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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]

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]

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]

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]

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]

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]

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]

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]

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]

Objective Methods Results Conclusion To identify the different uses and modalities of digital technologies to diagnose, plan and monitor peri‐implant soft tissue conditions and aesthetics.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.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.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]

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 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]

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]

During childhood, perceiving dental treatment as a “positive experience” is important not only for the therapeutic success itself, but also for educating patients in order to avoid the appearance of a whole generation of adult odontophobic patients. Evaluating the degree of anxiety of child patients towards dental treatments and finding therapeutic options that generate less fear and are better tolerated and accepted represent important steps in establishing a successful collaborative relationship between the child and the attending dentist. Laser-assisted dental diagnosis and treatment, which allow the clinician to comply with the principle of minimally invasive dentistry, represent an optimal therapeutic approach. The perception of replacing the milling cutter with laser instruments has a positive impact on the patient, because the laser works without direct contact, without vibrations, with less noise and – the essential argument – with less pain, determining the introduction of this technology in pediatric dentistry. Lasers used in dentistry offer the possibility of using a wide range of therapeutic protocols and ensure better precision and control, compared to conventional dental treatment procedures. The benefits of laser have been well documented over the past ten years, offering a positive alternative to conventional techniques. Dental treatment in general and pediatric treatment in particular – using laser radiation improves patients’ compliance through the analgesic effect and by reducing the degree of anxiety and the feeling of fear associated with the use of conventional dental instruments. Laser therapy in pediatric dentistry is the treatment of choice due to its many advantages, especially the safety of use and the much gentler approach to small patients. [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]

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]

Objective: This retrospective study aimed to characterize and evaluate the emergency approach, diagnosis, management, treatment, and follow‐up of nonspecific canine lameness cases. Design: Retrospective case series from September 25, 2013 to September 25, 2014. Setting: The study was conducted at an urban university teaching hospital. Animals: A consecutive sample of dogs presenting to the emergency service with nonspecific lameness in the designated timeframe was used to identify 134 cases. Owners were contacted to participate in the follow‐up survey; dogs that died prior to data collection were excluded from the survey. Medical records were reviewed for lameness localization, etiology of lameness, diagnostics obtained, medications prescribed, and owner recommendations. Interventions: Based on review of the medical records, the lameness localization, presumptive source of lameness (joint, soft tissue, neurological, or bone), diagnostics obtained, medications prescribed, and owner recommendations were recorded. Survey data included duration of lameness, perceived response to treatment, and activity level. Measurements and Main Results: Definitive diagnoses were not assigned in 88.8% of lameness cases. A presumptive diagnosis of soft tissue injury was assigned in 45.3% of cases. Single limb lameness was more prevalent than multiple limb lameness. Owners whose dogs were treated with medication were significantly more likely to report that the lameness resolved (P = 0.049). Dogs with injury localized to ≥1 of the joints were significantly less likely to have resolution of lameness (P = 0.037). Treatment recommendations were predominantly pain control and activity restriction. Conclusions: Nonspecific lameness represents approximately 4% of canine urban emergency cases. Highlighting the points of clinical care considerations in understanding the etiology of lameness in dogs represents an opportunity for improved patient care and growth in emergency referral and follow‐up. [ABSTRACT FROM AUTHOR]

This case report describes the intricate aspects of managing pediatric lower limb trauma. A 7-year-old patient had a severe compound fracture and significant soft tissue damage in the left lower limb, classified as Gustilo Grade IIIC. This necessitated the use of scoring systems such as the Mangled Extremity Severity Score and limb salvage index to assess the likelihood of limb preservation. Despite these high amputation risk indicators, a multidisciplinary approach has led to limb salvage surgery with internal fixation. Detailed postoperative monitoring revealed progressive recovery culminating in restored sensation, bone healing, and functional recovery. The discussion emphasizes the difficulties in deciding between limb salvage and amputation, stressing the importance of tailored care and cautious scoring system interpretation in pediatric cases. This conclusion advocates the prioritization of limb salvage in children owing to their unique healing capabilities while highlighting the need for further research to refine treatment protocols for pediatric lower limb trauma. [ABSTRACT FROM AUTHOR]

Leiomyomas are rare, benign tumors arising from smooth muscle cells. Due to the heterogeneous anatomical locations, as well as clinical and radiological findings, early and correct diagnosis is usually tricky. The clinical symptoms depend on the anatomical structure the tumors are compromising by their growth. We present a case of a 53-year-old male patient who suffered from swelling of the right foot and ankle. Initially, arthritis and deep vein thrombosis were ruled out. As the swelling progressed to the entire leg, CT scan was performed showing a tumor compressing the right femoral vein. However, a magnetic resonance imaging (MRI) and a biopsy did not show any conclusive findings. Tumor excision was planned and immunohistochemical staining confirmed leiomyoma. The authors conclude that unspecific, progressive symptoms should prompt further investigation and whenever planning a biopsy, a possible malignant finding should be considered and excision of the biopsy canal together with the tumor must be assured. [ABSTRACT FROM AUTHOR]

