine needle aspiration cytology cases which came to Cytology section of Department of Pathology, Chhattisgarh Institute of Medical Sciences. The patients were clinically evaluated and underwent routine hematological, biochemical and radiological investigations. After performing the fine needle aspiration, the smears were stained with May-Grünwald-Giemsa (MGG), hematoxylin and eosin (H and E) and papanicolau (Pap) stains. No major complications like penetration into the trachea, laryngeal nerve palsy, or hematoma were recorded. Only slight pain was reported by some patients. Results In our study we have included a total number of 768 cases. A broad classification included cases from Soft tissue lesions (217 cases), lymph node (184 cases), Breast (149 cases), Thyroid (137 cases), Salivary gland (56 cases) and Neck lesions(25 cases). The most common soft tissue lesion was lipoma (72 cases). Cystic/infective lesions were the second most common ones. In lymph nodes maximum cases were of reactive lymphadenitis (53 cases) followed by tubercular lymphadenitis (57 cases). In 149 breast fine needle aspiration cytology we had 75 benign cases, 16 Atypical ductal hyperplasia and 58 malignant cases. FNA of thyroidal lesions yielded Benign colloid nodule (30 cases), Nodular goitre (24 cases) and Autoimmune thyroiditis (36 cases). In malignant lesions of thyroid, we found Follicular carcinoma (9 cases), Follicular variant of papillary carcinoma (14 cases), Papillary carcinoma (16 cases), Medullary carcinoma (5 cases) and Anaplastic carcinoma (3 cases). In salivary gland lesions benign cases included Chronic sialadenitis (16 cases), Pleomorphic adenoma (9 cases), Mucinous cyst (8 cases), Granulomatous sialadenitis (3 cases), Sialadenosis (5 cases) and Warthin's tumor (3cases). Malignant cases were of Acinic cell carcinoma (4 cases), Mucoepidermoid carcinoma (3 cases), Squamous cell carcinoma (3 cases) and Adenocarcinoma NOS (2 cases). Other lesion in neck included Thyroglossal cyst (14 cases), Branchial cyst (9 cases) and lymphangioma (2 cases). Conclusion This study emphasizes the use of fine needle aspiration cytology as a first line diagnostic procedure for the investigation of lumps or masses. It is a relatively painless, inexpensive and easily accessible procedure for the patients. It readily generates the report and gives an insight into the nature of the lesion prior to the surgery. However, it has its limitations. Definitive treatment such as surgery is carried out only after histological confirmation of cytological findings. [ABSTRACT FROM AUTHOR]

A tough gel composed of atelocollagen, which lacks an immunogenetic site, is a promising material for biomedical application. In this study, we created a composite hydrogel composed of atelocollagen gel cross-linked with glutaraldehyde (GA) and poly-(N,N-dimethylacrylamide) gel exhibiting biocompatibility based on the double-network (DN) gel principle. The tensile toughness of atelocollagen gel remained constant regardless of the amount of cross-linker (GA) used. In contrast, tensile tests of the DN gel indicated that mechanical properties, such as fracture stress and toughness, were significantly higher than those of the atelocollagen gel. Moreover, fibroblast cells adhered and spread on the gels, the Schiff bases of which were treated via reductive amination for detoxification from GA. These findings demonstrate the potential of the proposed gel materials as artificial alternative materials to soft tissues with sub-MPa fracture stress. [ABSTRACT FROM AUTHOR]

Elastomers and composites made thereof have wide applications, e.g., in automobile, aerospace, and civil engineering. Predicting fracture in such materials is crucial for efficient design and optimum utilization. These materials are oftentimes hyperelastic and anisotropic in nature and in general subjected to mixed mode loading rather than merely pure modes. Soft biological tissues can also be considered anisotropic hyperelastic materials. Computational modeling helps in studying the role of different sources influencing mixed-mode fracture. A unifying thermodynamically consistent anisotropic phase field formulation for modeling the mixed-mode fracture of hyperelastic soft materials like elastomers, elastomeric fiber-reinforced composites, and soft biological tissues at finite strains is proposed and formulated. To model the mechanical response of anisotropic hyperelastic materials subjected to mixed-mode loading, a coupled Neo-Hookean model with orthotropic anisotropy is adopted considering volumetric-deviatoric and a tension-compression decomposition. For modeling the complex crack initiation and propagation, a phase field method based on a power law criterion is adopted by considering a single order parameter as the damage variable. This model is suitable for capturing the overall response of soft fiber-reinforced elastomeric composites as well as soft biological tissues. The proposed model is validated by conducting fracture tests on (a) silicone elastomers, (b) unidirectional fiber-reinforced elastomeric composites, (c) natural rubber reinforced with black carbon, and (d) brain tissue reinforced with axons. The results obtained are compared with experimental and numerical investigations from literature. [ABSTRACT FROM AUTHOR]

Aim: This study aims to determine the prevalence of calcified atherosclerotic plaques (CAPs) incidentally encountered in the carotid artery within panoramic radiography (PR) images. Materials and Methods: A total of 1,200 patients (646 females, 554 males) referred to our clinic in January 2022 and January 2023 was included. CAPs within PRs were assessed, with data stratified by gender, age, and systemic conditions. Statistical analysis employed descriptive statistics and chi-square tests (p<0.05). Results: Among the 1200 patients, 251 CAPs (20.92%) were detected, with 128 (50.1%) occurring in females and 123 (49.9%) in males. The gender-based analysis demonstrated no statistically significant disparity in CAPs occurrence. Conversely, a statistically significant difference was detecdet in the frequency of CAPs between age groups and systemic conditions (p<0.05). Conclusion: Panoramic radiography, routinely used in dental practice, offers a costeffective, low-radiation means for preliminary CAPs assessment. Dental practitioners should consider referring patients with identified CAPs in PRs to cardiology departments, potentially reducing stroke risks. [ABSTRACT FROM AUTHOR]

These days, laser systems and their use in oral surgery and dentistry are developing quickly. Diode lasers operating in continuous or pulsed modes with wavelengths between 810 and 980 nm are considered as a potential soft tissue surgery modality in the oral cavity. An 8-month-old baby girl with Ullrich muscular dystrophy was referred to the pediatric surgery service of our hospital for therapeutic management. The child had a global developmental disorder and growth failure, and the clinical examination of the oral cavity revealed marked, bimaxillary, bilateral gingival hyperplasia at the canine-molar level. In order to improve the weight curve by facilitating age-appropriate nutrition, we considered the surgical excision of the hyperplastic gingival tissue necessary. Since the hematological parameters were at the lower limit of normal, we decided that the minimally traumatic method was the laser intervention. Ten days after the laser intervention, the gum had a normal appearance both in terms of volume and coloration, the canines and first temporary molars were fully exposed and functional, allowing the feeding of semi-solid and, with caution, even solid foods. Lasers are now more appealing in pedodontic applications (including pediatric surgery) due to recent advancements in technology, as they can be utilized as an addition to or substitute for conventional methods. Keywords: di [ABSTRACT FROM AUTHOR]