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Simin W, Dezhou Z, Jun S, Xing W. A variant of suprasternal protrusions in a child. Asian J Surg 2023; 46:3997-3998. [PMID: 37076345 DOI: 10.1016/j.asjsur.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 04/06/2023] [Indexed: 04/21/2023] Open
Affiliation(s)
- Wang Simin
- Graduate School, Inner Mongolia Medical University, Hohhot, 010110, China
| | - Zhang Dezhou
- Graduate School, Inner Mongolia Medical University, Hohhot, 010110, China
| | - Shi Jun
- Department of Physiology, Inner Mongolia Medical University Basic Medical College, Hohhot, 010110, China.
| | - Wang Xing
- Graduate School, Inner Mongolia Medical University, Hohhot, 010110, China; Human Anatomy Teaching and Research Section (Digital Medical Center), Inner Mongolia Medical University Basic Medical College, Hohhot, 010110, China.
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Li S, Lei P, Liu Y, Chen C, Yang D, Li X, Tang ST. Sternum length norms in Han youngsters in central China. Exp Ther Med 2022; 24:559. [PMID: 35978914 PMCID: PMC9366273 DOI: 10.3892/etm.2022.11496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/06/2022] [Indexed: 11/27/2022] Open
Abstract
The sternum is one of the most important components of the chest wall. However, to the best of our knowledge, at present there is no reference value of the sternum length in normal Han Chinese children that has been published in the literature. The aim of the present study was therefore to establish the reference value of sternum length in a normal Han Chinese population of different ages and sex groups. Chest computed tomography scans and three-dimensional reconstruction images of 1,080 individuals who were younger than 18 years old and without congenital or acquired structural anomalies or congenital metabolic diseases were retrospectively reviewed. The length of the sternum was measured for each individual and comparisons of the sternum length according to sex were conducted using the Mann-Whitney test. Age or region group comparisons were performed using the ANOVA test, and the association between the length of the sternum and age was assessed by regression analysis. A significant association between the age (x) of the individual and the length of the sternum (y) was confirmed, although different regression patterns were identified for the sexes (the regression equation for males was y=5.616x+60.408; P<0.001; R2=0.890, whereas that for females was y=-0.134x2+6.543x+56.805; P<0.001, R2=0.890). No significant differences in sternum length were identified between the sexes for subjects aged 1-13 years old, whereas significant differences were observed comparing the sexes of the subjects aged 14-18 years old. In conclusion, the present study revealed that the length of the sternum in normal Han Chinese children can be precisely estimated by the age of the child using our formulae for the different sexes (where the most-fit formulae for the two sexes are different). This knowledge can be applied clinically in chest wall deformity assessment, and in surgery planning.
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Affiliation(s)
- Shuai Li
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Ping Lei
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Yuan Liu
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Cen Chen
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Dehua Yang
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Xin Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Shao-Tao Tang
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
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Cui X, Li RG, Ma DT. A safe area for sternal puncture in children: an MSCT study based on sternal development. Surg Radiol Anat 2021; 44:105-115. [PMID: 34748048 PMCID: PMC8573577 DOI: 10.1007/s00276-021-02850-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 10/11/2021] [Indexed: 10/29/2022]
Abstract
PURPOSE Multislice spiral CT (MSCT) was used to investigate the anatomical characteristics of sternal development, and to provide anatomical basis for sternal puncture in children. METHODS We retrospectively analyzed the thoracic MSCT data of 600 children who received thoracic MSCT from January to June 2020 with their age ranging from 1 month to 19 years. The distribution of sternal ossification centers and adjacent tissues and organs was observed. Subcutaneous soft tissue thickness and the distance between the skin and the posterior margin of the sternum were measured in the central areas of sternal manubrium and mesosternum (segments I and II), and the correlation between the two was calculated using linear correlation. RESULTS A total of 600 patients were enrolled, the mean age was 9.87 years and the standard deviation was 8.28 years. The sternal manubrium and ossification centers at the I and II segments of the mesosternum were visible in all cases (100%). There was no ossification in segment III of the mesosternum in 15 cases (2.5%), including 12 cases (80%) adjacent to the posterior pericardium and 7 cases (46.7%) of lung tissue. There were 274 cases (45.7%) of segment IV without ossification, including 204 cases (74.5%) of adjacent pericardium and 95 cases (32.8%) of lung tissue. The xiphoid process was not ossified in 258 cases (43%), including 190 cases (73.6%) adjacent to the pericardium and 97 cases (37.6%) adjacent to the lung tissue. Correspondingly, the thickness of subcutaneous soft tissue of the sternal manubrium and the central region of the I and II segments of the mesosternum had a low positive correlation with age (P < 0.001), the distance between the skin and the posterior margin of the sternum showed a moderate positive correlation with age (P < 0.001), and the distance between the skin and the posterior margin of the sternum showed a high positive correlation with the thickness of subcutaneous soft tissue (P < 0.001). CONCLUSIONS Nonossification of the sternal ossification center usually occurs below segment III of the mesosternum and is usually adjacent to heart and lung tissue. Pediatric sternal puncture should be performed at the sternal manubrium and the mesosternum of segments I and II. However, attention should be paid to the space between multiple ossification centers. The thickness of subcutaneous soft tissue is a critical factor that determines the depth of the puncture.
