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.

SourceResearch connectionFrom yearThrough year

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

At least 127 records · Page 7Linked to original sources

PubMed1989

An electrode montage for electrocardiographic monitoring.

An electrocardiographic electrode montage is described using electrodes mounted on the manubrium sterni (RA), xiphisternum (LA) and V5 position (LL). The lead II setting on the monitor, equivalent to CM5, offers optimal ischaemia detection, while lead I, now a vertical lead, manubrium to xiphisternum, results in maximal P wave amplitude. The montage has been evaluated in sixty-two intensive care patients with electrocardiographic abnormalities and has been used extensively in intensive care, the operating theatres and in shock wave lithotripsy. The 'Prince Henry' montage offers advantages over the standard bipolar leads in P wave amplitude, arrhythmia diagnosis and artefact rejection.

Arrhythmias, Cardiac↗

PubMed1993

Radiologic abnormalities of the sternum in Turner's syndrome.

Various skeletal abnormalities, including chest deformity, have been reported with Turner's syndrome. We report radiologic findings of the sternum on lateral chest roentgenograms in 15 children and adolescents with Turner's syndrome, whose ages ranged between 2 weeks and 20 years. Eight had associated congenital heart disease (CHD). Twelve patients (80 percent) had various sternal abnormalities; 5 had short sternum, 3 had premature fusion of the manubrio-sternal junction, and 4 had premature fusion of the mesosternum. Five had decreased ratio of sternal body to manubrium. Three patients had two ossification centers of the manubrium. Four patients had bowing of the mesosternum; three of these had mild pectus excavatum also. In this series, children with and without CHD had similar sternal abnormalities. Although not pathognomonic, sternal abnormalities on a lateral chest roentgenogram are common skeletal abnormalities associated with Turner's syndrome and are independent of associated CHD. In our series of 15 patients, 10 had monosomy (45,X) on blood karyotype; 7 of them had associated CHD. This is the first systematic analysis of radiologic abnormalities of the sternum in Turner's syndrome and includes findings not previously reported.

Adolescent↗

PubMed2003

Localization and quantification of carbonic anhydrase activity in the symbiotic Scyphozoan Cassiopea xamachana.

The relationship between density and location of zooxanthellae and levels of carbonic anhydrase (CA) activity was examined in Cassiopea xamachana. In freshly collected symbiotic animals, high densities of zooxanthellae corresponded with high levels of CA activity in host bell and oral arm tissues. Bleaching resulted in a significant loss of zooxanthellae and CA activity. Recolonization resulted in full restoration of zooxanthellar densities but only partial restoration of CA activity. High levels of CA activity were also seen in structures with inherently higher zooxanthellar densities, such as oral arm tissues. Similarly, the oral epidermal layer of bell tissue had significantly higher zooxanthellar densities and levels of CA activity than did aboral bell tissues. Fluorescent labeling, using 5-dimethylaminonapthalene-1-sulfonamide (DNSA) also reflected this tight-knit relationship between the presence and density of zooxanthellae, as DNSA-CA fluorescence intensity was greatest in host oral epithelial cells directly overlying zooxanthellae. However, the presence and density of zooxanthellae did not always correspond with enzyme activity levels. A transect of bell tissue from the margin to the manubrium revealed a gradient of CA activity, with the highest values at the bell margin and the lowest at the manubrium, despite an even distribution of zooxanthellae. Thus, abiotic factors may also influence the distribution of CA and the levels of CA activity.

Animals↗

PubMedDate not supplied

Mediastinal lymphangioma and chylothorax: thoracic involvement of Gorham's disease.

We report a case of mediastinal lymphangioma associated with Gorham's disease in a 38-year-old man who had suffered recurrent clavicular fractures during a seven-year period. Mediastinal widening associated with osteolysis of the clavicles and the sternal manubrium was revealed by chest radiography, while computed tomography demonstrated a cystic anterior mediastinal mass infiltrating mediastinal fat and associated with osseous destruction of the clavicles and manubrium. Chylothorax recurred during the course of the disease.

Adult↗

PubMed2006

Diagnostic values of sonography for assessment of sternal fractures compared with conventional radiography and bone scans.

OBJECTIVE: This study was prospectively undertaken to evaluate the diagnostic value of sonography for detection of sternal fractures. We compared sonographic, conventional radiographic, and bone scan examinations of sternal fractures. METHODS: Fifty consecutive patients (26 male and 24 female; mean age, 45.2 years) were evaluated. Conventional radiography and sonography were performed in all patients, and bone scans were performed in 39 patients. All patients had acute pain and tenderness in anterior midline chest areas. Sonography was performed by 2 musculoskeletal radiologists within 1 to 2 days after admission. Patients underwent conventional radiography at admission and bone scans within 4 to 7 days after admission. Two radiologists reviewed all imaging findings by means of consensus. In addition, sonography was performed in 20 asymptomatic patients in a normal control group. RESULTS: Conventional radiography depicted sternal fractures in 12 of 50 patients. Sternal fractures were detected in 31 of 50 patients on sonography. Fractures on sonography were located in the manubrium (8 cases), upper sternal body (11 cases), mid sternal body (5 cases), and lower sternal body (7 cases). Bone scans showed sternal hot uptakes (accumulations of the radionuclide used) in 18 of 39 patients. In the control group, there were no bony defects or abnormal contours. CONCLUSIONS: We could detect sternal fractures more effectively with sonography than with conventional radiography and bone scans. In addition, sternal fracture locations showed relatively even distributions, and focal fractures in the manubrium were not easily detected on bone scans.

Adolescent↗

PubMed1999

The role of angiography in periclavicular penetrating trauma.

Our objective was to evaluate whether physical examination in conjunction with chest X-ray can accurately diagnose the presence of significant vascular injury in penetrating periclavicular trauma. Results from a management protocol for penetrating periclavicular trauma were reviewed for the period January 1992 through December 1996 at an urban Level I trauma center. All patients requiring angiography for periclavicular penetrating trauma with trajectory of the injury falling between the lateral border of the manubrium and the anterior axillary line were entered into the management protocol. All patients underwent anterior-posterior chest radiography on arrival to the trauma center and 6 hours after admission. Tube thoracostomy was placed if clinically indicated on presentation or for X-ray findings. Clinical assessment was performed on all patients, with emphasis placed on the presence of "hard" signs for vascular injury. In addition to accepted hard signs for vascular injury, significant chest tube output (>1000 cc) and chest X-ray findings consistent with significant hemorrhage were also considered hard signs for vascular injury. Assuming hemodynamic stability, all patients with suspected subclavian/axillary arterial injury based on wound trajectory or clinical findings consistent with vascular injury underwent angiography. Forty-six patients were entered into the protocol with 30 left-sided injuries and 16 right sided injuries. The majority of injuries were secondary to gunshot wounds (31), with 14 stab wounds and 1 shotgun injury. Emergency room chest X-ray results revealed 32 negative chest X-rays, 7 pneumothoraces, 2 hemopneumothoraces, 2 hemothoraces, and 3 chest tubes placed before initial chest X-ray. A total of 7 injuries were diagnosed, with 1 missed injury, resulting in a sensitivity of 86 per cent for clinical assessment. The missed injury was a pseudoaneurysm of an axillary artery secondary to a self-inflicted shotgun wound. One mortality occurred in this series, which was a death in the operating room secondary to blood loss from an axillary artery injury. We conclude that clinical assessment can adequately diagnose the presence of surgically significant vascular injury in periclavicular penetrating injuries with trajectories lateral to the manubrium.

Adult↗

PubMed2002

[Metastatic sternal tumor from thyroid papillary carcinoma; report of a case].

A 68-year-old male was referred to our department for treatment of a metastatic sternal tumor in the manubrium sterni. Primary lesion was papillary carcinoma of the left lobe of the thyroid gland. Total thyroidectomy, cervical lymph node dissection, resection of manubrium sterni with concomitant resection of bilateral clavicles, 1st ribs and 2nd ribs, and chest wall reconstruction using Marlex Mesh were performed on January 29, 2001. Considering relatively good prognosis and good response to multimodality therapy, surgical resection of sternal metastatic lesion from differentiated thyroid cancer seems to be a choice of therapy as a part of multimodality approach, including surgery, radioiodine and external radiation therapy, to thyroid cancer with systemic spread.

Adenocarcinoma, Papillary↗

PubMed2003

[Superior mediastinum exposure in the removal of the advanced cancers in the lower neck regions].

OBJECTIVE: In order to achieve the radical removal of advanced cancers involving the lower neck regions. METHODS: Upon the thorough evaluation of tumors with different imaging methods, several kinds of superior mediastinum exposure were carried out in a series of 18 patients with advanced neck cancer of various kinds. There were 10 cases of stomal recurrence, 2 cases of recurrent thyroid carcinomas, 2 cases of advanced carcinomas in the cervical trachea, and 4 cases of metastatic carcinomas in the supraclavicular region. According to the site and extension of tumor invasion, simple manubrium resection were performed in 10 cases, resection of the medial half of the clavicle was adopted in 4 cases and resection of the manubrium and the medial 1/3 of both clavicles were used in 4 cases. Pectoralis major myocutaneous flaps were raised to reconstruct the defects resulting from tumor ablations. RESULTS: Radical removal of tumors was achieved in 16 cases. Minor complications occurred in 3 cases including one case of intraoperative pneumothorax and 2 cases of postoperative pharyngeal fistula. One patient developed aneurysm in the right common carotid artery after radical neck dissection and wound infection. One patient died of eruption of the innominate artery due to the major vessel injury caused by the tracheostomy tube two months after the operation. Results from postoperative follow-up demonstrated that one-year, two-year and three-year postoperative survival rate was 72.2% (13/18), 22.2% (4/18) and 11.1% (2/18), respectively, in this series. CONCLUSION: Superior mediastinum exposure is a necessary and reliable surgical approach in the removal of advanced tumors involving the lower neck and superior mediastinum.

Adult↗

PubMed2005

The thoracoacromial vessels as recipient vessels in microsurgery and supermicrosurgery: an anatomical and sonographic study.

The purpose of this study was to investigate the presence and the precise course of the pectoral branch of the thoracoacromial vessels on the underside of the pectoralis major muscle by anatomical dissection and by color Doppler ultrasound. A further goal was to determine whether these vessels were suitable as recipient vessels in microsurgery and supermicrosurgery for breast reconstruction. In 18 cadavers, the pectoral branch of the thoracoacromial vessels was followed caudally until the diameter of the artery diminished to 1 mm. The same examination was carried out in 40 young female volunteers by tracing the vessel course with color Doppler ultrasound. The 1-mm cutoff point of the artery was measured with reference to the manubrium, the midsternal line, the clavicle, and the upper border of the closest rib. In addition, in the cadavers, the 2-mm cutoff point was determined. At both cutoff points, the diameter of the accompanying vein was measured. The pectoral branch of the thoracoacromial vessels with the artery and concomitant veins could be detected on all 100 undersides of the pectoralis major muscle, anatomically and sonographically. In their course from the acromial region downward, the arteries reached a diameter of 1 mm at an average of 9.9 cm from the manubrium, horizontally 9.4 cm from the midsternal line, and vertically 4.0 cm from the lower border of the clavicle. The 1-mm reference point was situated on the upper border of the third rib in 85 percent of cases. The average distance between the 1-mm and the 2-mm cutoff points was 3.5 cm. At the 1-mm cutoff point, the diameter of the vein was 0.9 mm, and at the 2-mm cutoff point, it was 1.7 mm. Because of their central position at the anterior hemithorax, these vessels are easily accessible from mastectomy incisions, even in skin-sparing mastectomies; the donor-site morbidity is negligible; and as the diameters of the vessels gradually decrease along their caudal course, the recipient site can be chosen precisely according to the length and the diameter of the donor vessels and major mismatch can be avoided. Thus, the pectoral branches of the thoracoacromial vessels are well suited as recipient vessels for (super)microsurgery and are a very promising addendum to the thoracodorsal and internal mammary vessels.

Adult↗

PubMed1991

The influence of oligohydramnios on thoracic dimensions of fetal sheep.

Oligohydramnios frequently leads to lung hypoplasia in the fetus, but the underlying mechanisms are incompletely understood. Our aim was to determine the effects of oligohydramnios on the dimensions of the fetal thorax. Using pairs of implanted ultrasound transducers in 6 fetal sheep, we measured 4 thoracic dimensions (transverse, anterior-posterior, manubrium to left and right hand sides of the diaphragmatic dome) for 2 control days, 3 days of amniotic and allantoic fluid drainage (oligohydramnios), and 2 days after the return of drained fluids. The effect of oligohydramnios, which began at 121-2 days of gestation (term being c.145 days), on each dimension was quantified daily as the difference between the measured value and the value predicted from the growth of that dimension over the study period. Oligohydramnios led, within 48 hours, to significant reductions in the transverse dimension (5.9-6.1%) and in the distance between the manubrium and the dome of the diaphragm (1.7-2.2%). There was no change in the anterior-posterior dimension. We conclude that oligohydramnios causes alterations, within 48 hours, in the dimensions of the fetal thorax which can be reversed, at least partially, by re-expansion of the fluid sacs. These changes, which are expected to produce reductions in thoracic volume, may, if prolonged, lead to lung hypoplasia.

Animals↗

PubMed1990

[The functional kidney reserves of diabetics].

Ten patients with insulin-dependent diabetes mellitus not associated with any signs of diabetic nephropathy were examined for the reserves of filtration renal function and early morphological alterations in organ tissues. The reserves of filtration were detected under the conditions of acute oral administration of protein (1.5 g/kg) as difference between the initial and stimulated levels of glomerular filtration (GF). Two groups of patients were distinguished: group I included patients with preserved filtration reserves (increment of GF amounted to 35%), group II included patients with no filtration reserves (reduction of GF was 20%). Both the groups differed significantly only in the initial level of GF (120 and 209 ml/min, respectively) and in the degree of morphological changes in the glomeruli: group I manifested minimum structural changes, group II showed the commencing diabetic glomerulosclerosis characterized by pronounced injury to the manubrium of the glomeruli. Therefore, the lack of filtration reserves in diabetes mellitus patients suggests the presence of the commencing diabetic glomerulonephritis even with the lack of the clinical signs of renal injury, which does not require the resorting to organ biopsy. The primary injury to the manubrium of the glomeruli is likely to be related to a high gradient of intraglomerular hydrostatic pressure, resulting in hyperfiltration.

Adolescent↗

PubMed1979

[Suprasternal bone (author's transl)].

Human skeletons have many variations which may occasionally necessitate distinction from pathologic changes. Suprasternal bone is an unfamiliar normal variation in the vicinity of the sternoclavicular joint. It was first described by Béclard in 1820 and thereafter many reports have appeared, mostly in anatomy and embryology. An incidence less than 5% is reported abroad. This report describes the incidence of suprasternal bone in Japanese and a few clinical reference cases. Suprasternal bone is now considered to have derived from the persistent rudiment of epicoracoid which should have normally consisted of the part of manubrium sterni. Suprasternal tubercle is considered to be the osseously fused type of suprasternal bone. The material consisted of two groups: 1) Seventy-four sterna were examined roentgenographically which were removed en bloc from the cadavera. 2) 562 sterna of living subjects were examined roentgenographically by Kattan's method. In the seventy-four cadavera, eight cases had suprasternal bones (10.8%) and fourteen cases had suprasternal tubercles. Among them, three had suprasternal bone and tubercle on each side. In the 562 living subjects, thirty-nine cases had suprasternal bones (6.9%) and eight cases had suprasternal tubercles. Among them, three had both on each side. The incidence of suprasternal bone in Japanese is therefore higher than foreigners' reported previously. Kattan's method employed in this study is simple and excellent to show manubrium sterni and sternoclavicular joint clearly. It is emphasized that suprasternal bone is not uncommon and differential diagnosis from pathologic changes is easy as long as it is kept in mind.

Adult↗

PubMed1983

The anterior junction anatomy.

It is useful to consider the anterior junction anatomy in terms of three components: the superior recesses, the line, and the inferior recesses. Each component localizes to a specific area retrosternally: the superior recesses--behind the manubrium; the line--behind the upper two thirds of the sternal body; and the inferior recesses--behind the lower third of the sternal body and below where the cardiac mass abuts the anterior chest wall. Since the anterior chest wall curves backward from bottom to top (Figure 61), the coronal plane of the superior recesses is behind that of the anterior junction line, the coronal plane of the inferior recesses being in front of that of the anterior junction line. Accordingly, then, anteroposterior conventional tomograms will usually demonstrate the inferior recesses on the most anterior levels, the line a centimeter or so behind the inferior recesses, the superior recesses a centimeter or so behind the line. Understanding the anterior junction anatomy in terms of three components has widespread use, as shown above, by many examples obtained from everyday film reading. The presence, absence, and location of disease may be diagnosed. As well, mistaken diagnoses may be avoided. Since the anterior junction lung relates to the anterior pleural space, pleural space processes may alter the anterior junction anatomy. It must be realized that although visualization of the normal anterior junction anatomy components may help to exclude the presence of retrosternal abnormality, they are not infallible. It is possible for a small lesion to be entirely contained within the anterior mediastinum and, thus, not alter the normal anterior junction components. A deep retrosternal space, where normally the anterior junction line is formed, may allow an anterior mediastinal mass to be present and a normal anterior junction line to be seen if the mass does not occupy the entire depth of the space. Furthermore, in patients with markedly hyperexpanded lungs, it is conceivable that the cardiac mass may abut the chest wall at the level of the inferior recesses to a lesser degree than usual, or not at all. Marked lung hyperexpansion may also conceivably cause the superior recesses to extend above the manubrium.

Heart↗

PubMed1983

[Non-invasive recording of the His bundle electrogram: choice of leads and reliability of the "averaging" technic].

An improvement in detecting His bundle activity using a Marquette high resolution Mac unit, without pharmacologic depression of AV node conduction, was obtained with two surface lead systems, which were selected on the basis of the His bundle anatomical position and its electrostimulation axis. In 8 patients the direction of the His bundle bipolar stimulation vector was evaluated in the frontal plane, on the orthogonal leads and with map of the chest potential. In 39 patients the surface recording, using high-gain amplification, filtering between 50-300 Hz and an averaging of 256-512 cycles, was obtained by positioning the electrodes in the following sites: manubrium sterni-xiphisternum-V4. When this lead system failed, it was replaced by another one, which included V4-right sternal and right vertebral border at the level of the 3rd intercostal space. In 24 patients (PR less than 0.16" in 4 cases) intracavitary and surface H-V recording were compared. The surface interval was measured between the apex of the surface "blip" and onset of the QRS. Sensitivity was 86% with a good correlation (r = 0.94) between invasive and non-invasive measurements. The surface leads, in which the His bundle activity was best detected, were the manubrium-xiphisternum (on the midsternal line) and V4-right vertebral border at the 3rd intercostal space level. Our external measurement technique avoids subjective misinterpretations; the surface H-V interval was on an average 6 msec. shorter than the invasive one. The upper normal value of non-invasive H-V interval is therefore 50 msec in our measurement method.

Aged↗

PubMed1982

[X-ray findings of the sternum after sternotomy (author's transl)].

X-ray examination of the sternum after sternotomy supplies proof of rupture of a suture, of dehiscence of the sternum, malpositioning of the wire ligature, of the cutting-through of the fixation wire by the bone, of the fracture, pseudoarthrosis and inflammation. Fractures can be located in the manubrium sterni, the body of the sternum, the xiphoid process and in one of the two parts of the sternum. Pseudoarthroses can be seen in the manubrium, in the body of the sternum or as longitudinal pseudoarthroses. Pseudoarthroses were found only in conjunction with inflammatory chances. Signs pointing to an osteomyelitis of the sternum can be very discreet. This applies to both the reactive scleroses and to osteolyses. In individual cases the examination of a fistula system allows identification of a connection to the bone or to the ligature material. Retrosternal abscesses can be differentiated in the computer tomogram from dissections after bolus injection. Diagnosis by exclusion requires tomography in two planes with complicated blurs. In such cases the diagnostic reliability is probably far superior to the reliability achieved by plain roentgenography and with longitudinal blurring.

Abscess↗

PubMed1994

Innominate artery compression of the trachea. A simplified technique for anterior suspension of the innominate artery.

OBJECTIVE: When innominate artery compression of the trachea causes airway obstruction in infancy, the standard treatment is anterior suspension of the innominate artery by anchoring it to the back of the sternum to relieve the pressure on the trachea, known as aortotruncopexy. We describe a simplified technique for anterior suspension of the innominate artery, by suturing the pretracheal fascia to the back of the manubrium. EXPERIMENTAL DESIGN: We have used this technique in three infants with follow-up to eighteen months. SETTING: University teaching hospital, regional paediatric and cardiac surgical centre. PATIENTS: Three infants presenting with intractable respiratory difficulties, principally caused by the innominate artery compression of the trachea. INTERVENTION: All patients underwent right thoracotomy. The innominate artery was lifted away from the trachea by creating a pretracheal fascial sling attached to the back of the manubrium. MEASURES: Clinical follow-up. RESULTS: All patients have shown improvement in symptoms and none has required further hospitalization. CONCLUSIONS: This technique appears to give satisfactory results and may reduce the risk of complications, compared with more elaborate operations.

Brachiocephalic Trunk↗

PubMed1994

[Osteitis in psoriasis].

A 56-year-old man was diagnosed with psoriasis, after a year with pain over the manubrium sterni, a stiff neck and shoulders and an increased erythrocyte sedimentation rate. Imaging studies revealed widening and sclerosis of the manubrium sterni, ossification of the insertions of the first ribs and involvement of the sternoclavicular joints. Histological examination of the sternum showed signs of a chronic inflammatory process. Improvement of the skin lesions was accompanied by a reduction of the pain. Psoriasis may be complicated by osteitis/hyperostosis, which may precede the skin lesions. An effective therapy is lacking, although analgetics and antiphlogistics are often useful.

Arthritis, Psoriatic↗

PubMed1997

[Coronary artery bypass grafting in a patient with a permanent tracheal stoma].

The performance of open heart surgery in a patient with a tracheostoma can present difficult problems, including mediastinitis and inadequate operative exposure. A 79-year-old man was admitted because of angina pectoris, and had undergone tracheostomy for carcinoma of the larynx 14 years previously. He underwent coronary artery bypass grafting with saphenous vein graft to # 8, 12. A skin incision was made from the angle of Louis to the xiphoid process and carried down through the subcutaneous tissue. The sternum was divided from the xiphoid process to the manubrium and then dislocated from the intact manubrium. Operative time was 165 minutes and arrest time was 64 minutes. Postoperative course was satisfactory and discharged within 24 days after operation. We think that in a case of open heart surgery with a tracheostoma no dissection near a tracheostoma is necessary in order to decrease the risk of postoperative wound infection and mediastinitis.

Aged↗