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ABSTRACT: Subcutaneous metastasis in the operative route after intracranial meningioma resection is extremely rare. Here we describe the case of a 69-year-old male who was operated on in our department for a convexity meningioma that spread a few years after surgery in the soft tissues next to the craniotomy site. Twenty-one other cases have been found in the medical literature. In this article, we discuss mechanisms of growth, presentation and management of subcutaneous meningiomas. [ABSTRACT FROM AUTHOR]

Opinion statement: The therapeutic approach of pleomorphic liposarcoma (PLPS), a rare high-grade subgroup of soft tissue sarcoma, is commonly extrapolated from the management of other LPS subtypes. Only published retrospective data on PLPS currently serve as a guide for oncologists without clear recommendations or specific guidelines. In the advanced setting, specific systemic therapy such as eribulin and trabectedin showed promising activity in comparison to conventional therapy (doxorubicin- and gemcitabine-based protocols), which currently remains the current standard of care at initial stages of the disease. The better understanding of soft tissue sarcoma (STS) pathophysiology and disease course has led to the development of adapted clinical trial designs for rare STS histotypes with specific treatment approach. [ABSTRACT FROM AUTHOR]

Micronutrients, or essential trace elements, are important components in various metabolic processes inherent to the normal functioning of organism. To date, a substantial part of the world population suffers from a lack of micronutrients in the diet. Mussels are an important and cheap source of nutrients, which can be utilized to mitigate the micronutrient deficiency in the world. In the present work, using inductively coupled plasma mass spectrometry, the contents of the micronutrients Cr, Fe, Cu, Zn, Se, I, and Mo were studied for the first time in soft tissues, shell liquor, and byssus of females and males of the mussel Mytilus galloprovincialis as the promising sources of essential elements in the human diet. Fe, Zn, and I were the most abundant micronutrients in the three body parts. Significant sex-related differences in the body parts were detected only for Fe, which was more abundant in byssus of males, and Zn, which exhibited higher levels in shell liquor of females. Significant tissue-related differences were registered in the contents of all the elements under study. M. galloprovincialis meat was characterized as the optimal source of I and Se for covering the daily human needs. Regardless of sex, byssus turned out to be richer in Fe, I, Cu, Cr, and Mo in comparison with soft tissues, which fact allows recommending this body part for the preparation of dietary supplements to compensate for the deficiency of these micronutrients in the human body. [ABSTRACT FROM AUTHOR]

Introduction: The horizontal position of upper and lower lips has been of great concern when planning a treatment plan of an orthodontic patient, because the purpose of orthodontic treatment is to establish both an aesthetic facial profile and a functional occlusion. Objectives: To determine differences in anteroposterior lip position in different skeletal malocclusions in district Solan population and to compare these values with those of Sudanese population. Materials and Method: Pre-treatment lateral cephalogram of 114 subjects were taken in natural head position. The subjects were then divided into 3 groups on the basis of ANB angle. 5 reference lines (Steiner, Burstone, Sushner, Holdway, and Ricketts) were traced and their linear distance w.r.t upper and lower lips were measured for all the 3 groups. Then the results were compared to the distance of upper and lower lips from S1, B and E line in the Sudanese population in the 3 different skeletal malocclusion groups. Results: Skeletal class II was found to have the more protrusive lips and differed significantly from Class III. The distance of these lines showed variance in the Solan population and Sudanese population. Conclusion: The sagittal lip position was associated with the pattern of skeletal occlusion. [ABSTRACT FROM AUTHOR]

Introduction: Lumbar puncture is an important medical procedure for various diagnostics and therapies, but it can be hazardous due to individual variances in subcutaneous soft tissue, especially in the elderly and obese. Our research describes a novel robot-assisted puncture system that automatically controls and maintains the probe at the target tissue layer through a process of tissue recognition. Methods: The system comprises a robotic system and a master computer. The robotic system is constructed based on a probe consisting of a pair of concentric electrodes. From the probe, impedance spectroscopy measures bio-impedance signals and transforms them into spectra that are communicated to the master computer. The master computer uses a Bayesian neural network to classify the bio-impedance spectra as corresponding to different soft tissues. By feeding the bio-impedance spectra of unknown tissues into the Bayesian neural network, we can determine their categories. Based on the recognition results, the master computer controls the motion of the robotic system. Results: The proposed system is demonstrated on a realistic phantom made of ex vivo tissues to simulate the spinal environment. The findings indicate that the technology has the potential to increase the precision and security of lumbar punctures and associated procedures. Discussion: In addition to lumbar puncture, the robotic system is suitable for related puncture operations such as discography, radiofrequency ablation, facet joint injection, and epidural steroid injection, as long as the required tissue recognition features are available. These operations can only be carried out once the puncture needle and additional instruments reach the target tissue layer, despite their ensuing processes being distinct. [ABSTRACT FROM AUTHOR]

