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Fa Yi Xue Za Zhi Jun 2022To find the appropriate method for age estimation for different ages and sexes.
OBJECTIVES
To find the appropriate method for age estimation for different ages and sexes.
METHODS
The costal cartilage, sternum and pubic symphysis of 91 unknowns from 2000 to 2020 from the Forensic Department of the Criminal Investigation Team of Shanghai Public Security Bureau were collected. Costal cartilage, sternal and pubic symphysis inferences were used to estimate the age, and the consistency between the estimated results and the actual physiological age of the unknowns was tested. The accuracy of age estimation of different samples was compared, and the relationship between accuracy and age and sex was analyzed.
RESULTS
Using the costal cartilage method, the inference errors of males, females and the whole population under 40 years old were (0.608±2.298) years, (0.429±1.867) years and (0.493±2.040) years, while those over 40 years old were (-1.707±3.770) years, (-3.286±4.078) years and (-2.625±4.029) years. The differences between different age groups in these three populations were statistically significant (<0.05). Using the sternum method, the inference errors of males and females under the age of 40 were (0.921±3.019) years and (0.452±1.451) years, while those over the age of 40 were (-5.903±5.088) years and (-1.429±2.227) years. The differences between different age groups in males and females were statistically significant (<0.05). Using the pubic symphysis method, the inference errors of males and females under 40 years old were (-0.204±1.876) years and (0.238±2.477) years, while those over 40 years old were (1.500±2.156) years and (-2.643±4.270) years. The differences between different age groups in males and females were statistically significant (<0.05). Using the sternum method and pubic symphysis method for age estimation of over 40 years old, the difference between different sexes was statistically significant (<0.05).
CONCLUSIONS
All three methods of age estimation are stable and effective and more accurate for people under 40 years old. For age estimation of unknowns over 40 years old, the pubic symphysis method is preferred in males and the sternum method is preferred in females.
Topics: Adult; Age Determination by Skeleton; Child, Preschool; China; Female; Forensic Anthropology; Forensic Medicine; Humans; Infant; Male; Pubic Symphysis
PubMed: 36221820
DOI: 10.12116/j.issn.1004-5619.2021.410703 -
Autopsy & Case Reports 2021Primary malignant giant cell tumor (PMGCT) is a diagnosis based on the presence of a high-grade sarcomatous component along with a typical benign giant cell tumor (GCT).... (Review)
Review
Primary malignant giant cell tumor (PMGCT) is a diagnosis based on the presence of a high-grade sarcomatous component along with a typical benign giant cell tumor (GCT). We report the first case of PMGCT of the sternum in a 28-year-old male with painless swelling over the manubrium sterni. The differential diagnoses of PMGCT and giant cell-rich osteosarcoma were considered. Surgical resection was performed, and the reconstruction was done with a neosternum using polymethyl methacrylate and prolene mesh. At 30 months follow-up, the patient is disease-free.
PubMed: 34249788
DOI: 10.4322/acr.2021.281 -
Orthopedic Research and Reviews 2020Sternoclavicular joint (SCJ) instability is a rare condition and results from either a traumatic high energy impact, such as a motor vehicle crash or contact sports... (Review)
Review
Sternoclavicular joint (SCJ) instability is a rare condition and results from either a traumatic high energy impact, such as a motor vehicle crash or contact sports injury, or non-traumatically as a result of structural pathology. The infrequency of this injury has contributed to its diagnosis being missed as well as the paucity of literature on treatment and outcomes. Patients with SCJ instability often report diminished range of motion as well as shoulder girdle pain. The presentation of instability in the sternoclavicular joint can vary in severity and anterior or posterior directionality. Variation in severity of the instability changes the course of treatment regarding either operative or non-operative interventions to stabilize the SCJ. In general, anterior instability of the SCJ (the medial clavicle is displaced anterior to the sternum) is less urgent and generally manageable by symptom alleviation and rehabilitation, although some anterior instability cases require surgical intervention. In the case of posterior SCJ instability (the medial clavicle is displaced posterior to the sternum), patients require prompt joint reduction as they are at the greater risk of life-threatening injury due to the location of critical structures of the mediastinum posterior to the SCJ. Computed tomography visualization is useful to confirm dislocation or subluxation direction to better formulate a proper treatment plan. The purpose of this review is to report the clinical presentation and management of SCJ instability including pertinent symptoms, the diagnostic approaches to evaluating SCJ instability, as well as operative and non-operative management of the joint instability.
PubMed: 32801951
DOI: 10.2147/ORR.S170964 -
Experimental and Therapeutic Medicine Sep 2022The sternum is one of the most important components of the chest wall. However, to the best of our knowledge, at present there is no reference value of the sternum...
