First Rib Research Articles

On a dicraeosaurid specimen from the Mulichinco Formation (Valanginian, Neuquén Basin) of Argentina and phylogenetic relationships of the South American dicraeosaurids (Sauropoda, Diplodocoidea)

The osteology of Pilmatueia faundezi Coria, Windholz, Ortega & Currie, 2019, a dicraeosaurid sauropod from the Lower Cretaceous of Patagonia, is reassessed from the perspective of a new specimen (MLL-Pv-010) that provides additional information on the axial skeleton and the pectoral girdle. The specimen MLL-Pv-010 is composed of three articulated anterior-middle cervical vertebrae (with their respective ribs in position and an associated fourth rib), seven dorsal vertebrae with associated dorsal ribs, a distal caudal vertebra, a left scapula and the proximal end of a right scapula. The new specimen shows features, especially in the middle cervical vertebrae, that link it to Pilmatueia faundezi. Additionally, the specimen MLL-Pv-010 shows features previously unknown for the species, such as the morphology and orientation of the bifid neural spines of the anterior and mid-cervical vertebrae. The information obtained from the specimen MLL-Pv-010 allows us to propose an expanded diagnosis of Pilmatueia faundezi. Moreover, two phylogenetic analyses focusing on South American dicraeosaurids show that Pilmatueia Coria, Windholz, Ortega & Currie, 2019 is well nested within Dicraeosauridae Huene, 1927. One of our phylogenetic hypotheses differs from previous contributions in showing South American dicraeosaurids as a monophyletic group. However, in the second hypothesis these are not recovered as a natural group. We think that it is reasonable to recover a South American dicraeosaurid clade, and that eventually it will be best supported once more evidence is recovered.

Management of Rib Avascular Necrosis Complicated by Osteomyelitis in a Patient With Sickle Cell Anemia

Abstract Introduction Avascular necrosis of the rib is a rare presentation of sickle cell anemia's vaso-occlusive crisis. This report describes the case of a 45-year-old man known to have sickle cell anemia presenting with rib avascular necrosis complicated by osteomyelitis. The patient came to the outpatient department with left lateral chest wall pain. Antibiotics produced no improvement. A computed tomography scan of the chest revealed a left sixth rib fracture with a thick fluid collection consistent with pus. The patient was taken to surgery and underwent necrotic bone debridement and pus drainage. The patient showed improvement and became afebrile after the surgery. Conclusion The lack of distinct clinical indicators and low occurrence of rib avascular necrosis can lead to misdiagnosis and mismanagement of the disease.

Radiographic Reference Intervals for Cardiac Size in Common Mynahs (Acridotheres tristis).

Cardiovascular diseases in the common mynah (Acridotheres tristis) often go undiagnosed due to limitations with the physical examination and common concurrent illnesses. The aim of this study was to establish accurate reference intervals for cardiac size based on radiographs for this species. All birds were considered healthy based on physical examination. High-quality ventrodorsal radiographic images were obtained from 34 healthy common mynah birds. The cardiac width (CW), thoracic width, distance between third and fourth ribs, synsacral width, coracoid width, and distance between clavicular bones were evaluated on the ventrodorsal radiographic images. Additionally, the ratio between the CW and these anatomical indices were measured. In order to evaluate the correlation between CW and the radiographic indices, a linear regression model was used. The mean ± SD for CW in the 34 birds was 16.1 ± 0.9 mm (95% confidence interval: 14.1-18 mm). Significant moderate correlation was found for CW with thoracic width (R2 = 0.37; P < 0.001), coracoid width (R2 = 0.25; P = 0.002), and the distance between the third and fourth ribs (R2 = 0.34; P < 0.001). The radiographic reference intervals calculated in this study can be used to evaluate cardiac size in the common mynah bird.