Objective: The gold standard for a soft tissue augmentation around implants is a subepithelial connective tissue graft (CTG), but the xenogeneic collagen matrices (XCM) started to be used as an alternative. This systematic review aimed to assess the effectiveness XCM in comparison to CTG for the increasing the thickness of the soft tissue around implants. Data: All studies included at least two parallel groups comparing the use of CTG and XCM with a minimum follow-up of 3 months. As the primary outcome, the amount of soft tissue thickness gain after soft tissue augmentation with XCM or CTG was assessed. Secondary outcomes were clinical and patient-related outcomes; evaluation of aesthetic outcomes, patient-reported outcomes measures (PROMs) and complications. Eligible studies were selected based on the inclusion criteria. Meta-analysis was applied whenever possible. The quality of the evidence of studies including in meta-analysis was assessed using the GRADE approach. Source: A systematic literature search up to January 2022 was conducted using the following electronic databases: PubMed (MEDLINE), Scopus, Cochrane Library, LILACS, eLIBRARY.RU. Unpublished researches, the gray literature, nonprofit reports, government studies and other materials were reviewed electronically using an EASY search. An additional manual search was carried out in November 2022. Study selection: Of the 1376 articles from the initial search, 8 randomized controlled trials (RCTs) (306 patients and 325 implants) were included in this systematic review, and 7 studies were part of the meta-analysis. Meta-analysis revealed that XCM is less effective than the CTG in increasing soft tissue thickness around dental implants. However, XCM also provides soft tissue thickness gain and can be recommended for use in various clinical situations. Clinical significance: Previous systematic reviews and meta-analyses have shown that autologous grafts are more effective than collagen matrices in increasing soft tissue thickness, however, the latter can be used as an alternative. Studies included in previous systematic reviews varied in design, which could lead to limitations. The present systematic review and meta-analysis includes for the first time only randomized controlled clinical trials with collagen matrix of xenogeneic origin in the test group. Tight eligibility criteria were established, and the main parameter studied was soft tissue thickness. It was found that xenogeneic collagen matrix is effective for increasing soft tissue thickness around dental implants, however, the results obtained using an autogenous connective tissue graft are superior. [ABSTRACT FROM AUTHOR]

Objective: To describe the clinical use of nitride‐coated titanium CAD/CAM implant abutments in the maxillary esthetic zone in two patients with high esthetic and functional demands and, to highlight the advantages of nitride‐coated milled titanium abutments when compared to stock/custom titanium, one‐piece monolithic zirconia, and hybrid metal‐zirconia implant abutments. Clinical Considerations: Due to the inherent mechanical and esthetic clinical challenges, single implant‐supported reconstructions in the maxillary esthetic zone are a complex restorative treatment. While CAD/CAM technology has been suggested to enhance and ease implant abutment design and manufacturing, implant abutment material selection remains as a critical decision affecting restoration's long‐term clinical outcomes. To date, considering the esthetic disadvantages of conventional titanium implant abutments, the mechanical limitations of one‐piece zirconia abutments and the manufacturing time and costs associated with hybrid metal‐zirconia abutments, no abutment material can be considered "ideal" for all clinical scenarios. Due to their biocompatibility, biomechanical characteristics (hardness and wear resistance), optical properties (yellow color), and peri‐implant soft tissue esthetic integration, the use of CAD/CAM titanium nitride‐coated implant abutments has been suggested as a predictable implant abutment material in mechanically challenging but esthetically demanding clinical situations, as the maxillary esthetic zone. Conclusions: Two patients requiring a combined tooth‐implant restorative treatment in the maxillary esthetic zone were treated using CAD/CAM nitride coated titanium implant abutments. The principal advantages of TiN coated abutments include comparable clinical outcomes to stock abutments, optimal biocompatibility, adequate fracture, wear, and corrosion resistance, reduced bacterial adhesion, and excellent esthetic integration with adjacent soft tissues. Clinical Significance: Clinical reports and short term mechanical, biological and esthetic clinical outcomes indicate that CAD/CAM nitride coated titanium implant abutments can represent a predictable restorative alternative to stock/custom and metal/zirconia implant abutments and be considered a clinical relevant option in mechanically challenging but esthetically demanding situations, as often found in the maxillary esthetic zone. [ABSTRACT FROM AUTHOR]

