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Current Biology : CB Jan 2023Evolutionary transitions are frequently associated with novel anatomical structures, but the origins of the structures themselves are often poorly known. We use...
Evolutionary transitions are frequently associated with novel anatomical structures, but the origins of the structures themselves are often poorly known. We use developmental, genetic, and paleontological data to demonstrate that the therian sternum was assembled from pre-existing elements. Imaging of the perinatal mouse reveals two paired sternal elements, both composed primarily of cells with lateral plate mesoderm origin. Location, articulations, and development identify them as homologs of the interclavicle and the sternal bands of synapsid outgroups. The interclavicle, not previously recognized in therians, articulates with the clavicle and differs from the sternal bands in both embryonic HOX expression and pattern of skeletal maturation. The sternal bands articulate with the ribs in two styles, most clearly differentiated by their association with sternebrae. Evolutionary trait mapping indicates that the interclavicle and sternal bands were independent elements throughout most of synapsid history. The differentiation of rib articulation styles and the subdivision of the sternal bands into sternebrae were key innovations likely associated with transitions in locomotor and respiratory mechanics. Fusion of the interclavicle and the anterior sternal bands to form a presternum anterior to the first sternebra was a historically recent innovation unique to therians. Subsequent disassembly of the radically reduced sternum of mysticete cetaceans was element specific, reflecting the constraints that conserved developmental programs exert on composite structures.
Topics: Animals; Mice; Sternum; Biological Evolution; Mammals; Mesoderm; Ribs; Cetacea
PubMed: 36563692
DOI: 10.1016/j.cub.2022.11.055 -
Journal of Cardiac Surgery Nov 2022Some would argue that kids aren't just little adults, but what about their sternums? We are reviewing a manuscript by Horriat, McCandless, and colleagues in the Journal...
Some would argue that kids aren't just little adults, but what about their sternums? We are reviewing a manuscript by Horriat, McCandless, and colleagues in the Journal of Cardiac Surgery describing their experience with managing sternal wound infections (SWI) after congenital heart surgery. They report encouraging results in 14 patients who required plastic surgery consultation to manage their sternal wounds. The nature of congenital cardiac abnormalities and the necessary steps to repair them leads to physiologic derangements predisposing patients to SWI. Rates of SWI vary and have been reported at 1.53% in this population. There is little guidance on how the management of the congenital cardiac surgery patient should differ from the adult patient.
Topics: Adult; Cardiac Surgical Procedures; Heart Defects, Congenital; Humans; Plastic Surgery Procedures; Retrospective Studies; Sternum; Surgical Wound Infection
PubMed: 35979689
DOI: 10.1111/jocs.16845 -
The Journal of International Medical... May 2023Osteosarcoma and Ewing sarcoma of the rib, sternum, and clavicle are rare tumor entities, and their clinical features and treatment outcomes have been rarely reported....
OBJECTIVE
Osteosarcoma and Ewing sarcoma of the rib, sternum, and clavicle are rare tumor entities, and their clinical features and treatment outcomes have been rarely reported. The present study was performed to evaluate their survival and confirm independent survival predictors.
METHODS
Data on patients with osteosarcoma or Ewing sarcoma of the rib, sternum, and clavicle from 1973 to 2016 were retrospectively extracted from the database. Univariate and multivariate Cox regression analyses were used to determine the independent risk factors. Kaplan-Meier survival curves were applied to examine the prognostic difference between the groups.
RESULTS
In total, 475 patients with osteosarcoma or Ewing sarcoma of the rib, sternum, and clavicle were eligible for this study, including 173 (36.4%) with osteosarcoma and 302 (63.6%) with Ewing sarcoma. The 5-year overall survival and cancer-specific survival rates of all patients were 53.6% and 60.8%, respectively. Six independent variables were identified, including age at diagnosis, sex, histological grade, metastatic status, tumor type, and surgery.
CONCLUSIONS
Surgical resection is a reliable treatment for osteosarcoma and Ewing sarcoma of the rib, sternum, and clavicle. Further research is needed to reconfirm the role of chemotherapy and radiotherapy in survival of these patients.
