-
Bioengineering (Basel, Switzerland) May 2022The most common complication of median sternotomy surgery is sternum re-separation after sternal fixation, which leads to high rates of morbidity and mortality. The... (Review)
Review
The most common complication of median sternotomy surgery is sternum re-separation after sternal fixation, which leads to high rates of morbidity and mortality. The adhered sternal fixation technique comprises the wiring fixation technique and the use of bio-adhesives. Adhered sternal fixation techniques have not been extensively studied using finite element analysis, so mechanical testing studies and finite element analysis of sternal fixation will be presented in this review to find the optimum techniques for simulating sternal fixation with adhesives. The optimal wiring technique should enhance bone stability and limit sternal displacement. Bio-adhesives have been proposed to support sternal fixation, as wiring is prone to failure in cases of post-operative problems. The aim of this paper is to review and present the existing numerical and biomechanical sternal fixation studies by reviewing common sternal closure techniques, adhesives for sternal closure, biomechanical modeling of sternal fixation, and finite element modeling of sternal fixation systems. Investigating the physical behavior of 3D sternal fixation models by finite element analysis (FEA) will lower the expense of conducting clinical trials. This indicates that FEA studies of sternal fixation with adhesives are needed to analyze the efficiency of this sternal closure technique virtually.
PubMed: 35621476
DOI: 10.3390/bioengineering9050198 -
Internal Medicine (Tokyo, Japan) Jun 2022
Topics: Abdominal Wall; Hernia; Humans; Sternum
PubMed: 34803095
DOI: 10.2169/internalmedicine.8114-21 -
BMJ Case Reports Aug 2020Rib fractures due to blunt trauma are a common chest injury seen at the emergency department; however, injuries to the costovertebral joints are very rare. We present a...
Rib fractures due to blunt trauma are a common chest injury seen at the emergency department; however, injuries to the costovertebral joints are very rare. We present a case of a 24-year-old man who was admitted after a high-speed car collision and was assessed in a level 1 trauma centre in Amsterdam. He had multiple injuries, including dislocation of the costovertebral joint of ribs 7-10. After performing a literature search we concluded that patients with traumatic costovertebral joint dislocations have a high incidence of vertebral fractures, neurological deficits and additional fractures. We believe that isolated dislocation of one or multiple costovertebral joint(s) can safely be treated conservatively. Close monitoring of the patients is advisable as these injuries are caused by high impact and are associated with other injuries.
Topics: Accidents, Traffic; Contusions; Humans; Imaging, Three-Dimensional; Joint Dislocations; Lumbar Vertebrae; Male; Pneumothorax; Rib Fractures; Spinal Fractures; Sternum; Thoracic Vertebrae; Tomography, X-Ray Computed; Wounds, Nonpenetrating; Young Adult
PubMed: 32816931
DOI: 10.1136/bcr-2020-234931 -
Poultry Science Oct 2023Skeletal characteristics are important to the growth and development of poultry. In feeding management, constant free feeding (FF) of poultry may lead to imbalance...
Skeletal characteristics are important to the growth and development of poultry. In feeding management, constant free feeding (FF) of poultry may lead to imbalance between bone development and weight gain. Feed restriction (FR), to a certain extent, is one way to solve this problem. However, the effect of feed restriction on poultry bone development needs further elucidation at the molecular level. Therefore, in the present study, we investigated the effects of different levels of feed restriction (60% FR, 70% FR, 80% FR, and FF) on the sternum development of ducks at 7 and 8 wk old. In the seventh wk, with increasing feed restriction, the values of traits including body weight, breast muscle weight, sternal weight, keel length, and calcified keel length decreased. However, in the eighth wk, the sternum weight and keel length of ducks treated with 60% FR were unexpectedly higher than those of FF individuals, indicative of catch-up growth. Then, we conducted RNA-seq and metabolomic analysis on sterna from 7- and 8-wk-old FF and 60% FR ducks. The results identified multiple differentially expressed genes (DEGs) associated with sternum development that were influenced by feed restriction. Among them, we found that the mRNA expression levels of the chondroitin sulfate synthase 3 (CHSY3) and annexin A2 (ANXA2) which are involved in glycosaminoglycan biosynthesis and bone mineralization, had smaller changes over time under FR treatment than under FF treatment, implying that the FR treatment to a certain extent prevented the premature calcification and prolonged the development time of duck sternum. In addition, the metabolomic and integrative analyses revealed that several antiaging-related metabolites and genes were associated with sternal catch-up growth. Pyrimidine metabolism was identified as the most significant pathway in which most differential metabolites (DMs) between FF and 60% FR were enriched. The results from integrative analysis revealed that the content and expression of 4-aminobutyric acid (GABA) and its related genes showed relatively higher activity in the 60% FR group than in the FF group. The present study identifies multiple biomarkers associated with duck sternum development that are influenced by feed restriction and suggests the potential mechanism of feed restriction-associated duck sternal catch-up growth.
