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Soft Tissue Components (soft + tissue_component)
Selected AbstractsCalcifying epithelial odontogenic (Pindborg) tumor with malignant transformation and metastatic spreadHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 8 2001Michael J. Veness MB Abstract Background Pindborg tumors (calcifying epithelial odontogenic tumors) are uncommon neoplasms of odontogenic origin most often located in the posterior mandible. First described in detail in 1955 by Pindborg, these tumors are considered benign but can be locally aggressive in nature, with recurrence rates of 10% to 15% reported. The malignant form of this tumor is exceedingly rare. Methods We describe the case of a 64-year-old woman initially treated for a painful infected left mandibular third molar. The patient underwent extraction of the tooth and excision of an associated soft tissue component. Subsequent histologic review identified a Pindborg tumor of the left posterior mandible. Results After initial excision, this tumor recurred twice, with the recurrences exhibiting a progression to a malignant Pindborg tumor (odontogenic carcinoma) with vascular invasion and spread to a cervical lymph node. Further treatment involved radical surgery and adjuvant radiotherapy. At last review 12 months after treatment, the patient was disease free. Conclusions This article describes only the second case of odontogenic carcinoma. The transformation from benign to malignant histologic findings has not previously been documented in this tumor. The salient clinical features of this case are presented along with supportive pathologic and radiologic evidence. © 2001 John Wiley & Sons, Inc. Head Neck 23: 692,696, 2001. [source] Vascular alterations in the rabbit patellar tendon after surgical incisionJOURNAL OF ANATOMY, Issue 5 2001M. R. DOSCHAK Open incision of the patellar tendon (PT) is thought to promote acute vascular responses which ultimately result in an enhanced degree of tendon repair. Such a clinical procedure is commonly applied to patients with refractory tendinitis. The objective of this study was to quantify the vascular adaptations (both anatomical and physiological) to longitudinal incision of the PT, and the resultant effects on tendon organisation. Fifty-four New Zealand White rabbits were separated into 3 experimental groups and 2 control groups. Experimental groups underwent surgical incision of the right PT, and were assessed 3 d, 10 d and 42 d following injury; normal unoperated controls were evaluated at time zero, and sham-operated controls were evaluated at 3 d to control for the effects of incising the overlying skin. Quantitative measures of PT blood supply (blood flow, microvascular volume) and geometric properties of PT substance were obtained for each PT. Histomorphology was assessed to evaluate vascular remodelling and matrix organisation in the healing PT. Longitudinal open incision surgery of the PT led to rapid increases in both blood flow and vascular volume. The incision of overlying tissues alone (sham-operated) contributed to this measurable increase, and accounted for 36% and 42% of the elevated blood flow and vascular volume respectively at the 3 d interval. In the incised PT, blood flow significantly increased by 3 d compared with both time zero and sham-operated controls, and remained significantly elevated at the 10 d interval. Similarly, vascular volume of the incised PT increased at 3 d compared both with time zero and sham-operated controls. At the 10 d interval, the increase in vascular volume was greatest in the central PT substance. By 42 d both blood flow and vascular volume of the incised tendon had diminished, with only blood flow remaining significantly different from controls. In the contralateral limb, a significant neurogenically mediated vasodilation was measured in the contralateral PTs at both early time intervals, but was not seen by the later 42 d interval. With respect to PT geometric properties in the experimental animals, a larger PT results as the tendon matrix and blood vessels remodel. PT cross-sectional area increased rapidly by 3 d to 1·3 times control values, and remained significantly elevated at 42 d postinjury. Morphological assessments demonstrated the disruption of matrix organisation by vascular and soft tissue components associated with the longitudinal incisions. Substantial changes in matrix organisation persisted at 42 d after surgery. These findings suggest that open longitudinal incision of the PT increases the vascular supply to deep tendon early after injury. These changes probably arise through both vasomotor and angiogenic activity in the tissue. Since PT blood flow and vascular volume return towards control levels after 6 wk but structural features remain disorganised, we propose that vascular