Alveolar soft-part sarcoma (ASPS) is a rare soft tissue tumor that primarily involves the extremities. We report a case of a 30-year-old never-smoker man who presented with hematuria, dysuria, and constipation at an outside hospital. He was diagnosed with and treated for multiple episodes of urinary tract infection. However, he continued to have voiding symptoms for which a cystoscopy was performed and revealed a bladder neck mass. He underwent transurethral resection of a bladder tumor and was diagnosed with muscle-invasive urothelial carcinoma, nested variant, at an outside hospital. Subsequent to this diagnosis he transferred his care to our center. In-house imaging revealed a large vascular mass involving the prostate and pushing against the bladder base. Prostate needle biopsies were performed and revealed an epithelioid neoplasm with a nested growth pattern composed of cells with a moderate amount of eosinophilic cytoplasm, mildly pleomorphic nuclei, and occasional prominent nucleoli. Since the findings were not classic for urothelial carcinoma or for prostate cancer, we included a wider differential of poorly differentiated carcinoma, sarcoma, and paraganglioma. A wide panel of keratin stains was negative, ETS (erythroblast transformation-specific)-related gene highlighted an extensive vascular network and neuroendocrine stains were all negative. A transcription factor E3 fluorescent in-situ hybridization was positive and subsequently, an ASPSCR1 gene rearrangement was demonstrated. The outside hospital transurethral resection of bladder tumor was obtained for review and the tumor was morphologically similar to that seen on the in-house prostate needle biopsies. Based on the above findings a final diagnosis of primary ASPS of the prostate with involvement of the bladder was made. The patient was later diagnosed with bilateral lung metastases. He was treated with pazopanib, radiation therapy, and cystoprostatectomy and is symptom-free on a 15-month follow-up. [ABSTRACT FROM AUTHOR]

• There is an increasing incidence of non-tuberculous mycobacterial (NTM) skin/soft tissue (SST) disease. • Mycobacterium fortuitum is the most common NTM causing SST disease in the Northern Territory (NT). • In the NT, most NTM SST cases have been acquired in urban areas. • NTM SST cases may have no risk factors other than skin trauma. • There were less cases in the Aboriginal population compared to the non-Aboriginal population. A previous review demonstrated that the majority of NTM infections in the Northern Territory (NT) are pulmonary in nature [1] , however skin and soft tissue (SST) are likely the next most common sites of disease. The current epidemiology of NTM SST infections across the NT is not known. We aimed to establish the current and historical incidence rates, and the organisms involved. All NTM cases reported to the Centre for Disease Control in Darwin from 1989-2021 were retrospectively reviewed. 226 NTM notifications were reviewed. 73 (32%) cases were SST infections. The incidence of SST cases increased over the study period. Female cases were more common (p=0·002). Disease occurred across a wide age range (1-85 years). Only 16% of cases occurred in Aboriginal individuals which may reflect immunological factors requiring further investigation. Many cases had no clear provocation, but localised skin trauma was the most common risk factor. The most common organism identified was M. fortuitum (41%). Diagnosis was often delayed, with a median time to diagnosis of 69 days (IQR=31-149). Most cases (60%) underwent surgical intervention with adjunctive anti-mycobacterial medical therapy. NTM SST incidence rates increased over the study period. NTM SST infections are a rare but important differential diagnosis for non-healing cutaneous wounds. [ABSTRACT FROM AUTHOR]