The surgical treatment of locally advanced angiosarcoma of the anterior mediastinum. A clinical case

Tumors of the mediastinum is a collective term that includes neoplasms of various degrees of malignancy, different morphogenesis, originating from heterogeneous tissues and combined into one nosological form according to anatomical localization. Angiosarcoma is a rare malignant tumor originating from a vessel wall. In the general structure of sarcomas, its frequency is estimated at 1%. The tumor is characterized by an aggressive course, local recurrence, hematogenous metastasis, poor sensitivity to chemotherapy and radiotherapy. Surgery remains the main treatment for angiosarcomas. The article presents a clinical case. A 55-year-old patient has multiple primary malignant neoplasms: cancer of the body of the uterus pT1aN0M0 IA stage. Surgical treatment from 12.15.2020 panhysterectomy; angiosarcoma of the anterior mediastinum with lesions of the manubrium, body of the sternum and the 1st rib on the left, invasion into the left brachiocephalic vein with the formation of a tumor thrombus in it, growing into the upper lobe of the left lung, T3N0M0, G1. Surgical treatment from 08.12.2021 resection of the manubrium and body of the sternum with resection of the anterior segments I, II, III ribs on both sides, resection of the left brachiocephalic vein, removal of an anterior mediastinal tumor, atypical resection of the upper lobe of the left lung en bloc, reconstruction of the sternum and ribs with an individual titanium 3D prosthesis. The patient was discharged from the hospital in a satisfactory condition.

Effectiveness of unilateral sequential video-assisted sympathetic chain blockage for primary palmar hyperidrosis in children and adolescents.

Primary palmar hyperhidrosis (PPH) is a severely debilitating condition that can affect patients of any age. Thoracoscopic sympathectomy provides a definitive treatment for PPH. Aim of this study is to investigate the effectiveness of unilateral sequential video-assisted thoracic sympathetic chain clamping (VATSCC) by clips application in pediatric population. The surgical procedure was done in the semi-sitting position, under general anesthesia with orotracheal intubation. Mean operation time was 23 ± 6 min (range 12-45). Two 5 mm ports were inserted at the level of the middle axillary line in the second and fourth intercostal space respectively. The sympathetic chain was identified, and two clips were applied, the first one at the level of the third and the second one, at the level of the fourth rib. No chest tube was used. Resolution of symptoms, complications, recurrence rate, onset and duration of compensatory hyperhidrosis were analyzed. From August 2017 to September 2021, 58 patients (male:female ratio 32:26), mean age 16.5 years (range 14-19), with PPH underwent unilateral sequential VATSCC by clips application, starting on the dominant hand. The contralateral side was operated 2 months after. All patients except one (transient pneumothorax) were discharged on the first post-op day. No immediate or late complications have been recorded. Mean follow-up was 32 months (range 6-41). All patients except one (1,7%), affected by Raynaud's disease, showed a complete resolution of the symptom. Seven patients (12%) developed transient moderate compensative hyperhidrosis (CH) that spontaneously disappeared in the postoperative period. Unilateral sequential thoracoscopic sympathetic chain clamping for PPH in pediatric patients is a safe and very effective procedure with a low complication rate and low incidence of postoperative CH that, in our experience, resolved spontaneously in the postoperative period, after the second surgery leading to an improvement in the quality of life.

Estimation of Age-at-Death Using Cortical Bone Histomorphometry of the Rib and Femur: A Validation Study on a British Population.

Histomorphometry constitutes a valuable tool for age estimation. Histological interpopulation variability has been shown to affect the accuracy of age estimation techniques and therefore validation studies are required to test the accuracy of the pre-existing methodologies. The present research constitutes a validation study of widely known histological methods on the sixth rib and the femoral midshaft of a 19th century British population originating from Blackburn, England. An evaluation of the histomorphometric features of eleven ribs and five femora was performed and used to test the accuracy of selected methods. Results indicated that osteon area and circularity were the only histomorphometric variables that presented significant interpopulation variability. Cho et al.'s method for the ribs and the average value produced using Kerley and Ubelaker's method for intact osteon and percentage of lamellar bone equations for femur were considered the only reliable markers for estimating the age on the Blackburn sample. In the case of old individuals, Goliath et al.'s method provided more satisfactory results. Overall, the present study provides evidence on the applicability of the aging histomorphometric methods on a British sample and highlights the limitations of applying histomorphometric methods developed on different reference populations than the one under investigation.

