PURPOSE: The aim of this study was to compare the distribution and risk from hand positions applied at the center of the chest (CoC) versus the inter-nipple line (INL) during external chest compression by novice rescuers. METHODS: This simulation study included 105 participants. The participants were given photographs of the unexposed male chest and asked to mark a cross at the center of the chest and at the midpoint of the inter-nipple line. The range of contact with the chest was estimated by measuring the participants' palm width. The median and distribution of the two points were then compared and analyzed to determine whether the range in contact with the chest involved the xiphoid process. RESULTS: The level of the INL was approximately 0.8 cm higher at the sternum than the CoC (p<0.001), while the standard deviation of the CoC [1.8(0.6-3.8)] was higher than that of the INL [1.2(0.4-2.4)] (p<0.001). There were more cases in which the palm range involved the xiphoid process in the CoC group [15(14.3%)] than the INL group [1(0.9%)] (p<0.001). CONCLUSION: For male adult patients, chest compression at the level of the INL by novice rescuers is safer and more intensive than compression at the level of the CoC.
Adult ; Cardiopulmonary Resuscitation ; Hand ; Heart Massage ; Humans ; Male ; Nipples ; Sternum ; Thorax* ; Xiphoid Bone

Although the sternalis muscle has been well known to anatomists, it is quite unfamiliar to clinicians. During routine educational dissection, we came across a well-defined bilateral double sternalis muscle innervated by the intercostal nerve, respectively. The right sternalis muscle 1) became tendinous to insert into the sternum and 2) crossed midline and then intermingled with the left pectoralis major muscle, which could be classified into a double with single cross based on Snosek et al.'s criteria. The left sternalis muscle was composed of two bellies, which were combined at the midway, and became tendinous to insert into the contralateral manubrium, which could be classified into a bicipital diverging with double cross based on Snosek et al.'s criteria. The detailed knowledge on the sternalisis is important for clinicians as well as for anatomists, since the clinical importance of the sternalis muscle has been highlighted in recent years.
Anatomists ; Cadaver* ; Humans ; Intercostal Nerves ; Manubrium ; Sternum

No abstract available.
Chondrosarcoma* ; Sternum*

A 43-year-old man experienced chest trauma due to a car accident. Compound sternal fractures with severe dislocation were seen on computed tomography of the chest. Using a SternaLock plating system with manual reduction, fixation of the sternal fracture was successfully performed. There were no complications related to the operation.
Dislocations ; Sternum ; Thorax

Intraosseous neurilemmoma is a rare benign neoplasm that accounts for less than 1% of all primary bone tumors. The most frequent site of involvement is the mandible. We report a case of intraosseous neurilemmoma of the sternum which was discovered incidentally.
Mandible ; Neurilemmoma* ; Sternum*

Cutaneous bronchogenic cyst is an anomalous structure that arises from the tracheobronchial tree during embryonic development and is usually located in the area of the manubrium sternum or suprasternal notch. Histopathologically, bronchogenic cyst is lined by ciliated pseudostratified columnar epithelia with goblet cells. We report a case of cutaneous bronchogenic cyst in a 25-year-old male patient presented as a nodular lesion on the neck.
Adult ; Bronchogenic Cyst* ; Embryonic Development ; Female ; Goblet Cells ; Humans ; Male ; Manubrium ; Neck ; Pregnancy ; Sternum

Objective: To describe the demographic and clinical characteristics of patients diagnosed with intrathoracic thyroid masses managed surgically in our institution, determine associated factors affecting eventual operative approaches for these patients, and assess postoperative outcomes and complications associated with surgical intervention. Methods: Design: Retrospective descriptive case series. Setting:Tertiary National University Hospital. Participants: 24 patients. Results: The mean age of patients diagnosed with intrathoracic goiters was 55.71 years old, with a 1:1.4 male to female ratio; with most having an intrathoracic extent of Huins Grade 1 (67%) compared to others having Huins Grade 2-3. Majority of patients pre-operatively had a Fine Needle Aspiration (FNA) Bethesda Thyroid Nodule Classification of Category II (benign); 79% of total patients underwent excision of thyroid mass utilizing a transcervical approach alone. As Intrathoracic Extension (ITE) grade increased, additional transthoracic approaches were performed; duration of operation, average estimated blood loss, length of hospital stay was also noted to increase. Majority of post operative surgical histopathology results revealed malignant thyroid masses, in contrast to pre-operative FNA. Post-operative transient hypocalcemia was the most reported immediate complication. Conclusions Management of intrathoracic goiter is often multidisciplinary. Referral to the thoracic vascular service is warranted for access to the thoracic inlet. Classification by grade of intrathoracic goiters is helpful to determine the most appropriate operative approach and may be predictive of intraoperative and postoperative outcomes. Postoperative histopathology across all ITE grades mostly yield malignant results; hence, preoperative FNA results should be used with caution.
Thyroid Diseases ; Thyroid Neoplasms ; Goiter ; Thyroid Gland ; General Surgery ; Thyroidectomy ; Sternum ; Manubrium