The acquisition of insights concerning the mechanobiology of aneurysmatic aortic tissues is an important field of investigation. The complete characterization of aneurysm mechanical behaviour can be carried out by biaxial experimental tests on ex vivo specimens. In literature, several works proposed bulge inflation tests as a valid method to analyse aneurysmatic tissue. Bulge test data processing requires the adoption of digital image correlation and inverse analysis approaches to estimate strain and stress distributions, respectively. In this context, however, the accuracy of inverse analysis method has not been evaluated yet. This aspect appears particularly interesting given the anisotropic behaviour of the soft tissue and the possibility to adopt different die geometries. The goal of this study is to provide an accuracy characterization of the inverse analysis applied to the bulge test technique using a numerical approach. In particular, different cases of bulge inflation were simulated in a finite element environment as a reference. To investigate the effect of tissue anisotropic degree and bulge die geometries (circular and elliptical), different input parameters were considered to obtain multiple test cases. The specimen deformed shapes, resulting from the reference finite element simulations, were then analysed through an inverse analysis approach to produce an estimation of stress distributions. The estimated stresses were, at last, compared with the values from the reference finite element simulations. The results demonstrated that the circular die geometry produces a satisfactory estimation accuracy only under certain conditions of material quasi-isotropy. On the other hand, the choice of an elliptical bulge die was proven to be more suitable for the analysis of anisotropic tissues. [ABSTRACT FROM AUTHOR]

Background: The evaluation of soft tissues in patients undergoing orthodontic treatment plays a critical role in diagnosis and treatment planning. This study aims to evaluate the effect of body mass index (BMI) on facial soft tissues in skeletal Class I patients with normal vertical growth. Methods: The study included 72 patients with a normal vertical growth pattern (SNGoGn 26-38°) and skeletal Class I (ANB 2-4°) malocclusion. According to their BMI (kg/m²) values, the patients were divided into three groups of 24 individuals each: underweight (>5th percentile) (13 females, 11 males; mean age, 11.58 ± 1.95 years), normal weight (5-85th percentile) (12 females, 12 males; mean age, 11.54 ± 1.95 years), overweight (85-95th percentile) (12 females, 12 males; mean age, 11.62 ± 2.01 years). Soft tissue thickness and height measurements were made on lateral cephalometric radiographs. Results: In all soft tissue thickness measurements, except for the nasion, the overweight weight group had higher values. In comparing the underweight and normal weight groups, statistically significant differences were found in the thickness measurements at the nasion and gnathion (p < 0.05). The differences in thickness measurements at the glabella, labiale superius, stomion, labiale inferius, pogonion, gnathion, and menton are statistically significant between the underweight and overweight groups (p < 0.005). Comparing the normal and overweight groups revealed statistically significant differences the thickness measurements at the glabella, labiale superius, stomion, pogonion and menton (p < 0.05). [ABSTRACT FROM AUTHOR]

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High-energy heavy ions produced by accelerators are used in industrial and medical applications. Recently carbon ions have been used in the treatment of cancerous tumors. Heavy ions by the spallation process will activate the soft tissue components before tumors. In this research by GEANT4 toolkit and MCNPX code simulation were tried to calculate the secondary particles and radioactive elements produced in the soft tissue around tumors by the carbon ions spallation process. In the MCNPX code, the F8 tally card with the FT8 command was used to extract the activation and spallation information of secondary particles in the Z1=1 to Z2=25 atomic numbers range. It was shown that a wide range of radioactive elements was produced in healthy tissues in carbon therapy. In addition to produced secondary particles, the Be-10 and C-14 radioactive elements were produced in high-energy carbon ions in soft tissue. Also, the GEANT4 toolkit result of produced secondary particles dosimetry was shown that the secondary particles dose per carbon ion is between 1.66 to 33.54 nGy for carbon ion energy between 1140 to 5160 MeV. The tail for 3480, 4080, and 5160 MeV of carbon ion energy are 0.12, 1.01, and 11 cm respectively. The carbon ion beam divergence increases with beam energy and achieve to 33 mm for 5160 MeV carbon ion. [ABSTRACT FROM AUTHOR]

In vivo impact test assuming human-robot interaction has been conducted using live porcine and drop weight impact tester in order to obtain bruise injury criteria. As a results, bleeding was found to occur at the part of adipose tissue in the case of low velocity and high energy conditions. In contrast, bleeding was found to occur at the part of muscle in the case of high velocity and low energy conditions. In this study, 3-dimensional finite element analysis were conducted on simple model consist of skin and soft tissue in order to clarify the occurrence mechanism of soft tissue bruise injury caused by impact assuming human-robot interaction. FE model imitated subcutaneous structure of porcine skin used as impact test. Analytical conditions were assumed to the experimental condition that bleeding occurs at the parts of adipose tissue and muscle. As a results, the part of taking maximum first principal strain is good agreement with the bleeding point obtained by experiments. Moreover, it was found that subcutaneous hemorrhage was strongly affected by impact loading conditions than subcutaneous tissue structure. [ABSTRACT FROM AUTHOR]

