Sternal Length Research Articles

Practical anatomical landmark for optimal positioning of left-sided long-term central venous catheter (a pilot study).

Background:Long-term central venous catheter (CVC) insertion in dialysis patients is an accepted method of hemodialysis. The appropriate CVC tip placement may reduce both early and late complications related to catheter and increase patency rate. This study aimed to evaluate a new, simple, and feasible method based on surface anatomy for the proper placement of tunneled CVC in the left internal jugular vein for hemodialysis or chemotherapy.Materials and Methods:The study was carried out as a quasi-experimental model at Saint Al-Zahra Education Hospital in 2016. A total of forty patients with an indication of left-sided (upper) long-term CVC insertion were enrolled. The length of catheter to be inserted in the left internal jugular vein was considered as the sum of distance from the insertion point of the needle up to sternal notch plus the total distance between the left and right sternoclavicular joint and half-length of the sternum. The right atrium (RA) or superior vena cava-RA junction was the correct region for inserting the catheter tip. The collected data were analyzed using Fisher's exact test and t-test using SPSS (version 22).Results:The patients were 63.75 ± 17.96 years of age, weighed 67.33 ± 13.20 kg, and height of 166.92 ± 8.99 cm. Catheters were inserted successfully in 95% of patients (n = 38). No significant relationship was found between the success of new method and age, gender, height, weight, body mass index, and sternum half-length plus the distance between the right and left sternoclavicular joint.Conclusion:“The mid – sternal length plus sternoclavicular joints spacing” as a new formula (based on anatomical landmarks) was found practical and safe and could easily be used among adult patients who undergo tunneled CVC in the left internal jugular vein.

Estimation of stature from various sternal lengths: An autopsy based study in South Indian population

Estimation of stature from various sternal lengths: An autopsy based study in South Indian population

Phytase Superdosing in the Diet of Lightweight Replacement Pullets: Performance, Organ Biometry and Bone Characteristics

ABSTRACT The aim of this study was to evaluate the effect of two types of phytases (the 1st produced from Escherichia coli and the 2nd from Aspergillus oryzae) with different dosages (300 and 900 Unit Phytase or FTU) on performance, organ biometry and bone quality of replacement pullets in the period of 8 to 17 weeks of age. A total of 288 Hy-Line White laying hens were used at 8 weeks of age. A completely randomized design was adopted in a 2 x 2 factorial scheme, totaling 4 treatments with 8 replicates of 9 birds each. Performance, biometric variables and bone characteristics were evaluated. There was no significant interaction between the factors for any of the evaluated variables. The conversion and the accumulated consumption were influenced (p<0.05) by the phytase dosages, with the highest results being observed for the consumption obtained with 300 FTU, and the best results for the feed conversion obtained with the dosage of 900 FTU. The relative weight of the liver was influenced by the treatments (p<0.05), presenting higher values with bacterial phytase and a dosage of 900 FTU. The sternum length and tibial deformity were influenced by fungal phytase (p<0.05). It is concluded that the use of 900 FTU superdosing and fungal phytase improves the performance and bone characteristics of light replacement pullets.

Thoracic proportions in children without scoliosis.

PurposeScoliosis is a condition of abnormal growth resulting in 3D deformity of both the spine and thoracic cage. The aim of this study is to use chest radiographs of healthy children to define normal thoracic proportions so as to provide a useful normal reference range against which children with spinal deformity can be compared.MethodsThree independent reviewers assessed posteroanterior and lateral chest radiographs of 184 normal children aged between two and 15 years. Duplicate assessments were undertaken by all three raters on 36 of these radiographs. We measured the T1 to T12 length, sternal length, chest depth at T6, chest width at T3, chest width at T6 and maximum chest width. Ratios of thoracic dimensions were calculated to define the normal proportions of the thorax. Inter- and intra-rater variance was estimated for all dimensions and dimension ratios.ResultsThe intra-rater and inter-rater reliability was excellent with intra-class-correlation coefficients values > 80% and both intra- and inter-rater coefficients of variance < 9% for all parameters. All measured dimensions of the thorax and spine progressed linearly with respect to age. The mean proportions of T1 to 12 length of the sternal length, chest depth at T6, chest width at T3, chest width at T6 and maximum chest width were 0.5, 0.4, 0.7, 0.9 and 1.0, respectively.ConclusionIt is possible to accurately and reproducibly measure the dimensions of the thoracic cage and spine on plain film radiology. The ratios of T1 to T12 length with respect to sternal length, chest depth at T6, chest width at T3, chest width at T6 and maximum chest remain constant with increasing age. Thoracic dimensions in children progress linearly with increasing age.Level of EvidenceV