remodelling is more rapid and complete than matrix remodelling after surgical incision of the PT. [source] IMMEDIATE LOADING OF IMPLANTS IN THE ESTHETIC ZONEJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 5 2005Saj Jivraj DDS The predictability of dental implants using the traditional Branemark protocol has been well documented. Since its inception, this protocol has been progressively challenged to decrease treatment time, minimize the number of surgical procedures, and maximize esthetic outcomes. Today, in specific clinical situations, implants may be placed and immediately loaded with provisional restorations. Immediate loading in the edentulous mandible has been well documented. There are also good data to show that immediate loading of the edentulous maxilla is also feasible if bone quality is suitable. The focus now has shifted toward immediate loading of implants placed in the esthetic zone. Clinicians have recognized that the challenge of providing anterior tooth replacements is in preserving the hard and soft tissue components that exist around natural teeth. The advantages of immediate restoration are obvious; however, the application of immediate or early load may pose an increased risk of implant failure in single-tooth situations. The prerequisites for achieving and maintaining acceptable results are not fully known. This review examines some of the literature concerning the reliability of early or immediate loading of implants placed in the esthetic zone. [source] MRI of bone tumors: Fast STIR imaging as a substitute for T1-weighted contrast-enhanced fat-suppressed spin-echo imagingJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 4 2004Osamu Tokuda MD Abstract Purpose To compare the usefulness of short inversion recovery (STIR) and T1-weighted, contrast-enhanced, fat-suppressed (T1W-CEFS) sequences for the evaluation of bone tumors. Materials and Methods Eighteen patients with 19 bone tumors who underwent both STIR and T1W-CEFS imaging were evaluated. The tumors were categorized in pairs as follows: bone marrow and soft-tissue components, benign and malignant tumors, and tumors with and without mineralization. The signal difference-to-noise ratio (SDNR), signal-to-noise ratio (SNR), and tumor volume were calculated in each group. An additional qualitative analysis was performed by means of the ratings of imaging contrast. Results The mean SDNRs of all bone marrow components and bone marrow components without mineralization were significantly higher on fast STIR images than on T1W-CEFS images (P < 0.05). There was no significant difference in the mean SDNR and SNR of the other group (surrounding soft tissue components, bone marrow components with mineralization, benign and malignant lesions) between fast STIR images and T1W-CEFS images. The mean volume of the tumors was significantly higher with STIR than with the T1W-CEFS sequence (P < 0.05). Conclusion The STIR sequence should be used instead of T1W-CEFS imaging for the evaluation of bone tumors. J. Magn. Reson. Imaging 2004;19:475,481. © 2004 Wiley-Liss, Inc. [source] Histopathologic changes at "synovio,entheseal complexes" suggesting a novel mechanism for synovitis in osteoarthritis and spondylarthritisARTHRITIS & RHEUMATISM, Issue 11 2007Michael Benjamin Objective To determine the extent to which different entheses form part of a "synovio,entheseal complex" (SEC) and whether such SECs are commonly associated with the presence of inflammatory cells and evidence of enthesis microdamage. Methods Specimens from 49 cadaveric entheses were processed for histologic study, and all soft tissue components of the entheses or enthesis organs were examined. To exclude articular cartilage degeneration as a triggering factor for synovitis, the selected entheses included 17 that were not immediately adjacent to such cartilage. Results An SEC was present at 82% of entheses. These included 47% of the attachments not adjacent to articular cartilage, where the synovium was that of bursae or tendon sheaths. One or more of a wide variety of degenerative changes were noted on the soft tissue side of every enthesis; the most common changes were cell clustering and/or fissuring (in 76% of entheses). Synovial villus formation or inflammatory cell infiltration was seen in 85% of entheses, and in 73% of attachments there were also inflammatory cells in the enthesis organ itself. The changes included synovial invasion (pannus formation) of the enthesis. Conclusion Entheses are frequently juxtaposed to synovium, thus forming SECs. They are also often associated with both degenerative and inflammatory changes, and the latter may involve the immediately adjacent synovium. These findings suggest a novel mechanism by which synovitis could develop in both degenerative joint disease and spondylarthritis. [source] | ||||||||||