An 80-year-old woman affected by rheumatoid arthritis on immunosuppressive therapy was evaluated for an 11-month history of swelling of her left upper limb. The patient did not report systemic symptoms. Ultrasonographic examination showed hypoechoic masses in the upper limb soft tissue, brachial vein thrombosis, and suspected malignant axillary lymphadenopathy. The patient underwent an excisional biopsy of the lymphadenopathy for histologic examination; a diagnosis of diffuse large B-cell lymphoma was made. The patient started anticoagulation therapy and chemotherapy, with a follow-up at a hematology clinic. At a 3-month follow-up visit in our clinic, the swelling of her left upper limb decreased, and an ultrasonographic control demonstrated a reduction in the size and number of the soft tissue masses and resolution of vein thrombosis.

Background Most methods for soft tissue stiffness assessment require high financial resources, significant technical effort, or extensive therapist training. The PACT Sense device was developed to be used in a wide range of applications and user groups. However, to date, there are no data on its validity and reliability. The aim of this study was to investigate the validity and reliability of the PACT device. Methods A polyurethane phantom tissue model (PTM) mimicking the mechanical properties of the fascia profunda and the erector spinae muscle was used. Stiffness measurements with PACT were conducted by two independent investigators. For construct validity, correlations were calculated between the known stiffness of the PTM and values obtained with PACT. For concurrent validity, we determined the association between the PACT values and additional measurements with the established MyotonPRO device. To estimate interrater and intrarater (two measurements with an interval of 7 days) reliability, we used the intraclass correlation coefficient (ICC). Results Correlation analysis (PTM/PACT) revealed very high concurrent validity (r = 0.99; p < 0.001), construct validity (PACT/MyotonPRO) was 0.87, p < 0.001. Both, interrater reliability (ICC = 0.85; p = 0.036) and intrarater reliability were good (ICC = 0.89; p < 0.001). Conclusions The PACT provides valid and reliable stiffness measurements in tissue phantoms. Further studies in humans are needed to confirm its physiometric properties under in vivo conditions.

Abstract Background Intraoperative additional resection (IAR) of initially microscopically involved soft tissue resection margins negatively impacts tumor recurrence in oral squamous cell carcinoma (OSCC). Increasing the selected initial macroscopic resection margin distance beyond the tumor tissue may help prevent IAR; however, the existence of predictive factors for IAR and IAR repetition numbers remains unclear. This study aimed to identify predictive factors for IAR and to evaluate the IAR repetition numbers in soft tissue for surgically treated OSCC. Methods A cohort of 197 patients surgically treated for OSCC between 2008 and 2019 was retrospectively reviewed (44 patients with IAR and 153 patients without IAR). Clinical parameters (tumor location, midline involvement, clinical T-status, time between staging imaging and surgery, bone resection, monopolar use, and reconstruction flap size) and histopathological parameters (pathologic T-status [pT-status], grading, vascular invasion, and lymphatic invasion) of the two groups were compared. Results Patients with and without IAR differed in their histopathological parameters, such as pT-status above 2 (47.7% vs. 28.1%, p = 0.014) and lymphatic invasion (13.6% vs. 4.6%, p = 0.033); however, their clinical parameters were similar (all p > 0.05). Only pT-status above 2 was predictive for IAR in a multivariable regression analysis (odds ratio 2.062 [confidence interval 1.008–4.221], p = 0.048). The IAR repetition numbers varied from zero to two (zero = 84.4%, one = 11.4%, and two = 2.3%). Conclusions Only postoperative available pT-status was identified as a predictive factor for IAR, underscoring the importance of improving preoperative or intraoperative tumor visualization in OSCC before selecting the initial macroscopic resection margin distance to avoid IAR.

