This review delves into the forensic utility of the sternum in creating a biological profile, focusing on sex, stature, and age estimation. Emphasizing the sternum's significance in challenging scenarios, the study supports the combined length of the manubrium and sternal body as a crucial indicator in sex and stature estimation. However, it highlights the need for caution in applying findings across diverse populations and questions the reliability of Hyrtl's law. Age estimation, primarily based on morphological changes and ossification ages, is explored, with one study showing promise but requiring further validation. While acknowledging the sternum's advantages, the review underscores potential limitations and the absence of specific studies on ancestry estimation, leaving this aspect open for future research. In conclusion, the review provides a comprehensive overview of the sternum's forensic applications, urging continued research to enhance accuracy and applicability.

• Klíčová slova
• Sternum, age estimation, biological profile, sex estimation, stature estimation,
• MeSH
• lidé MeSH
• soudní antropologie * metody   MeSH
• sternum * anatomie a histologie   MeSH
• tělesná výška MeSH
• určení kostního věku metody   MeSH
• určení pohlaví podle kostry metody   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

The paper presents evaluation of the proposed phonocardiography (PCG) measurement system designed primarily for heartbeat detection to estimate heart rate (HR). Typically, HR estimation is performed using electrocardiography (ECG) or pulse wave as one of the fundamental diagnostic methodologies for assessing cardiac function. The system includes novel both sensory part and data processing procedure, which is based on signal preprocessing using Wavelet Transform (WT) and Shannon energy computation and heart sounds classification using K-means. Due to the lack of standardization in the placement of PCG sensors, the study focuses on evaluating the signal quality obtained from 7 different sensor locations on the subject's chest and investigates which locations are most suitable for recording heart sounds. The suitability of sensor localization was examined in 27 subjects by detecting the first two heart sounds (S1, S2). The HR detection sensitivity related to reference ECG from all sensor positions reached values over 88.9 and 77.4% in detection of S1 and S2, respectively. The placement in the middle of sternum showed the higher signal quality with median of the proper S1 and S2 detection sensitivity of 98.5 and 97.5%, respectively.

• MeSH
• elektrokardiografie MeSH
• fonokardiografie MeSH
• lidé MeSH
• srdeční frekvence MeSH
• srdeční ozvy * MeSH
• sternum MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Pectus excavatum is the most common chest wall deformity in the Czech Republic. This chest deformity is typically characterized by a wall depression with sternal rotation. If the excavation of the chest wall does not cause any physical or psychological problems, the patient does not need any specific treatment. However, if the deformity is painful, affects the function of the lungs, heart or results in psychological problems, we can propose an appropriate treatment for the specific age category of the patient. Up to 10 years, we choose a procedure that includes targeted exercises and rehabilitation; in the age group of 10-15 years, we can add to the exercises the vacuum bell therapy according to the patient's wishes and compliance; and in the age category of 16 years and above, the patient can be offered a surgical solution. The Nuss operation (so-called MIRPE - minimally invasive repair of pectus excavatum) is the gold standard in surgical treatment; during this surgery, a patient-shaped bar is inserted retrosternally into the patient's chest under thoracoscopic control and is left for 3 years. The aim of this article is to describe the most common modern methods used in the treatment of patients with pectus excavatum, supplemented by a historical overview.

• Klíčová slova
• MIRPE, Nuss operation, pectus excavatum, sternal hook, vacuum bell therapy,
• MeSH
• dítě MeSH
• hrudní stěna * chirurgie   MeSH
• hrudník vpáčený * chirurgie   MeSH
• lidé MeSH
• miniinvazivní chirurgické výkony metody   MeSH
• mladiství MeSH
• sternum chirurgie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Česká republika MeSH

