Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Manubrium”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources
PubMed1984

An anterior surgical approach to the upper thoracic vertebrae.

Of the various anterior surgical approaches to the spine, exposure of the upper two thoracic vertebrae remains the most challenging. An operative approach to this region is described. The major features include resection of a portion of the clavicle and the manubrium sterni. Following resection of the tumor and involved vertebra, anterior fusion is performed using the clavicle as a strut graft. Immediate stabilization may also be achieved with methyl methacrylate replacement of the vertebral bodies. The operation is well tolerated, and requires minimal postoperative immobilization. The clinical presentation, radiological features, and results of treatment in a series of seven patients operated on during a 2-year period are presented.

Abscess↗
PubMed2005

Pyogenic spondylitis in the cervicothoracic junction with high-positioned aortic arch. Case report and review of the literature.

The authors report the case of an 87-year-old woman who suffered from T1-2 pyogenic spondylitis resulting in progressive and severe paraplegia. Debridement and anterior manubrium-splitting fusion were difficult because a high-positioned aortic arch was very close to the infectious lesion. Because adequate intravenous antibiotic agents had nearly resolved the inflammation, the authors undertook anterior debridement and posterior fusion that involved costotransversectomy and the placement of a posterior cervical pedicle screw fixation system. At 1.5 years postoperatively, there were no signs of recurrent infection. Solid osseous union was documented, and the patient's paraplegia had improved. A high-positioned aortic arch will likely interfere with an anterior approach to the cervicothoracic junction. If adequate antibiotic therapy has successfully controlled the spinal infection, anterior debridement and posterior fusion can be conducted in cases involving such anatomical limitations.

Aged↗
PubMed2003

Bilateral sternalis with unusual left-sided presentation: a clinical perspective.

An unusual variation creates interest among anatomists, but is a cause of concern among clinicians when it mimics a pathology. The sternalis muscle is one such variant of the anterior chest wall located subcutaneously over the pectoralis major, ranging from a few short fibers to a well-formed muscle. We observed a bilateral case, which was accompanied by an atypical presentation on the left side where a huge, bulky sternalis muscle was associated with the absence of the sternal fibers of the pectoralis major. The fibers arose as a lateral strip from the upper two-thirds of the body of the sternum and costal cartilages 2 through 6 with the intervening fascia and aponeurosis of the external oblique. The right sternalis was strap-like and was placed vertically over the sternal fibers of the pectoralis major, arising from the underlying fascia and aponeurosis of the external oblique. The sternalis muscles, on each side, converged into an aponeurosis over the manubrium that was continuous with the sternal heads of the right and left sternocleidomastoid muscle, respectively. This rare anomaly has puzzled radiologists and surgeons in confirming diagnosis, missing it all together or mistaking it for a tumor on mammography or CT scan. These findings prompted us to review its topography, development, and application in relation to the anterior chest wall.

Adult↗
PubMed2000

Osteoreflectory treatment of alcohol abstinence syndrome and craving for alcohol in patients with alcoholism.

Osteoreflexotherapy is used alone as a treatment used for alcohol abstinence syndrome and for alcohol craving by intraosseal stimulation of the processus styloideus ulnae of the patient's left and right hands as well as the processus spinosus of the seventh cervical vertebra and the manubrium sterni osteoreceptors. This is done by intraosseal injection of 0.5 to 1.0 ml of 0.9% NaCl solution during a period of 3 to 5 seconds. Craving for alcohol and depressed mood, strongly manifested Alcohol Abstinence Syndrome (AAS) symptoms before osteoreflexotherapy, were reduced in a most convenient and fast manner under the influence of two sessions of osteoreceptive stimulation. The withdrawal symptoms caused by alcohol abstinence decreased markedly during the first two hours after the first osteoreflexotherapy treatment, continued to decrease in the next 24 hours and by the time the second osteoreflexotherapy session was given, the withdrawal symptoms completely disappeared in 72 hours. The most slowly and least reduced AAS symptoms were asthenia and disturbances of postular equilibrium. Based on clinical observations, it is speculated that osteoreceptive stimulations destroy ethanol dependent functional systems and restore the neurophysiological and neuromediatorial integration of the brain in alcoholismpatients. Primarily because of these two cited factors, the patient can be freed of the craving for alcohol for several years, and he or she also does not suffer from depression.

