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Costal cartilage

A V Kurkov, V S Paukov, A L Fayzullin, A B Shekhter
Pectus excavatum (PE) and pectus carinatum (PC) in children are the most common congenital deformities that cause complications in the thoracic organs; however, the role of chondrocytes and cartilage canals in the pathogenesis of these conditions remains unexplored. OBJECTIVE: To investigate qualitative and quantitative changes of cartilage lacunae and canals in the costal cartilages in children with PE and PC compared to those with normal chests. SUBJECT AND METHODS: Costal cartilages were investigated in 10 children with normal chests (a control group), in 12 children with PE, and in 12 children with PC...
2018: Arkhiv Patologii
Wojciech Rokicki, Marek Rokicki, Mateusz Rydel
Tietze's syndrome is a benign, self-limiting arthropathy, without purulent character. The disease most often involves articulations: sternocostal, sternoclavicular, or costochondral joints. The characteristic symptoms are tenderness, pain and edema involving one of the aforementioned joints on one side. Diagnosis of Tietze's syndrome is based on physical examination (increase of palpation tenderness in the affected joint), laboratory tests (increase of inflammatory parameters) and imaging studies (USG, MRI)...
September 2018: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Yukiko Rikimaru-Nishi, Hideaki Rikimaru, Shinichiro Hashiguchi, Tomonoshin Kanazawa, Keisuke Ohta, Kei-Ichiro Nakamura, Kensuke Kiyokawa
BACKGROUND: Limited information is available on the biological status of transplanted cartilage from which the perichondrium has been removed. This article describes the histological and three-dimensional structural picture of cartilage, using green fluorescent protein (GFP) transgenic rats and normal wild rats. METHODS: Three sections of costal cartilage were harvested from 10-week-old wild rats. One section was used as a specimen while two were subcutaneously collected from the dorsal region of 10-week-old GFP rats at 4 and 8 weeks post-transplant...
October 4, 2018: Journal of Plastic Surgery and Hand Surgery
Jose M Lasso, Esther Deleyto La Cruz
Wegener granulomatosis (WG) is a necrotizing vasculitis that involves the upper respiratory tract, the lungs, and the kidneys. It also causes deformities of the nose in practically all patients, altering the cartilaginous and bony structure as well as the inner lining of the nose.The surgical repair of these nasal distortions is a challenge mainly due to the impairment of wound healing and graft take that is caused both by the disease itself and by the prolonged immunosuppressant treatment.Many different reconstruction plans have been developed, using costal or calvarial bone grafts, cartilage grafts and local skin and mucosa flaps...
October 1, 2018: Journal of Craniofacial Surgery
Antonella LoMauro, Paolo Banfi, Chiara Mastella, Katia Alberti, Giovanni Baranello, Andrea Aliverti
The involvement of the respiratory muscular pump makes SMA children prone to frequent hospitalization and morbidity, particularly in type 1. Progressive weakness affects ribcage muscles resulting in bell-shaped chest that was never quantified. The aims of the present work were: (1) to quantify the presence of bell-shaped chest in SMA infants and children and to correlate it with the action of ribcage muscles, assessed by the contribution of pulmonary ribcage to tidal volume (ΔVRC, p ); (2) to verify if and how the structure of the ribcage and ΔVRC, p change after 1-year in SMA type 2...
2018: Frontiers in Neurology
Kwong Ming Tse, Long Bin Tan, Shu Jin Lee, Mohamed Zulfikar Rasheed, Bien Keem Tan, Heow Pueh Lee
The Nuss procedure is the most minimally invasive and commonly used surgical correction for pectus excavatum (PE) by using a prebent pectus bar to elevate the deformed chest wall. However, there are some complications associated with this procedure such as postoperative pain as well as surgical uncertainties because of human judgment. It is therefore important to understand the biomechanical effect of the pectus bar on PE thoraces undergoing an operation to alleviate the postoperative pain as well as to improve surgical outcome...
October 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Zhiyuan Jiang, Xiaobo You, Zhen Cai, Quan Liu, Liping Du, Wei Cui, Zaihong Chen, Yang Sheng
Objective: To investigate the technical points and effectiveness of autogenous costal cartilage transplantation in repair of Binder's syndrome. Methods: Between June 2012 and June 2017, 8 cases of Binder's syndrome were admitted. There were 3 males and 5 females, aged 16-31 years (mean, 22 years). All patients were conformed to the typical manifestations of Binder's syndrome. The autogenous costal cartilage was harvested and carved into the nasal dorsum graft, nasal column graft, and nasal basement graft...
