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At least 379 records · Page 21Linked to original sources
PubMed1996

[Pulsating tumor of the sternum: enlarged exeresis and reconstruction with marlex-methylmethacrylate prosthesis].

The authors report on a rare case of pulsating tumor of the sternum. En bloc resection was carried out with removal of the sternal manubrium and body, tracts of the I-II-III rib with the intercostal muscles and part of the left pectoralis major. Reconstruction of the thoracic wall was performed with a marlex MMA sandwich prosthesis. From a histological viewpoint, the carcinoma was well differentiated and compatible with thyroid primitivity. Non complementary antiblastic therapies were provided as all the examinations carried out were negative and the intervention was radical. The patient had been followed-up with serial controls and three complete stagings at one, three and five years after intervention (CT, echography and function tests of the thyroid, bone scintigraphy). At follow-up of more than six years the patient is doing well and is event free. The authors believe, even with the help of reports from the literature that, in sternal metastases from thyroid carcinomas, especially when single and large, surgical therapy is required.

Carcinoma↗
PubMed1997

[Laryngeal reconstruction using endoprostheses for benign stenosis].

A clinical trial was made of two types of laryngeal endoprostheses in surgery of stenosis caused by benign diseases. A total of 15 patients were operated on. In 11 patients endoprosthesis of biocompatible polymers was inserted, in 4 patients the stenosis was corrected with endoprosthesis of silicon rubber. Most of the patients had stenosis as a result of complication of thyroid surgery. The operative technique is described. In extensive defects of the anterior wall of the larynx and trachea, advanced scar stenoses a new operation is proposed-autoalloplasty using body and manubrium of the sternum.

Adolescent↗
PubMedDate not supplied

[The internal thoracic blood vessels (internal thoracic arteries and veins) and their practical significance].

Internal thoracic blood vessels (A. et Vv. thoracicae internae) are parietal vessels of the thoracic anterior wall. Because of their position, they are often exposed to injuries during the fracture of the ribs and the sternal bone. These facts require a general knowledge about the anatomical variations of these vessels, specifically the knowledge concerning their mutual relationship, their anastomoses and their distance from the lateral margins of the sternal bone. Due to the poor and different data in the available literature, we directed our investigations towards the study and confirmation of the described anatomical variations of the internal thoracic blood vessels. In this study we investigated the distance between the internal thoracic artery and the lateral margins of the sternal bone, the level of its bifurcation, the number of the internal thoracic veins and anastomoses between them. The investigation was carried out on 300 formalin specimens consisting of the anterior wall of the thorax (persons of different ages and sexes) by using the method of dissection and the method of contrast injection. In adults (200 specimens), the distance between the arterial trunk and the lateral margin of the sternal bone was not equal in the first fifth or sixth intercostal spaces, but in children up to five years of age (100 specimens), the distance was almost the same. In adults, the internal thoracic artery was nearest to the sternal bone in the first intercostal space, but going downward the artery was gradually more and more distant from the sternum and in the sixth intercostal space the distance measured approximately from 11 mm to 13 mm. In children, the distance of the artery from the lateral margin of the sternal bone, just in the above mentioned intercostal spaces, was from 5 mm to 10 mm. There was no difference according to sex in any of the two groups. Most frequently, the internal thoracic artery gave off its terminal branches at the level of the sixth costal cartilage (adults--35% and children--45%), and most rarely, the bifurcation of the artery was at the level of the seventh costal cartilage (adults--10% and children--8%). The internal thoracic vein that accompanies the same named artery, could be either single or double, on one or both sides. In cases of double veins-the artery was situated between the two of them, but in cases of single vein-the vein was located medially to the artery. In 82% of cases in the adult group, and in 69% of cases in the children-group, there were two veins accompanying the artery. The right and the left internal thoracic veins were connected in the region of the sternal bone by the retrosternal venous net (specifically in the region of the manubrium) and by one venous vessel lying in front of the xiphoid process. According to the position and the course of that venous vessel it could be called "arcus venosus prexiphoideus". The internal thoracic blood vessels were enclosed by the unique fascial sheath. They were superiorly separated from the costal pleura by the endothoracic fascia and inferiorly by the transversal thoracic muscle (m. transversus thoracis). The safest approach to the internal thoracic artery was at the level of the second and the third intercostal space. During the approach through some of the lower intercostal spaces it was necessary to be very careful because they could be narrowed at their anterior ends.

Adult↗
PubMedDate not supplied

p53 influences mice skeletal development.

The p53 tumor suppressor gene encodes a transcriptional activator whose targets include genes that regulate cell cycle progression and apoptosis. Since we have shown that a critical event in the life history of the chondrocyte is programmed cell death, we asked the question: does loss of the p53 gene influence skeletogenesis? Female p53(+/-) mice were mated with p53(+/-) male mice and 17-day-old fetal mice were studied. Exencephaly was the most profound skeletal defect of the p53 null mutation. This defect was due to failure of formation of the bones that comprise the mouse calvarium. There was also loss of the hyoid bone, and defective mineralization of the manubrium sternum and the terminal phalanges. In the homozygous state (-/-), in the absence of exencephaly, the number of skeletal deformities was markedly reduced. Aside from the gross changes associated with null status, the mutants exhibited alterations in bone length and width. Small differences in the size and orientation of the mineral crystals in embryonic bone, as evaluated by small-angle X-ray scattering, were found to disappear after birth. To explain these observations, we evaluated the extent of apoptosis in the tibial growth plates using the TUNEL stain. In the growth plate of the p53(-/-) homozygote, there was minimal labeling of the hypertrophic layer. Since the p53(-/-) TUNEL stain pattern at 17 days was very similar to the pattern of labeling of the p53(+/+) at 15 days, we concluded that the growth defect reflected a delay in cartilage maturation rather than a change in chondrocyte phenotype. On this basis, we predict that after birth, in mice that survive, differences in bone length would become minimal, and at maturity, the length of the long bones of (+/+) and (-/-) mice would be similar.

Animals↗
PubMed1998

[Open heart surgery in patients with a tracheostoma].

From April 1992 to May 1997 six patients underwent open heart surgery, who had tracheostoma at the time of operation. The sternum was divided completely in three patients whose tracheostoma lay highly on the neck, and it was cut transversely on the manubrium at the level of the first intercostal space, below which it was split longitudinally in two patients (partial median sternotomy). In one patient right anterolateral thoracotomy was used. There were no operative death and no complication related to infection. A left internal thoracic artery (LITA) was used successfully for a bypass conduit in two patients who underwent partial median sternotomy. Dissection of the proximal portion of the LITA through the second intercostal space prior to the sternotomy made the graft procurement feasible in this particular situation. In conclusion, full-length sternotomy is performable safely when the tracheostoma lies highly on the neck, and the partial sternotomy up to the midmanubrium is applicable, including LITA harvesting, even if it is just at the sternal angle.

Adolescent↗
PubMed1998

[Normal sternal bone marrow MRI using STIR].

The MR signal of sternal bone marrow was examined in 21 normal volunteers using a sagittal STIR sequence. Craniocaudal phase-encoding with a hand-made positioning device effectively eliminated artifacts due to cardiac pulsation. The sternal bone marrow signal could be classified into three patterns based on the signal distribution. The superior segment of the manubrium showed characteristic age-related changes. This method provided high spatial resolution and excellent bone marrow imaging. Knowledge of a normal marrow signal pattern may be useful for the evaluation of hematological disorders.

Adult↗
PubMed1998

Intrathyroid cysts of thyroglossal duct origin.

Thyroglossal duct cysts develop from a persistent portion of the thyroglossal tract and have been described as occurring anywhere from the base of the tongue to the manubrium. We present two patients who presented with a cystic thyroid nodule due to an intrathyroid thyroglossal duct cyst. A fine-needle aspiration biopsy was performed, which revealed benign squamous cells. Upon exploration, the first patient was found to have a 2-cm cyst within the thyroid isthmus, and in the second patient, a 1-cm cyst was found in the right thyroid lobe. Pathologic analysis revealed the cyst to be lined by a squamous epithelium consistent with a thyroglossal duct cyst. The lesions were completely surrounded by normal thyroid tissue. There was no evidence of a remnant of the thyroglossal duct extending from the thyroid in the region of the cyst. Both patients were treated by thyroid lobectomy and isthmusectomy and have remained without evidence of recurrence. Intrathyroid thyroglossal duct cysts should be included in the differential of patients with cystic thyroid lesions. Fine-needle aspiration revealing benign squamous cells is usually diagnostic and may detect an occult carcinoma arising within the cyst. Surgical resection is curative and should include a Sistrunk procedure if a thyroglossal duct tract is present.

Aged↗
PubMed1997

[Rib fractures and flail chest in closed chest trauma--stabilizing operations and the results].

A contingent of patients presenting closed chest injuries, sustained over a 12-year period (1985-1996), are analyzed. Of the total of 6938 traumas, chest injuries amount to 3286 (47.06 per cent) of which 2842 (40.7 per cent)-closed. Of the latter 2248 (79.09 per cent) are located in the left thoracic half, 420 (14.77 per cent)-in the right thoracic half, and in 174 (6.12 per cent) it is a matter of bilateral involvement. At the point of heaviest impact, involving 5th to 9th rib segment, left side injury is recorded in 2034 cases (71.56 per cent), right side--408 (14.35 per cent), and bilateral--in 155 (5.45 per cent). There are 28 fractures of the sternum (0.85 per cent). Of the latter 14 are located in the manubrium sterni region, twelve--in the middle portion, and two in the distal part of the sternum. Over the last 5 years (1991 through 1995), of 63 casualties with flail chest 16 are with indications for stabilization osteosynthesis, and accordingly subjected to operation. A Schimelmann plate is used in 13 cases, artificial rib type "Ampar"--in three, and sternal stabilization--in one.

Bone Plates↗
PubMed1997

CT anatomy of the mediastinal structures at the level of the manubriosternal angle.

The mediastinal structures said to lie on a horizontal plane at the level of the manubriosternal joint (manubriosternal plane) in the cadaver include the bifurcation of the trachea, the concavity of the arch of the aorta, and the azygos vein as it arches over the right principal bronchus to enter the superior vena cava. We have reviewed CT scans of the thorax in 51 subjects to determine 1) whether these structures lie consistently at this level in the living thorax and 2) the vertebral level of this plane. We found that the bifurcation of the trachea lay at the plane in 41% of subjects, that the plane passed through the concavity of the arch of the aorta in 49% of subjects, and that, although there was notable individual variation, the manubriosternal plane passed through the upper part of the fifth thoracic vertebra in 53% of cases.

Adult↗
PubMed1986

Acute gout presenting in the manubriosternal joint.

A 54-year-old black man developed acute pain and swelling of the manubriosternal joint. Acute gouty arthritis was diagnosed by arthrocentesis and polarizing microscopy. The histology of the manubriosternal joint and its involvement in other arthritides are briefly discussed.

Arthritis↗
PubMed1986

Psoriatic arthritis affecting the manubriosternal joint.

Manubriosternal synovitis in the absence of peripheral arthritis or spondylitis, in a patient with pustular psoriasis, is described. The radiologic changes noted on lateral chest radiograph consisted of erosions, sclerosis, and joint space widening. This coincidence of manubriosternal joint arthritis and pustular psoriasis is unusual in western populations.

Adult↗
PubMed1979

Extraosseous osteogenic sarcoma: case report.

Extraosseous osteogenic sarcoma is a highly malignant tumor, and in order to improve the chances of survival of those who have it, aggressive surgical treatment, including major amputations, should be performed. Based on the results obtained in the treatment of its osseous counterpart, the use of adjuvant chemotherapy is strongly recommended. Evaluation should not be done because it is usually followed by local recurrence.

Adult↗
PubMed1987

Monarthritis of the manubriosternal joint. A follow-up study.

Six women and three males, who initially had seronegative monarticular arthritis of the manubriosternal joint (MSJ) were followed for a mean period of 7.1 years (range 0.8-17 years). Rather severe, progressive disease occurred in five patients, three of whom had pustulosis palmoplantaris (PPP) and one acne vulgaris. The course was milder in four patients who had either psoriasis vulgaris, psoriasis in the family or HLA-B27, and the disease remained localized to the MSJ in these patients. None of the patients developed sacroiliitis or peripheral erosive joint changes, but one patient with PPP developed paravertebral ossification.

Adult↗
PubMed1985

Monarticular involvement of the manubriosternal joint.

Four females and two males with seronegative monoarthritis of the manubriosternal joint are reported. Two patients had pustulosis palmoplantaris, one psoriasis vulgaris, and one HLA-B27. The arthritis is considered to be a monoarticular manifestation of seronegative spondylarthritis. Two patients had no other diseases or signs. Four patients were followed for a mean of 8.5 years (range 2-16 years) during which time affection of other joints or the spine was not seen.

Adult↗