PSAT218 Technetium 99m-Methyl Diphosphonate (99mTc MDP) Radioguided Surgery in Patient With Tumor-Induced Osteomalacia (TIO)

Abstract Introduction TIO is a rare paraneoplastic syndrome of excess FGF23 secretion by mesenchymal tumors that results in myopathy, pain, weakness and osteomalacic fractures. Tumors are small and often difficult to locate, frequently delaying diagnosis. Surgery is considered definitive therapy, but recurrences remain common due to incomplete tumor resection. We present a novel approach of using Gallium (Ga) 68 DOTATATE PET/CT to identify the culprit tumor preoperatively followed by intraoperative 99mTc MDP radioguided surgical resection. Case Report A 41-year-old female presented with a four-year history of progressive weakness, fatigue, muscle and bone pain, and multiple subacute rib fractures and bilateral hip fractures with minimal trauma. On exam, she had proximal muscle weakness and walked with an antalgic gait aided by crutches. Laboratory evaluation revealed serum phosphorus of 2.1 mg/dL (2.5-4.5), tubular reabsorption of phosphate (TRP) of 78.9% (&amp;gt;85%), elevated alkaline phosphatase of 209 IU/L (31-125), 1,25 dihydroxy vitamin D [1,25 (OH)2 D] of 17 pg/ml (18-72) and serum FGF23 610 RU/ml (&amp;lt;180). Serum calcium, parathyroid hormone (PTH), estimated GFR and 25 hydroxy vitamin D were normal. Testing for genetic causes of hypophosphatemia was negative. With biochemical and genetic testing consistent with TIO, functional imaging was performed. Ga 68 DOTATATE PET/CT identified a single, 1.8 cm non-expansile sclerotic focus along the anterior left sixth rib with moderate uptake. She denied any recent trauma to the site. She was referred to thoracic surgery for a left sixth rib resection. Intraoperatively, she received 8.1 mCi Tc99m-MDP intravenously and the margin of the tumor was localized using a gamma probe allowing complete resection. Surgical pathology confirmed a 2.0 cm phosphaturic mesenchymal tumor (PMT)with widely negative margins. Postoperatively, her muscle strength, fatigue and ambulation improved significantly within six weeks and her serum phosphorus, TRP, 1,25 (OH)2 D normalized. Discussion Localization of PMTs is difficult because tumors are small and can be located anywhere in the body. Functional imaging using somatostatin analogs such Ga 68 DOTATATE PET/CT exploits the presence of somatostatin receptors expressed by many PMTs. Complete resection of PMTs can be challenging because they tend to be locally infiltrative along bone trabeculae. 99mTc MDP is a radiotracer localized to bone in proportion to osteoblastic activity as seen at sites of bony remodeling or bone metastasis. Accurate tumor localization and complete resection with widely negative margins are imperative for definitive treatment and cure. This case is unique in utilizing Ga 68 DOTATATE PET/CT for localization of the PMT paired with intraoperative 99mTc MDP in conjunction with a gamma camera for identifying tumor margins facilitating complete tumor resection and cure of the patient. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.

Congenital partial chest wall defect with extracorporeal intercostal liver herniation

Congenital herniation of the liver through the chest wall associated with chest wall deformity is an extremely rare clinical observation. There are only a few reports of intercostal liver herniation associated with Poland syndrome, which is characterized by hypoplastic unilateral chest wall structures. We present a case of a neonate with a mass drooping through a defect in the left side of the chest wall with diaphragmatic eventration. The patient demonstrated a left-sided hypoplastic pectoralis musculature defect and an ipsilateral costal cartilage defect in the left side of the sternum at the level of the fifth to sixth ribs. The radiological investigation revealed that the mass was a result of herniation of the left lobe of the liver. On the day after birth, resection of the mass was performed by laparotomy because the color of the mass gradually changed to a dark red appearance, and incarceration and necrosis were suspected. There were no intraoperative or postoperative complications. Postoperatively, the diaphragm was concluded to have normal movement on radioscopic examination.

Variant pectoralis minor muscle: a case study with clinical relevance.

