• Journal of Chest Surgery
• /
• v.32 no.10
• /
• pp.966-969
• /
• 1999

Congenital defects of the sternum are rare development anomalies. They result form the failure of the lateral sternal bars to fuse. This malformation may be associated with other ventral midline fusion defects and ectopia cordis. A complete sternal cleft is the rarest form and less than 10 cases have been reported in the medical literature. Here were report a 3-day-old boy with complete sternal cleft without other malformations, who underwent primary surgical repair. Surgical correction of complete sternal cleft should be performed in neonatal period whether the infant if symptomatic or not because it is usually simple, able to achieve good result and primary repair is usually feasible at this period.

• Journal of Chest Surgery
• /
• v.15 no.3
• /
• pp.308-310
• /
• 1982

During the closure of the sternum, following the mitral valve replacement for mitral stenoinsufficiency, hemodynamic instability with cardiac tamponade was developed. After transfusion of massive diuretics and albumin for a few times, reclosure of the sternum was attempted with development of hemodynamic instability. And so we decided delayed sternal closure. After 72 hours of mitral valve replacement, delayed sternal closure was done with success, and so we report this case with literatures.

• Korean Journal of Veterinary Research
• /
• v.29 no.2
• /
• pp.11-18
• /
• 1989

This study was undertaken to obtain basic data of the sternal development in Korean native cattle from the earliest sternal formation to the ossification using histological and histochemical methods. Thrity three sterna were collected from a series of embryos and fetuses ranging from 11 to 225mm (estimated age 37~120days) in crown rump length. The bilateral sternal bars were observed in the 2nd group(CRL 21~3mm) of Korean cattle embryos. Those bars initiated to be fused in the 3rd group (CRL 31~4mm) and completed in the 7th group(CRL 71~80mm). The ossification centers were detected in the 8th group(CRL 81~90mm) also bilateral ossification centers were found in the same group. The typical epiphyseal plates, endochondral bone and calcium deposit were found in the 9th group(CRL 91~100mm). Osteocytes, osteoblasts, osteoclasts and myeloid cells appeared in ossification centers in the 10th group(more than CRL 101mm). The alcianophility responded markedly in the 9th group that was decreased and showed slightly positive reaction in territorial matrix of the 10th group. Marked positive reaction to PAS was observed in bony trabeculae in the 10th group. The positive reaction to calcium deposit by trichrome stain was observed initially in the hypertrophied zone of epiphyseal plate in the 9th group and was conspicuous in the calcified zone of epiphyseal plate in the 10th group. The 1st positive reaction to the von Kossa stain was observed in the 9th group.

• Journal of Chest Surgery
• /
• v.54 no.3
• /
• pp.186-190
• /
• 2021

Background: Pre-lifting of the sternum marked a major turning point in pectus excavatum repair. The author developed the crane technique in 2002 and successfully applied it to more than 2,000 cases using sternal wire stitching. However, blind sternal suturing limited the use of the wire-stitch crane. We propose a novel screw for sternal lifting as a new tool for the crane technique. Methods: We developed a screw system strong enough to withstand the pressure needed for sternum lifting. The screw was designed to have a broader thread to hold the bony tissue securely. The screw's sustaining power was tested using the torsion, driving torque, and axial pull-out tests in a polyurethane block and ex-vivo porcine sternum. Results: The screws were easily driven into the sternum, and the head of the screw was connectable to the table-mounted retractor. In the torsion test, the 2° offset torsional yield was 4.53 N·m (reference value, 1 N·m). In the polyurethane block driving torque test, the maximum torque was 0.98 N·m (reference value, 0.70 N·m). The axial pull-out test was 446 N (reference value, 100 N). The maximum pull-out resistance in the ex-vivo porcine sternum model was 1,516 N. Conclusion: The screw crane was strong enough to sustain the chest wall weight to be lifted. Thus, the screws could effectively replace the sternal wire stitching in crane pre-lifting of the sternum. We expect that application of the screw-crane will be easy and that it will improve the safety and success rate of pectus repair surgery.

• Journal of Trauma and Injury
• /
• v.29 no.4
• /
• pp.184-186
• /
• 2016

Although sternal fractures are relatively common, treatment has not been clarified. Thus, the authors report a case of a patient with a sternal fracture associated with a thoracic spinal fracture who had received conservative treatment, but the outcome was not satisfactory.

• Animal Systematics, Evolution and Diversity
• /
• v.22 no.1
• /
• pp.17-22
• /
• 2006

Cryptocercus nymphs periodically groom ventral surface of their parents. The grooming might be licking-behavior to obtain secretions from the ventral surface of their parents, and some essential nutrients or hormones that facilitate nymphal development might be included in the secretions. We tried to find morphological structures for secretion outlets on the ventral surface. The deep depressions around setae were present, and their shape was an external morphological structure that liquid secretions from internal glands are likely to be well seized. There were also small holes on the depressions that might be external openings for secretions from the sternal glands. Another possible region on body surface for outlets of secretions might be the apophyses. In Cryptocercus individuals, mucous liquid on body surface was relatively highly present around coxa. The intercoxal apodemes, to which muscles are attached and which open externally between the mid and hindcoxae, might have evolved a secondary function of producing nourishment for the young.