Abstract Objective This article is a preliminary study to compare the ability of 0.05% chlorhexidine diacetate (CD) and 1% povidone‐iodine (PI) solutions to reduce bacterial contamination on the canine external ear canal during initial patient preparation and comparison of the incidence of immediate tissue reactions. Study design The study is a multi‐institutional, randomised, clinical prospective study. Animals or sample population Dogs (n = 19) undergoing total ear canal ablation with bulla osteotomy (TECABO). Methods The external ear of each dog was cleaned with the assigned antiseptic solution. Culture of the ear was performed by standard techniques to semi‐quantitatively evaluate bacterial growth and to identify bacterial organisms pre‐ and post‐antiseptic use. Results Both antiseptic groups showed a significant reduction in bacterial growth score (BGS) between pre‐ and post‐antiseptic use (CD p = 0.009, PI p = 0.005). There was no difference in the reduction of BGS between CD and PI solutions (p = 0.53). Minor adverse skin reactions occurred in 25% of cases. There was no significant difference in the occurrence of adverse skin reactions between antiseptics (p = 0.63). Conclusion CD and PI were similarly able to decrease the number of bacteria on the external ear following initial preparation. No difference in the incidence of adverse tissue reactions was found. Clinical significance Properly diluted aqueous formulations of either antiseptic may be used for safe preparation limited to the external ear canal of dogs. Additional studies evaluating outcomes such as duration of bacterial inhibition and incidence of surgical site infections are needed to fully elucidate differences between CD and PI antiseptics prior to TECABO.

Bioactive glass （BG） has been used as a candidate for bone and soft tissue repair materials because of its compatibility, bioactivity and ability to form a crystalline hydroxyapatite layer. This paper introduces the mechanism of BG ion release, discusses the application of borosilicate bioactive glass （BBG） in bone and soft tissue repair, and provides an overview of the potential and clinical translational challenges faced by BBG in bone cement, scaffold, hydrogel, and fiber research applications. [ABSTRACT FROM AUTHOR]

Commonly associated with autoimmune and renal disorders, calcinosis cutis is a disorder of systemic calcium deposition in soft tissues. The pathophysiology of such deposition varies based on subtype, therefore treatment options vary not only in terms of severity of disease but also with subtype. This case report describes a 52-year-old female with systemic sclerosis and an extensive past medical history who initially presented with complaints of worsening left lower leg pain, a negative workup for deep vein thrombosis, and an extensive palpable mass in the posterior thigh with erythema, drainage, and purulence. With multiple treatment options exhausted from her autoimmune disorders, she ultimately required surgical resection for her refractory infected calcinosis cutis. Identification of calcinosis cutis subtype in conjunction with appropriate history and physical is crucial to determining indications for treatment. [ABSTRACT FROM AUTHOR]

Pleomorphic hyalinizing angiectatic tumour (PHAT) is a very rare low-grade indeterminate neoplasm of connective and other soft tissue, which is not known to metastasize though local recurrence has been documented. It most commonly presents in the lower extremities, but other anatomical locations have been described. This is the second known case of PHAT from the Caribbean region and adds to the limited reported cases of the condition in the literature. [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.

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 (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.

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.

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.

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 Background Knee osteoarthritis (KOA) considered as one of the most common degenerative diseases of synovial joint. KOA is mostly managed by physical therapy, focused on pain management, the range of motion and muscle strengthening but muscle flexibility is usually neglected. A study was conducted to evaluate the effectiveness of dynamic soft tissue mobilization (DSTM) in comparison with the proprioceptive neuromuscular facilitation (PNF) stretching in the management of hamstring tightness, reduction of pain intensity and improvement of physical functionality in KOA. Methods Forty eight patients with KOA were randomly allocated to group A receiving DTSM and group B receiving PNF stretching. The cryotherapy and isometric strengthening exercises were also given to both groups. Total treatment duration consisted of 4 weeks, 3 sessions per week and total 12 sessions per patient. Each treatment session comprised of 30 min. At baseline and post treatment, Active knee extension test(AKET), Visual analogue scale (VAS), and Knee Injury and Osteoarthritis Outcome Score (KOOS) were used to assess hamstring flexibility, pain intensity level and physical functional capability respectively. The continuous variables were shown as mean and standard deviations. For the comparison of outcome within and between groups, paired sample and independent t-test was applied. Considerable p value was less than 0.05. Results The between group analysis of VAS, right AKE test, and left AKE test showed non-significant (p > 0.05) mean difference as 0.2 (95% CI= -0.29, 0.70), 1.79 (95% CI= -1.84, 4.59), 1.78 (95% CI= -1.6, 5.19) respectively. KOOS domains of symptom, pain, ADLs, sports and recreational, and quality of life had also non-significant (p > 0.05) mean difference as 1.12 (95% CI= -4.05, 6.3), -5.12 (95% CI= -12.71, 2.46), -2.55 (95% CI= -7.47, 2.38), -2.7 (95% CI= -9.72, 4.3), and − 0.68 (95% CI= -7.69, 6.36) respectively. Significant (p