Aim Materials and Methods Results Conclusions To assess the impact of the timing of implant placement following alveolar ridge preservation (ARP) on the need for soft‐tissue augmentation (STA) and to identify the risk factors for horizontal and vertical soft‐tissue loss.Patients with a single failing tooth in the anterior maxilla (15–25) were treated at six centres. Following tooth extraction, they were randomly allocated to the test group (immediate implant placement, IIP) or control group (delayed implant placement, DIP). ARP was performed in both groups and implants were immediately restored with an implant‐supported provisional crown. Six months after tooth extraction and ARP, a panel of five blinded clinicians assessed the need for STA on the basis of anonymized clinical pictures and a digital surface model. Lack of buccal soft‐tissue convexity and/or mid‐facial recession qualified for STA. Pre‐operative and 6‐month digital surface models were superimposed to assess horizontal and vertical soft‐tissue changes.Thirty patients were included per group (test: 20 females, 10 males, mean age 53.1; control: 15 females, 15 males, mean age 59.8). The panel deemed STA as necessary in 24.1% and 35.7% of the cases following IIP and DIP, respectively. The difference was not statistically significant (odds ratio [OR] = 1.77; 95% confidence interval [CI] [0.54–5.84]; p = .343). Loss of buccal soft‐tissue profile was higher following DIP (estimated mean ratio = 1.66; 95% CI [1.10–2.52]; p = .018), as was mid‐facial recession (mean difference [MD] = 0.47 mm; 95% CI [0.12–0.83]; p = .011). Besides DIP, regression analysis identified soft‐tissue thickness (−0.57; 95% CI [−1.14 to −0.01]; p = .045) and buccal bone dehiscence (0.17; 95% CI [0.01–0.34]; p = .045) as additional risk factors for mid‐facial recession. Surgeons found IIP significantly more difficult than DIP (visual analogue scale MD = −34.57; 95% CI [−48.79 to −20.36]; p < .001).This multi‐centre randomized controlled trial failed to demonstrate a significant difference in the need for STA between IIP and DIP when judged by a panel of blinded clinicians. Based on objective soft‐tissue changes, patients with thin buccal soft tissues, with a buccal bone dehiscence and treated with a delayed approach appeared particularly prone to soft‐tissue loss. [ABSTRACT FROM AUTHOR]

Biopsy puncture is commonly used to extract the suspected tissue of cancer for cytological diagnosis. However, the low accuracy and poor performance instability of puncture sample can lead to misdiagnosis. For this problem, the technology of vibration assisted was applied in the process of soft tissue puncture in this paper. The influence of process parameters on the puncture performances were investigated and analyzed. The results indicate that the method of vibration assisted has significant advantages on the puncture performances compared with conventional puncture. The fracture toughness is increased with the increase of insertion velocity and vibration frequency. And, the needle deflection is decreased with the increase of vibration frequency. The conclusions prompt the application of vibration assisted puncture technology in clinical practice. [ABSTRACT FROM AUTHOR]

Myofibroblastoma is a rare benign mesenchymal tumor first described in the breast. It is also known as mammary-type myofibroblastoma outside of the breast, more frequently located along the embryonic milk line. Exceptionally, myofibroblastoma can occur at visceral locations. We present a case of myofibroblastoma detected incidentally in the liver. A well-circumscribed mass, grossly measuring 6.2 cm in the liver parenchyma, was found on imaging studies. Histologically, the lesion is characterized by benign spindle cells in a hyalinized collagenous stroma, with positive staining for SMA and ER, focal positivity for CD34, negative for desmin, and loss of RB1. This rare tumor at such an unusual location makes it diagnostically challenging, especially on core biopsy of the lesion. To our knowledge, this is the second case of myofibroblastoma in the liver reported in the English literature and the first such case with a detailed pathology description. [ABSTRACT FROM AUTHOR]