Topics: Humans; Animals; Ducks; Transcriptome; Chickens; Calcification, Physiologic; Sternum; Animal Feed
PubMed: 37604023
DOI: 10.1016/j.psj.2023.102961 -
Asian Journal of Surgery Jul 2022
Topics: Chest Pain; Histiocytosis, Langerhans-Cell; Humans; Sternum
PubMed: 35277320
DOI: 10.1016/j.asjsur.2022.02.038 -
Cureus Aug 2021Bone marrow aspiration (BMA) and bone marrow biopsy (BMB), are medical modalities for the detection of non-malignant diseases as well as hematological malignancies in... (Review)
Review
Bone marrow aspiration (BMA) and bone marrow biopsy (BMB), are medical modalities for the detection of non-malignant diseases as well as hematological malignancies in children. BMA attained momentum in the past few years owing to the possibility of achieving hematopoietic stem cells. Liquid bone marrow is aspirated through posterior/anterior iliac crest, tibia, and vertebral spinous process during BMA procedure in children for assessment of morphology at the microscopic level while BMB allows for cytological evaluation of marrow. It is also used for molecular genetics, immune-phenotypic, cytogenetics, and other specialized examinations. Additionally, BMA is also helpful in the reconstruction of tissue. These procedures should be performed by a specialist who has knowledge about the indication, contradictions, and hazards of these procedures due to their invasive nature. Still, there are no transparent guidelines available especially in the case of BMA for children. The purpose of this overview article is to focus on the specific guidelines to carry out the BMA and BMB in children and the techniques as well as complications associated with the BMA and BMB.
PubMed: 34589333
DOI: 10.7759/cureus.17423 -
Scientific Reports Aug 2022The sternum is a stabilizing element in the axial skeleton of most tetrapods, closely linked with the function of the pectoral girdle of the appendicular skeleton.... (Review)
Review
The sternum is a stabilizing element in the axial skeleton of most tetrapods, closely linked with the function of the pectoral girdle of the appendicular skeleton. Modern mammals have a distinctive sternum characterized by multiple ossified segments, the origins of which are poorly understood. Although the evolution of the pectoral girdle has been extensively studied in early members of the mammalian total group (Synapsida), only limited data exist for the sternum. Ancestrally, synapsids exhibit a single sternal element and previously the earliest report of a segmental sternum in non-mammalian synapsids was in the Middle Triassic cynodont Diademodon tetragonus. Here, we describe the well-preserved sternum of a gorgonopsian, a group of sabre-toothed synapsids from the Permian. It represents an ossified, multipartite element resembling the mammalian condition. This discovery pulls back the origin of the distinctive "mammalian" sternum to the base of Theriodontia, significantly extending the temporal range of this morphology. Through a review of sternal morphology across Synapsida, we reconstruct the evolutionary history of this structure. Furthermore, we explore its role in the evolution of mammalian posture, gait, and ventilation through progressive regionalization of the postcranium as well as the posteriorization of musculature associated with mammalian breathing.
Topics: Biological Evolution; Fossils; Locomotion; Respiration; Sternum
PubMed: 35931742
DOI: 10.1038/s41598-022-17492-6 -
Boletin Medico Del Hospital Infantil de... Feb 2021Neonatal jaundice is a frequent benign condition in newborns. However, a rapid diagnosis must be established for its most appropriate treatment. The objective of this...
BACKGROUND
Neonatal jaundice is a frequent benign condition in newborns. However, a rapid diagnosis must be established for its most appropriate treatment. The objective of this study was to measure the correlation between total serum bilirubin (TSB) and transcutaneous bilirubin (in forehead and sternum) in full-term newborns at 3400 m above sea level.
METHODS
We conducted a prospective and cross-sectional study in full-term newborns with clinical jaundice from the Hospital Regional in Cusco-Peru. General characteristics and measurement of TSB, transcutaneous forehead bilirubin (TcBF), and transcutaneous bilirubin in the sternum (TcBS) were explored. Correlation, sensitivity, and specificity were calculated. Receiver operating characteristic (ROC) curves were constructed using the SPSS statistical package, version 22.0.
