Chest wall resection is performed for a variety of diseases, for primary rib and soft tissue tumors, metastatic lesions, or locally invasive growth of lung and mediastinal tumors being the most common indications. Following the resection phase, it is essential to determine the method of chest wall reconstruction that will restore the structural function, preserve pulmonary biomechanics, reduce the likelihood of residual pleural space, pulmonary hernia, and protect intrathoracic organs. The main objective of this study is to investigate the outcomes of chest wall resection with reconstruction using Codubix material.
METHODS: This retrospective multicenter study included 22 patients who underwent chest wall tumor resection with subsequent Codubix rib endoprosthesis reconstruction from 2019 to 2023. Four medical institutions participated in the study: P.A. Herzen Moscow Cancer Research Institute, Sverdlovsk Regional Oncology Hospital, Morozov Children\'s City Clinical Hospital and Kaluga Regional Oncology Hospital. Inclusion criteria were the presence of chest wall tumors, both primary and secondary, removal of more than 2 ribs, resection of the rib arch and the sternum.
RESULTS: The median age was 60 years (48-66), 11 (50%) patients were females and 11 (50%) males. Operations for chest wall sarcoma, metastatic lesions, and lung cancer were performed in 9 (40.9%), 4 (18.2%), and 3 (13.6%) patients, respectively. The median number of removed ribs was 3 (2-4), with a maximum of 7. Sternotomy was performed in 9 (40.9%) patients, and subtotal resection of the body or handle of the sternum was carried out in 77.7%. Combined resections were performed in 14 (63.6%) patients. Radical tumor removal (R0) was achieved in 21 (95.5%) patients. Complications were observed in 9 (40.9%) patients, with intermuscular seroma being the most common in three (33.3%), followed by hydrothorax in 2 (22.2%), bilateral pneumonia, acute respiratory failure, and postoperative delirium in 1 (11.1%) patient each. One patient had the Codubix plate removed due to postoperative wound infection. The median overall and recurrence-free survival was not reached, and the 1-year recurrence-free survival was 63.9%, with an overall survival of 86.8%.
CONCLUSIONS: Reconstruction with Codubix material allows for satisfactory functional and cosmetic results, characterized by a low complication rate and good adaptive properties.
Резекцию грудной стенки выполняют по поводу множества различных заболеваний, среди которых чаще всего встречаются первичные опухоли ребер и мягких тканей, метастатическое поражение либо местноинвазивный рост опухолей легкого и средостения. После выполнения резекционного этапа необходимо определить способ реконструкции грудной стенки, который позволит восстановить каркасную функцию, сохранить легочную биомеханику, уменьшить вероятность развития остаточной плевральной полости, легочной грыжи, обеспечить защиту органов грудной полости от внешних воздействий. Основная цель работы — изучить результаты резекции грудной стенки с реконструкцией при помощи материала Codubix (Tricomed, Польша).
UNASSIGNED: В данное ретроспективное мультицентровое исследование были включены 22 больных, которым выполнена резекция опухоли грудной стенки с последующей реконструкцией эндопротезом ребра Codubix с 2019 по 2023 г. В исследовании участвовали 4 медицинских учреждения: Московский научно-исследовательский онкологический институт им. П.А. Герцена — филиал «Национальный медицинский исследовательский центр радиологии» Минздрава России, ГАУЗ Свердловской области «Свердловский областной онкологический диспансер», ГБУЗ города Москвы «Морозовская детская городская клиническая больница Департамента здравоохранения города Москвы» и ГБУ «Калужский областной клинический онкологический диспансер». Критериями включения считали наличие опухоли грудной стенки как первичной, так и вторичной, удаление более 2 ребер, резекцию реберной дуги и грудины.
UNASSIGNED: Медиана возраста составила 60 лет (48—66), распределение по полу было равным: 11 (50%) женщин, 11 (50%) мужчин. Операция по поводу саркомы грудной стенки выполнена у 9 (40,9%), метастатического поражения — 4 (18,2%), рака легкого — 3 (13,6%). Медианное количество удаленных ребер составило 3 (2—4), максимальное количество — 7. Резекция грудины выполнена у 9 (40,9%) больных, у 77,7% произведена субтотальная резекция тела или рукоятки грудины. Комбинированные резекции выполнены 14 (63,6%) больным. Радикальное удаление опухоли (R0) осуществлено 21 (95,5%) пациенту. Осложнения диагностированы у 9 (40,9%) лиц, среди них чаще всего наблюдали межмышечную серому — у 3 (33,3%), гидроторакс — 2 (22,2%), двустороннюю пневмонию, острую дыхательную недостаточность, послеоперационный делирий — у 1 (11,1%) больного. Летальности не было. У одной больной пластина Codubix была удалена в связи с нагноением послеоперационной раны. Медиана общей и безрецидивной выживаемости не достигнута, 1-летняя безрецидивная выживаемость составила 63,9%, общая выживаемость — 86,8%.
UNASSIGNED: Реконструкция материалом Codubix позволяет добиться удовлетворительных функциональных и косметических результатов, характеризуется низкой частотой развития тяжелых осложнений, хорошими адаптационными свойствами.