August 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Robert Edward Kelly
The procedure introduced by Donald Nuss in 1997 for the treatment of pectus excavatum at the American Pediatric Surgical Association meeting has now been adopted by pediatric, thoracic, and plastic surgeons around the world. Rather than resection of the costal cartilages and sternal fracture, which had been standard practice for decades, he advocated using a metal bar to push the sternum into position. Reasoning that the chest wall of children is very flexible, he felt that resection was unnecessary. Since that time, medical centers from around the world have reported their experience with the procedure...
August 2018: European Journal of Pediatric Surgery
Rufan Zhang, Zihao Feng, Yong Zhang, Hui Tan, Jian Wang, Fazhi Qi
OBJECTIVES: Deep sternal wound infection (DSWI) is a refractory complication after heart surgery, and debridement is the first-line treatment. The accurate identification of the extent of the infection is the key to successful debridement. The present study assessed the diagnostic accuracy of fluorine-18 deoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) for identifying the infected area of DSWI. METHODS: Between February 2015 and May 2017, 73 consecutive patients with suspected DSWI received 18 F-FDG PET/CT examinations before their operation...
August 2, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Yue Wang, Wenshan Xing, Tun Liu, Xu Zhou, Jin Qian, Bingqing Wang, Shouqin Zhao, Qingguo Zhang
BACKGROUND: Congenital bilateral microtia with external ear canal (EAC)/middle ear malformation lead to severe appearance defects, hearing impairment and language barrier. Here we report an optimal integrated surgical technique for BoneBridge implantation and auricular reconstruction, which reduce time span of operation, total cost and patients' suffering as well. METHOD: Seven patients with bilateral external and middle ear malformation received 2-stage auricular reconstruction (age from 7 to 11 years old)...
October 2018: International Journal of Pediatric Otorhinolaryngology
Jeong Hee Oh, Soo Bin Park, Hong Chul Oh
We present an interesting image of a 62-year-old woman revealed with Tietze syndrome by F-FDG PET/CT and bone scintigraphy. She presented with right upper chest wall pain with a hard, palpable mass. However, chest radiograph and CT were unrevealing. On PET/CT, intense FDG uptake was noted at the anterior aspect of the right second costal cartilage with dense calcification, which was the correct symptomatic lesion. Bone scan showed increased radioactive uptake at the FDG uptake lesion, but mild uptake was also seen in the asymptomatic lesion...
November 2018: Clinical Nuclear Medicine
Patricia Oliván-Sasot, Begoña Martínez-Sanchis, Raquel Sánchez-Vañó, Ana María Yepes-Agudelo, Pilar Bello-Arques
Thoracic pain is an entity that can be difficult to diagnose etiologically. Once the cardiac origin has been ruled out, the rheumatologic, neoplastic, and infectious causes have to be taken into account. We present the case of a patient with atypical chest pain after triple-bypass surgery in whom F-FDG PET/CT scan showed an important uptake of the radiopharmaceutical in costal cartilages, in relation to pan-costochondritis due to Aspergillus.
October 2018: Clinical Nuclear Medicine
Honglei Ji, Junchen Wang, Chenghao Chen, Qi Zeng
Pectus carinatum (PC) is one of the most common chest wall anomalies, which is characterized by the protrusion of the anterior chest wall including the sternum and adjacent costal cartilages. Mildly patients suffer from mental problems such as self-abasement, while severely suffering patients are disturbed by significant cardiopulmonary symptoms. The traditional Haller index, which is widely used clinically to evaluate the severity of PC, is deficient in diagnosis efficiency and classification. This paper presents an improved Haller index algorithm for PC: first, the contour of the patient chest in the axial computed tomography (CT) slice where the most convex thorax presents is extracted; and then a cubic B-spline curve is employed to fit the extracted contour followed by an eclipse fitting procedure; finally, the improved Haller index and the classification index are automatically calculated based on the analytic curves...
