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Penetrating cardiac injury--to close the pericardium or not? A case report.

Many trauma surgeons who treat penetrating cardiac injuries do not routinely suture the pericardium closed after repairing the heart. The patient reported here died from exsanguination during attempts to mobilise the heart which had adhered to the sternum. With the increasing demand for coronary artery surgery and the high incidence of carcinoma of the oesophagus in South Africa, both of which require access to the mediastinum, we recommend that in the trauma setting, the pericardium be closed to facilitate future surgery if required.

The mechanism of fatal cardiopulmonary injury caused by a blow from a golf club.

In the course of a scuffle, a youth of 18 years was struck a single blow across the chest with a golf club. He collapsed dead on the spot. At autopsy, a precisely located and highly distinctive patterned imprint abrasion of the precordial region was revealed providing an excellent match with the weapon. The heart showed multiple internal ruptures and there was a laceration of the lingula of the left lung. Injury to the chest wall was confined to the soft tissues, the rib cage and sternum being intact. We postulate a novel mechanism to explain the cardiac rupture.

Chest wall injuries and the seat belt syndrome.

A 3-year prospective study of road traffic accidents in which injuries of the chest wall were accurately recorded and related to the use of seat belts was performed in Oxfordshire by a combined team of surgeons and engineers. An increased incidence of soft tissue injuries was noted in restrained front seat occupants though this was not the case for fractures of the clavicle or sternum. The overall incidence of broken ribs in front seat passengers was not affected by the wearing of belts but the incidence of those with four or more broken ribs was considerably reduced by wearing belts.

Failure of trimethoprim/sulfamethoxazole in invasive Nocardia asteroides infection.

A case of pulmonary nocardiosis occurred with progressive involvement of the pleura, pericardium, mediastinum, and sternum. Surgical resection and drainage procedures followed by administration of the drug combination, trimethoprim/sulfamethoxazole, over a six-month period led to clinical recovery. Discontinuation of drug therapy, however, was followed by relapse and further invasion by the same organism. A literature survey of Nocardia asteroides infections treated with trimethoprim/sulfamethoxazole disclosed that posttreatment follow-up is often too brief or unknown, making the ultimate succ…

Osteogenesis potential of different graft materials around dental implants: An animal study.

Limited research exists concerning the osteogenesis potential of different graft materials. This study compared the osteogenesis potential of autograft, xenograft, and synthetic graft material to support implants inserted in dogs' sternums. Thirteen dogs were divided into three groups based on the sacrifice time (2, 4, and 6 months). Extensive osteotomies were carried out in the sternum bone of dogs, and the implants were placed in the bone defects. The gaps around the implants were then filled with autograft, xenograft (CeraboneŴ), or synthetic graft (Osteone II) materials in all groups of an…

It's not about the dent: Anteroposterior insufficiency in pectus excavatum.

BACKGROUND: Pectus Excavatum (PEx) is an anterior chest wall deformity associated with sternal depression. Minimal invasive repair of PEx (M … CONCLUSION: Inadequate AP distance is common in patients with PEx. Pectus repair that elevates the sternum only to the level of the pectus ridge would fail to normalize the AP distance in most patients, despite correction of the visible indentation. Technical corrections with convex bars lifting the ribs and sternum above the pectus ridge are necessary t …

Широкие метастазы грудной клетки и стенки грудной клетки в качестве первоначального представления о раке молочной железы: доклад по делу и обзор литературы.

Метастатическое участие костей остается наиболее распространенной формой дальнего метастаза в раке груди, главным образом из-за анатомических и функциональных характеристик грудного позвоночника, ребер и грудины. Эти структуры примечательны высоким содержанием красного костного мозга, богатой сосудистой системы и их связью с венозным сплексом Бэтсона, что способствует их раннему участию в онкологическом распространении. В некоторых случаях многочисленные метастазы в грудном скелете могут представлять собой первое и единственное клиническое проявление недиагностированного злокачественного проце

Совпадение в аннотации оригинала
Metastatic involvement of the bones remains the most common form of distant metastasis in breast cancer, largely due to the anatomical and functional characteristics of the thoracic spine, ribs, and sternum. These structures are notable for their high content of red bone marrow, rich vascularization, and their connection to Batson's venous plexus, all of whi…

The shifting trends in the epidemiology and risk factors of non-accidental fractures in children.

BACKGROUND: Fractures are a common presentation of non-accidental trauma (NAT) in the pediatric population. However, the presentation could … ned to be non-accidental. Skull and face fractures constituted 17.9 % of all NAT fractures, but rib/sternum fractures had an RR = 6.7 for NAT. Children with intellectual and developmental disability (IDD) or autism spectrum disorder (ASD) had a 9 times higher risk for non-accidental fractures. The number of non-accidental fractures significantly increased …

Unusual pattern of firearm injury to trunk and limbs: Two case reports and review.

This article presents two cases of fatal injuries from rifled weapons with unconventional shapes of inlets and exits mismatched with the dis … case, a 25-year-old male, he had multiple wounds in the front of the chest, the first one over the sternum end measuring 9 × 7 cm rounded in shape with fracture of the ribs, sternum and lung laceration. The second wound was 3 × 5 cm in the lateral aspect - mid axillary line and it was superficial due to tangential passage of the missile. In the left thig …

Occurrence of Diastasis of the Rectus Abdominis Muscles in Patients with Medial Pectus Excavatum.