The sternum is one of the most important components of the chest wall. However, to the best of our knowledge, at present there is no reference value of the sternum length in normal Han Chinese children that has been published in the literature. The aim of the present study was therefore to establish the reference value of sternum length in a normal Han Chinese population of different ages and sex groups. Chest computed tomography scans and three-dimensional reconstruction images of 1,080 individuals who were younger than 18 years old and without congenital or acquired structural anomalies or congenital metabolic diseases were retrospectively reviewed. The length of the sternum was measured for each individual and comparisons of the sternum length according to sex were conducted using the Mann-Whitney test. Age or region group comparisons were performed using the ANOVA test, and the association between the length of the sternum and age was assessed by regression analysis. A significant association between the age (x) of the individual and the length of the sternum (y) was confirmed, although different regression patterns were identified for the sexes (the regression equation for males was y=5.616x+60.408; P<0.001; R=0.890, whereas that for females was y=-0.134x+6.543x+56.805; P<0.001, R=0.890). No significant differences in sternum length were identified between the sexes for subjects aged 1-13 years old, whereas significant differences were observed comparing the sexes of the subjects aged 14-18 years old. In conclusion, the present study revealed that the length of the sternum in normal Han Chinese children can be precisely estimated by the age of the child using our formulae for the different sexes (where the most-fit formulae for the two sexes are different). This knowledge can be applied clinically in chest wall deformity assessment, and in surgery planning.
PubMed: 35978914
DOI: 10.3892/etm.2022.11496 -
International Orthopaedics Dec 2023The purpose of this study is to present a classification of thoracic spine fractures based on anatomical and biomechanical characteristics. (Review)
Review
PURPOSE
The purpose of this study is to present a classification of thoracic spine fractures based on anatomical and biomechanical characteristics.
METHODS
This is a narrative review of the literature.
RESULTS
The classification is based on the relationship between movement and common forces acting on the spine. A mechanistic concept is incorporated into the classification, which considers both movements and the application of forces, leading to pathomorphological characteristics. A hierarchical ranking determines the severity of fractures within the thoracic spine, and treatment recommendations are presented in each category. The fourth column of the spine is incorporated into the classification through direct and indirect mechanisms.
CONCLUSIONS
The proposed classification accommodates several advantages, such as simplicity and practicality, that make this classification helpful in daily practice. The dynamic relationship between movement and force provides a better understanding of the fracture mechanism. Finally, incorporating the fourth column will strengthen the indication for surgical management. To the best of our knowledge, this classification is the first classification developed uniquely for the thoracic spine fractures and will help to address a critical gap in the literature.
Topics: Humans; Spinal Fractures; Sternum; Thoracic Vertebrae; Fractures, Bone; Thoracic Injuries
PubMed: 36943457
DOI: 10.1007/s00264-023-05778-x -
International Journal of Surgery Case... Sep 2023Primary sternal osteomyelitis is a rare condition that is frequently caused by Staphylococcus aureus. It is often confused with other cardiac and pulmonary conditions....
INTRODUCTION
Primary sternal osteomyelitis is a rare condition that is frequently caused by Staphylococcus aureus. It is often confused with other cardiac and pulmonary conditions. Early antimicrobial treatment and surgical debridement is the cornerstone of treatment.
CASE PRESENTATION
A 51-year-old male adult came to the emergency room (ER) with a 2-week history of chest pain, fever, and malaise. His past medical history was unremarkable. Examination revealed a tender anterior chest wall swelling. White Blood Cells (WBCs) (21.6 × 10)/mm) and C-reactive protein (CRP) (294.10 mg/L) were elevated. Pus from the swelling and blood samples were sent for culture and sensitivity. Electrocardiogram (ECG) was normal and a computed tomography (CT) scan of the chest showed a large dense anterior chest wall abscess extending deep in the chest and to both axillae which caused bony erosion of the sternum. Incision and drainage of the abscess were performed, followed by surgical debridement of the wound. Cultures along the course showed both Staphylococcus aureus and Enterococcus. The patient improved gradually and 2 months after his initial presentation, he became free of symptoms, and CT has shown complete resolution.
DISCUSSION
Osteomyelitis usually happens after an external bacterium seeds the bone where it begins to grow and thrive, leading to the destruction and pus accumulation under the periosteum. For the treatment, identifying the causative agent is critical in giving intravenous (IV) antibiotic. Thereafter, incision and drainage of an abscess can be performed, similar to what was done with the patient mentioned. Radiography, specifically a CT scan, is crucial as it clearly reveals bony margins and can differentiate between a sequestrum and an involucrum. It also identifies cortical erosion, intraosseous gases and periosteal reactions.
CONCLUSION
Sternal osteomyelitis can have a nonspecific clinical presentation. Laboratory investigations and radiological findings are crucial for a prompt diagnosis. To prevent the progression of the disease and complications, early intervention is vital to ensure a good prognosis.