RESULTS
A total of 123 newborns were evaluated. The mean bilirubin values were 13.7 ± 3.5 for TcBF, 14.1 ± 3.1 for TcBS, and 13.8 ± 3.9 for TSB. In addition, Pearson correlation coefficients between TSB/TcBF and TSB/TcBS were 0.90 and 0.91, respectively (p < 0.001). For the percentile 95 cut-off point, a sensitivity of 93% and 100% and a specificity of 89% and 80% were obtained for TcBF and TcBS, respectively, with an area under the curve of 0.813 for TcBF and 0.815 for TcBS (p < 0.001).
CONCLUSIONS
Measurement of transcutaneous bilirubin is a fast and painless method that can be considered a reliable tool for screening and monitoring neonatal jaundice, but not for a definitive diagnosis to decide the use of phototherapy in full-term newborns at 3400 m above sea level.
Topics: Bilirubin; Cross-Sectional Studies; Humans; Infant, Newborn; Jaundice, Neonatal; Neonatal Screening; Prospective Studies
PubMed: 33591961
DOI: 10.24875/BMHIM.20000125 -
Frontiers in Surgery 2023The conventional technique for pectus excavatum repair was pushing up the depressed chest wall by turning over the convexity of the bent pectus bar. We developed a new...
INTRODUCTION
The conventional technique for pectus excavatum repair was pushing up the depressed chest wall by turning over the convexity of the bent pectus bar. We developed a new concept in which a total crane lift was used as the source of power to elevate the depressed sternum without using pectus bar leverage. This study aims to verify the efficacy of exclusively crane-powered pectus excavatum repair in recent years.
METHODS
Among the 3622 pectus deformity repairs since 1999, 691 cases repaired with the total crane power between 2017 and 2022 were enrolled. The mean age was 12.0 years (3-45). The operative technique involved wire/screw crane elevation of the sternum, the entire chest wall remodeling with the cross or parallel bars, the bridge/claw bar fixations, and other adjunctive techniques. Outcome analysis included morphological variations, patterns of pectus bar placement, and complication rates.
RESULTS
The crane technique and pectoscopy (100%) were used. The bar placements were parallel (22.0%) and cross-bar (47.5%). The bar fixations were the claw fixators for a single bar (30.5%) and the bridge plates for multiple bars (69.5%). The flare-buster and magic strings were liberally used. No serious complications or catastrophic events occurred, but minor complications occurred in 16.9%: pneumothorax in 7.4% (51), pleural effusion in 1.6% (11), and wound problems in 0.4% (3). There was no case of bar displacement.
DISCUSSION
The crane-powered pectus excavatum repair showed excellent results with minimal complications and no bar displacement. This innovative approach, part of the NeoPectus surgery, represents a significant advancement in correcting pectus excavatum deformities by utilizing a crane machine to elevate the chest wall.
PubMed: 38192491
DOI: 10.3389/fsurg.2023.1267009 -
Brazilian Journal of Cardiovascular... Oct 2021In this study, we aimed to evaluate the anatomical deformations of the major vascular structures in the retrosternal area caused by adhesions following coronary artery...
INTRODUCTION
In this study, we aimed to evaluate the anatomical deformations of the major vascular structures in the retrosternal area caused by adhesions following coronary artery bypass grafting (CABG).
METHODS
This single-center, retrospective study included a total of 40 patients with a previous CABG who were admitted to our emergency unit for any reason and underwent a contrast-enhanced chest computed tomography (patient group) and 40 patients without previous cardiac surgery (control group) between January 2018 and November 2019. The retrosternal area was compared between the groups using the statistical shape analysis method. The distance between the sternum and the ascending aorta and pulmonary artery was measured and anatomical deformations of the retrosternal area were examined.
RESULTS
There was a statistically significant difference in the anatomical structures of the retrosternal area between the patient and control groups (P<0.001). The distance from the midsternal line to the highest point of the pulmonary artery was statistically significantly shorter in the patient group, compared to the control group (P=0.013). The distance from the sternum to the ascending aorta was also shorter in the patient group, although it did not reach statistical significance (P>0.05).
CONCLUSIONS
Our study results showed narrowing of the retrosternal area following CABG and a shorter distance from the sternum to the pulmonary artery than the ascending aorta. Based on these findings, surgeons should be cautious about possible injuries in patients requiring cardiac surgery with repeated median sternotomy.
Topics: Coronary Artery Bypass; Humans; Reoperation; Retrospective Studies; Sternotomy; Sternum; Treatment Outcome
PubMed: 33355804
DOI: 10.21470/1678-9741-2020-0294