Dermatofibrosarcoma protuberans (DFSP) is a rare, CD34+ mesenchymal neoplasm that classically involves the dermis. A COL1A1::PDGFB t(17;22) translocation is present in 91.4% to 96% of cases, resulting in aberrant proliferation due to tyrosine kinase hyperactivity. Here, we present a postmenopausal woman with a CD34-positive spindle cell neoplasm of the breast without cutaneous involvement, lacking muscle marker expression, STAT6 expression, and 13q14 deletion by fluorescence in situ hybridization (FISH). Although the classic PDGFB translocation was not detected by FISH, the overall features were highly suspicious for DFSP. Subsequent RNA-based next-generation sequencing revealed an EMILIN2::PDGFD fusion. A literature review showed that PDGFD fusions can be detected in up to 55% PDGFB FISH negative cases, with EMILIN2::PDGFD fusion highly associated with fibrosarcomatous transformation. This holds important diagnostic and prognostic information as fibrosarcomatous-DFSP is associated with higher recurrence and metastatic potential. The tumor was completely resected with clear margins, showed no fibrosarcomatous areas, and no evidence of recurrence is documented 2 years since resection. This review and case report adds to the literature regarding PDGFD -translocation positive DFSP as a differential diagnosis of CD34-positive spindle cell tumors of the breast, while emphasizing the prognostic importance of EMILIN2::PDGFD fusions. [ABSTRACT FROM AUTHOR]

Introduction: Molecular analysis plays a growing role in the diagnosis of mesenchymal neoplasms. The aim of this study was to retrospectively apply broad, multiplex molecular assays (a solid tumor targeted next-generation sequencing [NGS]) assay and single nucleotide polymorphism [SNP] microarray) to selected tumors, exploring the current utility and limitations. Methods: We searched our database (2010-2020) for diagnostically challenging mesenchymal neoplasms. After histologic review of available slides, tissue blocks were selected for NGS, SNP microarray, or both. DNA and RNA were extracted using the AllPrep DNA/RNA FFPE Kit Protocol on the QIAcube instrument. The NGS platform used was the TruSight Tumor 170 (TST-170). For SNP array, copy number variant (CNV) analysis was performed using the OncoScanTM CNV Plus Assay. Results: DNA/RNA was successfully extracted from 50% of tumors (n = 10/20). Specimens not successfully extracted included 6 core biopsies, 3 incisional biopsies, and 1 resection; 4 were decalcified (3 hydrochloric acid, 1 ethylenediaminetetraacetic acid). Higher tumor proportion and number of tumor cells were parameters positively associated with sufficient DNA/RNA extraction whereas necrosis and decalcification were negatively associated with sufficient extraction. Molecular testing helped reach a definitive diagnosis in 50% of tumors (n = 5/10). Conclusions: Although the overall utility of this approach is limited, these molecular panels can be helpful in detecting a specific "driver" alteration. [ABSTRACT FROM AUTHOR]

We investigated the influence of Achilles tendon (AT) geometry on local-strain magnitude and distribution during loading, using finite element analysis. We calculated the following eight AT parameters for 18 healthy men: thickness and width of the most distal part, minimum cross-sectional area (mCSA), and most proximal part; length; and position of the mCSA. To investigate the effect of AT geometry on the magnitude and distribution of local strain, we created three-dimensional numerical models by changing the AT parameter values for every one standard deviation (SD) in the range of ±2 SD. A 4000 N lengthening force was applied to the proximal surface of all the models. The mean first principal strain (FPS) was determined every 3% of the length. The highest FPS in each model was mainly observed in the proximal regions; the 86–89% site (the most proximal site was set at 100%) had the highest number of models with the highest FPS (nine models). The highest FPS was observed in the model with a distal thickness of −2 SD, which was 27.1% higher than that of the standard model observed in the 2–5% site. Therefore, the AT geometry influences local-strain magnitude and distribution during loading. [ABSTRACT FROM AUTHOR]

Introduction: Soft tissue sarcomas make up 7%-15% of childhood solid tumours. The aetiology of this disease is unknown. It is a fast-growing, painless tumour; histologically similar to adult fibrosarcoma, but having a lesser risk of metastasis and a better prognosis. The treatment is aimed towards localised intervention; complete surgical resection is the appropriate treatment as long as it can be performed. Case report: An 11 years old female was referred for resection of a soft tissue tumour on the right elbow with significant peripheral vascularisation. Tumour resection was scheduled, with the placement of a partial thickness skin graft, and a piece was sent to pathology; a histological type consistent with paediatric fibrosarcoma was obtained with margins less than 1 mm from the lesion. Therefore, the patient was referred to the paediatric oncology unit. Further studies with positron emission tomography were requested, in which no evidence of macroscopic anatomy-metabolic tumour activity was found. Subsequently, treatment was started by paediatric oncology with 2 sessions of chemotherapy and 20 sessions of radiotherapy with sufficient progress; finally, assessment by plastic and reconstructive surgery was performed and an adequate quality of graft was observed, without the need for any other intervention by their service. Conclusion: The involvement of the vascular surgeon in performing the tumour resection permitted the preservation of the best circulation to the extremity, thereby, avoiding amputation. The difficult decision made by the reconstructive surgeon to place a partial thickness graft over the surgical site, and to start radiotherapy/chemotherapy by paediatric oncology, were key to the success in achieving the patient's satisfactory progress. [ABSTRACT FROM AUTHOR]

