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INTRODUCTION: Cephalometric soft tissue findings have shown correlation with pharyngeal width. Facial photographic analysis of patients with Obstructive Sleep Apnea (OSA) shows an increase in width and flatness of the midface. However, three-dimensional facial soft tissue morphology of children with OSA has not been studied. OBJECTIVE: The objective of the current study was to evaluate the association between facial morphology, upper airway volume, Polysomnography (PSG), and Pediatric Sleep Questionnaire (PSQ) findings in children with OSA versus controls. MATERIAL AND METHODS: The sample included de-identified pre-treatment Cone-beam Computed Tomography images, PSG and PSQ results of 36 children (mean age 6.8 ± 2.8) from one pediatric dental practice. Three-dimensional facial soft tissue landmarks were digitized using Mimics v.20 software. Upper airway volume was segmented into right nasal cavity (RNC), left nasal cavity (LNC), nasopharynx (NP), oropharynx (OP), and hypopharynx (HP). Apnea Hypopnea Index (AHI), Respiratory Disturbance Index (RDI) scores and Pediatric sleep questionnaire (PSQ) values were correlated with soft tissue measurements (a modified Farkas anthropometric analysis) and upper airway volumes using Pearson’s correlation. Student’s T-test was used to evaluate the difference between facial soft tissue measurements of children with obstructive sleep apnea (OSA) versus the control group. RESULTS: Experimental versus control: Polysomnography findings: Apnea/Hipopnea Index and Respiratory Disturbance Index were statistically higher in obstructive sleep apnea children compared to controls (p=<.0001, 0.0001), and lowest oxygen percentage SpO2 was significantly lower (p=0.006). Airway volume findings: Right nasal cavity was statistically larger in obstructive sleep apnea children compared to controls (p=0.04). Soft tissue findings: Exocanthus right to midsagittal plane, Exocanthus right and Exocanthus left, and Soft tissue orbitale right to midsagittal plane were smaller in obstructive sleep apnea children compared to controls (p=0.01, 0.02, 0.03). Experimental group results: Transverse. Nose: Bialar distance was positively correlated to right nasal cavity and nasopharynx, and negatively correlated to hypopharynx, Apnea/Hipopnea Index, and Respiratory Disturbance Index. Lips: Chelion Right and Left, and Crista Philtri Right and Left were positively correlated to NasoPharynx. Anteroposterior. Most of nose and lips measurements were positively correlated to Right Nasal Cavity and negatively correlated to Respiratory Disturbance Index and low oxygen percentage SpO2. Vertical. Nose measurements were positively correlated to NasoPharynx. Lips measurements were positively correlated to NasoPharynx and OroPharynx and negatively correlated to low oxygen percentage SpO2. Control group result: Transverse. Nose: Nostril Base Right to midsagittal was positively correlated to NasoPharynx and average oxygen percentage SpO2 and negatively correlated to Respiratory Disturbance Index. ProNasale to Nostril Base Right and Nostril Base Left was negatively correlate to Pediatric Sleep Questionnaire. Lips: Crista Philtri Right to midsagittal and Chelion Right to midsagittal plane were positively correlated to NasoPharynx and average oxygen percentage SpO2. Anteroposterior. Nose measurements were positively correlated to Right Nasal Cavity, NasoPharynx, OroPharynx, and HypoPharynx and negatively correlated to Pediatric Sleep Questionnaire. Lips measurements were positively correlated to Right Nasal Cavity, NasoPharynx. And OroPharynx. Vertical. Most nose and lips measurements were positively correlated to Right Nasal Cavity, NasoPharynx, OroPharynx, and HypoPharynx, and negatively correlated to Apnea/Hypopnea Index and Respiratory Disturbance Index. CONCLUSION: It can be concluded that for the experimental group wider faces at the level of the eyes, nose and lips indicated increased upper airway volumes, decreased Polysomnography, and Pediatric Sleep Questionnaire values. Moreover, more forward position of the nose and lips in relation to the coronal plane were linked to increased nasal airway volume and decreased Polysomnography values. Finally, long-faced individuals displayed higher volume of the upper airway and decreased oxygen saturation levels. In regards to the control group, anteroposterior measurements positively correlated to all airway compartments and negatively correlated to Pediatric Sleep Questionnaire values. Vertically, longer faces exhibit larger airway compartments and decreased Polysomnography values.

Forensic facial reconstruction may be the final option available to draw the public attention in cases where the identity of an individual cannot be established by standard identification methods. Two fundamental components of all forensic facial reconstruction techniques are cranial morphology and soft tissue depths databases. The purpose of this study was to extend such databases by providing a complete set of accurate facial soft tissue thickness measurements, acquired from a contemporary adult population from Germany, for use in forensic facial reconstruction. The aims were to measure the distance between well-defined landmarks on the skull and reference points on the face in a standardised manner, to analyse how sex, age and body mass index (BMI) influence facial soft tissue depths, to identify patterns of facial asymmetry, and to conduct a comparative analysis with other populations. The material for this study consisted of 320 (160 male, 160 female) anonymised multi-slice computerised tomography (MSCT) scans of individuals drawn from a German population. Individuals between the ages of 18 and 84 years were analysed. Their statures varied between 1.50 m and 1.96 m; their weights ranged between 40 kg and 145 kg. The BMI fluctuated between 16.6 kg/m2 and 45.8 kg/m2. Patients with severe trauma or pathologies that may compromise facial soft tissue depth were excluded from the study as were patients known to have been treated with specific medication (e.g. cortisone). In Amira®, 3D models of the surfaces of the skull and the facial skin were semi-automatically segmented using previously calculated thresholds and surface extraction algorithms. The parameters were adjusted to permit semi-transparent visualisation and examination of the structures of both the 3D skull and facial skin surface models simultaneously. Facial soft tissue depth was measured at 10 midline and 28 bilateral anatomical landmarks, according to the main orientations of the skull. Statistical analyses and tests were performed with SPSS® Version 22 and TDStats Version v2015.1. The analysis of facial soft tissue thickness versus BMI, sex and age, for each landmark separately, indicated that, at a number of the landmarks, facial soft tissue depth is significantly (p < 0.05) influenced by all three biometric variables. Facial soft tissue thickness increased with increasing BMI, but the correlations with age were insignificant. The differences between males and females were statistically significant (p < 0.05) for almost all anatomical landmarks with the exception of a few in the region of the nasal root and orbitals. Asymmetry was noted at over half of the bilateral landmarks. The differences between the results from this sample and those obtained from comparable databases contradict the hypothesis that population-specificity significantly influences facial soft tissue thickness. Nevertheless, this and future studies of craniofacial soft tissues will improve our knowledge of the complexity of the human face. The information gathered will be invaluable when considering forensic facial reconstruction methods for neighbouring populations.

The response of porcine adipose and skeletal muscle tissues to shock compression has been investigated using the plate-impact technique in conjunction with manganin foil pressure gauge diagnostics. This approach has allowed for measurement of the levels of uniaxial stress imparted to both skeletal muscle and rendered adipose tissue by the shock. In addition, the lateral stress component generated within adipose tissue during shock loading has also been investigated. The techniques employed in this study have allowed for equation-of-state relationships to be established for the investigated materials, highlighting non-hydrodynamic behaviour in each type of tissue over the range of investigated impact conditions. While the adipose tissue selected in this work has been shown to strengthen with impact stress in a manner similar to that seen to occur in polymeric materials, the skeletal muscle tissues exhibited a ow strength, or resistance to compression, that was independent of impact stress. Both the response of the adipose material and tested skeletal muscle tissues lie in contrast with the shock response of ballistic gelatin, which has previously been shown to exhibit hydrodynamic behaviour under equivalent loading conditions. Plate-impact experiments have also been used to investigate the shock response of a homogenized variant of one of the investigated muscle tissues. In the homogenized samples, the natural structure of skeletal muscle tissue, i.e. a fibrous and anisotropic composite, was heavily disrupted and the resulting material was milled into a fine paste. Rather than matching the response of the unaltered tissues, the datapoints generated from this type of experiment were seen to collapse back on to the hydrodynamic response predicted for skeletal muscle by its linear equation-of-state (Us = 1.72 + 1.88up). This suggests that the resistance to compression apparent in the data obtained for the virgin tissues was a direct result of the interaction of the shock with the quasi-organized structure of skeletal muscle. A soft-capture system has been developed in order to facilitate post-shock analysis of skeletal muscle tissue and to ascertain the effects of shock loading upon the structure of the material. The system was designed to deliver a one-dimensional, at-topped shock pulse to the sample prior to release. The overall design of the system was aided by use of the non-linear and explicit hydrocode ANSYSR AUTODYN. Following shock compression, sections of tissue were imaged using a transmission electron microscope (TEM). Both an auxetic-like response and large-scale disruption to the I-band/Z-disk regions within the tissue's structure were observed. Notably, these mechanisms have been noted to occur as a result of hydrostatic compression of skeletal muscle within the literature.

published_or_final_version / Pathology / Master / Master of Medical Sciences

A thesis submitted to the Faculty of Medicine, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Medicine in Therapeutic Radiology. / Soft tissue sarcomas of the extremities were previously treated either with wide excision alone, leading to a 30 to 50% local recurrence rate, or amputation, which although lead to a recurrence rate of less than 5%, caused significant physical and psychological morbidity. In addition to the :risk of local recurrence, distant metaatases occur in 30 to 50% of high grade lesions.(Abbreviation abstract) / Andrew Chakane 2018

acase@tulane.edu / Soft tissue mechanics attempts to describe biological tissues such as skin, tendon, and the reproductive organs using concepts found in mechanical engineering. By approaching soft tissues using this framework, the complex biomechanical response of such tissues, which have been implicated in the development of disease and injury, can be ascertained and quantified. Robust mechanical tests, in which tissue stress-strain behavior is characterized, are needed in order to inform constitutive models of healthy and diseased tissue. The overall objective of this thesis was to design, construct, program, and validate a planar biaxial device capable of testing soft tissues. Improvements and redesigns were made to the device to better suit the nature of testing required for soft tissue. Custom grips, modules, and software were developed and fabricated to facilitate accurate biaxial mechanical tests. Optimized for testing of small soft tissues, the biaxial device is an evolution of the standard approach towards mechanical testing. The overall device and the individual systems were validated internally and externally. Pilot studies were conducted on murine skin, compared to existing data from literature, and observed to correspond with known stress-strain and load-displacement properties. Further, experimental protocols were developed to evaluate the biaxial behavior of soft tissues, including cervical, uterine, vaginal, and uterosacral ligament tissue. Studies were described in which experimental data could be used to establish structure-function relationships describing reproductive tissue. Results from these studies could be used to elucidate the underlying mechanical etiologies of preterm birth and pelvic organ prolapse. / 1 / Jonathan Nguyen

Thesis (M. Med. Sc.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 70-79).

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