Background: Lower Back Pain (LBP) with radiculopathy is a potentially more serious form of mechanical low back pain. A paucity of literature exists about the effect of the gross myofascial release (MFR) technique on the management of LBP. Objective: The study aimed to evaluate the effect of gross MFR when given as an adjunct to conventional physical therapy in subjects with low back pain with radiculopathy. Methods: Forty subjects ([Formula: see text]) clinically diagnosed with LBP with radiculopathy were enrolled and randomly allocated to either the control group ([Formula: see text]) or the experimental group ([Formula: see text]). Both study groups received 5 sessions of intervention. The control group received conventional physical therapy while the experimental group received gross MFR of the trunk and lower limb along with conventional physical therapy. The outcome measures included were pressure pain threshold for the lower back and lower extremity, lumbar flexion and extension range of motion (ROM), percentage disability, and patient satisfaction towards the treatment which were measured pre-intervention (day 1) and post-treatment (day 5). The interaction between group and time was analysed using two-way mixed ANOVA. Results: The results suggested that the experimental group was statistically significant over the control group in terms of pressure pain threshold in the lower back ([Formula: see text]) and lower limb ([Formula: see text]), disability ([Formula: see text]), and patient satisfaction ([Formula: see text]) and lumbar flexion ([Formula: see text]) except lumbar extension ROM ([Formula: see text]). Conclusion: When given as an adjuvant to conventional physical therapy, gross myofascial release proved to provide a significant and faster short-term improvement over conventional treatment alone in subjects diagnosed with low back pain with radiculopathy.

Background: Recurrent aphthous stomatitis (RAS) is a yellowish-white ulcer-shaped lesion in the oral mucosa. The prevalence of RAS is estimated to be 20% of the world population. Based on Basic Health Search Indonesia in 2018, the prevalence of RAS was 8% of all oral health problems in Indonesia. Stress is one of the risk factors for recurrent aphthous stomatitis. Someone who is stressed will experience a decrease in the immune system, resulting in tissue destruction in the oral cavity. Purpose: To analyze the relationship between stress and RAS in Faculty of Dentistry, Lambung Mangkurat University students. Methods: This is analytical observational research with a cross-sectional study design. The study used a simple random sampling technique with a total sample of 57 co-assistants of the Dentistry at Lambung Mangkurat University. RAS was examined using a questionnaire, and the stress level was measured using the Perceived Stress Scale (PSS) questionnaire. The results of the study were analyzed using the chi-square test. Results: The result shows that the stress level suffered by the respondents is mainly in the moderate category, with a percentage of 44%. In comparison, the incident of RAS with positive results is mainly experienced by respondents with a percentage of 70.18%. The analysis using the chi-square test showed a significant relationship between stress and SAR with a significance value of 0.01 (p

Τhis study aims to measure the abundance of microplastic (MP) particles in the soft tissue of mussel (Mytilus galloprovincialis) and pearl oyster (Pinctada imbricata radiata) specimens. Samples were collected at four sites in Greece (Sagiada, Malesina, Elounda, Rhodes) from wild and farmed populations. The identification of MPs was accomplished by Raman spectroscopy. Comparisons were made between the two different species where the two species co-existed (Malesina), between the four study sites (five sampling stations) in relation to P. imbricata radiata individuals, and also in every station for the different MP types found. For the specimens from Malesina, M. galloprovincialis had more MPs in their soft tissue compared to P. imbricata radiata. Microfibers were found in abundance in M. galloprovincialis, while microfragments were found in P. imbricata radiata specimens. The main MP type found in P. imbricata radiata specimens was microfragments in all five sampling stations, and ranged between 1.54 ± 0.63 (Rhodes-baskets) and 3.56 ± 0.35 (Sagiada) MP particles/g. While the samples of mussels and pearl oysters were similar in age, the differences found in the concentrations of MPs appears to be due to their different farming methods and location characteristics concerning the five sampling stations of pearl oysters. This study indicates that the culturing system does not affect MP concentration in bivalves, and further investigation is needed to find the most appropriate method to limit and reduce MPs that end up in the farmed organisms.