The pectoralis minor (PMn) muscle originates from the third, fourth, and fifth ribs near the costochondral junctionusually and gets inserted on the medial margin and upper surface of the coracoid process of the scapula. To look at the morphological insertion patterns and sites of attachment of the PMn muscle in the donated cadavers. Over all 19 limbs were included in the study (9 right and 10 left). Out of 19 limbs, 10 belonged to female and 9 belonged to male cadavers. The cadavers were meticulously dissected to determine the morphological insertion types and location of the attachment of the muscle. Unusual pattern of insertion was observed in 6 limbs (31.6%) out of total 19 limbs included in the study. The variations we observed does not fall completely in the classification by Le Double, hence variations we observed can be considered as new and rare variant which to our knowledge is not reported in literature. We propose this new variant to be type 4 of Le Double classification. The potential of ectopic PMn tendon should be taken into consideration and tested out, especially in patients with shoulder discomfort and stiffening who have ruled out the more frequent diseases. For proper surgical planning, a preoperative magnetic resonance imaging or USG examination of the shoulder joint is required considering the prevalence of variation in the insertion pattern of PMn muscle. Preoperative identification of any abnormal PMn insertion can help to reduce the risk of iatrogenic tendon injury and post-operative problems.

Almost slipped through the crack: Pediatric patient with bilateral slipped rib syndrome and twelfth rib syndrome of the eleventh ribs

Slipped rib syndrome is a rare disorder in which there is hypermobility of the anterior false ribs, resulting in the tips of the ribs moving or slipping under the superior rib. Alternatively, twelfth rib syndrome is caused by irritation of the twelfth intercostal nerve related to the hypermobility of the twelfth rib. In this report, we present a case of a 15-year-old male who presented with debilitating pain in the left posterior flank that persisted despite multiple medications and physical therapy. He was diagnosed with left-sided slipped rib syndrome and twelfth rib syndrome of the eleventh rib which was treated with eleventh rib excision. Less than one year later he developed right-sided pain and was ultimately diagnosed with right-sided slipped rib syndrome and twelfth rib syndrome of the eleventh rib for which he underwent right ninth and tenth costal cartilage excision and right eleventh rib excision. The patient then had complete resolution of his pain. A delineation between slipped rib syndrome and twelfth rib syndrome is important since they are both relatively rare and often misdiagnosed. Our case report is significant since our patient had both of these rare diseases bilaterally which to our knowledge has not been previously published. • Slipped rib syndrome and twelfth rib syndrome are rare causes of chest and back pain. • Increased awareness will decrease unnecessary studies and pain for these patients. • Our patient had bilateral SRS and twelfth rib syndrome, which has not been not previously described. • Resection of the affected rib with cryoablation of the intercostal nerve is a safe and effective treatment.