Normative Data of Optimally Placed Endotracheal Tube by Point-of-care Ultrasound in Neonates

To derive normative data of the distance between optimally placed endotracheal tube tip and arch of aorta by ultrasound in neonates across different weight and gestation. Cross-sectional study. Tertiary care neonatal intensive care unit from April 2015 to May 2016. All neonates requiring endotracheal intubation were eligible for the study. During intubation, insertional length was determined using weight-based formula. The distance between endotracheal tube tip and arch of aorta was measured by ultrasound. Endotracheal tube position was confirmed by chest radiograph. Out of 133 enrolled infants, 101 (75.9%) had optimally placed endotracheal tubes. The mean (SD) distance between endotracheal tube tip and arch of aorta by ultrasound was 0.78 (0.21) cm in infants <1500 g and 1.04 (0.32) cm in infants ≥1500 g. The regression equation to estimate insertional length from weight, crown heel length (CHL), occipito-frontal circumference (OFC), nasal tragus length (NTL) and sternal length (SL) were Wt(kg)+4.95, 0.15×CHL(cm)+0.57, 0.22×OFC(cm)+0.49, 0.82× NTL(cm)+1.24 and 0.75×SL(cm)+2.26, respectively. Our study reports normative data of the distance between optimally placed endotracheal tube tip and arch of aorta by ultrasound in neonates. The distance between endotracheal tube tip and arch of aorta increases with increase in weight and gestation. Insertional length correlates strongly with all the anthropometric parameters.

Estimation of Stature from the Sternal Length in American White Population Using Linear Regression Equation: A Preliminary Cadaveric Study

ObjectiveTo estimate stature from the sternal length in American white population using linear regression equation.RationaleThere is an extensive study to correlate the stature from long bones and sternum in the literature in the Asian continent population. However these studies are sporadic for white and Hispanic American population. In this study we used regression analysis to address the reliability of sternal length for estimation of stature in White American population.Material and MethodsThis preliminary research project was conducted at Touro College of Osteopathic Medicine during the academic year 2018–2019 and 21 female and 14 male cadavers from the Department of Anatomy were used for the study. The research project was approved by the Institutional research committee. Cadavers with any noticeable physical anomaly affecting the stature were excluded from the study. The age and ethnicity of the cadavers were obtained by the departmental records. Stature was measured using a steel tape from Heel to Vertex. After the reflexion of the skin, the length of the sternum was measured from incisura angularis to mesoxiphoid point using a digital Vernier Caliper. Regression equations were derived using SPSS statistical software.ResultsRegression equation for female: Y= 135.039 + (0.146) X where Y= stature and X= length of the sternum. Regression equation for male: Y=141.603 + (0.17) X where Y= stature and X= length of the sternum. The SD was 13.88, 16.21 and P value was 0.18, 0.12 respectively for females and males.ConclusionBased on the calculations and the P value, we concluded that the length of the sternum is not a reliable factor for stature estimation for American white population. Forensic importance of these findings and its comparison with existing literature will be discussed.Support or Funding InformationNAThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Evaluation of Gender in Living Male and Female Children Through the Measurement of Sternum Bone in the Population of Uttar Pradesh

Introduction: Sex evaluation from the skeletal remains is of very much important for medicolegal aspects in the field of medical science. On the basis of previous researcher, I have been planned to verify the existrnal data and establish them in reference to population in and around Lucknow. With the help of this study we were distinguishes the male and female sternum bone in children. Subjects and Methods: The technique described by Ashley GT -1956b was used for measurement of sternum. Each linear measurement has been taken thrice on the anatomical position of the sternum using Mitutoyo-digital vernier calipers to the nearest millimeter with precision of 0.01 mm. Results: Discussion: The previous researchers told that the sternum has distinguished in different zone of India, and it is shorter than European country. Our findings of manubrium were 49.45±3.45 mm for male and 44.47± 5.79 mm for female children respectively. The study done by previous researcher was provided full support to our present finding. Conclusion: The comparison of mean length of manubrium, mesosternum and sternum between 2 to 15 yrs, female and male sternum between two groups, significantly different and higher length of manubrium, mesosternum and sternum in males as compared to females children.