BACKGROUND: Myelolipoma is an uncommon benign tumor composed of mature adipose tissue and hematopoietic elements. These tumors generally affect the adrenal glands, with anomalous presentations being rare and with few cases described in the literature. Most myelolipomas are asymptomatic and discovered incidentally, either through imaging tests or at autopsies. However, depending on the location and size of the lesion, myelolipomas can cause symptoms of mass effect. This article aims to report a very rare presentation of a symptomatic primary myelolipoma affecting the ribs.
METHODS: A 21-year-old white female patient presented with a complaint of burning chest pain over 3 months, with gradual worsening in intensity, accompanied by a progressively growing bulge in the right thoracic wall. The patient underwent thoracotomy of the fifth and sixth ribs with complete excision of the lesion with a safety margin. Thoracic wall reconstruction was performed using a polypropylene mesh. The patient had a good postoperative course and was discharged on postoperative day 3. Histopathological examination revealed a histological image consistent with myelolipoma.
CONCLUSIONS: This report underscores the importance of considering a myelolipoma diagnosis for tumor masses in the ribs.

OBJECTIVE: To analyze the differences in cusp height on radiographs, establishing proportional relationships between cusp and alveolar bone crest (ABC) measurements. The goal of this study was to develop a correction coefficient by considering this proportion.
METHODS: Twenty-one artificial teeth, molars and premolars, and bovine ribs were used. Interproximal radiographs were taken with the aid of a positioner. The vertical angles used were: 0°, + 5°, and + 10°, and processed using three spatial resolutions measured in line pairs per mm (lp/mm): 20, 25 and 40. The Perio filter was applied to each image, in addition to the original one. Combinations of angle, resolution, and filter were made. Eighteen images were analyzed by three specialists, resulting in 252 measurements for each evaluator, totaling 756 measurements.
RESULTS: The overall variability of the measurements can be explained mainly by the variation in tooth anatomy. The 0° 25 lp/mm Perio filter method was the closest one to the actual clinical scenario for both cusps and ABC. The correction factor managed to explain 71.45% of the errors.
CONCLUSIONS: The variation in vertical angulation interferes with cusp and ABC measurements, and the angulation at 0º and spatial resolution of 25 lp/mm showed better results. The use of correction coefficients allowed approaching actual measurement values.
CONCLUSIONS: More accurate ABC height measurements are essential even in radiographic exams that do not meet the standard of excellence because the need to repeat radiographic exams is then eliminated.

BACKGROUND: Accurate assessment of the bone supporting the implant is crucial. Early detection of bone defects around the implant can prevent the loss of bone support that ultimately leads to the loss of the implant. Therefore, the purpose of this study is to check the accuracy of CBCT in detecting peri-implant fenestrations around the implant.
METHODS: In this laboratory study, healthy beef ribs were used. The ribs were divided into three groups of 12 (control group, 1-2 mm fenestration group, and 2-3 mm fenestration group). The blocks were cut to a length of 20 mm and 36 osteotomies with dimensions of 4 × 12 mm were made by the periodontist in order to place the implant in these bone blocks. Then the titanium implant was placed in the holes and the initial scan was performed with CBCT. In the second group, fenestration-like lesions were created on the same buccal side at a distance of 10 mm from the crest with a diameter of 1-2 mm and in the third group with a diameter of 2-3 mm, and the CBCT scan was performed again with the same parameters. Two radiologists evaluated the images twice for the presence and absence of fenestration.
RESULTS: There was no statistically significant difference between direct measurements and CBCT in the fenestration group of 1-2 mm (p < 0.05), but there was a significant difference between direct measurements and CBCT in the fenestration group of 2-3 mm and underestimation was observed in CBCT measurements.
CONCLUSIONS: The findings of this study showed that CBCT radiography has a higher accuracy in measuring the fenestration around the implant with a smaller diameter and has an acceptable diagnostic value in detecting bone loss around the implant.