PSEUDOMONAS AERUGINOSA COSTOCHONDRITIS ASSOCIATED WITH RECENT IV DRUG USE

PSEUDOMONAS AERUGINOSA COSTOCHONDRITIS ASSOCIATED WITH RECENT IV DRUG USE

WITHDRAWN

SESSION TITLE: COVID-19 Co-Infections SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/19/2022 12:45 pm - 1:45 pm INTRODUCTION: PAP is a rare entity that can occur secondary to infection, malignancy, or trauma. Mucormycosis in the setting of Covid-19 pneumonia has been increasingly recognized but PAP has only recently been reported in this setting. CASE PRESENTATION: A 44 year-old man with type 2 diabetes, non-ischemic cardiomyopathy, hypothyroidism, and ulcerative colitis presented with dyspnea and cough in July 2021. He was diagnosed with Covid-19 pneumonia and initially treated with molnupiravir. Eight days later he presented to the emergency room with worsening dyspnea, hypoxemia and diabetic ketoacidosis. He required 3L of oxygen and was intubated for airway protection. CT chest revealed mild bilateral patchy opacities and dexamethasone was started. Unfortunately, persistent fevers and worsening respiratory status ensued and repeat chest CT on hospital day (HD) 8 showed a new large left upper lobe (LUL) cavitary lesion. Cultures ultimately grew Rhizopus microsporus and he was started on amphotericin then isavuconazole after acute kidney injury developed. Dexamethasone was discontinued and interval imaging after ten days showed dramatic growth of the cavitary lesion (9 x 6 x 3 cm) with new extension through the chest wall, infiltrating the intercostal spaces and pectoralis muscle. Due to ventilator dependency a tracheostomy was performed on HD 24. Despite anti-fungal therapy the cavitary lesion persisted, with evidence of osseous destruction of the third and fourth ribs, as well as new fluid collections within the cavity and hilar extension. On HD 46 he was transferred to our institution for Thoracic Surgery and Interventional Radiology (IR) evaluations. Percutaneous drain placement followed by pneumonectomy vs. staged cavernostomy was considered; however, on HD 50, the patient suddenly developed massive hemoptysis. CTA of the chest showed a 1.6 x 1.5 cm PAP with active hemorrhage from the LUL anterior segmental artery with dispersion into the cavity. Urgent coil and glue embolization was successfully performed by IR. Ultimately, thoracic surgical intervention was deemed too high risk and thus he was medically managed with a regimen of isavuconazole, amphotericin, and terbinafine. Hemoptysis did not recur and he was eventually discharged from the hospital and liberated from both mechanical ventilation and tracheostomy. Chest CT 6 months from the initial diagnosis has shown stable to mildly decreased size of the cavitary lesion. DISCUSSION: This is the first case to our knowledge of PAP as a complication of Covid-19 and Mucor superinfection in the United States. Five cases of this combination have been recently reported in other countries. Risk factors for Mucor infection after Covid appear to be uncontrolled diabetes, DKA, and steroid administration. CONCLUSIONS: A high index of suspicion should be maintained in patients with these risk factors, as PAP can present as massive hemoptysis and is often fatal. Reference #1: Hoenigl M, Seidel D, Carvalho A, et al. The emergence of COVID-19 associated mucormycosis: a review of cases from 18 countries [ 2022 Jan 25]. Lancet Microbe. 2022;10.1016/S2666-5247(21)00237-8. doi:10.1016/S2666-5247(21)00237-8 Reference #2: Pruthi H, Muthu V, Bhujade H, et al. Pulmonary Artery Pseudoaneurysm in COVID-19-Associated Pulmonary Mucormycosis: Case Series and Systematic Review of the Literature. Mycopathologia. 2022;187(1):31-37. doi:10.1007/s11046-021-00610-9 Reference #3: Coffey MJ, Fantone J 3rd, Stirling MC, Lynch JP 3rd. Pseudoaneurysm of pulmonary artery in mucormycosis. Radiographic characteristics and management. Am Rev Respir Dis. 1992;145(6):1487-1490. doi:10.1164/ajrccm/145.6.1487 DISCLOSURES: No relevant relationships by Kevin Patel No relevant relationships by Clifford Sung

PO239 / #646 TWELFTH RIB SYNDROME TREATED WITH PERIPHERAL NERVE STIMULATION: A CASE REPORT: E-POSTER VIEWING

Twelfth rib syndrome is described as pain condition in the loin of the affected side and exacerbates with movement, caused by irritation of the twelfth intercostal nerve (1,2). A 70 year old male with metastatic prostate cancer, diabetes type 2 and Parkinson’s disease. Back pain since 2017. Pathological fractures on L4 elicited by metastases in 2019. In conjunction with this developed a pain condition in the right side of the abdomen and lower back. Bedridden and severe cognitive impairment due to pain and medication.

Right Kidney Position for Laparoscopic Liver Resection of Tumors Located in the Posterosuperior Region

Laparoscopic liver resection (LLR) for tumors located in posterosuperior (PS) region of the liver (segment 7 or 8) is extremely challenging. Several techniques have been proposed; however, no standard procedure has yet been established. The aim of this study was to present and discuss the usefulness of the right kidney position as a unique idea of surgical position in LLR for tumors located in the PS region. For the right kidney position, the patient lay on the operating table in the left lateral decubitus position with the body bent so that the kidney rest (approximately the level of the twelfth rib) was elevated to extend the surgical area. The surgeon was positioned on the right or left side of the patient according to the situation during operation. An intercostal port was not used in any of the cases. The operating table was liberally rotated as per the surgeon's preference. The liver was mobilized by dividing the right triangular and coronary ligaments. Full mobilization of the right liver was not routinely performed. Liver transection was performed under intermittent inflow occlusion in all cases. Thirteen patients with tumors located in the PS region underwent LLR in the right kidney position at Shinshu University Hospital between June 2019 and May 2021. Of the 13 patients, 11 patients underwent limited liver resection and two underwent anatomic liver resection of segment 8. The right kidney position enables the surgeon to secure a wider surgical field under the dome and prevent the camera and forceps from hitting the ilium and interfering with the operation, and the surgical device can easily reach the lesion under the dome because of the migration to the caudal side of the liver. No patients required blood transfusion or conversion to open liver resection. The median surgical margin was 6 mm (range 0 to 9 mm). The right kidney position is useful, especially for the resection of tumors located in the PS region of the liver.

