Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The use of particulate silicone in plastic surgery involves the introduction of solid silicone into the body. The silicone is in small pieces in order for it to adapt to the shape of the defect. This way large quantities can be introduced through small incisions. It is also possible to distribute the silicone particles from outside the skin to make the corrections more regular. This method has been very useful for correcting post-traumatic depressions in the face and all areas where the depression has a rigid back support. We consider it the treatment of choice for correcting the funnel chest deformity.
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PMID:Twenty years of experience with particulate silicone in plastic surgery. 173 31

Parallel measurements of pyridinoline content, the ratio of soluble:insoluble collagen, and the percentage of endogenous collagenolysis were made in samples of costal cartilage from forty-five children with funnel chest (FC) and from twenty-two control children. From an analysis of the influence of different factors, such as FC type (isolated or syndromic), a diagnosed syndrome, extent of FC depression (second or third), and age, two biochemical variants of FC-variants a and b, which were not related to the presence or absence of a known concurrent syndrome, were distinguished. These variants differed from each other in all the parameters under study. Variant a occurred about five times less frequently than b, and was characterized by a pyridinoline content of about 50% of that of b, an elevated soluble:insoluble collagen ratio, and an increased percentage of endogenous collagenolysis compared to controls. For variant b, the pyridinoline content fell within normal limits, but the soluble:insoluble collagen ratio, and the percentage of endogenous collagenolysis were below normal. The data suggest that the formation of variant a may be related to defect(s) in collagen crosslinking, whereas the formation of variant b may result from other unknown factor(s) involved in the formation and maturation of costal cartilage.
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PMID:Characterization of costal cartilage collagen in funnel chest. 184 25

Chest wall deformities are principally depression deformities, the most common being pectus excavatum (funnel chest). The most common protrusion deformity is pectus carinatum (pigeon breast). Pectus carinatum is a cosmetic problem, but its presence can be psychologically devastating to the patient. Pectus excavatum is definitely a physiologic problem, the effects of which may be reversible by surgical correction. Surgery is safe, complications are minimal, and results are usually satisfactory.
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PMID:Chest wall deformities. 267 52

We performed surgical reconstruction on 1655 cases of deformed thoracic cage, we later operated again on 11 of these to repair postoperatively re-deformed anterior chest walls. Based on these experiences, we have concluded as follows. 1: Postoperative recurrence of funnel chest deforming is mainly due to insufficient resection of costal cartilages. In particular transection of the sternum at low levels during sternal turn-over procedure results in postoperative recurrence of depression in the upper anterior chest wall. 2: In young children who have undergone sternal turn-over procedure, the first and second costal bones and cartilages overgrow and protrude anteriorly, and in compensation their junctions to the sternum recess posteriorly. This results in a depression in the upper anterior chest wall. 3: We recommend sternal turn-over with overlapping of the sternum for repair of postoperative funnel chest deformity. Through this procedure, the extent of resection of costal cartilages can easily be determined and the depression of the anterior chest wall satisfactorily reconstructed. 4: In re-do surgery, we obtained pathological evidence confirming our clinical experience that our sternal turn-over technique does not interfere with blood circulation or development of the turned-over sternum even though the sternum is not connected to the rectus abdominus muscle pedicle, preserved internal mammary vessels, or anastomosis of the internal mammary vessels.
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PMID:[Re-operation of pectus excavatum]. 276 29

80 cases of funnel chest were treated surgically, 9 by Gross procedure, 41 by turn-over technique and 30 by reverse "V" shape osteotomy of the sternum and ribs with internal fixation. There were 56 boys and 24 girls, with ages ranging from 2 to 14 years. The sternal depression varied in depth from 3 to 4 cm, and in volume from 20 to 120 ml. Roentgenographically, there were different extents of deviation of the heart to the left. Some patients had abnormal ECG. To study the results of operations, 48 cases were followed-up for 0.5 to 19 years. We found that the results of reverse "V" shape osteotomy of the sternum and ribs with internal fixation were superior to others. Its main advantage lies in the internal fixation which holds the sternum stable thus favoring wound healing and permanent correction. It is simple with less surgical trauma and postoperative complications. Some disappointing results in the other two techniques, such as uneven chest wall, flat chest and forward protruding of the sternum could also be avoided by this procedure. The internal fixation device was removed one year after operation. Follow-up for 3 to 4 years found the chest wall in satisfactory contour.
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PMID:[On the surgical treatment of pectus excavatum]. 280 94

Chest wall protrusion and depression deformities, also known as funnel chest and pigeon chest, are nosologically a uniform entity. Our own histopathological studies revealed secondary changes, found likewise in arthroses, scolioses, aseptic osteonecroses and inflammatory processes, as well as changes found in so-called primary collagenous diseases of unknown aetiology. Investigation of the collagen metabolism did not disclose differences from the normal II-type collagen either qualitatively or quantitatively. The aetiology of funnel chest and pigeon chest can be defined as follows: A hereditary disturbance of metabolism results in weakening of the wall of the parasternal cartilage, effecting a deformation secondary to mechanical strain by respiration and growth. Psychocosmetic reasons are recognised as indication for operation. In our opinion, the optimal age for operation is the second to the sixth year of life. During 20 years, 765 patients were operated on at our hospital without lethality. Postoperative complications were pneumothorax (4%), pneumonia (2%), after bleeding (2%) and disturbed wound healing (7%). Late results 5 years following surgery were excellent in 57%, good in 27%, satisfactory in 10% and unsatisfactory in 6% of the cases, thus adding up to 84% good results.
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PMID:[Clinical aspects and problems of pigeon breast and funnel chest]. 328 94

A questionnaire survey of 66 patients with funnel chest who underwent corrective surgical procedures by the sternal elevation method, with or without the application of metal strut, demonstrated that the operative result was good in 60.6% and fair in 39.4%. None of the patients rated the result as unsatisfactory. A computed tomogram of the chest wall was performed to study the depression (b/c), asymmetry (b'/b), and flatness (a/b) of the chest wall, where a was the maximum transverse distance of the chest wall, b and b' were the maximum distance from the anterior to the posterior chest wall at the left and right sides (b greater than b'), and c was the perpendicular distance from the point of the anterior chest wall at its greatest deformity to the level of the anterior tip of the spine. In patients with a good result, b/c and b'/b were well corrected, while in patients with a fair postoperative result, they were still significantly different from those in subjects with normal chest walls. Moreover, 85.7% of the patients (6/7) with b/c over 3.0 before operation had a fair postoperative result. The degree of a/b was not corrected in patients with either good or fair postoperative results. We conclude that an operative approach to lengthen ribs would be necessary to improve the degree of a/b, that in patients with severely depressed funnel chest, expressed as a b/c value over 3.0 by computed tomography, a transient support with struts should be applied, and finally, that a more careful approach for correction of asymmetry should be undertaken to improve the operative results.
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PMID:An evaluation of operative outcome in patients with funnel chest diagnosed by means of the computed tomogram. 356 Oct 6

From 1956-1980, 1112 thoracic deformities were operated on in the Surgical Clinic of the University of Erlangen. These are divided into 11 different types, according to whether a funnel chest (4 types), a pigeon chest (4 types), combinations of these, or a split-sternum was present. The indication for operation is given in patients where the depression is more than 25% of the a/p diameter of the chest. Scolioses - deformities of the spinal column - are found in 40-50%, depending on the type of funnel chest. They are rarely found in small children, but are fixed and irreversible in teenagers and older patients. Reconstruction of the thorax is carried out through a double-segment chondrotomy parasternal and at the apex of the funnel, using a horse-shoe-shaped metal support. Average length of stay in hospital is 7-10 days. Alternative procedures are Rehbein's operation, or Ravitch and Hecker's procedure. Postoperative physiotherapy is extremely important. Late results, on average 10.5 years after operation, showed recurrence of the funnel in 2.1% of cases, partial recurrence, ugly scars and cartilage nodules in 6.7%.
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PMID:[Indication and operative technique in chest deformities (author's transl)]. 728 94

Pectus excavatum is the most common congenital chest wall deformity; it is manifest by abnormal costal cartilage segments causing sternal depression and rotation. The most popular repair involves resection of the abnormal costal cartilage segments, followed by sternal osteotomy and fixation to the adjacent chest wall. Methods of sternal fixation have included metal bars and struts, K-wires, pins, sutures, synthetic mesh, vascularized rib struts, and large AO plates, but they have not included more recent rigid fixation technology. Current rigid fixation techniques allow incorporation of malleable, low-profile reconstruction plates that can be contoured to correct the three-dimensional aspect of these defects. Three pediatric patients are presented in whom plate fixation was utilized for sternal fixation. Current reconstruction plate technology provides an improved fixation alternative for the correction of congenital chest wall anomalies, as well as offering similar potential advantages for traumatic, oncologic, and reconstructive surgery of the thorax.
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PMID:Improved sternal fixation in the correction of pediatric pectus excavatum. 807 73

The purpose of the present study is to evaluate the effects of addition of a bridge external traction to our conventional sternocostal elevation technique in the surgical management of funnel chest in children. During the period from 1970 to 1979, a total of 29 children with funnel chest were treated surgically using sternocostal elevation technique (Group I). Operative technique consisted of total subperichondral resection of deformed costal cartilages (usually 3rd to 8th, bilaterally), transection of deformed portion of the sternum in 2-3 points and fixation of the sternum in elevated position using 2 Kirschner wires, and shortening resuturing of the opened perichondrium. Since 1980, an addition of the bridge external traction to our conventional sternocostal elevation technique was applied for about 10 days after operation in 82 consecutive children (Group II). The vertebral index (B/A = sagittal diameter of vertebral body/minimum sternovertebral distance), D/C ratio (maximum sagittal depth of depression of sternum/distance from anterior surface of the vertebral body to the sternum at Louis's angle) and E/C ratio (E = minimal sagittal distance from anterior surface of the vertebral body to the sternum) were measured in all cases and compared before and after operation and also between the two Groups. Preoperatively, there was no significant difference in all 3 indices between the two Groups. Postoperative B/A, D/C and E/C ratio in Group I were 0.28 +/- 0.06, 0.14 +/- 0.19, 1.09 +/- 0.32 (mean +/- SD), respectively. There were a significant drop in D/C ratio and a significant elevation in E/C ratio after operation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Early and long-term results of sternocostal elevation combined with bridge external traction for funnel chest in children]. 828 23


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