Adult↗
PubMed1990

[Holographic observation of the tympanic membrane vibration after stapes fixation].

Sclerosis of auditory ossicle was experimentally induced by fixation of the stapes, and its effect on the tympanic membrane vibration was examined using fresh 10 canine temporal bones by means of holographic interferometry. By changing the sound pressure (from 90 to 110dB) and the frequency (from 250Hz to 8kHz) in steps, vibration of the membrane was induced in a free field. At each frequency, the vibration of the membrane was photographed by the time averaged method using He-Ne laser. A small hole was created in the tympanic bulla and the stapes was fixed with an adhesive (Alon Alpha), followed by closure of the hole. Before stapes fixation, the posterior part of the membrane showed a simple vibration pattern, forming cocentric interference circles at frequencies from 250Hz to 2kHz. At 3kHz, segmental vibration began to be noted, and complex segmental vibration was seen at frequencies 4.5 and 6kHz. The vibration after stapes fixation became simpler at frequencies over 3kHz, accompanied by decrease in the number of segmental vibrations. Vibration amplitude in the posterior part of the membrane decreased from 250Hz to 3kHz, while it increased at frequencies over 4kHz. In the anterior part of the membrane, the amplitude decreased at frequencies under 2kHz, remained unchanged at 3kHz and increased at frequencies over 4kHz after stapes fixation. In the tip of the manubrium mallei, the amplitude decreased at frequencies under 3kHz and increased at frequencies over 4kHz. Thus, a shift of peak vibration to high sound region was observed after stapes fixation at every part of tympanic membrane.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

[Effects of an increase or decrease in the middle ear pressure on tympanic membrane vibrations (experimental study by holographic interferometry)].

The effects of positive and negative pressure in the middle ear on tympanic membrane (TM) vibrations were studied in twenty canine temporal bones by holographic interferometry. The displacement of the TM was measured by moiré topography. 1) When pressure was applied to the tympanic cavity, the curvature of the TM became small under negative pressure and large under positive pressure, with the displacement being greater under positive pressure. 2) Without pressure load, the vibration pattern below 2 kHz was simple and there were peak displacement regions in the posterior and anterior parts of the membrane and the peaks occurred approximately halfway along the manubrium. The TM vibrations showed sectional patterns, above 3 kHz in the posterior and above 4 kHz in the anterior. The amplitude of the anterior peak was larger than that of the mallear tip, but smaller than that of the posterior. 3) At frequencies below 2 kHz, the vibration pattern was not affected by negative pressure load. At frequencies of 3 kHz or higher, the sectional patterns changed into the simpler patterns and the sectional vibrations diminished as the pressure increased. 4) Below 2 kHz, the TM amplitude decreased with increasing negative pressure. Above 3 kH, the amplitude showed an initial increase but decreased at higher negative pressure loading. With the amplitude of the mallear tip, the same tendency was observed. The resonance frequency shifted to a higher frequency range with pressure loading. 5) Under positive pressure, the vibration pattern remained unchanged below 2 kHz, and above 3 kH, sectional vibrations changed to the simple vibrations.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2005

Cadaver testing to validate design criteria of an adult intraosseous infusion system.

INTRODUCTION: The FAST 1 intraosseous (IO) infusion system was designed to deliver fluids and medications into the adult sternum in the prehospital and battlefield environments. OBJECTIVE: To test the prototype in 106 cadavers and excised sterna and compare it with other IO devices. RESULTS: The insertion force was similar to that of other IO devices (mean, 8.5 kg; range, 2.3-19.6 kg). In 39 of 39 trials, the depth-control mechanism inserted the portal within 1.0 mm of a predetermined distance below the anterior surface of the cortical bone. If misplaced, underpenetration was more likely than overpenetration (mean displacement, -0.3 mm; SD, 0.5 mm). After release, the portal could not be advanced further into the manubrium. Marrow was accessed in 75 of 77 trials. Mean flow rates were 109 mL/min for normal saline solution and 102 mL/min for hypertonic saline/dextran, similar to the Cook Sur-Fast device. CONCLUSION: The cadaver and bench tests demonstrated the reliability and safety of the FAST 1 system at the design/prototype stage.

