Joint hypermobility syndrome is a condition in which a joint can move effortlessly beyond the normal limit of motion expected for that joint. This syndrome is affected by some factors including gender and tends to be ...Joint hypermobility syndrome is a condition in which a joint can move effortlessly beyond the normal limit of motion expected for that joint. This syndrome is affected by some factors including gender and tends to be inherited. It may cause some symptoms such as pain in an individual’s synovial joints. The objective of the current study was to compare the energy loss of connective tissues between joints with and without hypermobility. A differential equation model, namely the Kelvin-Voigt model, was used for the energy loss analysis. The results show the difference in energy loss for the tissues attached to joints with and without joint hypermobility. As the stiffness of the connective tissue decreases, the energy loss increases. Muscle activity about the ankle was measured via electromyography during simple functional tasks, and the recorded data were used to correlate with the theoretical analysis of the energy loss. The result would shed light on the pathology analysis of the symptoms such as the cause of pain.展开更多
We report the case of a 17-year-old boy with a soft tissue aneurysmal bone cyst(STABC) located in the posterior aspect of the right mandible.Conventional radiography revealed no positive findings.On the computed tomog...We report the case of a 17-year-old boy with a soft tissue aneurysmal bone cyst(STABC) located in the posterior aspect of the right mandible.Conventional radiography revealed no positive findings.On the computed tomography scan,the lesion appeared to have a nonuniform intralesional density.Magnetic resonance imaging revealed an abnormal soft tissue masses with cystic component in the superficial part of right mandibular body and angle with intact cortex.Following histopathological examination,fibro-histiocytic proliferation,blood-filled spaces and multinucleated giant cells were seen and the lesion was diagnosed as a STABC.The mass together with underlying bone and periosteum on its periphery was surgically resected under general anesthesia.Thirty-six months after surgery the patient was assessed at outpatient clinic and found no sign of recurrence This may be only the first reported case of the mandible in the English literature of this extremely rare benign tumor occurring in soft tissue.展开更多
Objective:The aim of this study was to evaluate the efficacy,adverse reaction and survival of MAID protocol as first-line treatment on 137 metastatic soft tissue sarcomas patients.Methods:One hundredand thirty-seven p...Objective:The aim of this study was to evaluate the efficacy,adverse reaction and survival of MAID protocol as first-line treatment on 137 metastatic soft tissue sarcomas patients.Methods:One hundredand thirty-seven patients with metastatic soft tissue sarcoma were given MAID protocol chemotherapy which consists of ifosfamide at a total dose of 8-10 g/m2 in 4-5 days,adriamycin at a dose of 60 mg/m2 on first day and dacarbazine at a dose of 200 mg/m2/d in 4-5 days.Twenty one days were regarded as a cycle and 2-6 cycles were completed.The median cycle number was 4.Results:Four cases had complete remission(CR)(2.9%),thirteen cases achieved partial remission(PR)(9.5%),eighty-eight cases maintained a stable disease(SD)(64.2%),and thirty-two cases had progressive disease(PD)(23.4%).The overall response rate(RR) was 12.4%,disease control rate(DCR) was 76.6%.The progression-free survival(PFS) was 2-14 months and median PFS was 5.00 ± 1.12 months.The overall survival(OS) was 3-19 months and median OS was 8.00 ± 1.32 months.Three months PFS rate was 56.9%,six months PFS rate was 27.2% and one year PFS rate was 7.8%.Three months OS rate was 100.0%,six months OS rate was 41.5% and one year OS rate was 10.7%.The main adverse reactions were bone marrow supression,nausea/vomiting and alopecia.Other adverse reactions were seldom observed.Conclusion:The effect of MAID protocol as first-line treatment on metastatic soft tissue sarcomas patients was exact,the treatment can control disease progression effectively and the side effects can be tolerable.It was obviously very worthy in clinical use as one of the first-line chemotherapy protocols on advanced soft tissue sarcomas.展开更多