Topics: Humans; Sarcoma, Ewing; Prognosis; Clavicle; Retrospective Studies; Osteosarcoma; Sternum; Bone Neoplasms; Ribs
PubMed: 37219447
DOI: 10.1177/03000605231175763 -
Folia Morphologica 2023The sternocleidomastoid muscles (SCM) are prominent paired muscles of the neck connecting proximally the manubrium sterni and the clavicle to the mastoid process and the... (Review)
Review
The sternocleidomastoid muscles (SCM) are prominent paired muscles of the neck connecting proximally the manubrium sterni and the clavicle to the mastoid process and the occipital bone distally. Following their points of attachment sternomastoid, sternooccipital, cleidomastoid and cleidooccipital portions of this muscle have been described. Altogether 23 case reports from year 2000 till 2020 with 29 subjects related to the SCM supernumerary variations were searched and analysed where parameters such as supernumerary proximal variation types (sternal vs. clavicular), insertional variation, unilaterality/bilaterality of the variation, study type, reported gender of the subjects and the country of research were extracted. The research shows that 48.3% of the subjects had bilateral presentation of SCM variations. If present unilaterally, three quarters of the cases were on the left side. The most frequent variation is located at the clavicular side of the proximal SCM head whereas isolated sternal sided proximal head variation or an insertional variation alone are very rare. Interestingly, with 96.6%, most of cases in the literature were discovered in cadavers during anatomical dissections. Male gender represented with 82.8% higher prevalence than females. The higher male prevalence in the body donor system, predominantly in the Asian continent could play a decisive role in the outcome as more than half of the reported cases stemmed from India in this period. Importantly, the knowledge of different anatomical variations of the SCM is highly relevant for surgical, clinical or radiological approaches in the neck.
Topics: Female; Humans; Male; Neck Muscles; Neck; Dissection; Sternum; Clavicle
PubMed: 35607877
DOI: 10.5603/FM.a2022.0045 -
Thoracic Cancer Jun 2020Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor composed of dendritic and endothelial cells, and accounts for less than 1% of all vascular tumors. The...
Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor composed of dendritic and endothelial cells, and accounts for less than 1% of all vascular tumors. The tumor may arise from any location in the body, but it has a predilection for veins of the extremities, the liver, bone, and skin. Herein, we report a case of a 43-year-old man who presented with a chest mass accompanied by chest pain. Computed tomography (CT) scan of the chest showed a 3 cm × 2 cm sternal mass in the chest wall. We performed tumor resection and reconstruction of the chest wall. EHE was confirmed via postoperative pathology. The patient underwent postoperative adjuvant radiotherapy, and no evidence of tumor recurrence was discovered during the one-year follow up.
Topics: Adult; Hemangioendothelioma, Epithelioid; Humans; Male; Prognosis; Sternum
PubMed: 32347015
DOI: 10.1111/1759-7714.13454 -
Diagnostics (Basel, Switzerland) Apr 2024A 54-year-old woman presented to an outpatient clinic with a recurrence of triple-negative breast cancer and multiple bone metastases. The patient had a large mass...
A 54-year-old woman presented to an outpatient clinic with a recurrence of triple-negative breast cancer and multiple bone metastases. The patient had a large mass lesion of 10 cm on the sternum. She received the immune checkpoint inhibitors pembrolizumab and taxane. Initially, the patient responded excellently to treatment, but stopped pembrolizumab for grade IV skin toxicity with multiple ulcerative wounds over the bilateral leg and trunk. The lesions abated following administration of antibiotics and oral prednisolone for two months. After that, she was referred to the radiation oncology department for further treatment. She received radiotherapy for the sternum mass but stopped radiation at 42Gy/21 fractions for severe dyspnea and fever. Blood sampling found leukocytosis with neutrophil predominance. Chest radiography showed bilateral lung infiltration. Pulmonary CT scan yielded bilateral lung patchy consolidation compatible with radiation isodose-line. Bronchial lavage showed positive Pneumocystis jiroveci PCR. Dyspnea improved after titrating methylprednisolone within two days. The patient recovered well with TMP-SMX and glucocorticoids after the initiation of therapy.