UNLABELLED: Since 1994, we have used soft silicone blocks sculpted intraoperatively to correct pectus excavatum in male patients. This technique involves a horizontal access incision in the region of the lower edge of the sternum. During the dissection to expose the sternum, we observed a constant diastasis of the rectus abdominis muscle and changes of the anatomy at its superior insertion. There is no report on this association. METHODS: Male patients with untreated medial pectus excavatum with indication for silicone block correction were enrolled. Age, weight, height, and the presence of o…

Assessment of thoracic aorta in different cardiac phases in patients with non-aorta diseases using cardiac CT.

The aim was to evaluate the thoracic aorta in different cardiac phases to obtain the correct cardiac phase for measuring the maximum diameter required to predict aortic disease. Cardiac CT was performed on 97 patients for suspected coronary artery disease. The average diameter of ascending (AAD) and descending aorta (DAD) in the plane of pulmonary bifurcation, in the plane of the sinus junction (AAD [STJ] and DAD [STJ]), descending aorta in the plane of the diaphragm (DAD [Dia]), the diameter of the main pulmonary artery (MPAD), distance from the sternum to the spine (S-SD), and distance from …

Sternal aspirate sampling of Bacillariophyceae (diatoms) and Cyanobacteria in suspected drowning cases.

A diagnosis of drowning is not always possible based on the traditional autopsy findings. The most widely used ancillary methods are based o … mortem sampling. Control experiments of non-drowning victims showed that cleaning the skin over the sternum can prevent external contamination. Sternal aspirate samples were taken from seven suspected drowning victims along with lung, spleen, and femoral bone marrow samples. All specimens were examined for the presence of diatoms by light microscope and C …

A new minimally invasive technique for correction of pectus carinatum.

BACKGROUND: The Abramson technique for the correction of pectus carinatum (PC) is commonly performed worldwide. However, the postoperative complications of this technique related to bar fixation, including wire breakage and bar displacement, are relatively high. In this study, a new minimally invasive technique for correction of PC is described, in which the pectus bar is secured by bilateral selected ribs, and for which no special fixation to the rib is needed. METHODS: The procedure was performed by placing the pectus bar subcutaneously over the sternum with both ends of the bar passing thr…

Concomitant fulvestrant with reirradiation for unresectable locoregional recurrent estrogen receptor positive (ER+) breast cancer: A case report and narrative review.

RATIONALE: Locoregional recurrence of breast cancer is a challenging issue for clinicians. Treatment options for unresectable recurrent estr … otherapy, followed by exemestane until November 2018, relapsed in internal mammary lymph nodes with sternum involved. DIAGNOSIS: The final diagnosis was breast cancer internal mammary lymph nodes metastasis with sternum involved. INTERVENTIONS: After diagnosis was made, concurrent fulvestrant with reirradiation as a palliative treatment were proposed un …

Migrated fractured sternal wire in proximity to the main pulmonary artery: Case report and review.

BACKGROUND: We present a case of a 83-year-old man with a prior history of coronary artery bypass who presented to his family physician with … phenomenon. Only a few reported cases in the literature were sternal wires have migrated beyond the sternum, leading to catastrophic clinical consequences, as detailed in the review table. CONCLUSION: Sternal wire complications secondary to migration beyond the sternum are rare but potentially fatal. Precise wire location and risk assessment with CT are …

Rib Cage Morphogenesis in the Human Embryo: A Detailed Three-Dimensional Analysis.

Formation of the skeletal structure in the human embryo has important consequences in terms of support, protection, and function of organs a … of corresponding ribs in the upper region elongated toward each other, leading to their joining and sternum formation between CS21 and CS23, while the lower region of the rib cage remained widely open. The rib cage area with the largest width shifted from the 5th rib pair at CS17 to the 9th pair at CS23. The depth of the rib cage was similar across the up …

Non-surgical treatment of pectus excavatum.

BACKGROUND: Previously used procedures to correct pectus excavatum (PE) were largely based on surgical techniques like Ravitch procedure or … mp is used to create a vacuum at the anterior chest wall. When creating the vacuum, the lift of the sternum is obvious and remains for a different time period. The device should be used for a minimum of 30 minutes (2/day), and may be used up to a maximum of several hours daily. We have an IRB approval for it. Since this paper was conducted as a retrospect …

Reoperative median sternotomy following the use of a right internal mammary artery pedicle graft crossing the midline to the left anterior descending artery.

BACKGROUND AND AIM: The purpose of the present study was to examine the outcomes of cardiac reoperations for the patients with a previously … ULTS: Preoperative computed tomography (CT) angiography showed the RITA at a safe distance from the sternum in six patients. No graft injury occurred during dissection. The patient who underwent emergent total arch replacement died from global brain ischemia at postoperative day 11. The remaining six patients recovered well without major complication and …

Application of lower sternal incision with on-pump, beating heart intracardiac procedures in congenital heart disease.

BACKGROUND: The purpose of this study was to explore the application of lower sternal incision with on-pump, beating heart intracardiac procedures for the treatment of congenital heart disease. METHODS: A total of 106 cases with congenital heart disease were performed with lower sternal incision under the beating heart condition. The sternum was sawed open to the third sternocostal joint through a small incision in the lower sternum. Cardiopulmonary bypass was developed without aortic cross-clamping. The simultaneous left atrium and ventricle suction and integrating sequential deairing proced…

Sonozaki syndrome: case report and review of literature.

Sonozaki syndrome--pustulotic arthro-osteitis (PAO) is a relatively rare, chronic illness. This disease belongs to the group of psoriatic ar … the erythemal basis. Oral and genital mucosa were free from changes. The oedema within clavicle and sternum joints was without features of the severe inflammation and tactical tenderness. In additional tests, increased BSR 36/62 was found. Bone scintigraphy-focuses of increased accumulation of MDP-Tc-99 m were found in the sternal projection of the clavic …