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Soft tissue sarcoma (STS) is a rare tumor, occurring in approximately 1 to 2 of every 100,000 individuals worldwide, and constitutes about 0.6% of all cancer cases and 0.7% of all cancer deaths. Prognosis is generally poor with a relative survival rate of approximately 67% at five years, with little difference by race. This chapter reviews the epidemiology of STS. Topics covered include classification, demographic patterns, environmental factors, host factors, pathogenesis, and preventive measures.

This chapter discusses tumours and malignancies occurring in the bones and soft tissues. These are common in children and rare in adults. Bone and soft tissue tumours may occur at any age; however, certain types of tumour follow a recognized pattern. Bone and soft tissue tumours grow and infiltrate locally, and they commonly affect the lungs via blood-borne metastasis. These tumours have great implications for the extent of local treatment required and the probability of local recurrence. Topics covered are the common symptoms associated with these tumours, such as pain, fungation and haemorrhage, as well as the management and treatment procedures that alleviate these.

Soft tissue sarcoma (STS) is a rare tumor, occurring in approximately one to four of every 100,000 individuals worldwide. Soft tissue sarcomas can form anywhere in the body, including muscle, tendons, fat, blood vessels, lymph vessels, nerves, and tissues around joints. They are most common in the head, neck, arms, legs, trunk, and abdomen. Prognosis is generally poor, with a relative survival rate of approximately 65% at five years, with little difference by race. Approximately 11,930 cases and 4,870 deaths from STS occurred in the United States in 2015. The etiology of STS is still poorly understood, which makes prevention of this relatively rare cancer difficult. A major complication in studying STS is the histologic diversity —more than 100 subtypes. Newer investigations are evaluating molecular characteristics and prognostic factors but continue to be hampered by a lack of standardized histology.

Biological tissue: The elastic properties of biological tissue show much greater contrast than their optical properties. Cells can be imaged in an aqueous medium, so that the variation with environment and time of their mechanical properties and adhesion to a substrate can be measured. For soft tissue, time‐resolved techniques are more relevant than Rayleigh wave interference. Mineralized tissues such as teeth can support Rayleigh waves, giving contrast from carious lesions and allowing line‐focus‐beam V(z) analysis to measure elastic anisotropy. Bone is an intermediate case, with contrast from its mechanical structure.

The search for an ideal soft tissue filler to correct facial folds and wrinkles has gone on for at least 100 years. Many products have been tried, including mineral oil, paraffin, and liquid silicone, in an effort to improve soft tissue imperfections. Most of the early substances were abandoned due to a high incidence of complications, including chronic edema, granuloma formation, scarring, and ulceration. The ideal tissue filler should be biocompatible, noncarcinogenic, nonteratogenic, nonmigratory, and free of adverse reaction. The ideal filler should also be inexpensive and easy to use, require little preparation, and provide long-lasting, natural, and predictable results with minimal recovery time. Although no currently available injectable substance possesses all of these ideal attributes, many currently available products provide more-than-satisfactory results and have excellent safety profiles. The indications for injectable filler agents have largely evolved through a better understanding of facial aging, specifically soft tissue deflation typically noted between youth and middle age. The limitations of surgical procedures to correct soft tissue atrophy, as well as the possibility of delaying surgical procedures by early intervention with injectable fillers, have made these agents very valuable in improving the appearance of the aging face. With the continued improvement in products and techniques during recent years, the clinical results with fillers have become more predictable. As a result of this improvement, an increasing number of patients are seeking nonsurgical methods for correcting age-related changes to their facial skin and soft tissue. There are essentially two types of natural facial wrinkles (or rhytides): dynamic and static. They may occur separately or in combination. Dynamic wrinkles appear within the skin due to repeated contracture by the underlying muscles of facial expression. Static wrinkles are present regardless of facial dynamics and result from intrinsic changes in the components of the dermal ground substance and from extrinsic factors such as smoking, gravity, and sun exposure. The formation of both dynamic and static wrinkles is influenced by the quality of the natural collagen matrix within the dermal layers of the skin. For the most part, dynamic wrinkles are best treated with Botulinum toxin injections, particularly in the upper face.

This chapter discusses skin and soft tissue tumours. Three known skin tumours are the basal cell carcinoma, the squamous cell carcinoma, and the melanoma. Basal cell carcinoma or rodent ulcer predominantly affects the elderly and is rarely a clinical problem except in a few neglected cases and in cases where there is an extensive invasion of the local soft tissues and bones. Squamous carcinoma emerges in middle-aged and elderly patients. Compared to basal cell carcinoma, squamous carcinoma spreads in the local and regional nodes and may develop blood-borne metastases. Melanoma, the most potent of the three skin tumours affects any age, although it is rare in children. It is associated with excessive sun exposure. This disease has rapid blood-borne metastases and can cause rapid death.

This chapter discusses the study and interpretation of the conodonts, a group of extinct animals whose identification and anatomical reconstruction was a mystery and a challenge throughout much of the twentieth century. It highlights the importance of conodonts in understanding the early history of vertebrates and the difficulties of paleontologists in analyzing the soft-tissue structure of the conodonts. The new understandings of conodonts reveal that vertebrates originated in the sea, and that the mineralized vertebrate skeleton in conodonts which served as a raptorial device is comparable to dentine and enamel. These findings are contrary to what Alfred Romer wrote in Man and the Vertebrates in 1933.

This chapter presents a biographical sketch of Arthur C. Aufderheide. This is followed by a discussion of his contributions to paleopathology. Aufderheide emerged as one of the guiding forces in the elaboration of soft tissue paleopathology. Complementing the case-specific work of prior researchers, his approach pioneered the first large-scale, population-based studies of mummies, allowing researchers to discuss prehistoric epidemiology on a scale not previously possible.

Patients with each of the 150 distinct rheumatic disorders frequently have overlapping muscle and joint complaints. Weakness, myalgias, arthralgias, spasm, lack of endurance, and stiffness are prominent features of fibromyalgia that may be difficult to differentiate from other conditions. The prominence of complaints in this area is what frequently brings patients to a musculoskeletal specialist such as a rheumatologist, as opposed to an infectious disease expert, general internist, or endocrinologist. Abigail was devastated after the unexpected death of her younger brother at age 30. Her physical and mental health had seemed tenuous, but she managed to pull herself together for the funeral and the visits of relatives from the Midwest. When it was over, Abigail’s coping skills began to fray. First, she began experiencing left-sided upper back pain and thought it was from lifting Aunt Minnie’s suitcase when taking her to the airport. Abigail saw the chiropractor she had consulted three or four times over a five-year period for similar backaches. However, this time the pain did not go away and spread to the right side. Dr. Johnson’s manipulations usually “snapped things back into place,” but this time they made her worse. Abigail became very concerned when her fiancée tried to take her to Myrtle Beach for a relaxing weekend and found that she was in agony whenever he hugged her. Although she had been an aerobics instructor, Abigail found it very difficult to do her morning exercise routine and after several weeks gave up. Trying to exercise was extremely painful. Innocent movements such as washing her back in the shower caused her muscles to tighten up and go into spasm. Dr. Johnson referred her to a rheumatologist, who diagnosed fibromyalgia and instituted a medication, education, and rehabilitation program. Over 80 percent of fibromyalgia patients have muscular symptoms or signs. Aching in the muscles, or myalgias, is common in the upper or lower back and neck area. Myalgias are usually present on both the right and left sides and present as a dull, throbbing discomfort. Spasm, defined as an involuntary muscular contraction, is less common than the sense of tightness in muscles that seems like spasm.