• Journal of Chest Surgery
• /
• v.54 no.5
• /
• pp.377-382
• /
• 2021

Background: Subclavian vein (SV) catheterization is a method for the delivery of fluids, drugs, and blood products, venous blood sampling, and central vein pressure monitoring in cardiac surgery. Catheter occlusion is a serious complication of SV catheterization during cardiac surgery, especially after sternal retractor expansion. Methods: In this observational study, 303 patients who had successful right infraclavicular SV catheterization from September 2019 to April 2020 were enrolled to determine the incidence of catheter occlusion. After catheterization, the lumens of all catheters were checked for the ability to infuse and withdraw blood from the catheter before and after sternal retractor expansion. The patients' characteristics, cannulation approach, on-pump or off-pump technique, occlusion of the catheter and its lumens, and any associated complications were recorded. The data were analyzed using IBM SPSS ver. 22.0 (IBM Corp., Armonk, NY, USA). Results: Of the 303 patients studied, 205 were male (67.7%) and 98 were female (32.3%). Catheter occlusion occurred in 11 patients with on-pump cardiopulmonary bypass (CPB) (227 patients) and 4 patients with off-pump CPB (76 patients) (p=0.863). The incidence of catheter occlusion was 4.95% (15 of 303 patients) with no cases of simultaneous 3-lumen occlusion in a catheter. The most commonly occluded lumen was the distal lumen (57.92%). Simultaneous 2-lumen occlusion occurred in 4 patients. Catheter occlusion was found in 3 of 13 malpositioned catheters (23.07%). Conclusion: The current study showed that malpositioning of the catheter tip was a risk factor for catheter occlusion and that the distal lumen of a triple-lumen catheter was the most commonly occluded lumen.

• Radiation Oncology Journal
• /
• v.26 no.2
• /
• pp.91-95
• /
• 2008

Purpose: To evaluate the response and survival rate after three-dimensional conformal radiation therapy(3D-CRT) of patients with a solitary sternal relapse of breast cancer. Materials and Methods: Seventeen patients between May 1996 and June 2005 were evaluated with the salvage 3D-CRT treatment of a solitary sternal relapse of breast cancer. The treatment fields included the gross tumor volume with 2 cm margins. The total radiation dose was $35.0{\sim}61.5$ Gy(biologic effective dose of $43.7{\sim}76.9Gy_{10}$ using an $\alpha/\beta$ ratio of 10 Gy), with a daily dose of $1.8{\sim}3.0$ Gy. The tumor response was evaluated by the change in maximum tumor size via follow up CT scans $1{\sim}3$ months after the completion of treatment. Results: An objective tumor response was achieved in all patients, with a complete response in 5 patients and a partial response in 12 patients. The 5-year overall survival rate was 51.9%(median survival time: 27 months), and the most important factor affecting overall survival was the disease-free interval(interval from primary surgery of breast cancer to the development of sternal metastasis): The 5-year overall survival rate was 61.8% for patients with a disease-free interval ${\geq}12$ months and 0.0% for patients with disease-free interval <12 months(p=0.03). Conclusion: The response to 3D-CRT was good in patients with solitary sternal relapse of breast cancer. Particularly, patients with long disease-free interval from primary surgery survived significantly longer than patients with short disease-free interval from primary surgery.

• Journal of Chest Surgery
• /
• v.45 no.6
• /
• pp.415-417
• /
• 2012

The development of Morgagni hernias is related to malformations of the embryologic septum transversum after failure of the sternal and costal fibrotendinous elements of the diaphragm to fuse. The overall incidence of Morgagni hernias among all congenital diaphragmatic defects is 3% to 4%. Inguinal hernias are the most common hernias in males and females (25% and 2%, respectively). An inguinal hernia is defined as a protrusion of the abdominal cavity contents through the inguinal canal. The combination of Morgagni and inguinal hernias is rare, and treatment using laparoscopic surgery has not been previously reported. This case presents a one-stage laparoscopic repair of Morgagni and inguinal hernias in a 2-month-old male.

• Journal of Chest Surgery
• /
• v.50 no.5
• /
• pp.346-354
• /
• 2017

Background: Ventilator-associated pneumonia (VAP) is a common disease that may contribute to morbidity and mortality among trauma patients in the intensive care unit (ICU). This study evaluated the associations between trauma factors and the development of VAP in ventilated patients with multiple rib fractures. Methods: We retrospectively and consecutively evaluated 101 patients with multiple rib fractures who were ventilated and managed at our hospital between January 2010 and December 2015, analyzing the associations between VAP and trauma factors in these patients. Trauma factors included sternal fracture, flail chest, diaphragm injury, traumatic aortic dissection, combined cardiac injury, pulmonary contusion, pneumothorax, hemothorax, hemopneumothorax, abbreviated injury scale score, thoracic trauma severity score, and injury severity score. Results: Forty-six patients (45.5%) had at least 1 episode of VAP, 10 (21.7%) of whom died in the ICU. Of the 55 (54.5%) patients who did not have pneumonia, 9 (16.4%) died in the ICU. Using logistic regression analysis, we found that VAP was associated with severe lung contusion (odds ratio, 3.07; 95% confidence interval, 1.12 to 8.39; p=0.029). Conclusion: Severe pulmonary contusion (pulmonary lung contusion score 6-12) is an independent risk factor for VAP in ventilated trauma patients with multiple rib fractures.