Identification of an individual is the mainstay of forensic investigation. In the present study, criteria for sex determination were established using 111 adult Korean sternums (63 males and 48 females). They were analyzed using identification points (IPs) and limit points (LPs), as reported previously. Only three of the ten parameters measured-sternal body length, sternal length (i.e., manubrium+body), and sternal area-were useful for sex determination, with sternal length being the most useful. The IP of sternal length was 147 and 130 mm for males and females, respectively. Using this parameter, 53.9% of males and 37.5% of females could be sexed with 100% accuracy. The LP was 141 mm for both males and females; sex could be discriminated accurately using this parameter in 85.7% of males and 85.4% of females
Adult ; Female ; Humans ; Male ; Sternum

Background: In recent years, open heart surgery has developed rapidly in Vietnam. Sternal infection is a very serious complication for this surgery, it lead to increasing treatment costs and higher risk of mortality. Treatment of local infections is always a difficult technique in sternal wound infections after open heart operations. Objectives: (1) To improve and apply two techniques called \u201cdemi \ufffd?open + irrigation\ufffd? and \u201cclosed \ufffd?Redon drainage\ufffd? (2) To evaluate the effects of these techniques. Subjects and method: 20 cases of sternal infection (at Viet Duc hospital and some other hospitals in Ha Noi) were researched and described prospectively about diagnosis, techniques and treatment results. The subjects were divided in to 2 group based on the infection processing techniques. Results:Diagnosis had to reply on clinical signals (100%). Bacterial culture only provided 45% positive results, Pseudomonas aeruginosa (44.4%) were obtained more than Staphylococcus au\u2019reus (22.2%). Both techniques have their own reasonable creativeness and the standardized process, improving the limitations of ordinary technique, providing high treatment effectiveness \ufffd?85% have recovered after only one operation. Conclusion: For treatment of local infections, two techniques are both very efficient and suitable with the conditions in Vietnam, especially \u201cclosed \ufffd?Redon drainage\ufffd?technique.
Thoracic Surgery/methods ; Infection/ therapy ; Sternum ;

PURPOSE: The purpose of this study was to assess optimal chest compression depth for infants and children compared with adults, when the simulated compression depth was delivered according to the current guidelines. METHODS: A total of 467 consecutive chest computed tomography scans (93 of infants, 110 of children, and 264 of adults) were reviewed. The anteroposterior (AP) diameter and compressible diameter (CD) for infants and children were measured at the inter-nipple level and at the middle of the lower half of the sternum for adults. Compression ratio (CR) to CD was calculated at simulated one-fourth, onethird, and one-half AP compressions in infants and children and simulated 5-cm, 6-cm compressions in adult. RESULTS: In adults, the CRs to CD at simulated 5-cm, 6-cm compression depth were 41.7±0.16%, 50.0±7.3%, respectively. In children and infants, the CRs to CD at onethird chest compression were, respectively, 55.1±2.4%, 51.8±2.4% and 82.7±3.7%, 77.7±3.6% at one-half chest compression. The CRs to CD of 4-cm compression depth in infants and 5-cm compression depth in children were 74.4±10.9%, 62.5±8.7%, respectively. The CRs to CD for children and infants were significantly higher compared with adults (p<0.001). The CR to CD of 4-cm compression depth in children was similar to that of 6-cm compression depth in adults (50.0±6.9% vs 50.0±7.3%, p=0.985). CONCLUSION: The current pediatric guideline for compression depth was too deep compared with adults. We suggest that one third of the AP chest diameter or approximately 4-cm in children and less than 4-cm in infants is more appropriate.
Adult ; Child ; Humans ; Infant ; Pediatrics ; Sternum ; Thorax*