Diagnosis of extremity soft-tissue tumors can be challenging.Characteristics of tumor margins can help precisely identify locally aggressive or non-aggressive behavior for surgical planning,but cannot differentiate be...Diagnosis of extremity soft-tissue tumors can be challenging.Characteristics of tumor margins can help precisely identify locally aggressive or non-aggressive behavior for surgical planning,but cannot differentiate benign from malignant lesions.Most malignant tumors can have inhomogeneous signals on T2-weighted images.Although a uniform signal on T2-weighted images can be a reliable indication of a benign lesion,a well-defined mass with homogeneous internal signal intensity does not definitively identify a benign lesion.Some common and distinctive soft-tissue lesions can have specific clinical and imaging features allowing a diagnosis without biopsy.These are known as determinate lesions.This illustrative report presents a diagnostic guide for extremity soft-tissue tumors based on tissue signal and morphological characteristics on magnetic resonance images.It is important for clinicians to be familiar with the imaging characteristics of common determinate lesions.展开更多
BACKGROUND The anorectal leiomyosarcoma (LMS) is an aggressive malignant neoplasm. Owing to the rarity of LMSs, an optimal treatment modality has yet to be determined. AIM To collect all published data on anorectal LM...BACKGROUND The anorectal leiomyosarcoma (LMS) is an aggressive malignant neoplasm. Owing to the rarity of LMSs, an optimal treatment modality has yet to be determined. AIM To collect all published data on anorectal LMS characteristics, explore current treatment options, and review recent cases of postradiation LMS. METHODS A literature search of the PubMed electronic database was conducted using the MeSH terms "rectal neoplasms","anus neoplasms" and "gastrointestinal neoplasms" combined with "leiomyosarcoma". The search was limited to English language and human studies. All available case reports and case series of anal or rectal LMSs that were published from the beginning of January 1996 to May 2017 were included if the diagnosis of LMS had been confirmed by histopathologic examination. Data were analyzed using simple statistics (mean, median, and standard deviation). Independent sample t-test was used to compare means for continuous variables. RESULTS A total of 27 articles reporting on 51 cases of anorectal LMS were identified. Among these cases, 11.7% had undergone previous pelvic radiotherapy (developing LMS at 13-35 years afterwards). Anorectal LMS affected the rectum in 92.2% of the cases, and no sex-based predominance was observed. Surgical resection with negative margins remains the mainstay of treatment, which can be accomplished with wide local excision or radical resection. The local recurrence rate was higher among cases who received wide local excision (30%), as compared to radical resection (20%);however, the overall rate of metastasis was 51.61% regardless of the treatment approach. The use of neoadjuvant radiation lowers the risk of local recurrence compared to adjuvant radiotherapy, and facilitates R0 resection of the tumor. Cases treated with adjuvant chemotherapy showed better rates of distant recurrence and overall survival. Nonetheless, multidisciplinary team discussion is necessary to determine the optimal management plan whilst considering patient- and disease-related factors. CONCLUSION A multidisciplinary team approach, considering the underlying patient- and disease- related factors, is necessary for optimal management of these complex tumors.展开更多
Aggressive angiomyxoma （AAM） is a rare tumour that often occurs in soft tissues of the female genital tract. Eight cases of AAM are reported in this article, and the clinical features and ultrasound and magnetic res...Aggressive angiomyxoma （AAM） is a rare tumour that often occurs in soft tissues of the female genital tract. Eight cases of AAM are reported in this article, and the clinical features and ultrasound and magnetic resonance imaging （MRI） results of the eight cases are reviewed and summarized. The main complaints of all the patients were palpable and painless masses in the vulva or scrotum. The lesions were mainly located in the vulva, pelvis, and perineal region, with a large scope of involvement. The sonographic features of AAM were characteristic. On sonography, all of the masses were of irregular shape and showed hypoechogenicity, with a heterogeneous inner echotexture. Intratumoural and peritumoural blood fows were detected by colour Doppler imaging. On real-time ultrasonic imaging, prominent deformation of the lesions was observed bycompressing the masses with the probe. Some special imaging features were also revealed, including a la-minated or swirled appearance of inner echogenicity, and a fnger-like or tongue-like growth pattern. On MRI imaging, the lesions showed intermediate-intensity signals and intermediate to high-intensity signals on TI-weighted and T2-weighted sequences. A rapid and uneven enhancement pattern was demonstrated. After the comparison of sonographic features with MRIand pathological findings, we found the relevance of the ultrasonographic characteristics with MRI and his-tological features of AAM. Ultrasound can be a valuable imaging method for the preoperative diagnosis, eva-luation of scope, and follow-up of AAM.展开更多
BACKGROUND Primary intracranial extraskeletal myxoid chondrosarcoma(EMC)is an extremely rare low-to intermediate-grade malignant soft tissue sarcoma,and only 15 cases have been reported in the literature.Due to its ra...BACKGROUND Primary intracranial extraskeletal myxoid chondrosarcoma(EMC)is an extremely rare low-to intermediate-grade malignant soft tissue sarcoma,and only 15 cases have been reported in the literature.Due to its rarity,clinical data and research on this tumor type are extremely limited,the pathogenesis and histological origin are still unclear,and the diagnostic and standard clinical treatment strategies for intracranial EMC remain controversial and undefined.CASE SUMMARY We reported a case of a 52-year-old male who was admitted to the hospital with headache and dizziness for 1 mo,and his health status deteriorated during the last week.CT of the head showed a well-defined low-density lesion situated in the left cavernous sinus.Brain magnetic resonance imaging(MRI)showed a 3.4 cm×3.0 cm sized,well-defined,round-shaped and heterogeneously enhanced lesion located in the left cavernous sinus.The entire lesion was removed via supratentorial craniotomy and microsurgery.Postoperative pathological diagnosis indicated primary intracranial EMC.Subsequently,the patient underwent 45 Gy/15 F stereotactic radiotherapy after discharge.At present,it is 12 mo after surgery,with regular postoperative follow-up and regular MRI examinations,that there are no clinical symptoms and radiographic evidence indicating the recurrence of the tumor,and the patient has returned to normal life.CONCLUSION Currently,the most beneficial treatment for primary intracranial EMC is gross total resection combined with postoperative radiotherapy.Long-term follow-up is also necessary for patients.展开更多
目的:从临床指标方面系统评价并比较自体软组织替代材料与结缔组织移植物联合冠向复位瓣技术治疗天然牙牙龈退缩的疗效。方法:计算机检索PubMed、EMBASE、Web of Science、维普、万方、知网等数据库中关于自体软组织替代材料或结缔组织...目的:从临床指标方面系统评价并比较自体软组织替代材料与结缔组织移植物联合冠向复位瓣技术治疗天然牙牙龈退缩的疗效。方法:计算机检索PubMed、EMBASE、Web of Science、维普、万方、知网等数据库中关于自体软组织替代材料或结缔组织移植物(CTG)治疗牙龈退缩的随机对照试验,检索时限从2013年1月至2023年12月。结果:最终纳入14个随机对照研究,1117个牙龈退缩位点。Meta分析显示,术后6个月时,CTG与异种胶原基质(XCM)比较能更好地降低牙龈退缩深度,与富血小板纤维蛋白(PRF)、脱细胞真皮基质(ADM)比较无明显区别;CTG与PRF、ADM、XCM比较角化龈宽度增量更明显;根面覆盖率指标差异无统计学意义;PRF、XCM可以明显降低患者术后的疼痛感。结论:研究表明,自体软组织替代材料与CTG相比,对于治疗牙龈退缩的效果并没有显著差异,但是前者可以降低患者术后疼痛感。展开更多
BACKGROUND Solitary fibrous tumor(SFT)is a remarkably uncommon mesenchymal tumor.STAT6 level and a combination of clinical,pathological,and molecular features are required to arrive at a proper diagnosis.CASE SUMMARY ...BACKGROUND Solitary fibrous tumor(SFT)is a remarkably uncommon mesenchymal tumor.STAT6 level and a combination of clinical,pathological,and molecular features are required to arrive at a proper diagnosis.CASE SUMMARY In this report,we present an intriguing case involving a 43-year-old woman who initially exhibited symptoms of a bleeding retroperitoneal tumor,initially resembling a gastrointestinal stromal tumor,but later confirmed as an SFT.However,a year later,what was initially believed to be a recurrence of her SFT was instead identified as a desmoid tumor.CONCLUSION Distinguishing SFT from other tumors was pivotal.Correcting misdiagnoses of tumor type initially and of recurrence later was necessary for appropriate treatment of the correct desmoid type.展开更多
目的:分析上颌前牙区,延期种植同期进行引导骨再生(guided bone regeneration,GBR)术后6个月唇侧骨吸收的影响因素。探究种植二期手术时种植体唇侧骨宽度对种植体边缘骨吸收的影响。方法:本研究为回顾性队列研究,随访至最终修复后1年。...目的:分析上颌前牙区,延期种植同期进行引导骨再生(guided bone regeneration,GBR)术后6个月唇侧骨吸收的影响因素。探究种植二期手术时种植体唇侧骨宽度对种植体边缘骨吸收的影响。方法:本研究为回顾性队列研究,随访至最终修复后1年。采用锥形束CT(cone beam CT,CBCT)测量术后即刻(T1)和术后6个月(T2)种植体唇侧水平骨宽度和垂直骨高度,采用广义线性混合模型分析影响因素。根据T2时的唇侧骨宽度,将种植体分为3个队列:0骨壁组、骨壁<2 mm组和骨壁≥2 mm组,探究组间边缘骨吸收差异。结果:共纳入57例患者,94枚种植体。容纳性骨缺损、种植体连接愈合基台与更少的骨吸收显著相关;在修复后1年的随访中,组间边缘骨吸收差异无统计学意义;种植位点行软组织增量手术与更少的边缘骨丧失显著相关。结论:GBR术中使用愈合基台更有利于维持水平、垂直骨量;软组织增量手术利于维持稳定的边缘骨水平。展开更多
文摘Joint hypermobility syndrome is a condition in which a joint can move effortlessly beyond the normal limit of motion expected for that joint. This syndrome is affected by some factors including gender and tends to be inherited. It may cause some symptoms such as pain in an individual’s synovial joints. The objective of the current study was to compare the energy loss of connective tissues between joints with and without hypermobility. A differential equation model, namely the Kelvin-Voigt model, was used for the energy loss analysis. The results show the difference in energy loss for the tissues attached to joints with and without joint hypermobility. As the stiffness of the connective tissue decreases, the energy loss increases. Muscle activity about the ankle was measured via electromyography during simple functional tasks, and the recorded data were used to correlate with the theoretical analysis of the energy loss. The result would shed light on the pathology analysis of the symptoms such as the cause of pain.
文摘We report the case of a 17-year-old boy with a soft tissue aneurysmal bone cyst(STABC) located in the posterior aspect of the right mandible.Conventional radiography revealed no positive findings.On the computed tomography scan,the lesion appeared to have a nonuniform intralesional density.Magnetic resonance imaging revealed an abnormal soft tissue masses with cystic component in the superficial part of right mandibular body and angle with intact cortex.Following histopathological examination,fibro-histiocytic proliferation,blood-filled spaces and multinucleated giant cells were seen and the lesion was diagnosed as a STABC.The mass together with underlying bone and periosteum on its periphery was surgically resected under general anesthesia.Thirty-six months after surgery the patient was assessed at outpatient clinic and found no sign of recurrence This may be only the first reported case of the mandible in the English literature of this extremely rare benign tumor occurring in soft tissue.
文摘Objective:The aim of this study was to evaluate the efficacy,adverse reaction and survival of MAID protocol as first-line treatment on 137 metastatic soft tissue sarcomas patients.Methods:One hundredand thirty-seven patients with metastatic soft tissue sarcoma were given MAID protocol chemotherapy which consists of ifosfamide at a total dose of 8-10 g/m2 in 4-5 days,adriamycin at a dose of 60 mg/m2 on first day and dacarbazine at a dose of 200 mg/m2/d in 4-5 days.Twenty one days were regarded as a cycle and 2-6 cycles were completed.The median cycle number was 4.Results:Four cases had complete remission(CR)(2.9%),thirteen cases achieved partial remission(PR)(9.5%),eighty-eight cases maintained a stable disease(SD)(64.2%),and thirty-two cases had progressive disease(PD)(23.4%).The overall response rate(RR) was 12.4%,disease control rate(DCR) was 76.6%.The progression-free survival(PFS) was 2-14 months and median PFS was 5.00 ± 1.12 months.The overall survival(OS) was 3-19 months and median OS was 8.00 ± 1.32 months.Three months PFS rate was 56.9%,six months PFS rate was 27.2% and one year PFS rate was 7.8%.Three months OS rate was 100.0%,six months OS rate was 41.5% and one year OS rate was 10.7%.The main adverse reactions were bone marrow supression,nausea/vomiting and alopecia.Other adverse reactions were seldom observed.Conclusion:The effect of MAID protocol as first-line treatment on metastatic soft tissue sarcomas patients was exact,the treatment can control disease progression effectively and the side effects can be tolerable.It was obviously very worthy in clinical use as one of the first-line chemotherapy protocols on advanced soft tissue sarcomas.
文摘Diagnosis of extremity soft-tissue tumors can be challenging.Characteristics of tumor margins can help precisely identify locally aggressive or non-aggressive behavior for surgical planning,but cannot differentiate benign from malignant lesions.Most malignant tumors can have inhomogeneous signals on T2-weighted images.Although a uniform signal on T2-weighted images can be a reliable indication of a benign lesion,a well-defined mass with homogeneous internal signal intensity does not definitively identify a benign lesion.Some common and distinctive soft-tissue lesions can have specific clinical and imaging features allowing a diagnosis without biopsy.These are known as determinate lesions.This illustrative report presents a diagnostic guide for extremity soft-tissue tumors based on tissue signal and morphological characteristics on magnetic resonance images.It is important for clinicians to be familiar with the imaging characteristics of common determinate lesions.
文摘BACKGROUND The anorectal leiomyosarcoma (LMS) is an aggressive malignant neoplasm. Owing to the rarity of LMSs, an optimal treatment modality has yet to be determined. AIM To collect all published data on anorectal LMS characteristics, explore current treatment options, and review recent cases of postradiation LMS. METHODS A literature search of the PubMed electronic database was conducted using the MeSH terms "rectal neoplasms","anus neoplasms" and "gastrointestinal neoplasms" combined with "leiomyosarcoma". The search was limited to English language and human studies. All available case reports and case series of anal or rectal LMSs that were published from the beginning of January 1996 to May 2017 were included if the diagnosis of LMS had been confirmed by histopathologic examination. Data were analyzed using simple statistics (mean, median, and standard deviation). Independent sample t-test was used to compare means for continuous variables. RESULTS A total of 27 articles reporting on 51 cases of anorectal LMS were identified. Among these cases, 11.7% had undergone previous pelvic radiotherapy (developing LMS at 13-35 years afterwards). Anorectal LMS affected the rectum in 92.2% of the cases, and no sex-based predominance was observed. Surgical resection with negative margins remains the mainstay of treatment, which can be accomplished with wide local excision or radical resection. The local recurrence rate was higher among cases who received wide local excision (30%), as compared to radical resection (20%);however, the overall rate of metastasis was 51.61% regardless of the treatment approach. The use of neoadjuvant radiation lowers the risk of local recurrence compared to adjuvant radiotherapy, and facilitates R0 resection of the tumor. Cases treated with adjuvant chemotherapy showed better rates of distant recurrence and overall survival. Nonetheless, multidisciplinary team discussion is necessary to determine the optimal management plan whilst considering patient- and disease-related factors. CONCLUSION A multidisciplinary team approach, considering the underlying patient- and disease- related factors, is necessary for optimal management of these complex tumors.
基金Supported by the International S and T Cooperation Program of China,No.2015DFA30440the National Natural Science Foundation of China,No.81301268Beijing Nova Plan,No.xxjc201812 and No.Z131107000413063
文摘Aggressive angiomyxoma （AAM） is a rare tumour that often occurs in soft tissues of the female genital tract. Eight cases of AAM are reported in this article, and the clinical features and ultrasound and magnetic resonance imaging （MRI） results of the eight cases are reviewed and summarized. The main complaints of all the patients were palpable and painless masses in the vulva or scrotum. The lesions were mainly located in the vulva, pelvis, and perineal region, with a large scope of involvement. The sonographic features of AAM were characteristic. On sonography, all of the masses were of irregular shape and showed hypoechogenicity, with a heterogeneous inner echotexture. Intratumoural and peritumoural blood fows were detected by colour Doppler imaging. On real-time ultrasonic imaging, prominent deformation of the lesions was observed bycompressing the masses with the probe. Some special imaging features were also revealed, including a la-minated or swirled appearance of inner echogenicity, and a fnger-like or tongue-like growth pattern. On MRI imaging, the lesions showed intermediate-intensity signals and intermediate to high-intensity signals on TI-weighted and T2-weighted sequences. A rapid and uneven enhancement pattern was demonstrated. After the comparison of sonographic features with MRIand pathological findings, we found the relevance of the ultrasonographic characteristics with MRI and his-tological features of AAM. Ultrasound can be a valuable imaging method for the preoperative diagnosis, eva-luation of scope, and follow-up of AAM.
文摘BACKGROUND Primary intracranial extraskeletal myxoid chondrosarcoma(EMC)is an extremely rare low-to intermediate-grade malignant soft tissue sarcoma,and only 15 cases have been reported in the literature.Due to its rarity,clinical data and research on this tumor type are extremely limited,the pathogenesis and histological origin are still unclear,and the diagnostic and standard clinical treatment strategies for intracranial EMC remain controversial and undefined.CASE SUMMARY We reported a case of a 52-year-old male who was admitted to the hospital with headache and dizziness for 1 mo,and his health status deteriorated during the last week.CT of the head showed a well-defined low-density lesion situated in the left cavernous sinus.Brain magnetic resonance imaging(MRI)showed a 3.4 cm×3.0 cm sized,well-defined,round-shaped and heterogeneously enhanced lesion located in the left cavernous sinus.The entire lesion was removed via supratentorial craniotomy and microsurgery.Postoperative pathological diagnosis indicated primary intracranial EMC.Subsequently,the patient underwent 45 Gy/15 F stereotactic radiotherapy after discharge.At present,it is 12 mo after surgery,with regular postoperative follow-up and regular MRI examinations,that there are no clinical symptoms and radiographic evidence indicating the recurrence of the tumor,and the patient has returned to normal life.CONCLUSION Currently,the most beneficial treatment for primary intracranial EMC is gross total resection combined with postoperative radiotherapy.Long-term follow-up is also necessary for patients.
文摘目的:从临床指标方面系统评价并比较自体软组织替代材料与结缔组织移植物联合冠向复位瓣技术治疗天然牙牙龈退缩的疗效。方法:计算机检索PubMed、EMBASE、Web of Science、维普、万方、知网等数据库中关于自体软组织替代材料或结缔组织移植物(CTG)治疗牙龈退缩的随机对照试验,检索时限从2013年1月至2023年12月。结果:最终纳入14个随机对照研究,1117个牙龈退缩位点。Meta分析显示,术后6个月时,CTG与异种胶原基质(XCM)比较能更好地降低牙龈退缩深度,与富血小板纤维蛋白(PRF)、脱细胞真皮基质(ADM)比较无明显区别;CTG与PRF、ADM、XCM比较角化龈宽度增量更明显;根面覆盖率指标差异无统计学意义;PRF、XCM可以明显降低患者术后的疼痛感。结论:研究表明,自体软组织替代材料与CTG相比,对于治疗牙龈退缩的效果并没有显著差异,但是前者可以降低患者术后疼痛感。
文摘BACKGROUND Solitary fibrous tumor(SFT)is a remarkably uncommon mesenchymal tumor.STAT6 level and a combination of clinical,pathological,and molecular features are required to arrive at a proper diagnosis.CASE SUMMARY In this report,we present an intriguing case involving a 43-year-old woman who initially exhibited symptoms of a bleeding retroperitoneal tumor,initially resembling a gastrointestinal stromal tumor,but later confirmed as an SFT.However,a year later,what was initially believed to be a recurrence of her SFT was instead identified as a desmoid tumor.CONCLUSION Distinguishing SFT from other tumors was pivotal.Correcting misdiagnoses of tumor type initially and of recurrence later was necessary for appropriate treatment of the correct desmoid type.