FAMILY MATTERS: CHEST PAIN AS THE INITIAL PRESENTATION OF EARLY-ONSET METASTATIC PROSTATE CANCER

FAMILY MATTERS: CHEST PAIN AS THE INITIAL PRESENTATION OF EARLY-ONSET METASTATIC PROSTATE CANCER

Arterial Thoracic Outlet Syndrome - Clinical Presentation, Surgical Management, and Outcome

Objective: The main objective of this study was to review the clinical presentations, surgical management, and outcome of surgical procedures for arterial thoracic outlet syndrome (TOS). Methodology: This is a retrospective analysis of arterial TOS patients admitted in our department (Institute of Vascular Surgery, Madras Medical College, Chennai) from August 2012 to July 2022. Results: This study enrolled 81 patients, with mean age of 41.13 (12-65 years) and 50.61% male (41) and 49.39% female (40), associated with distal arterial lesions - 63 (77.77%), among which 50.61% - occlusion in the brachial artery (33), 24.69% in forearm arteries (15), and 24.69% in the axillary artery (15). About 95.06% of patients had cervical rib (77), 2.46% - first rib abnormality (2), 2.46% - soft-tissue compression (2), 59.25% was SCHER Stage III (48), 33.33% SCHER stage I (27), and 7.40% SCHER stage II (6). All patients had undergone a supraclavicular approach. The most common arterial lesions were subclavian artery (SCA) thrombus in 53.08% (43), occlusion in 17.28% (14), and dilatation in 29.62% (24) cases. The cervical rib excision with anterior scalenectomy in 95.06% (77), and 1st rib excision with anterior scalenectomy 2.46% (2) and soft tissue resection with anterior scalenectomy 2.46% (2) of patients. SCA intervention/reconstruction was done in 88.88% (72) of cases. Two patients had underwent above elbow amputation (2.46%) and no mortality and SCA patency was 100%. Conclusion: Cervical rib excision with anterior scalenectomy with or without thrombectomy is an effective procedure for arterial TOS cases.

Percutaneous Radiofrequency Sympatholysis in the Treatment of Primary Palmar Hyperhidrosis: A Retrospective Case-Controlled Study of Rib-Based Anatomical Targeting

PurposeTo compare the efficacy, adverse reactions, quality of life, and patient satisfaction of percutaneous radiofrequency (RF) thoracic sympatholysis at different rib-based anatomic targets for primary palmar hyperhidrosis (PPHH). Materials and MethodsPatients with PPHH were divided according to the target, namely, the upper edge (Group U) and lateral border (Group L) of the fourth rib; there were 30 patients (mean age, 24.9 years; women, 31, 51.7%) and 60 cases in each group. The Hyperhidrosis Disease Severity Scale (HDSS) and Dermatology Life Quality Index (DLQI) were assessed. ResultsFrom before RF sympatholysis to 12 months after, the proportion of patients with HDSS Grades III and IV (100%–26.7%) and the DLQI (19.78 ± 5.08 to 4.98 ± 4.18) decreased significantly (P < .001). At 3, 6, and 12 months after RF, the HDSS grades were better in Group L than in Group U (P = .005, .002, and .004). At 6 and 12 months after RF, the DLQI in Group L was lower than that in Group U (P = .012 and .016), and at 1, 6, and 12 months after RF, patient satisfaction was higher than that in Group U (P = .025, .014, and .009). Adverse events were mild; 8 patients (13.3%) demonstrated compensatory hyperhidrosis at 12 months after RF, and there was no difference between the 2 groups (P = .448); neuralgia and pneumothorax also did not differ (P = .522 and .643). ConclusionsRF sympatholysis targeting the lateral border of the fourth rib had higher efficacy, better quality of life, and higher patient satisfaction.