In forensic contexts, sternal anatomical varieties represent useful tools for the identification of an individual, either by comparison of ante-mortem and post-mortem data, or by potential comparison of data from biologically related individuals. Sternal body variation is also used to detect the biological affinity of individuals in bioarchaeology. However, no study has been made available to date on the degree to which the overall shape of the sternal body reflects the degree of biological relatedness. We, therefore, analyzed the sternal body shape of 10 individuals with known genealogical data, members of one family over three generations including inbred individuals (19th-20th centuries, Bohemia, Czech Republic), and a control sample of 12 biologically unrelated individuals. First, closely biologically related individuals were compared with unrelated individuals based on 10 variables expressing the morphological characteristics of the sternum, and then all individuals were compared based on Fourier analysis depending on their degree of relationship. The results showed that there is a greater degree of shape similarity in biologically related individuals than in unrelated individuals, and variability decreases with an increasing degree of relatedness. Inbred individuals showed the lowest sternum-shape distances and degree of variability, while unrelated individuals, showed the highest distances and variability. Moreover, in some cases, the documented relationships were also supported by a similar morphology of the ossified and fused xiphoid process. Thus, sternal shape analysis expands the possibilities for individual identification and the detection of the biological affinity of individuals for both the forensic sciences and bioarchaeology.

• Klíčová slova
• Fourier analysis, family, inbreeding, outline, sternum morphology,
• MeSH
• lidé MeSH
• osteogeneze MeSH
• pitva MeSH
• rodinné vztahy MeSH
• somatotypy * MeSH
• sternum * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Reconstruction of the anterior chest wall defect after sternectomy is a challenge for cardiothoracic surgeons. In 2010, the Padua group published the first case of cadaveric sternum transplantation after sternectomy. This multicenter study reports the clinical indications and early and long-term results of sternal chondral allograft transplantation. METHODS: This is a retrospective multicenter study from 7 academic centers. We collected demographic data, surgical indications, technical details, and early postoperative results. The complications, long-term stability, and tolerance of the allografts were also analyzed. RESULTS: Between January 2008 and December 2019, 58 patients underwent sternectomy followed by reconstruction using cadaveric-cryopreserved sternochondral allografts. Thirty-two patients were male, median age 63.5 years (interquartile range, 50-72 years). Indications for sternectomy were secondary sternal tumors (n = 13), primary sternal tumors (n = 15), and nonneoplastic disease (n = 30). Thirty patients underwent total sternectomy, 16 lower-body sternectomy, and 12 upper-body manubrium resection. The 30-day mortality was 5%; overall morbidity was 31%. Six early reoperations were necessary because of bleeding (n = 1), titanium plate dislocation (n = 1), and resuture of the skin in the lower part of the incision (n = 4). Overall, 5-year survival was 74%. In all the survived patients, the reconstructions were stable and free from mechanical or infective complications. CONCLUSIONS: The main indications for sternal allograft implantation were complex poststernotomy dehiscence followed by primary or secondary tumor involvement of the sternum. The collected results demonstrate that sternochondral allograft transplantation is a safe and effective method in reconstructing the anterior chest wall after sternectomy. Further studies to demonstrate the integration of the bone grafts into the patients' sternal wall will be made.

• MeSH
• alografty * MeSH
• dárci tkání MeSH
• dítě MeSH
• dospělí MeSH
• homologní transplantace MeSH
• komorbidita MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mrtvola MeSH
• nádory kostí chirurgie   MeSH
• nemoci kostí chirurgie   MeSH
• předškolní dítě MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sternum chirurgie   transplantace   MeSH
• transplantace kostí MeSH
• zákroky plastické chirurgie MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

• MeSH
• infekce chirurgické rány diagnóza   terapie   MeSH
• infekce v ráně * MeSH
• lidé MeSH
• polyethylentereftaláty MeSH
• retrospektivní studie MeSH
• srdeční komory diagnostické zobrazování   chirurgie   MeSH
• sternum diagnostické zobrazování   chirurgie   MeSH
• terapie ran pomocí řízeného podtlaku * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• polyethylentereftaláty MeSH