Aged↗
PubMed1999

Chronic inflammatory ear disease and cholesteatoma: creation of auxiliary attic aeration pathways by microdissection.

HYPOTHESIS: The attic compartments, except for Prussak's space, are aerated through the tympanic isthmus. The aim of this study was to develop aeration pathways that would bypass the isthmus in surgery for chronic inflammatory ear disease and cholesteatoma. BACKGROUND: Microdissection of the epitympanum has shown that the anterior attic and the supratubal recess are separated by the tensor fold, the excision of which creates a large new aeration pathway. METHODS: Earlier surgical experience was reexamined as to the access to the tensor fold. Twenty temporal bones were dissected to create clinically useful new surgical routes for tensor fold removal in the presence of an intact ossicular chain. RESULTS: An endaural atticotomy, extended to the supratubal recess, allows excision of the tensor fold; however, the excision must be performed blindly. Cutting the neck of the malleus to allow lateral lifting of the manubrium exposes the tensor tendon and allows rapid excision of the fold. The elasticity of the tendon assists in approximation of the cut edges. In canal wall up surgery, removal of the lateral attic bone until the root of the zygoma exposes the anterior surface of the head of the malleus and the lateral portion of the transverse crest. Drill-out of the crest leads directly to the posterior side of the tensor fold, allowing its excision under direct vision. Thinning of the attic bone lateral to the body and short process of the incus allows simultaneous removal of the lateral incudomalleal fold. CONCLUSIONS: When the ossicular chain is discontinuous, tensor fold resection can be made under direct vision. With an intact chain, cutting of the neck of the malleus used in tympanic glomus tumors causes no hearing changes, allows complete fold excision, and is adaptable to chronic ear surgery. The frontolateral attic route for removal of tensor fold, together with the lateral incudomalleal fold, can be used in the canal wall up surgery to improve attic aeration.

Cholesteatoma, Middle Ear↗
PubMed1999

Surgical anatomy of the ear of the fat sand rat.

OBJECTIVE: This study was conducted to investigate and describe the anatomical details of the ear of the fat sand rat (Psammomys obesus). METHODS: Thirty ears (15 in dry skull and 15 in live animals) were dissected with the aid of an operating microscope and microsurgical techniques. Photographs were taken through an operating microscope. RESULTS: The temporal bone of the fat sand rat consists mainly of an unusually large bulla. Three distinct auditory ossicles were visualized and the manubrium of the malleus is relatively long in relation to the size of the ear. Most parts of the inner ear bulge into the bulla cavity and are easily accessible. The cochlea consists of 3.25 turns. The tympanic membrane, facial nerve, stapedial artery, and eustachian tube are described in detail. The large size of the bulla is probably related to the high sensitivity, particularly at low frequencies of the animals ear. CONCLUSION: The fat sand rat was found to be an excellent experimental animal for the investigation of middle and inner ear physiology.

Animals↗
PubMed1999

A case of abnormal localization of osteomyelitis.

A patient with osteomyelitis and abnormal localization of the changes is presented--left sterno-clavicular joint, the medial parts of the clavicular bone and the first rib, as well as the manubrium sterni. General and target radiography, tomography and chest CT-scan were performed. The reported case is of interest because of the rare localization, the characteristics of the X-ray conduct and the symptomatology in differential and diagnostic aspect.

Clavicle↗
PubMed1999

Occult breast cancer detection with technetium-99m-sestamibi: a case report.

A 74-y-old woman with a 4-y history of left arm lymphedema and multiple negative mammography studies presented to her physician with a palpable subcutaneous nodule in the left upper arm. After biopsy the nodule was read pathologically as secondary breast carcinoma. We report a finding of a positive 99mTc-sestamibi scintimammography in the presence of an unremarkable mammogram. The study also revealed a positive uptake in a metastatic lesion in the manubrium of the sternum.

Aged↗
PubMed1995

Objective Tinnitus and the Tensor Tympani Muscle.

Objective tinnitus (OT) may be caused by contraction of the tensor tympani muscle (TTM). The more forcefully the TTM contracts, the greater the intensity of the OT heard. Forceful closure of both eyelids can reflexively cause OT by contracting the TTM. The Forceful Eyelid Closure Syndrome (FECS) was reported at the Proceedings of the Second International Tinnitus Seminar in 1983.(1) FECS consists of several factors: (1) Objective tinnitus (2) An associated waning of hearing primarily of the lower frequencies, as much as 45 dB at 125 Hz, 30 to 40 dB at 250 Hz ascending to the patient's norm at 2000 Hz and approximately a 5 to 10 dB at 4000 Hz and 5 to 20 dB at 8000 Hz (3) Retraction of the manubrium and posterior mid-third of the tympanic membrane (TM) at the malleus-umbo area as seen under the otomicroscope (OM) in 25% (108) of 432 ears examined (4) These same ears were 75% (324) positive for increased impedance at maximum compliance with FEC. Of the patients studied, 25% had no response under the otomicroscope or by impedance audiometry.

Journal Article↗
PubMed2000

Cutaneous promyelocytic sarcoma at sites of vascular access and marrow aspiration. A characteristic localization of chloromas in acute promyelocytic leukemia?

Extramedullary disease (EMD) is a rare clinical event in acute promyelocytic leukemia (APL). Although the skin is involved in half of the reported EMD cases, the occurrence of cutaneous promyelocytic sarcoma (PS) has been described very rarely. We report here three cases of PS which have the peculiarity of appearing at sites of punctures for arterial and venous blood and marrow samples (sternal manubrium, antecubital fossa, wrist over the radial artery pulse, catheter insertion scar). At presentation, all patients had hyperleukocytosis and a morphologic diagnosis of microgranular acute promyelocytic leukemia variant confirmed at the genetic level by demonstration of the specific chromosomal translocation t(15;17). A BCR3 type PML/RARa transcript was documented in the two patients for whom diagnostic RT-PCR was available. Patients had morphologic bone marrow remission at the time the PS appeared. A predilection for the development of cutaneous PS at sites of previous vascular damage has been noted, but the pathogenesis remains largely unknown. A potential role for all-trans retinoic acid has been advocated, although one of the three patients in our series had received no ATRA. A review of the literature revealed six similar cases and hyperleukocytosis at diagnosis was a consistent finding in all of them. A careful physical examination of these particular sites in the follow-up of patients at risk, as well as cutaneous biopsy and laboratory examination of suspected lesions are strongly recommended.

Adolescent↗
PubMed1975

Comparison between Wilson's thoracic leads and the telemetrically transmitted lead CM6 in patients with heart diseases during exertion.

In 76 patients suffering from heart diseases and 19 healthy men simultaneously the chest leads V(2), V(4) and V(5) were recorded and the bipolar lead CM(6) (Manubrium sterni-Apex cordis, 6th intercostal space) transmitted telemetrically during increasing exercise load on the bicycle ergometer. The lead CM(6) was most similar to chest lead V(5) with regard to R/S-ratio, ST-depression, form and amplitude of the T-wave, QX-QT-ratio and ST-elevation. ST-depressions of V(5) were found nearly without exception in CM(6), mostly more pronounced. Ascending ST-depressions are more frequent in CM(6) than in V(5), in single patients also ST-depressions with horizontal or downward slope. ST-elevations registrated in V(2) and V(4) are not reliably reproduced in CM(6). It is concluded that the wireless transmission of the bipolar chest lead CM(6) is sufficient for the diagnosis of coronary insufficiency during exercise,

Adult↗
PubMed2001

Extrapericardial cardiac tamponade caused by traumatic retrosternal hematoma.