A morphometric study of adult human trachea in West Bengal population

Background: Keeping in view the great variations in different dimensions of the human trachea and its remarkable clinical importance, the present work was undertaken. It included the study of dimensions of adult trachea of both sexes in West Bengal population. In addition, an effort was made to establish their relationship with selected external measurements. Methods: This was a cross-sectional, observational study on 60 cadavers. Relatively disease-free fresh adult cadavers were selected from West Bengal population. Study variables were tracheal length, internal transverse diameter and internal anteroposterior diameter. Selected external measurements were height and sternal length. Results: In males, the highest correlation was observed between tracheal length and height (r = 0.800), and tracheal length and sternal length (r = 0.799). In females, the highest correlation coefficient was found between tracheal length and height (r = 0.809). Conclusion: Different formulae were obtained by linear regression with all measurements being in centimeters. Therefore, it is possible to predict the tracheal dimensions from simple external measurements.

The optimal chest compression point on sternum based on chest-computed tomography: A retrospective study

Background: High-quality chest compression is crucial for cardiac arrest patients. However, only few studies are focusing on the optimal compression point. Objective: The aim of this study was to explore the optimal compression point based on chest-computed tomography. Methods: We retrospectively selected 166 adult health subjects between January 2018 and May 2018 in a university-affiliated hospital. Results: The median length of sternum was 14.9 cm. The median length from the inter-nipple line to the distal end of sternum was 1.0 cm. The median length from the point at which the maximal left ventricular diameter projected onto the sternum to the distal end of the sternum was −1.4 (–2.2 to 0.0) cm. The median value of the length from the inter-nipple line to the distal end of sternum plus the length from the point at which the maximal left ventricular diameter projected onto the sternum to the distal end of the sternum was 2.0 (1.0–3.1) cm. Conclusion: One size does not fit all. The point recommended by the current guideline may not appropriate for Chinese person. Further studies are required focusing on individual chest compression during cardiopulmonary resuscitation.

Thoracic cage volume and dimension assessment by optoelectronic molding in normal children and adolescents during growth.

The thoracic spine, the chondral and osseous ribs, and the sternum together make up the thoracic cage. These elements are strictly correlated, although their growth is not synchronous. The purpose of this study is to provide a comprehensive data set of thoracic dimensions and non-invasive volumetric assessment in a large cohort of males and females from early childhood to young adult age. In all, 622 healthy individuals (406 girls, 216 boys) aged 6-18years were consecutively enrolled between 2006 and 2016. All had to be healthy with no history of spinal deformity, or any lung, cardiovascular, systemic or neuromuscular disease. The optical ORTEN system for trunk surface data acquisition was used to calculate thoracic cage volume (V) and perimeter (Pe), anterior-posterior depth (AP) and transverse diameter (TD), AP/TD ratio, sternal length (St), and T1-T12 distance (Tle) in all patients. The overall average age was 11.1 ± 2.5years (4-18) for girls and 11.0 ± 3.1years (4-18) for boys. Average growth parameters were: standing height 146.2 ± 14.6cm (103-172) for girls and 146.4 ± 20.0cm (94-192) for boys, sitting height 75.4 ± 8.6cm (61-91) for girls and 75.5 ± 10.3cm (60-99) for boys, weight 37.6 ± 10.4kg (16-65) for girls and 38.3 ± 14.3kg (13.7-104) for boys, BMI 16.7 ± 3.7 (18.5-26) for girls and 17.0 ± 3.3 (18.7-34.3) for boys. At age 6-8years: V was 52.5% of its final size in girls and 44.9% in boys; Pe was 80.2% its final length in girls and 76.8% in boys; St reached 68% of its final size in girls and 66.9% in boys; Tle reached 73.3% of its final length in girls and 71.2% in boys. At skeletal maturity, thoracic cage volume in boys was 19.4% greater than in girls (p < 0.05). AP/TD ratio remained < 1 in all age groups and did not differ between genders (p > 0.05). Growth of the thoracic cage is shown to be a gradual process that is more linear than previously reported. Only small increases in annual growth rates were observed during the pubertal growth spurt. The most important events characterizing thoracic cage development occurred during the first few years of postnatal growth. The circular cross-section of the very young child's thorax reached adult-like proportions together with its ovoid shape before age 6years.

Morphometric Variation of the Sand MartinRiparia ripariaPopulations in Serbia

This study describes the morphometric variation among Sand Martin Riparia riparia populations in Serbia and assesses the relationship between breeding habitat characteristics and morphometric traits. Univariate and multivariate morphometric analyses based on 11 morphometric characters were performed on 233 adult Sand Martins from five populations. The populations showed differences in five morphometric traits: claw length, bill length, bill width, sternum length, and body weight. The differences were most pronounced in populations breeding at high densities in habitats under least human impact compared with urban habitats. Individuals from the Deliblato Sands Special Nature Reserve differed from all other populations in having distinctive characteristics (lower body weight, longer claws and wider bills). The morphological traits we analyzed are related to nesting, foraging and predator avoidance. Thus observed morphological variation might reflect differences in habitat characteristics.

Simplified equation for determining proper depth of peripherally inserted central catheter in relation to anatomical landmarks.

BackgroundThe aim of this study was to develop a formula guiding the peripherally inserted central catheter (PICC) tip placement based on anatomical landmarks such as the upper arm, clavicle, and sternum as well as the patient’s height, weight, and body mass index.MethodsFifty-five patients who were scheduled to have PICCs were included in the study. We measured four distances along the passage of the PICC, which were as follows; the tip of the third finger to the middle of the elbow crease (Distance A), the middle of the elbow crease to the acromion process (Distance B), the acromion process to the sternal head of the clavicle (Distance C), and the sternal head of the clavicle to the end of the xiphoid process (Distance D). The lengths from the elbow creases to their carina bifurcations as determined by fluoroscopy during PICC insertions were recorded and used as reference.ResultsThe formula for determining PICC depth based on the four distances was determined by regression analysis. The optimal formula was determined to be 25.3 + 0.5 × (Distance C) + 0.6 × (Distance D) which yielded an R2 value of 0.3.ConclusionsThe formula proposed for proper depth of the adult, 25.0 + 0.5 × (clavicle length) + 0.6 × (sternum length) for PICC insertion can be used to place the tip at the carina bifurcation level. The distance from elbow crease to catheter insertion point should be added to the length generated by this formula.

Comparison of optimal point on the sternum for chest compression between obese and normal weight individuals with respect to body mass index, using computer tomography: A retrospective study

BackgroundAbdominal fatty tissue deposition in obese individuals could alter the proper hand position for chest compression during cardiopulmonary resuscitation, similar to that in pregnant women. This study aimed to identify the difference in body mass index between obese and normal weight individuals by measuring the optimal point of maximal left ventricular diameter (OPLV), using computed tomography (CT). MethodsWe performed a retrospective analysis of chest CT scans between January 2012 and August 2016 and measured the sternal length and OPLV and estimated the ratio of OPLV to that individual sternal length. We also investigated whether OPLV was within the clinically relevant range of 20 mm to the position advised by the Guidelines 2015. We compared these outcomes between the two groups. ResultsWe randomly selected and analysed 50 of 7229 normal weight and 50 of 394 obese individuals from a database. The mean ± standard deviation of the ratio of OPLV was 22.0 ± 5.7% and 14.8 ± 6.6% of the sternal length, as measured from its most caudal point, respectively, for the obese and normal weight groups (p < 0.001). Both are more caudal than at the middle point of “the lower half of the sternum” as currently recommended. Notably, 96% of the OPLV in the obese group was within ±20 mm of the guideline point versus 52% for normal weight group. ConclusionOPLV on the sternum in obese individuals was more cranial than that in normal weight individuals. The optimal point for chest compression in obese individuals could be slightly more cranial than that in the others.

Estimation of stature from sternum – Exploring the quadratic models

Identification of the dead is significant in examination of unknown, decomposed and mutilated human remains. Establishing the biological profile is the central issue in such a scenario, and stature estimation remains one of the important criteria in this regard. The present study was undertaken to estimate stature from different parts of the sternum. A sample of 100 sterna was obtained from individuals during the medicolegal autopsies. Length of the deceased and various measurements of the sternum were measured. Student's t-test was performed to find the sex differences in stature and sternal measurements included in the study. Correlation between stature and sternal measurements were analysed using Karl Pearson's correlation, and linear and quadratic regression models were derived. All the measurements were found to be significantly larger in males than females. Stature correlated best with the combined length of sternum, among males (R = 0.894), females (R = 0.859), and for the total sample (R = 0.891). The study showed that the models derived for stature estimation from combined length of sternum are likely to give the most accurate estimates of stature in forensic case work when compared to manubrium and mesosternum. Accuracy of stature estimation further increased with quadratic models derived for the mesosternum among males and combined length of sternum among males and females when compared to linear regression models. Future studies in different geographical locations and a larger sample size are proposed to confirm the study observations.

Estimation of stature from the length of sternum: A two year study

Estimation of stature from the length of sternum: A two year study

Estimation of Stature from the Length of the Sternum: An Autopsy Based Study

Estimation of Stature from the Length of the Sternum: An Autopsy Based Study

An Autopsy Based Correlation Study about Determination of Sex from the Combined Length of Sternum (Manubrium + Body) in the Central India Indore Region (M.P.)

An Autopsy Based Correlation Study about Determination of Sex from the Combined Length of Sternum (Manubrium + Body) in the Central India Indore Region (M.P.)

Reliability of Sternal Length and Sternal Index in Sex Determination

Reliability of Sternal Length and Sternal Index in Sex Determination

THE EFFECT OF IGF-1 GENE POLYMORPHISMS ON SOME PHYSIOLOGICAL AND PRODUCTIVE PARAMETRS IN BROILER CHICKEN BREED COBB500.

This experiment investigated the association between SNP 5 UTR region of insulin –like growth factor-1 ( IGF-1 ) and phenotypic productive and physiological traits in cobb500 broiler breed .The study was conducted at poultry farm in Abu-Graib region during a period from 1Nov 2016-14Dec 2016 .Four hundred fifty broiler chicks one day old (cobb500) were wing –banded and divided to three treatment groups (three replicates each) according to gene polymorphisms .DNA was extracted from fresh blood samples .Restriction fragment length polymorphism was used in the 5 UTR region of IGF-1. Chicks were reared under conventional conditions according the guide and fed ad libitum at the end of experiment number of birds were killed to measure carcass cuts. Results showed a significant (P≤ 0.05) increase in live body weight of TT comparing with TC and CC in 1st week, whereas no significant differences was found between different polymorphisms in weight gain, blood traits and serum components in all weeks .on the other hand a significant (p≤ 0.05) increase was found in final body weight ,carcass weight and length of sternum and thigh bones for TT polymorphism in comparison with TC and CC.

Correlation of Posterior Curve Length of Sternum and Stature: A Postmortem Study in Delhi Population

Background: The primary characteristics to establish the identification of an individual are sex, age, and stature [1]. Determination of stature is easy if a complete body or the entire skeleton is found. When only some parts of the body or skeleton are available, it is necessary to have different formulae for determination of stature from their osteometric measurements. The present study aims to assess the stature of an individual from his or her sternum with the help of Posterior Curve Length (PCL). Methods: The study was conducted on 100 cadavers, including 50 females and 50 males, died 18 years or older age. The cases were referred for medico-legal postmortem examination to the Department of Forensic Medicine, Maulana Azad Medical College, New Delhi. Sternum samples were obtained during autopsy (as fresh sternum) and after removal of muscular coverings, cleaned and dried at room temperature (as dry sternum) for the study. PCL was measured and linear regression was used to recognize sternum correlation with stature. Results: In our study which was conducted on fresh and dry samples of sternum, the stature can be estimated by 68% accuracy with linear regression equation of Y=91.51+3.5 (Posterior Curve Length of fresh sternum) with standard error±3.5 cm and correlation coefficient of 0.872. Also the stature can be estimated through Y=96.1+3.4 (Posterior Curve Length of dry sternum) with standard error of ±3.9 cm and correlation coefficient of 0.610. Conclusion: From the present study we found some synergistic factors which are helpful for estimation of stature from respective PCL of sternum which clearly shows that sample of sternum obtained from decomposed body, or in cases where long bones are missing, PCL of sternum acts as an alternative to estimate stature in Delhi population.