BACKGROUND: There is a lack of information regarding the CT appearance of sternal lymph nodes in dogs. This retrospective anatomic study was aimed to describe the general appearance of sternal lymph nodes in healthy dogs. RESULTS: Twenty-seven dogs with no abnormality in blood work, urinalysis and CT images were included in the study. Dogs were divided into three weight groups; ≤10 kg, 10.1 to 30 kg and ≥ 30.1 kg. Multi-planar reconstructions of CT images were made to identify sternal lymph nodes. The number, location, size, density and heterogeneity of sternal lymph nodes were recorded. Density and heterogeneity of lymph nodes were measured on pre- and postcontrast images. Except for one dog, sternal lymph nodes were identified in all the dogs. The mean number of sternal lymph nodes per dog was 2.1 (SD 0.6), and the most frequent localisation was at the level of the second sternebra (23 dogs; 85%). There was a positive correlation between the weight and all the dimensions of sternal lymph nodes. A significant negative correlation was found between the age and dorsoventral dimension of the lymph node. Short-to-long axis ratios were not significantly different between the weight groups. None of the measured dimensions nor the ratio values was significantly different between the medium-sized dogs (10.1 to 30 kg) and the large dogs (≥ 30.1 kg). There was a significant difference between precontrast and postcontrast density and heterogeneity values of sternal lymph nodes. CONCLUSIONS: Based on the results, we recommend using the short-to-long axis ratios for sternal lymph node size evaluation among dogs of different size. Sternal lymph nodes in this study appeared on precontrast examination as heterogeneous, and homogenous on the postcontrast examination.

• Klíčová slova
• anatomy, dog, lymph node size, sternal lymph centre, thorax,
• MeSH
• kontrastní látky MeSH
• lymfatické uzliny diagnostické zobrazování   MeSH
• počítačová rentgenová tomografie veterinární   MeSH
• psi anatomie a histologie   MeSH
• retrospektivní studie MeSH
• sternum MeSH
• tělesná hmotnost MeSH
• věkové faktory MeSH
• zvířata MeSH
• Check Tag
• mužské pohlaví MeSH
• psi anatomie a histologie   MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• kontrastní látky MeSH

OBJECTIVES: The ASD2 (Acute Extravascular Defibrillation, Pacing, and Electrogram) study evaluated the ability to adequately sense, pace, and defibrillate patients with a novel implantable cardioverter-defibrillator (ICD) lead implanted in the substernal space. BACKGROUND: Subcutaneous ICDs are an alternative to a transvenous defibrillator system when transvenous implantation is not possible or desired. An alternative extravascular system placing a lead under the sternum has the potential to reduce defibrillation energy and the ability to deliver pacing therapies. METHODS: An investigational lead was inserted into the substernal space via a minimally invasive subxiphoid access, and a cutaneous defibrillation patch or subcutaneous active can emulator was placed on the left mid-axillary line. Pacing thresholds and extracardiac stimulation were evaluated. Up to 2 episodes of ventricular fibrillation were induced to test defibrillation efficacy. RESULTS: The substernal lead was implanted in 79 patients, with a median implantation time of 12.0 ± 9.0 min. Ventricular pacing was successful in at least 1 vector in 76 of 78 patients (97.4%), and 72 of 78 (92.3%) patients had capture in ≥1 vector with no extracardiac stimulation. A 30-J shock successfully terminated 104 of 128 episodes (81.3%) of ventricular fibrillation in 69 patients. There were 7 adverse events in 6 patients causally (n = 5) or possibly (n = 2) related to the ASD2 procedure. CONCLUSIONS: The ASD2 study demonstrated the ability to pace, sense, and defibrillate using a lead designed specifically for the substernal space.