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Affiliation(s)
- Xue Cui
- Department of Radiology, Tai'an City Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, Shandong Province, 271000, People's Republic of China
| | - Rui-Guang Li
- Department of Radiology, Tai'an City Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, Shandong Province, 271000, People's Republic of China
| | - De-Ting Ma
- Department of Radiology, Tai'an City Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, Shandong Province, 271000, People's Republic of China.
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Gans BD, Neunuebel AD, Umbarger LJ, Trumble BC, Cummings DK, Wann LS, Lehenbauer KR, Mahadev A, Rodriguez DE, Michalik DE, Rowan CJ, Finch CE, Sutherland ML, Sutherland JD, Allam AH, Stieglitz J, Gurven M, Kaplan H, Thomas GS, Thompson RC. High prevalence of sternal foramina in indigenous Bolivians compared to Midwest Americans and indigenous North Americans (sternal foramina in indigenous Bolivians). Anat Sci Int 2021; 96:517-523. [PMID: 34053001 DOI: 10.1007/s12565-021-00618-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/15/2021] [Indexed: 11/28/2022]
Abstract
The sternal foramen, usually an asymptomatic osteological defect, can lead to catastrophic consequences if not recognized prior to certain medical procedures. This study reports the prevalence of a sternal foramen in two South Amerindian populations compared with other published populations. We evaluated the presence of sternal foramina using thoracic computed tomography scans of 1334 (48% female) participants from two indigenous populations of Bolivia (n = 900 Tsimane, 434 Moseten). The prevalence of sternal foramina was compared to two U.S. populations of similar sex/age distribution (n = 572 Midwest Americans, 131 self-identified Native North Americans) via similar CT scans. A sternal foramen was significantly more common in the two Bolivian populations (prevalence ranging from 12.8 to 13.4%), compared to 4.4-5.1% in the two U.S. groups, consistent with prior estimates in studies from industrialized populations. Males had higher frequency of a sternal foramen compared to females in each of the four groups (OR = 1.904, 95% CI: 1.418-2.568, p < 0.001). Age was not associated with sternal foramen presence. These data show both a higher rate of sternal foramina in the South Amerindian populations versus comparator populations in North America and the highest rate of any studied living population. Although it is not possible to determine from our data the relative contribution of genetics versus early life or environmental causes to the higher rates of sternal foramen, we note that small prior studies have likewise demonstrated a higher prevalence in lower income countries. Further determination of the contributing factors warrants greater investigation and research.