UNASSIGNED: Chronic osteomyelitis of the ribs in adolescents and adults is a rare condition. Current understanding of its diagnosis and management is primarily derived from case reports and small series studies. Here, we present a case of chronic rib osteomyelitis initially managed conservatively with antibiotics, followed by debridement, sequestrectomy, and continued antibiotic therapy. However, due to recurrence, rib excision was ultimately chosen as the definitive management approach.
UNASSIGNED: A 18-year-old male presents with a discharging sinus from the chest persisting for 6 months, with no history of fever, shivering, or weight loss. He sustained a blunt injury to the chest with a bamboo stick 9 months ago. Initially, the patient was treated with antibiotics, but there was no relief. He was later operated on with debridement, sequestrectomy, and antibiotics. Six weeks later, he again presented to us with a discharging sinus. Due to recurrence, he underwent re-operation with partial resection of the 6th rib. At the 1-year follow-up after rib excision, the patient is doing well, with all blood parameters within the normal range and without any systemic or local complications.
UNASSIGNED: Rib osteomyelitis is a rare complication of blunt chest trauma. Surgical management is indicated in cases of persistent infection. Sequestrectomy and antibiotics, though standard procedures in chronic osteomyelitis, may encounter failure due to various factors. Moreover, due to limited literature on chronic osteomyelitis of ribs, the standard approach to its management is not available. Partial excision of the rib with appropriate antibiotics in our case provided complete cure for the patient.

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OBJECTIVE: To determine the correlation between the primary implant stability quotient and the implant percussion sound frequency.
METHODS: A total of 14 pigs\' ribs were scanned using a dental cone beam computed tomography (CBCT) scanner to classify the bone specimens into three distinct bone density Hounsfield units (HU) value categories: D1 bone: >1250 HU; D2: 850-1250 HU; D3: <850 HU. Then, 96 implants were inserted: 32 implants in D1 bone, 32 implants in D2 bone, and 32 implants in D3 bone. The primary implant stability quotient (ISQ) was analyzed, and percussion sound was recorded using a wireless microphone connected and analyzed with frequency analysis software.
RESULTS: Statistically significant positive correlations were found between the primary ISQ and the bone density HU value (r = 0.719; p < 0.001), and statistically significant positive correlations between the primary ISQ and the percussion sound frequency (r = 0.606; p < 0.001). Furthermore, significant differences in primary ISQ values and percussion sound frequency were found between D1 and D2 bone, as well as between D1 and D3 bone. However, no significant differences were found in primary ISQ values and percussion sound frequency between D2 and D3 bone.
CONCLUSIONS: The primary ISQ value and the percussion sound frequency are positively correlated.

Osteochondroma rarely occurs in the ribs; therefore, the treatment is not standardized. There are few studies of resection via complete thoracoscopic surgery (CTS), although video-assisted thoracoscopic surgery with mini-thoracotomy has been reported. Herein, we report a case of costal osteochondroma managed with CTS. A 23-year-old woman presented to our hospital due to left chest pain. Chest computed tomography revealed a bone-like structure protruding into the thoracic cavity from the left fourth rib. Thus, surgery was performed to obtain a definitive diagnosis and provide appropriate treatment. The tumor was resected from the base at the border of the normal bone via CTS using three 5.5-mm ports. A pathological diagnosis of costal osteochondroma was made. The patient had an uneventful clinical course and did not present with a recurrence 1 year after surgery. Therefore, CTS can be a good approach for cases with slim and stalked costal osteochondroma.

Genetic and fragmented palaeoanthropological data suggest that Denisovans were once widely distributed across eastern Eurasia1-3. Despite limited archaeological evidence, this indicates that Denisovans were capable of adapting to a highly diverse range of environments. Here we integrate zooarchaeological and proteomic analyses of the late Middle to Late Pleistocene faunal assemblage from Baishiya Karst Cave on the Tibetan Plateau, where a Denisovan mandible and Denisovan sedimentary mitochondrial DNA were found3,4. Using zooarchaeology by mass spectrometry, we identify a new hominin rib specimen that dates to approximately 48-32 thousand years ago (layer 3). Shotgun proteomic analysis taxonomically assigns this specimen to the Denisovan lineage, extending their presence at Baishiya Karst Cave well into the Late Pleistocene. Throughout the stratigraphic sequence, the faunal assemblage is dominated by Caprinae, together with megaherbivores, carnivores, small mammals and birds. The high proportion of anthropogenic modifications on the bone surfaces suggests that Denisovans were the primary agent of faunal accumulation. The chaîne opératoire of carcass processing indicates that animal taxa were exploited for their meat, marrow and hides, while bone was also used as raw material for the production of tools. Our results shed light on the behaviour of Denisovans and their adaptations to the diverse and fluctuating environments of the late Middle and Late Pleistocene of eastern Eurasia.