PubMed: 38667495
DOI: 10.3390/diagnostics14080850 -
Radiologia Brasileira 2022To examine the relationship that the types and locations of fractures of the sternum have with mortality and morbidity.
OBJECTIVE
To examine the relationship that the types and locations of fractures of the sternum have with mortality and morbidity.
MATERIALS AND METHODS
We analyzed the records of 115 patients diagnosed with fracture of the sternum, due to blunt trauma, between 2007 and 2018. Records of computed tomography studies were obtained from the radiology archive of a tertiary teaching hospital. The type of fracture was classified as linear, displaced, or comminuted, whereas the fracture location was classified as the manubrium, body, or xiphoid process.
RESULTS
A total of 108 patients were included in the study. Of those patients, 92 (85.2%) were male and 16 (14.8%) were female. The etiology was a traffic accident in 72 cases (62.6%) and a fall from height in 36 (31.3%). The mean age was 42.1 ± 17.7 years for males and 53.9 ± 20.0 years for females. The mortality rate was 11.1%. Among the 12 deceased patients, the mean age was 44.4 ± 18.3 years. The fracture was located exclusively in the manubrium in 64 patients (59.3%), exclusively in the body of the sternum in 41 (38.0%), and in both locations in three (2.7%), whereas none were located in the xiphoid process. Morbidity rates were higher in the patients with fractures of the manubrium than in those with fractures of the body of the sternum, as was the incidence of accompanying bone fractures and organ injuries. The fracture was linear in 44 patients (40.7%), displaced in 62 (57.4%), and comminuted in 30 (27.8%). The mortality was significantly higher for comminuted fractures than for the other fracture types ( = 0.045; β = 4.40).
CONCLUSION
Fracture of the manubrium can be indicative of the severity of trauma and has a poor prognosis.
PubMed: 35795607
DOI: 10.1590/0100-3984.2021.0074 -
PeerJ 2022Domestication, including selective breeding, can lead to morphological changes of biomechanical relevance. In birds, limb proportions and sternum characteristics are of... (Comparative Study)
Comparative Study
BACKGROUND
Domestication, including selective breeding, can lead to morphological changes of biomechanical relevance. In birds, limb proportions and sternum characteristics are of great importance and have been studied in the past for their relation with flight, terrestrial locomotion and animal welfare. In this work we studied the effects of domestication and breed formation in limb proportions and sternum characteristics in chicken (), mallard ducks () and Muscovy ducks ().
METHODS
First, we quantified the proportional length of three long bones of the forelimb (humerus, radius, and carpometacarpus) and the hind limb (femur, tibiotarsus, and tarsometatarsus) in domestic chickens, mallard ducks, and Muscovy ducks and their wild counterparts. For this, we took linear measurements of these bones and compared their proportions in the wild the domestic group in each species. In chicken, these comparisons could also be conducted among different breeds. We then evaluated the proportional differences in the context of static and ontogenetic allometry. Further, we compared discrete sternum characteristics in red jungle fowl and chicken breeds. In total, we examined limb bones of 287 specimens and keel bones of 63 specimens.
RESULTS
We found a lack of significant change in the proportions of limb bones of chicken and Muscovy duck due to domestication, but significant differences in the case of mallard ducks. Variation of evolvability, allometric scaling, and heterochrony may serve to describe some of the patterns of change we report. Flight capacity loss in mallard ducks resulting from domestication may have a relation with the difference in limb proportions. The lack of variation in proportions that could distinguish domestic from wild forms of chicken and Muscovy ducks may reflect no selection for flight capacity during the domestication process in these groups. In chicken, some of the differences identified in the traits discussed are breed-dependent. The study of the sternum revealed that the condition of crooked keel was not unique to domestic chicken, that some sternal characteristics were more frequent in certain chicken breeds than in others, and that overall there were no keel characteristics that are unique for certain chicken breeds. Despite some similar morphological changes identified across species, this study highlights the lack of universal patterns in domestication and breed formation.
Topics: Animals; Chickens; Domestication; Ducks; Lower Extremity; Phenotype
PubMed: 35502208
DOI: 10.7717/peerj.13229