• Klíčová slova
• anterior mediastinum, defibrillation lead, extravascular, implantable cardioverter-defibrillator, substernal, tachyarrhythmia,
• MeSH
• defibrilátory implantabilní * škodlivé účinky   statistika a číselné údaje   MeSH
• elektrokardiografie MeSH
• implantace protézy škodlivé účinky   metody   mortalita   statistika a číselné údaje   MeSH
• kardiostimulace umělá * škodlivé účinky   statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mediastinum chirurgie   MeSH
• prospektivní studie MeSH
• senioři MeSH
• srdeční arytmie terapie   MeSH
• sternum chirurgie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinická studie MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH

Leiomyomas are the most common benign tumor of the uterus. Occasionally, they may reach an extreme dimension. The authors present a case of a 44-year old woman, who suffered a car accident as a driver of personal motor vehicle. At the hospital, a huge tumor mass filling the entire abdominopelvic cavity was incidentally detected. The patient admitted a progressive abdominal enlargement for the last 5 years. An urgent laparotomy was performed, during which a giant, well-demarcated tumor arising from the uterine body had been disclosed. It was completely surgically removed and sent for histopathology. Grossly, the tumor measured 30 × 30 × 20 cm in the largest diameters and weighed 8.1 kg. The tissue was markedly edematous with foci of massive hemorrhages and contained confluent pseudocystic formations of various sizes, filled with a fluid and fresh blood. Solid foci of rubber consistency were also visible. Microscopic examination revealed a conventional subserous uterine leiomyoma with marked regressive and degenerative changes. Giant uterine leiomyomas occur extremely rare, but because of the often unexpected finding and atypical presentation, they may represent a great diagnostic challenge for both, pathologists and clinicians. At the biopsy examination, a multiple-section sampling is very important to avoid the possibility of underlying malignancy.

• Klíčová slova
• degenerative changes, giant size, uterine leiomyoma,
• MeSH
• dopravní nehody * MeSH
• dospělí MeSH
• fraktury žeber diagnostické zobrazování   MeSH
• hemoperitoneum diagnostické zobrazování   MeSH
• játra diagnostické zobrazování   zranění   MeSH
• leiomyom diagnostické zobrazování   patologie   MeSH
• lidé MeSH
• nádory dělohy diagnostické zobrazování   patologie   MeSH
• náhodný nález * MeSH
• plíce diagnostické zobrazování   MeSH
• počítačová rentgenová tomografie MeSH
• poškození plic diagnostické zobrazování   MeSH
• sternum diagnostické zobrazování   zranění   MeSH
• tumor burden MeSH
• zhmoždění diagnostické zobrazování   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

OBJECTIVES: The number of turns at the end of a wire closure is not described or discussed in any cardiosurgical guidelines. The hands-on experience of the surgeon plays a significant role. The aim of this work was to clarify the relationship between the number of turns of the suture and the resulting strength of the sternal fixation. METHODS: The study was performed in 2 independent steps. The first step was a finite element simulation, where the stress and strain distribution of the sternal fixation was observed. The second step included the experimental set-up and the statistical evaluation of the results. RESULTS: Our study showed that the failure force rose linearly as the number of turns increased. The lowest average measured force was 370 N (3 turns); the highest was 430 N (7 turns). The failure modes were either untwisting of the wires or rupture of the closure, which is controlled by the number of turns. As the number of turns increases, superficial cracks can occur. CONCLUSIONS: Based on our results, the 5-turn option is the best solution for the closure. The failure force is still double the value reported in the literature, so there is a high safety margin for failure. The failure mode is untwisting; hence, no unexpected fracture can occur, and there is still an elastic core in the cross-section of the wire.

• MeSH
• analýza selhání vybavení MeSH
• kostní dráty * MeSH
• lidé MeSH
• ohebnost (fyzika) MeSH
• pevnost v tahu MeSH
• šicí techniky * MeSH
• sternum chirurgie   MeSH
• sutura MeSH
• teoretické modely MeSH
• testování materiálů MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH