Total Sternum Research Articles

Sex- related morphometric difference in sternal index and dimensions amongst Nepalese adults

Introduction: The comprehensive goal in forensic anthropology is the identification of skeletal remains for which researchers are constantly working to produce methods that are as accurate as possible. Because of distinct sexual dimorphism, bones of the pelvis and skull are preferred; however, when these bones are unavailable other bones like sternum have to be used as it holds a great deal of sexual dimorphism.
 Objective: To evaluate sexual dimorphism in the metric parameters of the sternum through MDCT images amongst Nepalese adults.
 Materials and Methods: Sternal dimensions of 105 study participants (62 male and 43 female) were measured using Computed Tomography (CT) images from Radiology Department of Dhulikhel Hospital. An independent t test was performed to assess the strength of association between different variables and genders. Differences were considered significant at P < 0.05. ROC curve analysis was done to determine the discriminating power of variables for sex determination.
 Result: The different measurements of sternal lengths were significantly greater in male than females(p<0.001) except Sternal Index which was found to be higher in female (p<0.001). Despite this difference in mean, most of the sterna were in overlapping zone. The limiting point of 126 was determined for total sternum which could correctly classify majority of sternum. Using ROC curve the mesosternum and total sternum were found to be most accurate (>95%) in sex determination. Hyrtl’s law could classify 91.9% of the male and Ashley’s rule of 136 could 97.67% of the female.
 Conclusion: Hence this study made an effort in sexing the sternum in Nepalese population amongst which mesosternal length and total sterna length were found to be best estimators of sex whereas manubrium length and sternal index were not found to be satisfactory.

Morphology of sternum in patients with Scheuermann's kyphosis: is it different from that of healthy adolescents?

Methods 20 SD patients with thoracic kyphosis aged 10 to 18 years were included in this study. 30 healthy volunteers were recruited to serve as controls. Computed tomography 3D reconstruction of the total sternum in supine position was performed. The length, width, thickness of manubrium and mesosternum was measured respectively. Meanwhile, the angle (a) between the axis of manubrium and that of mesosternum were also measured. The size of sternum and angle a were compared between SD patients and normal controls using the Studenst test.

Sexual dimorphism of human sternum in a contemporary spanish population

Sex estimation is one of the first steps in forensic anthropology to identify human remains. In absence of the skull or the pelvis, any skeletal remain becomes fundamental for identification, especially in mass-disaster cases. The sternum is a potentially useful element in anthropological analysis with a high recovery rate in both forensic-and archaeological context. This study aims to develop classification functions for use in Spanish population. For this, sternum sexual dimorphism is studied in a sample of 105 individuals, known age-at-death, ancestry and sex, from San José Municipal Cemetery of Granada (Spain). Lin’s concordance correlation coefficient was used to estimate intra-and inter-observer error. In discriminant analysis for estimating sex, cross-validation shows accuracy rates exceeds 90% for sternum body length and maximum width (91.8%), or total length with maximum width (90.7%). Isolated variables with higher accuracy rates are total sternum length (89.1%), and sternum body length (87%). Although there is compliance with Hyrtl’s law it is not useful for estimating sex in Spanish population. These discriminant functions have also been validated successfully in two samples from Portugal (Coimbra identified skeletal collection – CISC, and 21st century identified ckeletal collection – Santarém XXI): the variables with higher accuracy rates sternum total length with its maximum width (92.3% the correctly classified individual in the sample CISC; and 83.5% in the sample of Santarém XXI) and the sternum total length (92.1% and 78.5%, respectively). The discriminant functions achieved with the collection of the San Jose cemetery of Granada can be applied to current remains, provided that study populations present a similar sexual dimorphism, like the two samples from Portuguese population presented in this study.

胸骨全縦割進入法による上位胸椎前方除圧固定術の治療経験

【はじめに】胸椎における後縦靭帯骨化症（以下OPLL）など前方からの圧迫病変に対しては，生理的後彎があるため後方除圧術では効果が不確実であるため前方除圧固定術が合理的である．ただし前方除圧固定術は手技が煩雑，心臓，肺，大血管が近接しており重篤な胸腔内合併症の危険性があるなど手術手技の難易度が高い．上位胸椎OPLL2例に対して胸骨全縦割侵入法による上位胸椎前方除圧固定術の治療を経験したので報告する．【対象・方法】胸椎OPLL2例に対してTh2/3とTh1から3の前方除圧固定術を施行した．【結果】2例ともに周術期合併症を認めず，術前歩行困難であったが，術後歩行可能に麻痺の改善を認めた．JOAスコアは4点から8点，3点から9点とそれぞれ改善を認めた．胸骨縦割による合併症はなかった．【考察】胸骨全縦割進入法は内胸動脈損傷のリスクが低く安全で，良好な術野を展開でき有用な進入法である．

Septic rupture of the ascending aorta after aortocoronary bypass surgery

We describe an exceptional case of non-fatal septic rupture of the ascending aorta in a patient with sternal dehiscence, deep sternal wound infection (DSWI) and pleural empyema after aortocoronary bypass surgery. Routine follow-up computed tomography (CT) detected a mediastinal pseudoaneurysm originating from the ascending aorta. Thereby, massive and irregular sternal bone defects and contrast-enhancing mediastinal soft tissue suggest osteomyelitis and highly-active and aggressive DSWI as initial triggers. Urgent thoracotomy 1 day later included ascending aorta reconstruction, total sternum resection and broad wound debridement. Follow-up CT 1 year later showed a regular postoperative result in a fully recovered patient.

Göğüs duvarı tümörlerinde cerrahi tedavi deneyimlerimiz

Thoracic Wall Tumors; Our Surgical Treatment Experience The aim of the study is to discuss clinical features, the pathology, our experience and surgical approaches of the chest wall tumors. The patients who had been operated on chest wall tumors in our department between September 1998 - September 2002 were evaluated retrospectively. The number of patient was 15, eight male and seven female, the range of age was 15-69, meanly 45±4.8 years. Twenty surgical approaches were performed on 15 patients. The chest wall tumors were benign in 3 cases and malignant in 12 cases. Resection of sternum for 2 patients, soft tissue resections for 3 patients and chest wall resections for 10 patients were performed. Reconstructive approach was needed for 8 patients. Adjuvan therapy was applied for 7 patients. Treatment of the chest wall tumors can be provided successfully with surgical resection. The defects of the chest wall can be repaired by different reconstruction materials. Amac gogus duvari tumorlerinin klinik ozelliklerini, patolojilerini ve cerrahi tedavilerini ve deneyimlerimizi sunarak tartismaktir. Eylul 1998 - Eylul 2002 arasinda gogus duvari tumoru nedeniyle ameliyat edilen 15 hasta retrospektif olarak degerlendirildi. Hastalarin 8'i erkek ve 7'si kadin olup yas araligi 15-69, yas ortalamasi 45±4.8 idi. Onbes hastaya 20 ameliyat uygulandi. Olgularin 12'si malign, 3'u benign karakterliydi. Hastalarin 2'sine total sternum rezeksiyonu, 3'une yumusak doku rezeksizyonu, 10'una kot rezeksiyo-nu uygulandi. Sekiz hastada rekonstruksiyon gerekti. Yedi olguya adjuvan kemoterapi ve radyoterapi uygulandi. Gogus duvari tumorlerinin tedavisi cerrahi rezeksiyon ile basariyla saglanabilir. Gogus duvarindaki defektler cesitli rekonstruksiyon materyalleri ile onarilabilir.

レジン板による胸骨全置換後に発生した人工胸骨逸脱の1例

レジン板による胸骨全置換後に発生した人工胸骨逸脱の1例