Redefining the costal margin: A pilot study.

Classical teaching of rib anatomy contends that the false ribs (7th to 10th) fuse anteriorly to form the costal margin of the chest. Slipped rib syndrome consists of false rib subluxation into the thorax with symptomatic impingement of the intercostal nerve. We sought to determine the incidence of this anatomic finding through anatomic study of the costal margin. Cadavers were evaluated for mobility and attachment of the ninth and tenth ribs. Experienced anatomists and chest wall surgeons conducted a standardized dissection and assessed rib tip mobility using predefined criteria. Videos of dissections were submitted to a single investigator who reviewed the findings. Costal margins of 40 cadavers (45% male) were evaluated bilaterally. The average age was 83 years ± 11 years. The ninth rib was found to be attached to the eighth rib 100% of the time by an interchondral cartilaginous attachment along the body of the eighth and ninth ribs. Internal subluxation was noted in 19% (15 of 80), and the tip of the rib was mobile in 86% (69 of 80) evaluations. The tenth rib was attached to the ninth rib in 18%(14/80). A "floating" 10th rib was noted in 59% (47 of 80) of specimens. Subluxation was noted in 33% (26 of 60). Half of the ribs that subluxed moved medially to the ninth rib and half moved externally. An upwardly hooked tip was noted in 10% (8 of 80). Ribs with a hooked tip subluxed in 63% (5 of 8), and all of these ribs (5 of 5) moved to the interior of the chest ( p = 0.020). The ninth rib is commonly attached to the eighth rib, but the tenth rib is often not attached to the ninth rib. Most commonly, the tenth rib is a "floating" rib. Internal subluxation of the tenth rib as well as the presence of a hooked tip may predispose individuals to the development of "slipped rib syndrome." Diagnostic Tests or Criteria; Level III.

Does the Rearing Management following by Charolais Cull Cows Influence the Qualities of Carcass and Beef Meat?

This study characterized, for the first time, the rearing managements (from birth to slaughter) applied throughout the cull cows’ life and observed the effect of these managements on the carcass and meat properties. From the individual data of 371 Charolais cull cows, three rearing managements were defined and characterized with 60 rearing factors. The results showed that the rearing managements had low effects on the carcass and meat properties. For the carcass traits, only the carcass weight, and fat and longissimus (LM) colors at the level of the sixth rib were impacted. Concerning the meat, only the red color intensity, the fat aroma, the flavor intensity and persistence were affected. According to our results, this study confirmed that it is possible to produce carcass or meat with similar properties; consequently, it is difficult to favor a rearing management. However, to manage jointly both carcass and meat qualities, trade-offs are needed.

Caudal pulmonary artery to vein ratio on radiography can predict pulmonary hypertension in dogs with mitral regurgitation.

Pulmonary hypertension (PH) is an important predictor of poor outcomes in dogs with mitral regurgitation (MR). The feasibility of radiography to predict PH in dogs with MR is unknown. This retrospective, observational, and analytic study aimed to identify a radiographic parameter to predict PH in dogs with MR. A total of 302 dogs diagnosed with MR on echocardiography were enrolled. Medical record and radiographic findings such as the size of the main pulmonary artery, left atrium, left ventricle, and right chamber, and cranial and caudal pulmonary arteries and veins were evaluated according to the presence of PH. The diameters of the cranial and caudal pulmonary vessels were compared to the fourth rib and the ninth rib, respectively, and the ratio of the pulmonary artery to the corresponding vein (CdPA/CdPV) was calculated. Pulmonary hypertension was diagnosed in 77 dogs (25.5%) and the prevalence of PH increased with MR grade. The CdPA/CdPV was significantly higher (P < 0.001) in the presence of PH. Multivariate analysis showed that the CdPA/CdPV was the only independent radiographic parameter that had a significant association with PH in dogs with MR (P = 0.028). The cut-off value of the CdPA/CdPV = 1.10 showed 90.6% specificity and 31.1% sensitivity for detecting PH in dogs with MR. In dogs with MR, PH can be predicted with high specificity when the caudal pulmonary artery is 1.1 times larger than the corresponding vein on radiographs.