Background: Major extremity trauma forms a considerable proportion of CRI. The aim of this study was to determine whether time to reconstruction and number of debridement's had an impact on flap success in upper limb CRI. Methods: A literature search was conducted on Pubmed, Dynamed, DARE, EMBASE, Cochrane, TRIP, Google scholar and BMJ databases. A random effects model was used due to significant heterogeneity between the papers and a meta-regression was implemented for the analysis of outcomes. Results: Eight articles met the inclusion criteria, covering 65 patients and 74 flaps. Flap success rate was 93% (95% CI: 0.87 – 0.98) with an overall flap complication rate of 10.3% (95% CI 3.4% - 17.2%, p=0.02). Successful flaps had a mean of 8.3 (SD 4.76) pre-flap debridement's versus 5.7 (SD 2.16) debridement's in failed flaps. Conclusions: Soft-tissue reconstruction in CRI often faces complexities due to associated injuries and the risk of infection. Whilst timely reconstruction is important, prioritizing meticulous and often multiple debridement's over time targets may aid in flap success. Level of evidence: Level III, Therapeutic. [ABSTRACT FROM AUTHOR]

The phosphorus content in the dry matter of modern-day Cnidarians (Hydrozoa, Scyphozoa and Anthozoa) collected in the different parts of the world's oceans ranges from 0.14 to 1.3% wt. Nektonic Cnidarians can form major aggregations in marine basins and should therefore be regarded as an important component of phosphorus flux into sediment. Seventy-five per cent of the Ediacaran fossils were interpreted as the moulds of soft-bodied organisms resembling modern-day Cnidaria. Therefore, ancient Cnidarians in the Ediacaran epeiric basins could be a source of phosphorus during the deposition of the earliest sedimentary phosphorites. [ABSTRACT FROM AUTHOR]

Early complications in total knee arthroplasty (TKA) associated with modern robotics platforms integrated with digital balancing technology have not been investigated. The objective was to compare 90-day complication rates between a manual technique and a modern robotic-assisted ligament balancing TKA platform. 895 primary TKA procedures from a single surgeon were retrospectively reviewed (614 manual TKA, 281 using a modern robotics platform with an integrated digitally controlled ligament balancing device). Post-operative complications within the 90-day episode of care were recorded by the Michigan Arthroplasty Registry Collaborative Quality Initiative. Differences in complication rates between techniques were further divided into inpatient hospital, outpatient hospital, and ambulatory surgery center (ASC) cohorts. In the pooled hospital cohort and inpatient hospital cohort, ‘Return to OR’ was significantly lower for the robotic assisted group (1.3% vs 5.2% and 0% vs 4.9%, respectively, p< 0.0370). Specifically, the need for manipulation under anesthesia (MUA) was reduced for the robotics group (0.0% vs 2.5%, p= 0.0352). No differences in overall complication rate or cause of complication was found between manual and robotics cases for the hospital outpatient and ASC cohorts (p⩾ 0.68). Within the hospital setting, robotic assisted ligament balancing technology was associated with reduced 90-day postoperative complications for ‘Return to OR’ and MUA. [ABSTRACT FROM AUTHOR]

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]

Purpose: Perivascular epithelioid cell tumors (PEComas) of the bone and soft tissues are rare mesenchymal neoplasms, some of which are malignant. However, their clinical and pathological characteristics remain unclear. This study was performed to investigate the clinical and pathological characteristics of PEComas in bone and soft tissues by leveraging information from the Japanese Musculoskeletal Oncology Group. Methods: Nine patients, including four male and five female patients with a median age of 50 years, were retrospectively reviewed. PEComas of the visceral organs, including the uterus and retroperitoneum, were excluded. Results: Eight tumors arose in the soft tissue and one in the bone, with a mean size of 8.8 cm. Four patients showed local recurrence or distant metastasis. The 1-year survival rate was 78%. Pathologically, eight tumors were classified as malignant and one as having uncertain malignancy potential. Half of the tumors showed high MIB-1 index values of > 30%. Immunohistochemically, the melanocyte marker HMB45 was expressed in 89% of the cases, and muscle-specific markers were expressed only in 30–50% of the cases. Transcription factor binding to IGHM enhancer 3 (TFE3) expression was positive in 100% of the patients. Tumors with high expression of TFE3 were classified as PEComas with malignant potential according to Folpe's classification. Conclusions: Bone and soft tissue PEComas may have a higher malignancy potential than other visceral PEComas and are more likely to develop as TFE3-rearranged PEComas. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Key Points 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.(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.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.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. 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. 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]

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]

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]

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]