April 1, 2018: Sheng Wu Yi Xue Gong Cheng Xue za Zhi, Journal of Biomedical Engineering, Shengwu Yixue Gongchengxue Zazhi
Anton Herbert Schwabegger
Surgical procedures for pectus excavatum (PE) repair, such as minimally invasive repair of pectus excavatum or similar interventions (modified open videoendoscopically assisted repair of pectus excavatum), for remodeling the anterior thoracic wall may finally not always achieve sufficiently pleasing aesthetic results. Particularly in the asymmetric and polymorphic cases, remnant deformities may still be present after any sophisticated remodeling attempt. On the other hand, some cases despite optimal surgical management develop mild recurrences with partial concavity or rib cartilage distortion shortly after pectus-bar removal...
August 2018: European Journal of Pediatric Surgery
Erji Gao, Yang Li, Tiancheng Zhao, Xiang Guo, Weiwei He, Weiming Wu, Yonghong Zhao, Yi Yang
There are studies confirmed that for severe flail chest or sternal fractures, even multiple rib fractures, surgery can effectively reduce hospital stay and relieve chest wall pain. But it is a challenge to fix too many costal cartilage fractures in such a small area if we just put internal fixator directly on the sternum. Through this case report we want to share our method of fixation of multiple costal cartilage and sternal fractures at the same time through a small incision, and it is also appropriate for multiple costal cartilage fractures without sternal fracture...
August 3, 2018: Annals of Thoracic Surgery
Guangzhi Zhang, Xian Chen, Junji Ohgi, Fei Jiang, Seiryo Sugiura, Toshiaki Hisada
The effect of intercostal muscle contraction on generating rib motion has been investigated for a long time and is still controversial in physiology. This may be because of the complicated structure of the rib cage, making direct prediction of the relationship between intercostal muscle force and rib movement impossible. Finite element analysis (FEA) is a useful tool, which is good at solving complex structural mechanic problems. In this study, we individually activated the intercostal muscle groups from the dorsal to ventral portions, and obtained five different rib motions classified based on rib moving directions...
July 26, 2018: Journal of Applied Physiology
Yulia M Alexandrovskaya, Evgeniy G Evtushenko, Mariya M Obrezkova, Valery V Tuchin, Emil N Sobol
Infrared (IR) laser impact has no analogues for rapid and safe cartilage reshaping. For better penetration of radiation optical clearing agents (OCAs) can be applied. In present work, the effect of low-osmolality agent iohexol on costal cartilage is studied. Specifically, it is shown that ½ of total increase of optical transparency occurs in 20 minutes of immersion. Maximally, cartilage transparency on 1560 nm can be increased in 1.5 times. Injection of iohexol results in increased tissue hygroscopicity, lower drying rate and higher percentage of bound water...
July 25, 2018: Journal of Biophotonics
Yong Ju Jang, Sung Hee Kim
Tip surgery during rhinoplasty is particularly difficult in Asians. Tip grafting is the best approach. Conchal cartilage with perichondrium and costal cartilage are powerful grafting materials. The most important grafting techniques are tip-onlay grafting, shield grafting, and multilayer tip grafting. Tip-onlay grafts are useful for dorsal convexity. Shield grafts require sufficient support to prevent bending. Multilayer tip grafts (usually 2 layers) are versatile. Asians vary in cartilage configuration, skin thickness, and aesthetic desires: tip-grafting strategies must be tailored to meet the aesthetic goals of individuals...
August 2018: Facial Plastic Surgery Clinics of North America
Man-Koon Suh
Autogenous materials used for Asian dorsal augmentation are temporal fascia, dermofat, solid block type of costal cartilage, and diced cartilage. The temporal fascia is used for radix augmentation or correction of minor focal depression. Dermofat, solid block costal cartilage, and diced cartilage are recommended for major dorsal augmentation. The vertically oriented folded dermal graft curtails use of the fat component. Diced cartilage wrapped in temporal fascia exhibits a lower resorption rate, and may easily fit into the contour of the dorsum...
August 2018: Facial Plastic Surgery Clinics of North America
Minh D Tran, Jason A Varzaly, Justin C Y Chan, Yugesh Caplash, Michael G Worthington
Resection of sternal tumors can leave large defects, which exposes major mediastinal structures, and can affect respiratory mechanics. If feasible, resection is potentially a complex reconstructive challenge to restore normal and functional anatomy using conventional techniques. We report the first Australian use of a three-dimensional-printed titanium and PoreStar prosthesis in a 39-year-old woman for reconstruction after major surgical resection of the sternum for metastatic breast cancer. The patient successfully underwent excision of the sternum and costal cartilages as well as implantation of the prosthesis...
July 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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