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Affiliation(s)
- Benjamin D Gans
- St. Luke's Mid-America Heart Institute of Kansas City, 4330 Wornall Rd., Suite 2000, Kansas City, MO, 64111, USA.,Arkansas College of Osteopathic Medicine, Fort Smith, AR, USA
| | - Angela D Neunuebel
- St. Luke's Mid-America Heart Institute of Kansas City, 4330 Wornall Rd., Suite 2000, Kansas City, MO, 64111, USA.,University of Missouri -Kansas City, Kansas City, MO, USA
| | - Leah J Umbarger
- Arkansas College of Osteopathic Medicine, Fort Smith, AR, USA
| | - Benjamin C Trumble
- School of Human Evolution and Social Change, Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA.,Tsimane Health and Life History Project, San Borja, Bolivia, USA
| | - Daniel K Cummings
- Tsimane Health and Life History Project, San Borja, Bolivia, USA.,Economic Science Institute, Chapman University, Orange, CA, USA
| | | | - Kyle R Lehenbauer
- St. Luke's Mid-America Heart Institute of Kansas City, 4330 Wornall Rd., Suite 2000, Kansas City, MO, 64111, USA.,University of Missouri -Kansas City, Kansas City, MO, USA
| | - Ashna Mahadev
- St. Luke's Mid-America Heart Institute of Kansas City, 4330 Wornall Rd., Suite 2000, Kansas City, MO, 64111, USA.,University of Missouri -Kansas City, Kansas City, MO, USA
| | - Daniel Eid Rodriguez
- Tsimane Health and Life History Project, San Borja, Bolivia, USA.,Institute of Biomedical Research, Faculty of Medicine, San Simon University, Cochabamba, Bolivia, USA
| | - David E Michalik
- Division of Infectious Diseases, Irvine School of Medicine, University of California, Irvine, CA, USA
| | - Chris J Rowan
- Renown Institute for Heart and Vascular Health, University of Nevada School of Medicine, Reno, NV, USA
| | - Caleb E Finch
- University of Southern California Leonard Davis School of Gerontology, Los Angeles, CA, USA
| | | | | | - Adel H Allam
- Department of Cardiology, Al Azhar University, Cairo, Egypt
| | - Jonathan Stieglitz
- Tsimane Health and Life History Project, San Borja, Bolivia, USA.,Institute for Advanced Study in Toulouse, Toulouse, France
| | - Michael Gurven
- Tsimane Health and Life History Project, San Borja, Bolivia, USA.,Department of Anthropology, University of California, Santa Barbara, CA, USA
| | - Hillard Kaplan
- Tsimane Health and Life History Project, San Borja, Bolivia, USA.,Economic Science Institute, Chapman University, Orange, CA, USA
| | - Gregory S Thomas
- MemorialCare, Southern California, USA.,Division of Cardiology, University of California, Irvine, CA, USA
| | - Randall C Thompson
- St. Luke's Mid-America Heart Institute of Kansas City, 4330 Wornall Rd., Suite 2000, Kansas City, MO, 64111, USA. .,University of Missouri -Kansas City, Kansas City, MO, USA.
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Hirst CS, White S, Siek T, Gasparik A. Honeycomb sterna: an unusual case of a developmental abnormality in the sternum. Surg Radiol Anat 2019; 42:91-94. [PMID: 31673764 PMCID: PMC6942570 DOI: 10.1007/s00276-019-02350-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 09/24/2019] [Indexed: 11/28/2022]
Abstract
This report details an unusual case of a human sternal developmental abnormality of an anatomical specimen part of the skeletal collection curated by University College London, Anthropology Department skeletal collection. This rarely reported developmental abnormality is caused by the non-fusion of lateral ossification centres in the sternebrae, resulting in the mesosternum having a honeycomb-like appearance. Sternal defects are typically underreported in the clinical literature as many cases being asymptomatic that they are typically diagnosed incidentally, as such there is a dearth in our current understanding of the development and anatomical variants of the sternum. Although in recent years, large-scale CT studies have investigated the prevalence of sternal developmental abnormalities, these studies have not reported sternal defects similar to the individual presented in this report. While most sternal defects are clinically uneventful, the lack of awareness of these variants can result in misinterpretation of radiological and pathological findings as such an understanding of anatomical variants even when asymptomatic is vital.
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Affiliation(s)
- Cara Stella Hirst
- Anthropology Department, University College London, London, UK. .,University College London, Institute of Archaeology, London, UK.
| | - S White
- Anthropology Department, University College London, London, UK
| | - T Siek
- University College London, Institute of Archaeology, London, UK
| | - A Gasparik
- University College London, Institute of Archaeology, London, UK
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