PubMed: 37591189
DOI: 10.1016/j.ijscr.2023.108654 -
The Korean Journal of Pain Oct 2021Percutaneous osteoplasty (POP) is defined as the injection of bone cement into various painful bony lesions, refractory to conventional therapy, as an extended technique... (Review)
Review
Percutaneous osteoplasty (POP) is defined as the injection of bone cement into various painful bony lesions, refractory to conventional therapy, as an extended technique of percutaneous vertebroplasty (PVP). POP can be applied to benign osteochondral lesions and malignant metastatic lesions throughout the whole skeleton, whereas PVP is restricted to the vertebral body. Common spinal metastases occur in the thoracic (70%), lumbosacral (20%), and cervical (10%) vertebrae, in order of frequency. Extraspinal metastases into the ribs, scapulae, sternum, and humeral head commonly originate from lung and breast cancers; extraspinal metastases into the pelvis and femoral head come from prostate, urinary bladder, colon, and uterine cervical cancers. Pain is aggravated in the dependent (or weight bearing) position, or during movement (or respiration). The tenderness and imaging diagnosis should match. The supposed mechanism of pain relief in POP is the augmentation of damaged bones, thermal and chemical ablation of the nociceptive nerves, and local inhibition of tumor invasion. Adjacent (facet) joint injections may be needed prior to POP (PVP). The length and thickness of the applied needle should be chosen according to the targeted bone. Bone cement is also selected by its osteoconduction, osteoinduction, and osteogenesis. Needle route should be chosen as a shortcut to reach the target bony lesions, without damage to the nerves and vessels. POP is a promising minimally invasive procedure for immediate pain relief. This review provides a technical survey for POPs in painful bony lesions.
PubMed: 34593656
DOI: 10.3344/kjp.2021.34.4.375 -
Acta Ortopedica Brasileira 2022To evaluate the sagittal tomographic reformatting of the sternum using unpublished radiographic parameters (indexes and angles), comparing them between the different...
OBJECTIVE
To evaluate the sagittal tomographic reformatting of the sternum using unpublished radiographic parameters (indexes and angles), comparing them between the different types of pectus, and controls.
METHODS
44 patients with pectus deformities and controls underwent chest CT for analysis. The types of pectus were classified into: inferior (IPC), superior (SPC) and lateral (LPC), and broad (BPE) and localized (LPE). The following tomographic parameters were created and measured: (1) spine-manubrium-sternum index (SMS); (2) column-sternum index (CSI); (3) manubrium-sternal angle (MSA); (4) inferior manubrium angle (IMA); and (5) inferior sternum angle (ISA). Statistical analysis was performed between the pectus and control groups, and between the different types of pectus.
RESULTS
There was a significant difference between: a) and when analyzing the SMS, CSI, MSA and ISA indexes. b) LPE and control group for SMS and ISA. c) LPC and LPE, and LPC and BPE for SMS; d) BPE and LPC for CSI; e) IPC and LPE, and IPC and BPE for ISA; f) SPC and LPE, and SPC and BPE for IMA.
CONCLUSION
The radiographic indexes and angles created provided differentiation parameters between patients with different types of pectus, and between these and controls.
PubMed: 36451784
DOI: 10.1590/1413-785220223005e250612 -
Journal of Pediatric Intensive Care Jun 2022The objective of this study was to compare the transcutaneous bilirubin (TcB) with total serum bilirubin (TSB) and to find out the effect of phototherapy on correlation...
The objective of this study was to compare the transcutaneous bilirubin (TcB) with total serum bilirubin (TSB) and to find out the effect of phototherapy on correlation of TcB and TSB during and after phototherapy in Indian neonates. Prospective observational study was performed at neonatal intensive care unit of Uttar Pradesh University of Medical Sciences, Saifai, Etawah, India. Blood samples for TSB estimation of 276 jaundiced neonates were sent, and simultaneously, TcB was measured at forehead and sternum on admission and 12 hourly till discontinuation of phototherapy as per the American Academy of Pediatrics nomogram chart and their correlation was assessed. The effect of phototherapy on correlation of TcB and TSB during and after phototherapy was also observed. The correlation between TSB and TcB was linear and significant for the entire study population over forehead (Pearson's = 0.802, = 0.644, < 0.001) as well as over sternum (Pearson's = 0.825, = 0.681, < 0.001) before starting the phototherapy. This correlation becomes slightly lower for TSB versus TcB forehead (Pearson's = 0.753, = 0.568, < 0.001) and for TSB versus TcB sternum (Pearson's = 0.754, = 0.569, < 0.001) after giving phototherapy for at least 24 hours. The correlation coefficients for TSB versus TcB measurements over forehead and sternum were 0.758 and 0.806, respectively, after 36 hours of phototherapy. TcB measurements using the transcutaneous bilirubinometer correlate closely with TSB levels, so it can be used as an easy and rapid noninvasive method of bilirubin measurement in jaundiced neonates.
PubMed: 35734214
DOI: 10.1055/s-0040-1721067