Cardiac tamponade is an uncommon complication of blunt chest trauma, resulting typically from hemorrhage into the pericardial space. We report a case of hemodynamic compromise secondary to an extrapericardial compression caused by the acute formation of a retrosternal hematoma associated with a sternal fracture. The patient was involved in a violent deceleration accident. Initially, he only complained of an anterior thoracic pain, but subsequently became restless, pale, and dyspneic. A severe hypotension associated with sinus bradycardia (45 bpm) rapidly occurred. Both jugular veins became markedly turgescent, but no significant pulsus paradoxus was noted. Echocardiography disclosed a large hematoma, compressing anteriorly both the right ventricular cavity and outflow tract. Surgical evacuation of the retrosternal hematoma related to a bifocal fracture of the manubrium was followed by instantaneous hemodynamic improvement. Regional extrapericardial tamponade secondary to the acute formation of compressive retrosternal hematoma is an unusual cause of circulatory failure after severe blunt chest trauma. Since conventional clinical signs associated with typical tamponade physiology may be lacking in this setting, echocardiography is ideally suited for early recognition of this unusual condition.

Accidents, Traffic↗
PubMedDate not supplied

[About an exceptional case of congenital sternal fissure: Eugene Groux (1859)].

The congenital sternal fissure of Eugene Groux is outstanding in every respect: at first, it constitutes a sole case in history of medicine, for this fissure was complete (from the manubrium to the xiphoid process). Secondly, it was an object of medical examinations for over 2000 physicians all around the world. Thirdly, the patient himself wrote a monograph devoted to his malformation (1859). We analyze in this paper the monograph of Eugene Groux, as well as the anatomicomedical conclusions which followed this exceptional case.

Congenital Abnormalities↗
PubMed2001

Clinical studies of bioabsorbable poly-L-lactide sternal coaptation pins.

BACKGROUND: Median sternotomy has become the most commonly used incision in cardiac surgery. Since sternal dehiscence, however, is a major complication, we used bioabsorbable poly-L-lactide (P-L-LA) sternal coaptation pins for sternal closure to prevent it. METHODS: From February 1998 to October 1999, 99 patients (64 men, 35 women; mean age, 63+/-1.2 years) underwent median sternotomy for cardiac surgery using sternal coaptation pins. Nineteen patients had diabetes mellitus and seven had renal failure. In closure, two sternal pins were inserted into the bone marrow of the sternum, one into the manubrium, the other into the body, and the sternum was sutured with five stainless steel wires. RESULTS: Five patients died in the hospital. The causes of death were cardiac failure in two patients, respiratory problem in two and perforation of the stomach in one. The average length of hospitalization was 2 4.5+/-2.5 days. Sternal dehiscence occurred in one patient and mediastinitis in four. There was no bleeding from the bone marrow and no complication related to the use of the sternal pins. CONCLUSIONS: P-L-LA sternal pins were easy to insert and may be effective in preventing dehiscence of the sternum.

Absorbable Implants↗
PubMedDate not supplied

Treatment of locally aggressive well-differentiated thyroid cancer.

The object of this study, conducted at Unicamp between 1988 and 1998, was to evaluate retrospectively the outcome of patients treated for locally aggressive well-differentiated thyroid carcinomas (LATC). Nineteen (42%) of 45 patients with thyroid carcinomas were considered to have LATC. The preoperative diagnosis of carcinoma was made either by fine needle aspiration biopsy (15 patients) or during surgery (4 patients). The usual prognostic factors were analyzed and classified according to risk groups. Survival was evaluated using the Kaplan-Meier method. Most of the patients were female (73%), with a mean age of 48 years. Eighteen (95%) had papillary carcinomas. Four patients were classified as high risk (21%) and the remaining 15 (79%) as intermediate risk. All patients underwent total thyroidectomy and different types of neck dissections. The structures invaded by tumors were strap muscles and trachea (four cases); recurrent nerve and larynx (three cases); manubrium, esophagus, and jugular vein (two cases); and hyoid bone and pharynx (one case). Complete tumor resection was carried out according to the extent of local invasion; no postoperative deaths resulted. Details of the procedures are provided in Table 4 and in the Discussion. Postoperative radioactive iodine treatment was used in 15 patients (79%). A mean follow-up (+/-7 years) revealed 13 (68%) patients without disease, 4 patients (21%) alive with controlled systemic disease, and 2 (11%) deaths from distant metastasis. The Kaplan-Meir survival curve was comparable with other studies in the literature. This study found that the frequency of LATC (42%) was higher than in most studies. Aggressive surgical therapy to treat these tumors is compatible with a low recurrence rate and long-term survival in a significant proportion of patients.

Adenocarcinoma, Follicular↗